This page is part of the CCDA: Consolidated CDA Release (v5.0.0-ballot: CCDA 5.0 Ballot) generated with FHIR (HL7® FHIR® Standard) v5.0.0. This version is a pre-release. The current official version is 4.0.0. For a full list of available versions, see the Directory of published versions
<documentationOf xmlns="urn:hl7-org:v3">
<serviceEvent classCode="PCPR">
<!-- The effectiveTime reflects the provision of care summarized in the document.
In this scenario, the provision of care summarized is the lifetime for
the patient -->
<!-- The high value represents when the summarized provision of care being
ended. In this scenario, when chart summary was created -->
<effectiveTime>
<low value="19750501"/>
<!-- The low value represents when the summarized provision of care began.
In this scenario, the patient's date of birth -->
<high value="20120915"/>
</effectiveTime>
<performer typeCode="PRF">
<functionCode displayName="Primary Performer"
codeSystemName="Provider Role" codeSystem="2.16.840.1.113883.12.443" code="PP">
<originalText>Primary Care Provider</originalText>
</functionCode>
<assignedEntity>
<id root="2.16.840.1.113883.4.6" extension="5555555555"/>
<code displayName="Adult Medicine Physician" codeSystemName="NUCC"
codeSystem="2.16.840.1.113883.6.101" code="207QA0505X"/>
<addr use="H">
<streetAddressLine>23 Anywhere Street</streetAddressLine>
<city>El Paso</city>
<state>TX</state>
<postalCode>90210</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-1004" use="WP"/>
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>