Connectathon 11 Snapshot

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Diagnosticreport-example-ghp.xml

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An Example of a report with multiple specimen and panels (id = "ghp")

<DiagnosticReport xmlns="http://hl7.org/fhir">
  <id value="ghp"/>
  <meta>
    <lastUpdated value="2015-08-16T10:35:23Z"/>
  </meta>
  <!--    ************** CBC observation panel************************   -->
  <text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: ghp</p><p><b>meta</b>: </p><p><b>contained</b>: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
         , , , , , , , , , , , </p><p><b>identifier</b>: ghp-example</p><p><b>status</b>: final</p><p><b>code</b>: General Health Profile <span>(Details : {http://acme.com/labs/reports code 'GHP' = '??', given as 'General Health Profile'})</span></p><p><b>subject</b>: <a>Patient/pat2</a></p><p><b>effective</b>: 16/08/2015 4:40:17 PM</p><p><b>issued</b>: 17/08/2015 4:40:17 PM</p><p><b>performer</b>: <a>Acme Laboratory, Inc</a></p><p><b>specimen</b>: </p><ul><li>Red Top Tube. Generated Summary: id: rtt; Serum sample <span>(Details : {SNOMED CT code '119364003' = '119364003', given as 'Serum sample'})</span>; Patient/pat2; 20150816-00124</li><li>Lavender Top Tube. Generated Summary: id: ltt; Blood specimen with EDTA <span>(Details : {SNOMED CT code '445295009' = '445295009', given as 'Blood specimen with EDTA'})</span>; Patient/pat2; 20150816-00124</li><li>Urine Sample. Generated Summary: id: urine; Urine specimen <span>(Details : {SNOMED CT code '122575003' = '122575003', given as 'Urine specimen'})</span>; Patient/pat2; 20150816-00124</li></ul><p><b>result</b>: </p><ul><li>Chemistry Panel. Generated Summary: id: p1; status: final; Comprehensive metabolic 2000
           panel - Serum or Plasma <span>(Details : {LOINC code '24323-8' = 'Comprehensive metabolic 2000 panel - Serum or Plasma',
             given as 'Comprehensive metabolic 2000 panel - Serum or Plasma'})</span>; effective: 16/08/2015 4:40:17 PM; issued: 17/08/2015 4:40:17 PM; Acme Laboratory, Inc</li><li>CBC. Generated Summary: id: p2; status: final; Complete blood count (hemogram) panel -
           Blood by Automated count <span>(Details : {LOINC code '58410-2' = 'Complete blood count (hemogram) panel - Blood by Automated
             count', given as 'Complete blood count (hemogram) panel - Blood by Automated count'})</span>; effective: 16/08/2015 4:40:17 PM; issued: 17/08/2015 4:40:17 PM; Acme Laboratory, Inc</li><li>Urinalysis. Generated Summary: id: p3; status: final; Urinalysis macro (dipstick) panel
           - Urine <span>(Details : {LOINC code '24357-6' = 'Urinalysis macro (dipstick) panel - Urine', given
             as 'Urinalysis macro (dipstick) panel - Urine'})</span>; effective: 16/08/2015 4:40:17 PM; issued: 17/08/2015 4:40:17 PM; Acme Laboratory, Inc</li></ul></div></text><contained>
    <Specimen>
      <id value="rtt"/>
      <type>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="119364003"/>
          <display value="Serum sample"/>
        </coding>
      </type>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <accessionIdentifier>
        <system value="http://acme.com/labs/accession-ids"/>
        <value value="20150816-00124"/>
      </accessionIdentifier>
      <collection>
        <collector>
          <reference value="Practitioner/f202"/>
        </collector>
        <collectedDateTime value="2015-08-16T06:40:17Z"/>
      </collection>
      <container>
        <type>
        <coding>
          <system value="http://acme.com/labs"/>
          <code value="SST"/>
          <display value="Serum Separator Tube"/>
        </coding>
        </type>
      </container>
    </Specimen>
  </contained>
  <contained>
    <Specimen>
      <id value="ltt"/>
      <type>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="445295009"/>
          <display value="Blood specimen with EDTA"/>
        </coding>
      </type>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <accessionIdentifier>
        <system value="http://acme.com/labs/accession-ids"/>
        <value value="20150816-00124"/>
      </accessionIdentifier>
      <collection>
        <collector>
          <reference value="Practitioner/f202"/>
        </collector>
        <collectedDateTime value="2015-08-16T06:40:17Z"/>
      </collection>
      <container>
        <type>
        <coding>
          <system value="http://acme.com/labs"/>
          <code value="LTT"/>
          <display value="Lavender Top Tube"/>
        </coding>
        </type>
      </container>
    </Specimen>
  </contained>
  <contained>
    <Specimen>
      <id value="urine"/>
      <type>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="122575003"/>
          <display value="Urine specimen"/>
        </coding>
      </type>
      <subject>
        <reference value="Patient/pat2"/>
      </subject>
      <accessionIdentifier>
        <system value="http://acme.com/labs/accession-ids"/>
        <value value="20150816-00124"/>
      </accessionIdentifier>
      <collection>
        <collector>
          <reference value="Practitioner/f202"/>
        </collector>
        <collectedDateTime value="2015-08-16T06:40:17Z"/>
      </collection>
      <container>
        <type>
        <coding>
          <system value="http://acme.com/labs"/>
          <code value="UCUP"/>
          <display value="100mL sterile cup"/>
        </coding>
        </type>
      </container>
    </Specimen>
  </contained>
  <contained>
    <Observation>
      <id value="p2"/>
            <status value="final"/>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="58410-2"/>
          <display value="Complete blood count (hemogram) panel - Blood by Automated count"/>
        </coding>
      </code>
      <effectiveDateTime value="2015-08-16T06:40:17Z"/>
      <issued value="2015-08-17T06:40:17Z"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <specimen>
        <reference value="#ltt"/>
        <display value="Lavender Top Tube"/>
      </specimen>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r1"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r2"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r3"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r4"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r5"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r6"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r7"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r8"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r9"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r10"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r11"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r12"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r13"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r14"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r15"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r16"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#r17"/>
        </target>
      </related>
    </Observation>
  </contained>
      
      <contained>
        <Observation>
          <!--     
  all the data items (= Observations) are contained
  in this diagnostic report. It would be equally
    valid - and normal - for them to be separate trackable
    items. However for the purposes of this example, it's
  more convenient to have them here. For more discussion,
  see under"Contained Resources" on the Resource Definitions
  topic page       -->
          <!--       for users steeped in v2, each observation roughly corresponds with an
    OBX, and the Diagnostic Report with an ORU_R01 message       -->
          <id value="r1"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="718-7"/>
              <display value="Hemoglobin [Mass/volume] in Blood"/>
            </coding>
            <text value="Haemoglobin"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="176"/>
            <unit value="g/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="g/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="135"/>
              <unit value="g/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="g/L"/>
            </low>
            <high>
              <value value="180"/>
              <unit value="g/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="g/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r2"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="789-8"/>
              <display value="Erythrocytes [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Red Cell Count"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="5.9"/>
            <unit value="x10*12/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*12/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="4.2"/>
              <unit value="x10*12/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*12/L"/>
            </low>
            <high>
              <value value="6.0"/>
              <unit value="x10*12/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*12/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r3"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="4544-3"/>
              <display value="Hematocrit [Volume Fraction] of Blood by Automated count"/>
            </coding>
            <text value="Haematocrit"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="55"/>
            <unit value="%"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="H"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="38"/>
              <unit value="%"/>
            </low>
            <high>
              <value value="52"/>
              <unit value="%"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r4"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="787-2"/>
              <display value="Erythrocyte mean corpuscular volume [Entitic volume] by Automated count"/>
            </coding>
            <text value="Mean Cell Volume"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="99"/>
            <unit value="fL"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="fL"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="H"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="80"/>
              <unit value="fL"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="fL"/>
            </low>
            <high>
              <value value="98"/>
              <unit value="fL"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="fL"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r5"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="785-6"/>
              <display value="Erythrocyte mean corpuscular hemoglobin [Entitic mass] by Automated count"/>
            </coding>
            <text value="Mean Cell Haemoglobin"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="36"/>
            <unit value="pg"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="pg"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="H"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="27"/>
              <unit value="pg"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="pg"/>
            </low>
            <high>
              <value value="35"/>
              <unit value="pg"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="pg"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r6"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="777-3"/>
              <display value="Platelets [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Platelet Count"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="444"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="150"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="450"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r7"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="6690-2"/>
              <display value="Leukocytes [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="White Cell Count"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="4.6"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="4.0"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="11.0"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r8"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="770-8"/>
              <display value="Neutrophils/100 leukocytes in Blood by Automated count"/>
            </coding>
            <text value="Neutrophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="20"/>
            <unit value="%"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </valueQuantity>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r9"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="751-8"/>
              <display value="Neutrophils [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Neutrophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="0.9"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="LL"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="2.0"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="7.5"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r10"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="736-9"/>
              <display value="Lymphocytes/100 leukocytes in Blood by Automated count"/>
            </coding>
            <text value="Lymphocytes"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="20"/>
            <unit value="%"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </valueQuantity>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r11"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="731-0"/>
              <display value="Lymphocytes [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Lymphocytes"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="0.9"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="L"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="1.1"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="4.0"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r12"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="5905-5"/>
              <display value="Monocytes/100 leukocytes in Blood by Automated count"/>
            </coding>
            <text value="Monocytes"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="20"/>
            <unit value="%"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </valueQuantity>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r13"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="742-7"/>
              <display value="Monocytes [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Monocytes"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="0.9"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="0.2"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="1.0"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r14"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="713-8"/>
              <display value="Eosinophils/100 leukocytes in Blood by Automated count"/>
            </coding>
            <text value="Eosinophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="20"/>
            <unit value="%"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </valueQuantity>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r15"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="711-2"/>
              <display value="Eosinophils [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Eosinophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="0.92"/>
            <unit value="x10*9/L"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="HH"/>
            </coding>
          </interpretation>
          <referenceRange>
            <low>
              <value value="0.04"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </low>
            <high>
              <value value="0.40"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r16"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="706-2"/>
              <display value="Basophils/100 leukocytes in Blood by Automated count"/>
            </coding>
            <text value="Basophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="20"/>
            <unit value="%"/>
            <system value="http://unitsofmeasure.org"/>
            <code value="%"/>
          </valueQuantity>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="r17"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="704-7"/>
              <display value="Basophils [#/volume] in Blood by Automated count"/>
            </coding>
            <text value="Basophils"/>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="0.92"/>
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            <system value="http://unitsofmeasure.org"/>
            <code value="10*9/L"/>
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            <high>
              <value value="0.21"/>
              <unit value="x10*9/L"/>
              <system value="http://unitsofmeasure.org"/>
              <code value="10*9/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>

  <!--    ******************CHEM PANEL observations **************************   -->
  <contained>
    <Observation>
      <id value="p1"/>
            <status value="final"/>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="24323-8"/>
          <display value="Comprehensive metabolic 2000 panel - Serum or Plasma"/>
        </coding>
      </code>
      <effectiveDateTime value="2015-08-16T06:40:17Z"/>
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      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
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      <specimen>
        <reference value="#rtt"/>
        <display value="Red Top Tube"/>
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        <type value="has-member"/>
        <target>
          <reference value="#o1"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o2"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o3"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o4"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o5"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o6"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o7"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o8"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o9"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o10"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o11"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o12"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o13"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o14"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o15"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o16"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o17"/>
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      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o18"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o19"/>
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      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o20"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o21"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#o22"/>
        </target>
      </related>
    </Observation>
  </contained>
      <contained>
        <Observation>
          <id value="o1"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2951-2"/>
              <display value="Sodium [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="104934005"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="140"/>
            <unit value="mmol/L"/>
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          <referenceRange>
            <low>
              <value value="137"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="147"/>
              <unit value="mmol/L"/>
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          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o2"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2823-3"/>
              <display value="Potassium [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="59573005"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="4.2"/>
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            <low>
              <value value="3.5"/>
              <unit value="mmol/L"/>
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            <high>
              <value value="5.0"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o3"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2075-0"/>
              <display value="Chloride [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="46511006"/>
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          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="105"/>
            <unit value="mmol/L"/>
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            <low>
              <value value="96"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="109"/>
              <unit value="mmol/L"/>
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          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o4"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="1963-8"/>
              <display value="Bicarbonate [Moles/volume] in Serum"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="88645003"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="26"/>
            <unit value="mmol/L"/>
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            <low>
              <value value="25"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="33"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o5"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="1863-0"/>
              <display value="Anion gap 4 in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="271057005"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="13"/>
            <unit value="mmol/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="4"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="17"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o6"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14749-6"/>
              <display value="Glucose [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="36048009"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="7.4"/>
            <unit value="mmol/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="3.0"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="7.7"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o7"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14937-7"/>
              <display value="Urea nitrogen [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="273967009"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
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          <valueQuantity>
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            <unit value="mmol/L"/>
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            <low>
              <value value="2.0"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="7.0"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o8"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14682-9"/>
              <display value="Creatinine [Moles/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="70901006"/>
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          </code>
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          <valueQuantity>
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            <low>
              <value value="0.04"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="0.11"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o9"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14933-6"/>
              <display value="Urate [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="86228006"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="0.39"/>
            <unit value="mmol/L"/>
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          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="H"/>
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          </interpretation>
          <referenceRange>
            <low>
              <value value="0.14"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="0.35"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o10"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14631-6"/>
              <display value="Bilirubin.total [Moles/volume] in Serum or Plasma"/>
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            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="27171005"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
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            <unit value="umol/L"/>
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            <low>
              <value value="2"/>
              <unit value="umol/L"/>
            </low>
            <high>
              <value value="20"/>
              <unit value="umol/L"/>
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          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o11"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14629-0"/>
              <display value="Bilirubin.direct [Moles/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="39748002"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="3"/>
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          <referenceRange>
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              <value value="0"/>
              <unit value="umol/L"/>
            </low>
            <high>
              <value value="8"/>
              <unit value="umol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o12"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="6768-6"/>
              <display value="Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="88810008"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
            <value value="108"/>
            <unit value="U/L"/>
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          <referenceRange>
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              <value value="30"/>
              <unit value="U/L"/>
            </low>
            <high>
              <value value="115"/>
              <unit value="U/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o13"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2324-2"/>
              <display value="Gamma glutamyl transferase [Enzymatic activity/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="69480007"/>
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          </code>
          <subject>
            <reference value="Patient/pat2"/>
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            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
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          <valueQuantity>
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            <unit value="U/L"/>
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          <referenceRange>
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              <value value="0"/>
              <unit value="U/L"/>
            </low>
            <high>
              <value value="45"/>
              <unit value="U/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o14"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="1742-6"/>
              <display value="Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="34608000"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
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          </performer>
          <valueQuantity>
            <value value="54"/>
            <unit value="U/L"/>
          </valueQuantity>
          <interpretation>
            <coding>
              <system value="http://hl7.org/fhir/v2/0078"/>
              <code value="H"/>
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          <referenceRange>
            <low>
              <value value="0"/>
              <unit value="U/L"/>
            </low>
            <high>
              <value value="45"/>
              <unit value="U/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o15"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="1920-8"/>
              <display value="Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="45896001"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
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          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="30"/>
            <unit value="U/L"/>
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          <referenceRange>
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              <value value="0"/>
              <unit value="U/L"/>
            </low>
            <high>
              <value value="41"/>
              <unit value="U/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o16"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2532-0"/>
              <display value="Lactate dehydrogenase [Enzymatic activity/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="11274001"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="131"/>
            <unit value="U/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="80"/>
              <unit value="U/L"/>
            </low>
            <high>
              <value value="250"/>
              <unit value="U/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o17"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2000-8"/>
              <display value="Calcium [Moles/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="71878006"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="2.38"/>
            <unit value="mmol/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="2.25"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="2.65"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o18"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="13959-2"/>
              <display value="Calcium.ionized [Moles/volume] in Serum or Plasma by calculation"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="166708003"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="2.39"/>
            <unit value="mmol/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="2.25"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="2.65"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o19"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="14879-1"/>
              <display value="Phosphate [Moles/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="104866001"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="1.5"/>
            <unit value="mmol/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="0.8"/>
              <unit value="mmol/L"/>
            </low>
            <high>
              <value value="1.5"/>
              <unit value="mmol/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o20"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2885-2"/>
              <display value="Protein [Mass/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="74040009"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="67"/>
            <unit value="g/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="60"/>
              <unit value="g/L"/>
            </low>
            <high>
              <value value="82"/>
              <unit value="g/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o21"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="1751-7"/>
              <display value="Albumin [Mass/volume] in Serum or Plasma"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="104485008"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="42"/>
            <unit value="g/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="35"/>
              <unit value="g/L"/>
            </low>
            <high>
              <value value="50"/>
              <unit value="g/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="o22"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="10834-0"/>
              <display value="Globulin [Mass/volume] in Serum by calculation"/>
            </coding>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="104979009"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="25"/>
            <unit value="g/L"/>
          </valueQuantity>
          <referenceRange>
            <low>
              <value value="20"/>
              <unit value="g/L"/>
            </low>
            <high>
              <value value="40"/>
              <unit value="g/L"/>
            </high>
          </referenceRange>
        </Observation>
      </contained>

  <!--    ******************UA observations **************************    -->
  <contained>
    <Observation>
      <id value="p3"/>
            <status value="final"/>
      <code>
        <coding>
          <system value="http://loinc.org"/>
          <code value="24357-6"/>
          <display value="Urinalysis macro (dipstick) panel - Urine"/>
        </coding>
      </code>
      <effectiveDateTime value="2015-08-16T06:40:17Z"/>
      <issued value="2015-08-17T06:40:17Z"/>
      <performer>
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
        <display value="Acme Laboratory, Inc"/>
      </performer>
      <specimen>
        <reference value="#urine"/>
        <display value="Urine Sample"/>
      </specimen>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u1"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u2"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u3"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u4"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u5"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u6"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u7"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u8"/>
        </target>
      </related>
      <related>
        <type value="has-member"/>
        <target>
          <reference value="#u9"/>
        </target>
      </related>
    </Observation>
  </contained>
      <contained>
        <Observation>
          <id value="u1"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2756-5"/>
              <display value="pH of Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="5.0"/>
            <unit value="pH"/>
          </valueQuantity>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u2"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2887-8"/>
              <display value="Protein [Presence] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="260385009"/>
              <display value="Negative"/>
            </coding>
          </valueCodeableConcept>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u3"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2965-2"/>
              <display value="Specific gravity of Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="1.009"/>
          </valueQuantity>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>

      <contained>
        <Observation>
          <id value="u4"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="33051-4"/>
              <display value="Erythrocytes [Presence] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="260385009"/>
              <display value="Negative"/>
            </coding>
          </valueCodeableConcept>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u5"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="2349-9"/>
              <display value="Glucose [Presence] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="260385009"/>
              <display value="Negative"/>
            </coding>
          </valueCodeableConcept>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u6"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="33052-2"/>
              <display value="Leukocytes [Presence] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueCodeableConcept>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="260385009"/>
              <display value="Negative"/>
            </coding>
          </valueCodeableConcept>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u7"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="30405-5"/>
              <display value="Leukocytes [#/volume] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="1"/>
            <unit value="/uL"/>
          </valueQuantity>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u8"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="30391-7"/>
              <display value="Erythocytes [#/volume] in Urine"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="1"/>
            <comparator value="&lt;"/>
            <unit value="/uL"/>
          </valueQuantity>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>
      <contained>
        <Observation>
          <id value="u9"/>
          <status value="final"/>
          <code>
            <coding>
              <system value="http://loinc.org"/>
              <code value="13654-9"/>
              <display value="Epithelial cells.squamous [#/volume] in Urine sediment"/>
            </coding>
          </code>
          <subject>
            <reference value="Patient/pat2"/>
          </subject>
          <effectiveDateTime value="2015-08-16T06:40:17Z"/>
          <issued value="2015-08-17T06:40:17Z"/>
          <performer>
            <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
            <display value="Acme Laboratory, Inc"/>
          </performer>
          <valueQuantity>
            <value value="1"/>
            <comparator value="&lt;"/>
            <unit value="/mL"/>
          </valueQuantity>
          <specimen>
            <reference value="#urine"/>
            <display value="Urine Sample"/>
          </specimen>
        </Observation>
      </contained>

  <identifier>
    <system value="http://acme.com/lab/reports"/>
    <value value="ghp-example"/>
  </identifier>
  <status value="final"/>
  <code>
    <coding>
      <system value="http://acme.com/labs/reports"/>
      <code value="GHP"/>
      <display value="General Health Profile"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/pat2"/>
  </subject>
  <effectiveDateTime value="2015-08-16T06:40:17Z"/>
  <issued value="2015-08-17T06:40:17Z"/>
  <performer>
    <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/>
    <display value="Acme Laboratory, Inc"/>
  </performer>
  <specimen>
    <reference value="#rtt"/>
    <display value="Red Top Tube"/>
  </specimen>
  <specimen>
    <reference value="#ltt"/>
    <display value="Lavender Top Tube"/>
  </specimen>
  <specimen>
    <reference value="#urine"/>
    <display value="Urine Sample"/>
  </specimen>
  <result>
    <reference value="#p1"/>
    <display value="Chemistry Panel"/>
  </result>
  <result>
    <reference value="#p2"/>
    <display value="CBC"/>
  </result>

  <result>
    <reference value="#p3"/>
    <display value="Urinalysis"/>
  </result>

</DiagnosticReport>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.