This page is part of the C-CDA on FHIR Implementation Guide (v1.2.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<entry>
<act classCode="ACT" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.30" extension="2015-08-01"/>
<templateId root="2.16.840.1.113883.10.20.22.4.30"/>
<!--identifier[0]->system identifier[0]->value -->
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.10" extension="545077400001"/>
<!--identifier[1]->system identifier[1]->value -->
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.10" extension="545077400003"/>
<code code="CONC" codeSystem="2.16.840.1.113883.5.6"/>
<statusCode code="active"/>
<effectiveTime xsi:type="IVL_TS">
<low nullFlavor="NI"/>
</effectiveTime>
<entryRelationship typeCode="SUBJ">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.7" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.7"/>
<!--identifier[0]->system identifier[0]->value -->
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.10.2" extension="545077400001"/>
<!--identifier[1]->system identifier[1]->value -->
<id root="1.3.6.1.4.1.22812.3.2009316.3.4.10.2" extension="545077400003"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<statusCode code="completed"/>
<effectiveTime xsi:type="IVL_TS">
<!--onsetDateTime-->
<low value="20080501"/>
</effectiveTime>
<!-- generated because this is a drug allergy-->
<value xsi:type="CD" code="419511003" codeSystem="2.16.840.1.113883.6.96">
<originalText>
<reference value="#allergy1"/>
</originalText>
</value>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<playingEntity classCode="MMAT">
<!--code = code->coding->code[0] codeSystem=translate system to urn-->
<code code="1191" codeSystem="2.16.840.1.113883.6.88">
<!--code = code->coding->code[1] codeSystem=translate system to urn-->
<translation code="293586001" codeSystem="2.16.840.1.113883.6.96"/>
</code>
</playingEntity>
</participantRole>
</participant>
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.9" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.9"/>
<id nullFlavor="NI"/>
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy1reaction1"/>
</text>
<statusCode code="completed"/>
<!--code = reaction->manifestation[0]->coding->code[0] codeSystem=translate system to urn-->
<value xsi:type="CD" code="247472004" codeSystem="2.16.840.1.113883.6.96">
<originalText>
<reference value="#allergy1reaction1"/>
</originalText>
</value>
<entryRelationship typeCode="SUBJ" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.8" extension="2014-06-09"/>
<templateId root="2.16.840.1.113883.10.20.22.4.8"/>
<code code="SEV" codeSystem="2.16.840.1.113883.5.4"/>
<text>
<reference value="#allergy1reaction1Severity"/>
</text>
<statusCode code="completed"/>
<!-- built from mapping reaction->manifestation[0]->severity using CF_AllergyIntoleranceReactionSeverity-->
<value xsi:type="CD" code="24484000" codeSystem="2.16.840.1.113883.6.96"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</observation>
</entryRelationship>
</act>
</entry>