At-Home In-Vitro Test Report
1.0.0 - STU 1 United States of America flag

This page is part of the At-Home In-Vitro Test Report (v1.0.0: STU 1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

At-Home In-Vitro Test with Prescription V2 Example

MSH|^~\&|OneAbbottSol.STAG^2.16.840.1.113883.3.8589.4.2.7.2^ISO|AbbottInformatics^00Z0000002^CLIA|AIMS.INTEGRATION.STG^2.16.840.1.114222.4.3.15.2^ISO|AIMS.PLATFORM^2.16.840.1.114222.4.1.217446^ISO|20210128162413-0500||ORU^R01^ORU_R01|20210128162413.806_P21-0000105078|T|2.5.1|||NE|NE|||||PHLabReport-NoAck^ELR251R1_Rcvr_Prof^2.16.840.1.113883.9.11^ISO
SFT|Abbott Informatics|PH12.1|STARLIMS PH|Binary ID Unknown
PID|1||P21-0000105075^^^OneAbbottSol.STAG&2.16.840.1.113883.3.8589.4.2.7.2&ISO^SID^OneAbbottSol.STAG&2.16.840.1.113883.3.8589.4.2.7.2&ISO||Trevor^Stacy^^||19880121190000-0500|F||2054-5^Black or African American^HL70005^^^^Vunknown|11 Norman drive^^Palatine^IL^60067^USA^^^||^^^^^847^2260356|||||||||U^Unknown^HL70189^^^^Vunknown||||||||
ORC|RE|2gcxDYvIHHLr+e5hO9Lxrg^OneAbbottSol.STAG^2.16.840.1.113883.3.8589.4.2.7.2^ISO|P21-0000105078^OneAbbottSol.STAG^2.16.840.1.113883.3.8589.4.2.7.2^ISO|||||||||1760801666^Amanda^Sundling^^^^^^NPI&2.16.840.1.113883.4.6&ISO^^^^NPI||^^^^^701^6405718|20210128160603-0500||||||North Dakota Health Clinic|610 2nd St. N^^Wahpeton^ND^58075^^^^|^^^^^701^6405718|610 2nd St. N^^Wahpeton^ND^58075^^
OBR|1|2gcxDYvIHHLr+e5hO9Lxrg^OneAbbottSol.STAG^2.16.840.1.113883.3.8589.4.2.7.2^ISO|P21-0000105078^OneAbbottSol.STAG^2.16.840.1.113883.3.8589.4.2.7.2^ISO|94558-4^SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay^LN^1^SARS Coronavirus 2 Ag^L^Vunknown^Vunknown|||20210128160603-0500|||||||||1760801666^Amanda^Sundling^^^^^^NPI&2.16.840.1.113883.4.6&ISO^^^^NPI|^^^^^701^6405718|||||20210128160621-0500||LAB|F|||||||||||
OBX|1|SN|30525-0^Age^LN^^^^Vunknown||^33|a^year^UCUM^^^^Vunknown|||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|2|CWE|95417-2^Whether this is the patient's first test for the condition of interest^LN^^^^2.69||N^No^HL70136^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|3|CWE|95418-0^Whether patient is employed in a healthcare setting^LN^^^^2.69||N^No^HL70136^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|4|CWE|95419-8^Whether patient has symptoms related to condition of interest^LN^^^^2.69||Y^Yes^HL70136^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|5|CWE|77974-4^Whether patient was hospitalized because of this condition^LN^^^^2.69||N^No^HL70136^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|6|CWE|95421-4^Whether patient resides in a congregate care setting^LN^^^^2.69||Y^Yes^HL70136^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|7|CWE|82810-3^Pregnancy status^LN^^^^2.69||60001007^Not pregnant^SCT^^^^Vunknown||||||F|||20210128160603-0500|00Z0000015||||||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||QST
OBX|8|CWE|94558-4^SARS-CoV-2 (COVID-19) Ag [Presence] in Respiratory specimen by Rapid immunoassay^LN^^^^Vunknown||260373001^Detected^SCT^SARS Coronavirus 2 A^LA6576-8^L^Vunknown^Vunknown^LA6576-8||||||F|||20210128160603-0500|00Z0000015||QuickVue At-Home COVID-19 Test_Quidel Corporation^^99ELR^^^^Vunknown||20210128160621-0500||||SA.Prescription^^^^^CLIA&2.16.840.1.113883.4.7&ISO^XX^^^00Z0000015|12 Fake AtHome Test Street^^Fake City^AK^99689^^^^02282|||||
NTE|1|L|QuickVue At-Home COVID-19 Test_Quidel Corporation
SPM|1|^P21-0000105075&OneAbbottSol.STAG&2.16.840.1.113883.3.8589.4.2.7.2&ISO||445297001^Swab of internal nose^SCT^^^^Vunknown|||||||||||||20210128160603-0500|20210128160603-0500