minimal Common Oncology Data Elements (mCODE) Implementation Guide
1.16.0 - STU Release 2 (Ballot Version)
minimal Common Oncology Data Elements (mCODE) Implementation Guide
1.16.0 - STU Release 2 (Ballot Version)
This page is part of the HL7 FHIR Implementation Guide: minimal Common Oncology Data Elements (mCODE) Release 1 - US Realm | STU1 (v1.16.0: STU 2 Ballot 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
<Bundle xmlns="http://hl7.org/fhir">
<id value="mcode-patient-bundle-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-patient-bundle"/>
</meta>
<type value="collection"/>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/cancer-disease-status-jenny-m"/>
<resource>
<Patient>
<id value="cancer-patient-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-patient"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><blockquote><p><b>US Core Race Extension</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title="{urn:oid:2.16.840.1.113883.6.238 2106-3}">White</span></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: White</p></blockquote><blockquote><p><b>US Core Ethnicity Extension</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <span title="{urn:oid:2.16.840.1.113883.6.238 2186-5}">Not Hispanic or Latino</span></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: Not Hispanic or Latino</p></blockquote><p><b>identifier</b>: Medical Record Number: MRN1234 (USUAL)</p><p><b>name</b>: Jenny M </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1965-01-01</p><p><b>address</b>: 123 Main St Anytown 12345 United States </p><h3>Contacts</h3><table class="grid"><tr><td>-</td><td><b>Telecom</b></td></tr><tr><td>*</td><td>ph: 555-867-5309(HOME), <a href="mailto:example@example.com">example@example.com</a></td></tr></table><h3>Communications</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td></tr><tr><td>*</td><td><span title="Codes: {urn:ietf:bcp:47 en-US}">English</span></td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-race">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2106-3"/>
<display value="White"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="White"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity">
<extension url="ombCategory">
<valueCoding>
<system value="urn:oid:2.16.840.1.113883.6.238"/>
<code value="2186-5"/>
<display value="Not Hispanic or Latino"/>
</valueCoding>
</extension>
<extension url="text">
<valueString value="Not Hispanic or Latino"/>
</extension>
</extension>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
<display value="Medical Record Number"/>
</coding>
</type>
<system value="http://hospital.example.org"/>
<value value="MRN1234"/>
</identifier>
<name>
<family value="M"/>
<given value="Jenny"/>
</name>
<gender value="female"/>
<birthDate value="1965-01-01"/>
<address>
<line value="123 Main St"/>
<city value="Anytown"/>
<postalCode value="12345"/>
<country value="United States"/>
</address>
<contact>
<telecom>
<system value="phone"/>
<value value="555-867-5309"/>
<use value="home"/>
</telecom>
<telecom>
<system value="email"/>
<value value="example@example.com"/>
</telecom>
</contact>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en-US"/>
</coding>
<text value="English"/>
</language>
</communication>
</Patient>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/cancer-genetic-variant-jenny-m"/>
<resource>
<Observation>
<id value="cancer-genetic-variant-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-genetic-variant"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>value</b>: <span title="Codes: {http://loinc.org LA9633-4}">Present</span></p><p><b>method</b>: <span title="Codes: {http://loinc.org LA26398-0}">Sequencing</span></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 48018-6}">Gene studied [ID]</span></p><p><b>value</b>: <span title="Codes: {http://www.genenames.org HGNC:26144}">PALB2</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes: {http://www.ncbi.nlm.nih.gov/clinvar 128144}">NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 81290-9}">Genomic DNA change (gHGVS)</span></p><p><b>value</b>: <span title="Codes: {http://varnomen.hgvs.org NC_000016.10:g.23603471G>T}">NC_000016.10:g.23603471G>T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://loinc.org 48002-0}">Genomic source class [Type]</span></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA6684-0}">Somatic</span></p></blockquote></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="69548-6"/>
<display value="Genetic variant assessment"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA9633-4"/>
<display value="Present"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://loinc.org"/>
<code value="LA26398-0"/>
<display value="Sequencing"/>
</coding>
</method>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48018-6"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.genenames.org"/>
<code value="HGNC:26144"/>
<display value="PALB2"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81252-9"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
<code value="128144"/>
<display value="NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81290-9"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://varnomen.hgvs.org"/>
<code value="NC_000016.10:g.23603471G>T"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48002-0"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6684-0"/>
<display value="Somatic"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/DiagnosticReport/cancer-genomics-report-jenny-m"/>
<resource>
<DiagnosticReport>
<id value="cancer-genomics-report-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-genomics-report"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: final</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 LAB}">Laboratory</span>, <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 81247-9}">Master HL7 genetic variant reporting panel</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>issued</b>: Mar 15, 2020 12:00:01 AM</p><p><b>specimen</b>: <a href="#Specimen_genetic-specimen-left-breast-jenny-m">See above (Specimen/genetic-specimen-left-breast-jenny-m)</a></p><p><b>result</b>: </p><ul><li><a href="#Observation_cancer-genetic-variant-jenny-m">See above (Observation/cancer-genetic-variant-jenny-m)</a></li><li><a href="#Observation_genomic-region-studied-jenny-m">See above (Observation/genomic-region-studied-jenny-m)</a></li></ul></div>
</text>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="LAB"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="GE"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="81247-9"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<issued value="2020-03-15T00:00:01+00:00"/>
<specimen>
<reference value="Specimen/genetic-specimen-left-breast-jenny-m"/>
</specimen>
<result>
<reference value="Observation/cancer-genetic-variant-jenny-m"/>
</result>
<result>
<reference value="Observation/genomic-region-studied-jenny-m"/>
</result>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m"/>
<resource>
<Procedure>
<id value="cancer-related-surgical-procedure-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-surgical-procedure"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent (qualifier value)</span></p><p><b>status</b>: completed</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 387713003}">Surgical procedure (procedure)</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 64368001}">Partial mastectomy (procedure)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-04-01</p><p><b>asserter</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><p><b>bodySite</b>: <span title="Codes: {http://snomed.info/sct 80248007}">Left breast structure (body structure)</span></p></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="387713003"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="64368001"/>
<display value="Partial mastectomy (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-04-01"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</asserter>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m"/>
<resource>
<Procedure>
<id value="radiotherapy-treatment-summary-chest-wall-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-course-summary"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Radiotherapy Number of Sessions</b>: 31</p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent</span></p><p><b>Radiotherapy Modality</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/umls C3539769}">Photon Beam Radiation Therapy</span></p><p><b>Radiotherapy Modality</b>: <span title="Codes: {http://snomed.info/sct 45643008}">Teleradiotherapy using electrons (procedure)</span></p><p><b>Radiotherapy Technique</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/umls C3489631}">Volumetric Modulated Arc Therapy</span></p><p><b>Radiotherapy Technique</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/radiotherapy 3D}">Three Dimensional</span></p><blockquote><p><b>Radiotherapy Dose Delivered To Body Volume</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <a href="BodyStructure-jenny-m-chest-wall-treatment-volume.html">Generated Summary: id: 1.2.246.352…1; <span title="Codes: {http://snomed.info/sct 78904004}">Chest wall structure (body structure)</span>; <span title="Codes: {http://snomed.info/sct 255503000}">Entire (qualifier value)</span>; description: Chest Wall</a></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 6000 cGy</p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 30</p></blockquote><blockquote><p><b>Radiotherapy Dose Delivered To Body Volume</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <a href="BodyStructure-jenny-m-chest-wall-lymph-nodes-treatment-volume.html">Generated Summary: id: 1.2.246.352…2; <span title="Codes: {http://snomed.info/sct 245276004}">Mediastinal lymph node group (body structure)</span>; <span title="Codes: {http://snomed.info/sct 51440002}">Right and left (qualifier value)</span>; description: Chest Wall Lymph Nodes</a></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 5000 cGy</p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 25</p></blockquote><p><b>status</b>: completed</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 108290001}">Radiation oncology AND/OR radiotherapy (procedure)</span></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs mcode-radiotherapy-course-summary}">Radiotherapy Course Summary Resource</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-05-01 --> 2018-06-29</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-kyle-anydoc.html">Generated Summary: id: 9988776655; Kyle Anydoc ; gender: male</a></p><p><b>reasonCode</b>: <span title="Codes: {http://hl7.org/fhir/sid/icd-10-cm C50.811}">Malignant neoplasm of overlapping sites of right female breast</span></p><p><b>bodySite</b>: <span title="Codes: {http://snomed.info/sct 78904004}">Chest Wall Structure (body structure)</span></p></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-sessions">
<valueUnsignedInt value="31"/>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/umls"/>
<code value="C3539769"/>
<display value="Photon Beam Radiation Therapy"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="45643008"/>
<display value="Teleradiotherapy using electrons (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/umls"/>
<code value="C3489631"/>
<display value="Volumetric Modulated Arc Therapy"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/radiotherapy"/>
<code value="3D"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="6000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
<extension url="fractionsDelivered">
<valueUnsignedInt value="30"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="5000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
<extension url="fractionsDelivered">
<valueUnsignedInt value="25"/>
</extension>
</extension>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="108290001"/>
<display value="Radiation oncology AND/OR radiotherapy (procedure)"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs"/>
<code value="mcode-radiotherapy-course-summary"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedPeriod>
<start value="2018-05-01"/>
<end value="2018-06-29"/>
</performedPeriod>
<asserter>
<reference value="Practitioner/us-core-practitioner-kyle-anydoc"/>
</asserter>
<reasonCode>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10-cm"/>
<code value="C50.811"/>
<display
value="Malignant neoplasm of overlapping sites of right female breast"/>
</coding>
</reasonCode>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="78904004"/>
<display value="Chest Wall Structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/teleradiotherapy-treatment-phase-chest-wall-jenny-m"/>
<resource>
<Procedure>
<id value="teleradiotherapy-treatment-phase-chest-wall-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-teleradiotherapy-treatment-phase"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Radiotherapy Modality</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/umls C3539769}">Photon Beam Radiation Therapy</span></p><p><b>Radiotherapy Technique</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/umls C3489631}">Volumetric-Modulated Arc Therapy</span></p><p><b>Radiotherapy Fractions Delivered</b>: 25</p><blockquote><p><b>Radiotherapy Dose Delivered To Body Volume</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <a href="BodyStructure-jenny-m-chest-wall-treatment-volume.html">Generated Summary: id: 1.2.246.352…1; <span title="Codes: {http://snomed.info/sct 78904004}">Chest wall structure (body structure)</span>; <span title="Codes: {http://snomed.info/sct 255503000}">Entire (qualifier value)</span>; description: Chest Wall</a></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 5000 cGy</p></blockquote><blockquote><p><b>Radiotherapy Dose Delivered To Body Volume</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <a href="BodyStructure-jenny-m-chest-wall-lymph-nodes-treatment-volume.html">Generated Summary: id: 1.2.246.352…2; <span title="Codes: {http://snomed.info/sct 245276004}">Mediastinal lymph node group (body structure)</span>; <span title="Codes: {http://snomed.info/sct 51440002}">Right and left (qualifier value)</span>; description: Chest Wall Lymph Nodes</a></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 5000 cGy</p></blockquote><p><b>partOf</b>: <a href="#Procedure_radiotherapy-treatment-summary-chest-wall-jenny-m">See above (Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m)</a></p><p><b>status</b>: completed</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 108290001}">Radiation oncology AND/OR radiotherapy (procedure)</span></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs mcode-teleradiotherapy-treatment-phase}">Teleradiotherapy Treatment Phase Resource</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-05-01 --> 2018-06-29</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-kyle-anydoc.html">Generated Summary: id: 9988776655; Kyle Anydoc ; gender: male</a></p></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/umls"/>
<code value="C3539769"/>
<display value="Photon Beam Radiation Therapy"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/umls"/>
<code value="C3489631"/>
<display value="Volumetric-Modulated Arc Therapy"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-fractions-delivered">
<valueUnsignedInt value="25"/>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="5000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="5000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
</extension>
<partOf>
<reference
value="Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m"/>
</partOf>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="108290001"/>
<display value="Radiation oncology AND/OR radiotherapy (procedure)"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs"/>
<code value="mcode-teleradiotherapy-treatment-phase"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedPeriod>
<start value="2018-05-01"/>
<end value="2018-06-29"/>
</performedPeriod>
<asserter>
<reference value="Practitioner/us-core-practitioner-kyle-anydoc"/>
</asserter>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/teleradiotherapy-treatment-phase-boost-jenny-m"/>
<resource>
<Procedure>
<id value="teleradiotherapy-treatment-phase-boost-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-teleradiotherapy-treatment-phase"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Radiotherapy Modality</b>: <span title="Codes: {http://snomed.info/sct 45643008}">Teleradiotherapy using electrons (procedure)</span></p><p><b>Radiotherapy Technique</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/radiotherapy 3D}">Three dimensional</span></p><p><b>Radiotherapy Fractions Delivered</b>: 5</p><blockquote><p><b>Radiotherapy Dose Delivered To Body Volume</b></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: <a href="BodyStructure-jenny-m-chest-wall-treatment-volume.html">Generated Summary: id: 1.2.246.352…1; <span title="Codes: {http://snomed.info/sct 78904004}">Chest wall structure (body structure)</span>; <span title="Codes: {http://snomed.info/sct 255503000}">Entire (qualifier value)</span>; description: Chest Wall</a></p><h3>Urls</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>value</b>: 1000 cGy</p></blockquote><p><b>partOf</b>: <a href="#Procedure_radiotherapy-treatment-summary-chest-wall-jenny-m">See above (Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m)</a></p><p><b>status</b>: completed</p><p><b>category</b>: <span title="Codes: {http://snomed.info/sct 108290001}">Radiation oncology AND/OR radiotherapy (procedure)</span></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs mcode-teleradiotherapy-treatment-phase}">Teleradiotherapy Treatment Phase Resource</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-08-01 --> 2018-09-30</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-kyle-anydoc.html">Generated Summary: id: 9988776655; Kyle Anydoc ; gender: male</a></p></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-modality">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="45643008"/>
<display value="Teleradiotherapy using electrons (procedure)"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-technique">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/radiotherapy"/>
<code value="3D"/>
<display value="Three dimensional"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-fractions-delivered">
<valueUnsignedInt value="5"/>
</extension>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-radiotherapy-dose-delivered-to-volume">
<extension url="volume">
<valueReference>
<reference
value="BodyStructure/jenny-m-chest-wall-treatment-volume"/>
</valueReference>
</extension>
<extension url="totalDoseDelivered">
<valueQuantity>
<value value="1000"/>
<system value="http://unitsofmeasure.org"/>
<code value="cGy"/>
</valueQuantity>
</extension>
</extension>
<partOf>
<reference
value="Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m"/>
</partOf>
<status value="completed"/>
<category>
<coding>
<system value="http://snomed.info/sct"/>
<code value="108290001"/>
<display value="Radiation oncology AND/OR radiotherapy (procedure)"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/mcode-resource-identifier-cs"/>
<code value="mcode-teleradiotherapy-treatment-phase"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedPeriod>
<start value="2018-08-01"/>
<end value="2018-09-30"/>
</performedPeriod>
<asserter>
<reference value="Practitioner/us-core-practitioner-kyle-anydoc"/>
</asserter>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-stage-group-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-stage-group"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 21908-9}">Stage group.clinical Cancer</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: <span title="Codes: {http://cancerstaging.org 2B}">IIB</span></p><p><b>method</b>: <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></p><p><b>hasMember</b>: </p><ul><li><a href="Observation-tnm-pathologic-primary-tumor-category-jenny-m.html">Generated Summary: <span title="Codes: {http://loinc.org 21899-0}">Primary tumor.pathology Cancer</span>; effective: 2018-04-01; <span title="Codes: {http://cancerstaging.org pT3}">pT3</span>; <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></a></li><li><a href="Observation-tnm-pathologic-regional-nodes-category-jenny-m.html">Generated Summary: <span title="Codes: {http://loinc.org 21900-6}">Regional lymph nodes.pathology [Class] Cancer</span>; effective: 2018-04-01; <span title="Codes: {http://cancerstaging.org pN0}">pN0</span>; <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></a></li><li><a href="Observation-tnm-pathologic-distant-metastases-category-jenny-m.html">Generated Summary: <span title="Codes: {http://loinc.org 21901-4}">Distant metastases.pathology [Class] Cancer</span>; effective: 2018-04-01; <span title="Codes: {http://cancerstaging.org pM0}">pM0</span>; <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></a></li></ul></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21908-9"/>
<display value="Stage group.clinical Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="2B"/>
<display value="IIB"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
<hasMember>
<reference
value="Observation/tnm-pathologic-primary-tumor-category-jenny-m"/>
</hasMember>
<hasMember>
<reference
value="Observation/tnm-pathologic-regional-nodes-category-jenny-m"/>
</hasMember>
<hasMember>
<reference
value="Observation/tnm-pathologic-distant-metastases-category-jenny-m"/>
</hasMember>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-primary-tumor-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-primary-tumor-category"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 21905-5}">Primary tumor.clinical [Class] Cancer</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: <span title="Codes: {http://cancerstaging.org cT3}">cT3</span></p><p><b>method</b>: <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21905-5"/>
<display value="Primary tumor.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cT3"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-regional-nodes-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-regional-nodes-category"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 21906-3}">Regional lymph nodes.clinical [Class] Cancer</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: <span title="Codes: {http://cancerstaging.org cN0}">cN0</span></p><p><b>method</b>: <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21906-3"/>
<display value="Regional lymph nodes.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cN0"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m"/>
<resource>
<Observation>
<id value="tnm-clinical-distant-metastases-category-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tnm-distant-metastases-category"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 21907-1}">Distant metastases.clinical [Class] Cancer</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: <span title="Codes: {http://cancerstaging.org cM0}">cM0</span></p><p><b>method</b>: <span title="Codes: {http://snomed.info/sct 897275008}">American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21907-1"/>
<display value="Distant metastases.clinical [Class] Cancer"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueCodeableConcept>
<coding>
<system value="http://cancerstaging.org"/>
<code value="cM0"/>
</coding>
</valueCodeableConcept>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="897275008"/>
<display
value="American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Specimen/genetic-specimen-left-breast-jenny-m"/>
<resource>
<Specimen>
<id value="genetic-specimen-left-breast-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genetic-specimen"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: available</p><p><b>type</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TISS}">Tissue</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><h3>Collections</h3><table class="grid"><tr><td>-</td><td><b>Collector</b></td><td><b>BodySite</b></td></tr><tr><td>*</td><td><a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></td><td><span title="Codes: {http://snomed.info/sct 80248007}">Left breast structure (body structure)</span></td></tr></table><h3>Processings</h3><table class="grid"><tr><td>-</td><td><b>Time[x]</b></td></tr><tr><td>*</td><td>2018-03-06</td></tr></table></div>
</text>
<status value="available"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0487"/>
<code value="TISS"/>
</coding>
</type>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<collection>
<collector>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</collector>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</collection>
<processing>
<timeDateTime value="2018-03-06"/>
</processing>
</Specimen>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/genomic-region-studied-jenny-m"/>
<resource>
<Observation>
<id value="genomic-region-studied-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-genomic-region-studied"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 53041-0}">DNA region of interest panel</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-15</p><p><b>issued</b>: Mar 15, 2018 12:00:01 AM</p><h3>Components</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td><span title="Codes: {http://loinc.org 48018-6}">Gene studied [ID]</span></td><td><span title="Codes: {http://www.genenames.org 1100}, {http://www.genenames.org 1101}, {http://www.genenames.org 1748}, {http://www.genenames.org 26144}, {http://www.genenames.org 9588}, {http://www.genenames.org 11389}, {http://www.genenames.org 11998}">BRCA1</span></td></tr></table></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="53041-0"/>
<display value="DNA region of interest panel"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-15"/>
<issued value="2018-03-15T00:00:01+00:00"/>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48018-6"/>
<display value="Gene studied [ID]"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://www.genenames.org"/>
<code value="1100"/>
<display value="BRCA1"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="1101"/>
<display value="BRCA2"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="1748"/>
<display value="CDH1"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="26144"/>
<display value="PALB2"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="9588"/>
<display value="PTEN"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="11389"/>
<display value="STK11"/>
</coding>
<coding>
<system value="http://www.genenames.org"/>
<code value="11998"/>
<display value="TP53"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/ecog-performance-status-jenny-m"/>
<resource>
<Observation>
<id value="ecog-performance-status-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-ecog-performance-status"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 89247-1}">ECOG Performance Status score</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-12</p><p><b>performer</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: 0</p><p><b>interpretation</b>: <span title="Codes: {http://loinc.org LA9622-7}">Fully active, able to carry on all pre-disease performance without restriction</span></p><p><b>method</b>: <span title="Codes: {http://snomed.info/sct 5880005}">Physical examination procedure (procedure)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="89247-1"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-12"/>
<performer>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueInteger value="0"/>
<interpretation>
<coding>
<system value="http://loinc.org"/>
<code value="LA9622-7"/>
<display
value="Fully active, able to carry on all pre-disease performance without restriction"/>
</coding>
</interpretation>
<method>
<coding>
<system value="http://snomed.info/sct"/>
<code value="5880005"/>
<display value="Physical examination procedure (procedure)"/>
</coding>
</method>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-er-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 85337-4}">Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA6576-8}">Positive</span></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85337-4"/>
<display
value="Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6576-8"/>
<display value="Positive"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-pr-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 85339-0}">Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA6577-6}">Negative</span></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="85339-0"/>
<display
value="Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6577-6"/>
<display value="Negative"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-her2-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 48676-1}">HER2 [Interpretation] in Tissue</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-10</p><p><b>performer</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>value</b>: <span title="Codes: {http://loinc.org LA6577-6}">Negative</span></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="48676-1"/>
<display value="HER2 [Interpretation] in Tissue"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-10"/>
<performer>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA6577-6"/>
<display value="Negative"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m"/>
<resource>
<Observation>
<id value="tumor-marker-test-oncotype-dx-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-marker-test"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://hl7.org/fhir/us/mcode/CodeSystem/mcode-catch-code-cs TMT-OTHER}, {http://www.ncbi.nlm.nih.gov/gtr 509910}">Oncotype DX Breast Recurrence Score Assay</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-04-12</p><p><b>performer</b>: <a href="Organization-us-core-organization-bedrock-medicine.html">Generated Summary: id: 1265710000; active; name: Bedrock Medicine</a></p><p><b>value</b>: 47 Recurrence score</p><p><b>interpretation</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation H}">High</span></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/mcode/CodeSystem/mcode-catch-code-cs"/>
<code value="TMT-OTHER"/>
<display value="Other Tumor Marker Test, Specify"/>
</coding>
<coding>
<system value="http://www.ncbi.nlm.nih.gov/gtr"/>
<code value="509910"/>
<display value="Oncotype DX Breast Recurrence Score Assay"/>
</coding>
<text value="Oncotype DX Breast Recurrence Score Assay"/>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-12"/>
<performer>
<reference value="Organization/us-core-organization-bedrock-medicine"/>
</performer>
<valueQuantity>
<value value="47"/>
<unit value="Recurrence score"/>
<system value="http://unitsofmeasure.org"/>
<code value="{ScoreOf}"/>
</valueQuantity>
<interpretation>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation"/>
<code value="H"/>
<display value="High"/>
</coding>
</interpretation>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-doxorubicin-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent (qualifier value)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/medicationrequest-category outpatient}">Outpatient</span></p><p><b>medication</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 3639}">DOXOrubicin</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><h3>DosageInstructions</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="3639"/>
<display value="DOXOrubicin"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="doxorubicin (60 mg/m² IV)"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-01"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<rateQuantity>
<value value="60"/>
<unit value="mg/m2"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg/m2"/>
</rateQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-cyclophosphamide-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent (qualifier value)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/medicationrequest-category outpatient}">Outpatient</span></p><p><b>medication</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 3002}">cyclophosphamide</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><h3>DosageInstructions</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="3002"/>
<display value="cyclophosphamide"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="cyclophosphamide (600 mg/m² IV), 932.59mg"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-01"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="932.59"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-paclitaxel-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent (qualifier value)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/medicationrequest-category outpatient}">Outpatient</span></p><p><b>medication</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 56946}">PACLitaxel</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-04-12</p><p><b>requester</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><h3>DosageInstructions</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="outpatient"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="56946"/>
<display value="PACLitaxel"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-04-12"/>
<requester>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="doxorubicin (175 mg/m² IV), 272.01mg"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-04-12"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="47625008"/>
<display value="Intravenous route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="272.01"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="3"/>
<unit value="week"/>
<system value="http://unitsofmeasure.org"/>
<code value="wk"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m"/>
<resource>
<MedicationRequest>
<id value="cancer-related-medication-request-anastrozole-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-cancer-related-medication-request"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>Treatment Intent</b>: <span title="Codes: {http://snomed.info/sct 373808002}">Curative - procedure intent (qualifier value)</span></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/medicationrequest-category community}">Community</span></p><p><b>medication</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 84857}">anastrozole</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>authoredOn</b>: 2018-09-30</p><p><b>requester</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><h3>DosageInstructions</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table></div>
</text>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-treatment-intent">
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="373808002"/>
<display value="Curative - procedure intent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</extension>
<status value="active"/>
<intent value="order"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/medicationrequest-category"/>
<code value="community"/>
</coding>
</category>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="84857"/>
<display value="anastrozole"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<authoredOn value="2018-09-30"/>
<requester>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</requester>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<dosageInstruction>
<text value="1mg orally once daily"/>
<timing>
<repeat>
<boundsPeriod>
<start value="2018-09-30"/>
</boundsPeriod>
</repeat>
</timing>
<route>
<coding>
<system value="http://snomed.info/sct"/>
<code value="26643006"/>
<display value="Oral route (qualifier value)"/>
</coding>
</route>
<doseAndRate>
<doseQuantity>
<value value="1"/>
<unit value="mg"/>
<system value="http://unitsofmeasure.org"/>
<code value="mg"/>
</doseQuantity>
</doseAndRate>
<maxDosePerPeriod>
<numerator>
<value value="1"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="day"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</denominator>
</maxDosePerPeriod>
</dosageInstruction>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/cancer-related-mcode-comorbidities-elixhauser-jenny-m"/>
<resource>
<Observation>
<id value="cancer-related-mcode-comorbidities-elixhauser-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbidities-elixhauser"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 78923-0}">Comorbid condition panel</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>performer</b>: <a href="#Practitioner_us-core-practitioner-owen-oncologist">See above (Practitioner/us-core-practitioner-owen-oncologist)</a></p><blockquote><p><b>component</b></p><p><b>Specific Condition Reference for Comorbidity</b>: <a href="Condition-us-core-condition-depression-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 35489007}">Depressive disorder (disorder)</span>; onset: 2005-01-01</a></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser DEPRESS}">Depression Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 52101004}">Present (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>Specific Condition Reference for Comorbidity</b>: <a href="Condition-us-core-condition-hypertension-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}">Active</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 77970009}">Benign hypertensive heart disease without congestive heart failure (disorder)</span>; onset: 2012-01-01</a></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser HTN_CX}">Hypertension, complicated Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 52101004}">Present (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser ARTH}">Arthropathies Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser CHF}">Congestive heart failure Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser LUNG_CHRONIC}">Chronic pulmonary disease Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser DIAB_CX}">Diabetes with chronic complications Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser DIAB_UNCX}">Diabetes without chronic complications Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser OBESE}">Obesity Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser PERIVASC}">Peripheral vascular disease Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser PULMCIRC}">Pulmonary circulation disease Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser RENLFL_MOD}">Renal failure, moderate Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 2667000}">Absent (qualifier value)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser DRUG_ABUSE}">Drug abuse Elixhauser category</span></p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 261665006}">Unknown (qualifier value)</span></p></blockquote></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="78923-0"/>
<display value="Comorbid condition panel"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<performer>
<reference value="Practitioner/us-core-practitioner-owen-oncologist"/>
</performer>
<component>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference">
<valueReference>
<reference value="Condition/us-core-condition-depression-jenny-m"/>
</valueReference>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="DEPRESS"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="52101004"/>
<display value="Present (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<extension
url="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-comorbid-condition-reference">
<valueReference>
<reference
value="Condition/us-core-condition-hypertension-jenny-m"/>
</valueReference>
</extension>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="HTN_CX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="52101004"/>
<display value="Present (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="ARTH"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="CHF"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="LUNG_CHRONIC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="DIAB_CX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="DIAB_UNCX"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="OBESE"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="PERIVASC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="PULMCIRC"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="RENLFL_MOD"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="2667000"/>
<display value="Absent (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
<component>
<code>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/comorbidities-elixhauser"/>
<code value="DRUG_ABUSE"/>
</coding>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="261665006"/>
<display value="Unknown (qualifier value)"/>
</coding>
</valueCodeableConcept>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16"/>
<resource>
<Observation>
<id value="bodyweight-jenny-m-2018-03-16"/>
<meta>
<profile value="http://hl7.org/fhir/StructureDefinition/bodyweight"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}">Vital Signs</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 29463-7}">Body weight</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-06</p><p><b>value</b>: 155 lb</p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="vital-signs"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="29463-7"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-06"/>
<valueQuantity>
<value value="155"/>
<unit value="lb"/>
<system value="http://unitsofmeasure.org"/>
<code value="[lb_av]"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-neutrophils-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 26499-4}">Neutrophils [#/volume] in Blood</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: May 20, 2018 12:00:00 AM</p><p><b>value</b>: 3000 10*3/uL</p><h3>ReferenceRanges</h3><table class="grid"><tr><td>-</td><td><b>Low</b></td><td><b>High</b></td><td><b>AppliesTo</b></td></tr><tr><td>*</td><td>2500 10*3/uL</td><td>5000 10*3/uL</td><td><span title="Codes: {http://terminology.hl7.org/CodeSystem/referencerange-meaning normal}">Normal Range</span></td></tr></table></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="26499-4"/>
<display value="Neutrophils [#/volume] in Blood"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-05-20T00:00:00Z"/>
<valueQuantity>
<value value="3000"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</valueQuantity>
<referenceRange>
<low>
<value value="2500"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</low>
<high>
<value value="5000"/>
<unit value="10*3/uL"/>
<system value="http://unitsofmeasure.org"/>
<code value="10*3/uL"/>
</high>
<appliesTo>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/referencerange-meaning"/>
<code value="normal"/>
<display value="Normal Range"/>
</coding>
</appliesTo>
</referenceRange>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Organization/us-core-organization-physician-services-inc"/>
<resource>
<Organization>
<id value="us-core-organization-physician-services-inc"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span></p><p><b>name</b>: Physician Services, Inc.</p><p><b>telecom</b>: ph: 999-999-9999(WORK)</p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US </p></div>
</text>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="Physician Services, Inc."/>
<telecom>
<system value="phone"/>
<value value="999-999-9999"/>
<use value="work"/>
</telecom>
<address>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m"/>
<resource>
<Observation>
<id value="us-core-smokingstatus-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-smokingstatus"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>code</b>: <span title="Codes: {http://loinc.org 72166-2}">Tobacco smoking status</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>issued</b>: Mar 16, 2018 12:00:00 AM</p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 449868002}">Smokes tobacco daily (finding)</span></p></div>
</text>
<status value="final"/>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="72166-2"/>
<display value="Tobacco smoking status"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<issued value="2018-03-16T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="449868002"/>
<display value="Smokes tobacco daily (finding)"/>
</coding>
</valueCodeableConcept>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-procedure-biopsy-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-biopsy-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 723990008}">Biopsy of breast using ultrasonographic guidance (procedure)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-03-06</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-mary-obgyn.html">Generated Summary: id: 234512367; Mary Obgyn ; gender: female</a></p><h3>Performers</h3><table class="grid"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href="Practitioner-us-core-practitioner-mary-obgyn.html">Generated Summary: id: 234512367; Mary Obgyn ; gender: female</a></td></tr></table><p><b>reasonReference</b>: <a href="Condition-primary-cancer-condition-jenny-m.html">Generated Summary: <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical remission}">Remission</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}">Confirmed</span>; <span title="Codes: {http://terminology.hl7.org/CodeSystem/condition-category problem-list-item}">Problem List Item</span>; <span title="Codes: {http://snomed.info/sct 353431000119107}">Primary malignant neoplasm of female left breast (disorder)</span>; onset: 2018-03-16</a></p><p><b>bodySite</b>: <span title="Codes: {http://snomed.info/sct 80248007}">Left breast structure (body structure)</span></p></div>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="723990008"/>
<display
value="Biopsy of breast using ultrasonographic guidance (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-03-06"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</actor>
</performer>
<reasonReference>
<reference value="Condition/primary-cancer-condition-jenny-m"/>
</reasonReference>
<bodySite>
<coding>
<system value="http://snomed.info/sct"/>
<code value="80248007"/>
<display value="Left breast structure (body structure)"/>
</coding>
</bodySite>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-procedure-mammogram-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-mammogram-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 71651007}">Mammography (procedure)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-02-01</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-mary-obgyn.html">Generated Summary: id: 234512367; Mary Obgyn ; gender: female</a></p><h3>Performers</h3><table class="grid"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href="Practitioner-us-core-practitioner-jane-radiotech.html">Generated Summary: id: 234512367; Jane Radiologist ; gender: female</a></td></tr></table></div>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="71651007"/>
<display value="Mammography (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-02-01"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference value="Practitioner/us-core-practitioner-jane-radiotech"/>
</actor>
</performer>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m"/>
<resource>
<FamilyMemberHistory>
<id value="family-member-history-aunt-jenny-m"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>patient</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>relationship</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode MAUNT}">maternal aunt</span></p><h3>Conditions</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>Onset[x]</b></td></tr><tr><td>*</td><td><span title="Codes: {http://snomed.info/sct 363443007}">Malignant tumor of ovary (disorder)</span></td><td>69 a</td></tr></table></div>
</text>
<status value="completed"/>
<patient>
<reference value="Patient/cancer-patient-jenny-m"/>
</patient>
<relationship>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="MAUNT"/>
<display value="maternal aunt"/>
</coding>
</relationship>
<condition>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="363443007"/>
<display value="Malignant tumor of ovary (disorder)"/>
</coding>
</code>
<onsetAge>
<value value="69"/>
<system value="http://unitsofmeasure.org"/>
<code value="a"/>
</onsetAge>
</condition>
</FamilyMemberHistory>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m"/>
<resource>
<Procedure>
<id value="us-core-procedure-mammogram-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 71651007}">Mammography (procedure)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>performed</b>: 2018-02-01</p><p><b>asserter</b>: <a href="Practitioner-us-core-practitioner-mary-obgyn.html">Generated Summary: id: 234512367; Mary Obgyn ; gender: female</a></p><h3>Performers</h3><table class="grid"><tr><td>-</td><td><b>Actor</b></td></tr><tr><td>*</td><td><a href="Practitioner-us-core-practitioner-jane-radiotech.html">Generated Summary: id: 234512367; Jane Radiologist ; gender: female</a></td></tr></table></div>
</text>
<status value="completed"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="71651007"/>
<display value="Mammography (procedure)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<performedDateTime value="2018-02-01"/>
<asserter>
<reference value="Practitioner/us-core-practitioner-mary-obgyn"/>
</asserter>
<performer>
<actor>
<reference value="Practitioner/us-core-practitioner-jane-radiotech"/>
</actor>
</performer>
</Procedure>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m"/>
<resource>
<FamilyMemberHistory>
<id value="family-member-history-uncle-jenny-m"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: completed</p><p><b>patient</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>relationship</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v3-RoleCode PUNCLE}">paternal uncle</span></p><p><b>deceased</b>: true</p><h3>Conditions</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>ContributedToDeath</b></td></tr><tr><td>*</td><td><span title="Codes: {http://snomed.info/sct 363418001}">Malignant tumor of pancreas (disorder)</span></td><td>true</td></tr></table></div>
</text>
<status value="completed"/>
<patient>
<reference value="Patient/cancer-patient-jenny-m"/>
</patient>
<relationship>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="PUNCLE"/>
<display value="paternal uncle"/>
</coding>
</relationship>
<deceasedBoolean value="true"/>
<condition>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="363418001"/>
<display value="Malignant tumor of pancreas (disorder)"/>
</coding>
</code>
<contributedToDeath value="true"/>
</condition>
</FamilyMemberHistory>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m"/>
<resource>
<DiagnosticReport>
<id value="us-core-diagnosticreport-lab-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: final</p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 LAB}">Laboratory</span>, <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0074 SP}">Surgical Pathology</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 22637-3}">Pathology report final diagnosis Narrative</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>issued</b>: Apr 5, 2018 12:00:00 AM</p><p><b>performer</b>: <a href="#Organization_us-core-organization-physician-services-inc">See above (Organization/us-core-organization-physician-services-inc)</a></p><p><b>resultsInterpreter</b>: <a href="#Practitioner_us-core-practitioner-peter-pathologist">See above (Practitioner/us-core-practitioner-peter-pathologist)</a></p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p><p><b>result</b>: </p><ul><li><a href="#Observation_us-core-observation-lab-tumor-invasion-jenny-m">See above (Observation/us-core-observation-lab-tumor-invasion-jenny-m)</a></li><li><a href="#Observation_us-core-observation-lab-tumor-margins-jenny-m">See above (Observation/us-core-observation-lab-tumor-margins-jenny-m)</a></li><li><a href="#Observation_us-core-observation-lab-sentinel-nodes-jenny-m">See above (Observation/us-core-observation-lab-sentinel-nodes-jenny-m)</a></li><li><a href="#Observation_tumor-size-jenny-m">See above (Observation/tumor-size-jenny-m)</a></li><li><a href="#Observation_us-core-observation-lab-tumor-dcis-jenny-m">See above (Observation/us-core-observation-lab-tumor-dcis-jenny-m)</a></li><li><a href="#Observation_tumor-marker-test-her2-jenny-m">See above (Observation/tumor-marker-test-her2-jenny-m)</a></li></ul></div>
</text>
<status value="final"/>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="LAB"/>
</coding>
</category>
<category>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
<code value="SP"/>
<display value="Surgical Pathology"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="22637-3"/>
<display value="Pathology report final diagnosis Narrative"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<issued value="2018-04-05T00:00:00Z"/>
<performer>
<reference
value="Organization/us-core-organization-physician-services-inc"/>
</performer>
<resultsInterpreter>
<reference value="Practitioner/us-core-practitioner-peter-pathologist"/>
</resultsInterpreter>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-invasion-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-margins-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-sentinel-nodes-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-size-jenny-m"/>
</result>
<result>
<reference
value="Observation/us-core-observation-lab-tumor-dcis-jenny-m"/>
</result>
<result>
<reference value="Observation/tumor-marker-test-her2-jenny-m"/>
</result>
</DiagnosticReport>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-diagnosticreport-lab-jenny-m"/>
<resource>
<Observation>
<id value="observation-smoking-history-jenny-m"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category social-history}">Social History</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 401201003}">Cigarette pack-years (observable entity)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: 2018-03-16</p><p><b>value</b>: 20 Pack-Years</p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="social-history"/>
<display value="Social History"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="401201003"/>
<display value="Cigarette pack-years (observable entity)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-03-16"/>
<valueQuantity>
<value value="20"/>
<unit value="Pack-Years"/>
<system value="http://unitsofmeasure.org"/>
<code value="{PackYears}"/>
</valueQuantity>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-invasion-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://snomed.info/sct 370052007}">Status of invasion by tumor (observable entity)</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>value</b>: <span title="Codes: {http://snomed.info/sct 260385009}">Negative (qualifier value)</span></p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="370052007"/>
<display value="Status of invasion by tumor (observable entity)"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="260385009"/>
<display value="Negative (qualifier value)"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-margins-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 44669-0}">Margin involvement in Breast tumor</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>value</b>: <span title="Codes: {http://loinc.org LA27151-2}">Uninvolved by invasive carcinoma</span></p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="44669-0"/>
<display value="Margin involvement in Breast tumor"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="LA27151-2"/>
<display value="Uninvolved by invasive carcinoma"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-sentinel-nodes-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 92832-5}">Sentinel lymph nodes with metastasis [#] in Cancer specimen</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p><h3>Components</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td><span title="Codes: {http://loinc.org 92833-3}">Lymph nodes examined [#] in Cancer specimen by Light microscopy</span></td><td>3 Count</td></tr></table></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92832-5"/>
<display
value="Sentinel lymph nodes with metastasis [#] in Cancer specimen"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="92833-3"/>
<display
value="Lymph nodes examined [#] in Cancer specimen by Light microscopy"/>
</coding>
</code>
<valueQuantity>
<value value="3"/>
<unit value="Count"/>
<system value="http://unitsofmeasure.org"/>
<code value="{Count}"/>
</valueQuantity>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl value="http://example.org/fhir/Observation/tumor-size-jenny-m"/>
<resource>
<Observation>
<id value="tumor-size-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/mcode/StructureDefinition/mcode-tumor-size"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 21889-1}">Size Tumor</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>method</b>: <span title="Codes: {http://loinc.org 24419-4}">Pathology report gross observation</span></p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p><h3>Components</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td><span title="Codes: {http://loinc.org 33728-7}">Size.maximum dimension in Tumor</span></td><td>2.5 centimeters</td></tr></table></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="21889-1"/>
<display value="Size Tumor"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<method>
<coding>
<system value="http://loinc.org"/>
<code value="24419-4"/>
<display value="Pathology report gross observation"/>
</coding>
</method>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
<component>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="33728-7"/>
<display value="Size.maximum dimension in Tumor"/>
</coding>
</code>
<valueQuantity>
<value value="2.5"/>
<unit value="centimeters"/>
<system value="http://unitsofmeasure.org"/>
<code value="cm"/>
</valueQuantity>
</component>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m"/>
<resource>
<Observation>
<id value="us-core-observation-lab-tumor-dcis-jenny-m"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-observation-lab"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p></p><p><b>category</b>: <span title="Codes: {http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span></p><p><b>code</b>: <span title="Codes: {http://loinc.org 29308-4}">Diagnosis</span></p><p><b>subject</b>: <a href="#Patient_cancer-patient-jenny-m">See above (Patient/cancer-patient-jenny-m)</a></p><p><b>effective</b>: Apr 1, 2018 12:00:00 AM</p><p><b>value</b>: <span title="Codes: {http://loinc.org 85336-6}">DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy</span></p><p><b>specimen</b>: <a href="Specimen-tumor-specimen-left-breast-jenny-m.html">Generated Summary: BodyStructure: Tumor 1234 (USUAL); status: available; <span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0487 TUMOR}">Tumor</span>; receivedTime: 2018-04-01</a></p></div>
</text>
<status value="final"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/observation-category"/>
<code value="laboratory"/>
</coding>
</category>
<code>
<coding>
<system value="http://loinc.org"/>
<code value="29308-4"/>
<display value="Diagnosis"/>
</coding>
</code>
<subject>
<reference value="Patient/cancer-patient-jenny-m"/>
</subject>
<effectiveDateTime value="2018-04-01T00:00:00Z"/>
<valueCodeableConcept>
<coding>
<system value="http://loinc.org"/>
<code value="85336-6"/>
<display
value="DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy"/>
</coding>
</valueCodeableConcept>
<specimen>
<reference value="Specimen/tumor-specimen-left-breast-jenny-m"/>
</specimen>
</Observation>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Pracititioner/us-core-practitioner-owen-oncologist"/>
<resource>
<Practitioner>
<id value="us-core-practitioner-owen-oncologist"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 9988776655</p><p><b>name</b>: Owen Oncologist </p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US (WORK)</p><p><b>gender</b>: male</p><h3>Qualifications</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td></tr><tr><td>*</td><td><span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0360 MD}">Doctor of Medicine</span></td></tr></table></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9988776655"/>
</identifier>
<name>
<family value="Oncologist"/>
<given value="Owen"/>
<prefix value="Dr."/>
</name>
<address>
<use value="work"/>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
<gender value="male"/>
<qualification>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
<version value="2.7"/>
<code value="MD"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl
value="http://example.org/fhir/Pracititioner/us-core-practitioner-peter-pathologist"/>
<resource>
<Practitioner>
<id value="us-core-practitioner-peter-pathologist"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 1122334455</p><p><b>name</b>: Peter Pathologist </p><p><b>address</b>: 123 Corporate Drive Anytown MA 12345 US (WORK)</p><p><b>gender</b>: female</p><h3>Qualifications</h3><table class="grid"><tr><td>-</td><td><b>Code</b></td></tr><tr><td>*</td><td><span title="Codes: {http://terminology.hl7.org/CodeSystem/v2-0360 MD}">Doctor of Medicine</span></td></tr></table></div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1122334455"/>
</identifier>
<name>
<family value="Pathologist"/>
<given value="Peter"/>
<prefix value="Dr."/>
</name>
<address>
<use value="work"/>
<line value="123 Corporate Drive"/>
<city value="Anytown"/>
<state value="MA"/>
<postalCode value="12345"/>
<country value="US"/>
</address>
<gender value="female"/>
<qualification>
<code>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0360"/>
<version value="2.7"/>
<code value="MD"/>
</coding>
</code>
</qualification>
</Practitioner>
</resource>
</entry>
</Bundle>
IG © 2019+ HL7 International Clinical Interoperability Council. Package hl7.fhir.us.mcode#1.16.0 based on FHIR 4.0.1. Generated 2021-04-15
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