Bundle mcode-patient-bundle-jenny-m of type collection

Entry 1 - Full URL = http://example.org/fhir/Patient/cancer-patient-jenny-m

Resource Patient:

Jenny M Female 1965-01-01 ( Medical Record Number: MRN1234 (USUAL))

Entry 2 - Full URL = http://example.org/fhir/Condition/primary-cancer-condition-jenny-m

Resource Condition:

Generated Narrative

Resource "primary-cancer-condition-jenny-m"

Profile: Primary Cancer Condition Profile

Histology-Morphology-Behavior Extension: Adenocarcinoma, no subtype, intermediate grade (morphologic abnormality) (SNOMED CT#413448000)

clinicalStatus: Remission (Condition Clinical Status Codes#remission)

verificationStatus: Confirmed (ConditionVerificationStatus#confirmed)

category: Problem List Item (Condition Category Codes#problem-list-item)

code: Primary malignant neoplasm of female left breast (disorder) (SNOMED CT#353431000119107)

subject: Patient/cancer-patient-jenny-m " M"

onset: 2018-03-16

asserter: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

Stages

-	Summary	Assessment
*	3C (cancerstaging.org#3C)	Observation/tnm-clinical-stage-group-jenny-m

Entry 3 - Full URL = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-cyclophosphamide-jenny-m

Resource MedicationRequest:

Generated Narrative

Resource "cancer-related-medication-request-cyclophosphamide-jenny-m"

Profile: Cancer-Related Medication Request Profile

Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)

status: ACTIVE

intent: ORDER

category: Outpatient (MedicationRequest Category Codes#outpatient)

subject: Patient/cancer-patient-jenny-m " M"

authoredOn: 2018-04-12

requester: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

Entry 4 - Full URL = http://example.org/fhir/Observation/cancer-disease-status-jenny-m

Resource Observation:

Generated Narrative

Resource "cancer-disease-status-jenny-m"

Profile: Cancer Disease Status Profile

Cancer Disease Status Evidence Type Extension: Imaging (procedure) (SNOMED CT#363679005)

status: FINAL

code: Cancer Disease Progression (LOINC#97509-4)

subject: Patient/cancer-patient-jenny-m " M"

focus: Condition/primary-cancer-condition-jenny-m

effective: 2018-11-01

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

value: Patient's condition improved (finding) (SNOMED CT#268910001)

Entry 5 - Full URL = http://example.org/fhir/Observation/genomic-variant-jenny-m

Resource Observation:

Generated Narrative

Resource "genomic-variant-jenny-m"

Profile: Genomic Variant Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Genetic variant assessment (LOINC#69548-6)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-15

value: Present (LOINC#LA9633-4)

method: Sequencing (LOINC#LA26398-0)

component

code: Gene studied [ID] (LOINC#48018-6)

value: PALB2 (HUGO Gene Nomenclature#HGNC:26144)

component

code: Discrete genetic variant (LOINC#81252-9)

value: NM_024675.3(PALB2):c.3549C>A (p.Tyr1183Ter) (clinvar#128144)

component

code: Genomic DNA change (gHGVS) (LOINC#81290-9)

value: NC_000016.10:g.23603471G>T (Human Genome Variation Society nomenclature#NC_000016.10:g.23603471G>T)

component

code: Genomic source class [Type] (LOINC#48002-0)

value: Somatic (LOINC#LA6684-0)

Entry 6 - Full URL = http://example.org/fhir/DiagnosticReport/genomics-report-jenny-m

Resource DiagnosticReport:

Master HL7 genetic variant reporting panel (Laboratory, Genetics)

Subject	Jenny M ?? 1965-01-01 ( Medical Record Number: MRN1234 (USUAL))
When For	2018-03-15
Reported	2020-03-15T00:00:01Z

Report Details

Code	Value	When For	Reported
Genetic variant assessment	Present	2018-03-15
DNA region of interest panel		2018-03-15	2018-03-15T00:00:01Z

Entry 7 - Full URL = http://example.org/fhir/Procedure/cancer-related-surgical-procedure-jenny-m

Resource Procedure:

Generated Narrative

Resource "cancer-related-surgical-procedure-jenny-m"

Profile: Cancer-Related Surgical Procedure Profile

Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)

status: COMPLETED

category: Surgical procedure (procedure) (SNOMED CT#387713003)

code: Partial mastectomy (procedure) (SNOMED CT#64368001)

subject: Patient/cancer-patient-jenny-m " M"

bodySite: Left breast structure (body structure) (SNOMED CT#80248007)

Entry 8 - Full URL = http://example.org/fhir/Procedure/radiotherapy-treatment-summary-chest-wall-jenny-m

Resource Procedure:

Generated Narrative

Resource "radiotherapy-treatment-summary-chest-wall-jenny-m"

Profile: Radiotherapy Course Summary Profile

Radiotherapy Number of Sessions Extension: 31

Procedure Intent Extension: Curative - procedure intent (SNOMED CT#373808002)

Radiotherapy Modality And Technique Extension

value: External beam radiation therapy using photons (procedure) (SNOMED CT#1156506007)

value: Volumetric Modulated Arc Therapy (procedure) (SNOMED CT#1156530009)

Radiotherapy Modality And Technique Extension

value: Teleradiotherapy using electrons (SNOMED CT#45643008)

value: Three dimensional external beam radiation therapy (procedure) (Requested SNOMED Codes Code System#1162782007)

Radiotherapy Dose Delivered To Volume Extension

value: BodyStructure/jenny-m-chest-wall-treatment-volume

value: 6000 cGy (Details: UCUM code cGy = 'cGy')

value: 30

Radiotherapy Dose Delivered To Volume Extension

value: BodyStructure/jenny-m-chest-wall-lymph-nodes-treatment-volume

value: 5000 cGy (Details: UCUM code cGy = 'cGy')

value: 25

status: COMPLETED

category: Radiation oncology AND/OR radiotherapy (procedure) (SNOMED CT#108290001)

code: Radiotherapy Course of Treatment (regime/therapy) (Requested SNOMED Codes Code System#USCRS-33529)

subject: Patient/cancer-patient-jenny-m " M"

bodySite: Chest Wall Structure (body structure) (SNOMED CT#78904004)

Entry 9 - Full URL = http://example.org/fhir/Observation/tnm-clinical-stage-group-jenny-m

Resource Observation:

Generated Narrative

Resource "tnm-clinical-stage-group-jenny-m"

Profile: Cancer Stage Group Profile

status: FINAL

code: Stage group.clinical Cancer (LOINC#21908-9)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

value: IIB (cancerstaging.org#2B)

method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

hasMember:

• Observation/tnm-pathologic-primary-tumor-category-jenny-m
• Observation/tnm-pathologic-regional-nodes-category-jenny-m
• Observation/tnm-pathologic-distant-metastases-category-jenny-m

Entry 10 - Full URL = http://example.org/fhir/Observation/tnm-clinical-primary-tumor-category-jenny-m

Resource Observation:

Generated Narrative

Resource "tnm-clinical-primary-tumor-category-jenny-m"

Profile: TNM Primary Tumor Category Profile

status: FINAL

code: Primary tumor.clinical [Class] Cancer (LOINC#21905-5)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

value: cT3 (cancerstaging.org#cT3)

method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 11 - Full URL = http://example.org/fhir/Observation/tnm-clinical-regional-nodes-category-jenny-m

Resource Observation:

Generated Narrative

Resource "tnm-clinical-regional-nodes-category-jenny-m"

Profile: TNM Regional Nodes Category Profile

status: FINAL

code: Regional lymph nodes.clinical [Class] Cancer (LOINC#21906-3)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

value: cN0 (cancerstaging.org#cN0)

method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 12 - Full URL = http://example.org/fhir/Observation/tnm-clinical-distant-metastases-category-jenny-m

Resource Observation:

Generated Narrative

Resource "tnm-clinical-distant-metastases-category-jenny-m"

Profile: TNM Distant Metastases Category Profile

status: FINAL

code: Distant metastases.clinical [Class] Cancer (LOINC#21907-1)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

value: cM0 (cancerstaging.org#cM0)

method: American Joint Commission on Cancer, Cancer Staging Manual, 8th edition neoplasm staging system (tumor staging) (SNOMED CT#897275008)

Entry 13 - Full URL = http://example.org/fhir/Specimen/genomic-specimen-left-breast-jenny-m

Resource Specimen:

Generated Narrative

Resource "genomic-specimen-left-breast-jenny-m"

Profile: Genomic Specimen Profile

status: AVAILABLE

type: Tissue (specimenType#TISS)

subject: Patient/cancer-patient-jenny-m " M"

Collections

-	Collector	BodySite
*	Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"	Left breast structure (body structure) (SNOMED CT#80248007)

Processings

-	Time[x]
*	2018-03-06

Entry 14 - Full URL = http://example.org/fhir/Observation/genomic-region-studied-jenny-m

Resource Observation:

Generated Narrative

Resource "genomic-region-studied-jenny-m"

Profile: Genomic Region Studied Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: DNA region of interest panel (LOINC#53041-0)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-15

issued: Mar 15, 2018 12:00:01 AM

Components

-	Code	Value[x]
*	Gene studied [ID] (LOINC#48018-6)	BRCA1 (HUGO Gene Nomenclature#1100; HUGO Gene Nomenclature#1101 "BRCA2"; HUGO Gene Nomenclature#1748 "CDH1"; HUGO Gene Nomenclature#26144 "PALB2"; HUGO Gene Nomenclature#9588 "PTEN"; HUGO Gene Nomenclature#11389 "STK11"; HUGO Gene Nomenclature#11998 "TP53")

Entry 15 - Full URL = http://example.org/fhir/Observation/ecog-performance-status-jenny-m

Resource Observation:

Generated Narrative

Resource "ecog-performance-status-jenny-m"

Profile: ECOG Performance Status Profile

status: FINAL

code: ECOG Performance Status score (LOINC#89247-1)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-12

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

value: 0

interpretation: Fully active, able to carry on all pre-disease performance without restriction (LOINC#LA9622-7)

method: Physical examination procedure (procedure) (SNOMED CT#5880005)

Entry 16 - Full URL = http://example.org/fhir/Observation/tumor-marker-test-er-jenny-m

Resource Observation:

Generated Narrative

Resource "tumor-marker-test-er-jenny-m"

Profile: Tumor Marker Test Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain (LOINC#85337-4)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-10

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

value: Positive (LOINC#LA6576-8)

Entry 17 - Full URL = http://example.org/fhir/Observation/tumor-marker-test-pr-jenny-m

Resource Observation:

Generated Narrative

Resource "tumor-marker-test-pr-jenny-m"

Profile: Tumor Marker Test Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain (LOINC#85339-0)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-10

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

value: Negative (LOINC#LA6577-6)

Entry 18 - Full URL = http://example.org/fhir/Observation/tumor-marker-test-her2-jenny-m

Resource Observation:

Generated Narrative

Resource "tumor-marker-test-her2-jenny-m"

Profile: Tumor Marker Test Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: HER2 [Interpretation] in Tissue (LOINC#48676-1)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-10

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

value: Negative (LOINC#LA6577-6)

Entry 19 - Full URL = http://example.org/fhir/Observation/tumor-marker-test-oncotype-dx-jenny-m

Resource Observation:

Generated Narrative

Resource "tumor-marker-test-oncotype-dx-jenny-m"

Profile: Tumor Marker Test Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Oncotype DX Breast Recurrence Score Assay (gtr#509910)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-12

performer: Organization/us-core-organization-bedrock-medicine "Bedrock Medicine"

value: 47 Recurrence score (Details: UCUM code {ScoreOf} = '{ScoreOf}')

interpretation: High (ObservationInterpretation#H)

Entry 20 - Full URL = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-doxorubicin-jenny-m

Resource MedicationRequest:

Generated Narrative

Resource "cancer-related-medication-request-doxorubicin-jenny-m"

Profile: Cancer-Related Medication Request Profile

Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)

status: ACTIVE

intent: ORDER

category: Outpatient (MedicationRequest Category Codes#outpatient)

subject: Patient/cancer-patient-jenny-m " M"

authoredOn: 2018-04-12

requester: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

Entry 21 - Full URL = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-paclitaxel-jenny-m

Resource MedicationRequest:

Generated Narrative

Resource "cancer-related-medication-request-paclitaxel-jenny-m"

Profile: Cancer-Related Medication Request Profile

Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)

status: ACTIVE

intent: ORDER

category: Outpatient (MedicationRequest Category Codes#outpatient)

subject: Patient/cancer-patient-jenny-m " M"

authoredOn: 2018-04-12

requester: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

Entry 22 - Full URL = http://example.org/fhir/MedicationRequest/cancer-related-medication-request-anastrozole-jenny-m

Resource MedicationRequest:

Generated Narrative

Resource "cancer-related-medication-request-anastrozole-jenny-m"

Profile: Cancer-Related Medication Request Profile

Procedure Intent Extension: Curative - procedure intent (qualifier value) (SNOMED CT#373808002)

status: ACTIVE

intent: ORDER

category: Community (MedicationRequest Category Codes#community)

subject: Patient/cancer-patient-jenny-m " M"

authoredOn: 2018-09-30

requester: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

Entry 23 - Full URL = http://example.org/fhir/Observation/cancer-related-mcode-comorbidities-elixhauser-jenny-m

Resource Observation:

Generated Narrative

Resource "cancer-related-mcode-comorbidities-elixhauser-jenny-m"

Profile: Comorbidities Elixhauser Profile

status: FINAL

code: Elixhauser Comorbidity Panel (Requested LOINC Codes Code System#comorbidities-elixhauser)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

performer: Practitioner/us-core-practitioner-owen-oncologist " ONCOLOGIST"

component

Comorbid Condition Reference Extension: Condition/us-core-condition-depression-jenny-m

code: Depression (Elixhauser comorbidity category) (Requested LOINC Codes Code System#DEPRESS)

value: Present (qualifier value) (SNOMED CT#52101004)

component

Comorbid Condition Reference Extension: Condition/us-core-condition-hypertension-jenny-m

code: Hypertension, complicated (Elixhauser comorbidity category) (Requested LOINC Codes Code System#HTN_CX)

value: Present (qualifier value) (SNOMED CT#52101004)

component

code: Arthropathies (Elixhauser comorbidity category) (Requested LOINC Codes Code System#ARTH)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Congestive heart failure (Elixhauser comorbidity category) (Requested LOINC Codes Code System#CHF)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Chronic pulmonary disease (Elixhauser comorbidity category) (Requested LOINC Codes Code System#LUNG_CHRONIC)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Diabetes without chronic complications (Elixhauser comorbidity category) (Requested LOINC Codes Code System#DIAB_UNCX)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Diabetes with chronic complications (Elixhauser comorbidity category) (Requested LOINC Codes Code System#DIAB_CX)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Obesity (Elixhauser comorbidity category) (Requested LOINC Codes Code System#OBESE)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Peripheral vascular disease (Elixhauser comorbidity category) (Requested LOINC Codes Code System#PERIVASC)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Pulmonary circulation disease (Elixhauser comorbidity category) (Requested LOINC Codes Code System#PULMCIRC)

value: Absent (qualifier value) (SNOMED CT#2667000)

component

code: Renal failure, moderate (Elixhauser comorbidity category) (Requested LOINC Codes Code System#RENLFL_MOD)

value: Absent (qualifier value) (SNOMED CT#2667000)

Entry 24 - Full URL = http://example.org/fhir/Observation/bodyweight-jenny-m-2018-03-16

Resource Observation:

Generated Narrative

Resource "bodyweight-jenny-m-2018-03-16"

Profile: Observation Body Weight Profile

status: FINAL

category: Vital Signs (Observation Category Codes#vital-signs)

code: Body weight (LOINC#29463-7)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-06

value: 155 lb (Details: UCUM code [lb_av] = '[lb_av]')

Entry 25 - Full URL = http://example.org/fhir/Observation/us-core-observation-lab-neutrophils-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-observation-lab-neutrophils-jenny-m"

Profile: US Core Laboratory Result Observation Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Neutrophils [#/volume] in Blood (LOINC#26499-4)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-05-20T00:00:00Z

value: 3000 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL')

ReferenceRanges

-	Low	High	AppliesTo
*	2500 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL')	5000 10*3/uL (Details: UCUM code 10*3/uL = '10*3/uL')	Normal Range (Observation Reference Range Meaning Codes#normal)

Entry 26 - Full URL = http://example.org/fhir/Organization/us-core-organization-physician-services-inc

Resource Organization:

Generated Narrative

Resource "us-core-organization-physician-services-inc"

Profile: US Core Organization Profile

active: true

type: Healthcare Provider (Organization type#prov)

name: Physician Services, Inc.

telecom: ph: 999-999-9999(WORK)

address: 123 Corporate Drive Anytown MA 12345 US

Entry 27 - Full URL = http://example.org/fhir/Observation/us-core-smokingstatus-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-smokingstatus-jenny-m"

Profile: US Core Smoking Status Observation Profile

status: FINAL

category: Social History (Observation Category Codes#social-history)

code: Tobacco smoking status (LOINC#72166-2)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

issued: Mar 16, 2018 12:00:00 AM

value: Smokes tobacco daily (finding) (SNOMED CT#449868002)

Entry 28 - Full URL = http://example.org/fhir/Observation/us-core-procedure-biopsy-jenny-m

Resource Procedure:

Generated Narrative

Resource "us-core-procedure-biopsy-jenny-m"

Profile: US Core Procedure Profile

status: COMPLETED

code: Biopsy of breast using ultrasonographic guidance (procedure) (SNOMED CT#723990008)

subject: Patient/cancer-patient-jenny-m " M"

Performers

-	Actor
*	Practitioner/us-core-practitioner-mary-obgyn " OBGYN"

bodySite: Left breast structure (body structure) (SNOMED CT#80248007)

Entry 29 - Full URL = http://example.org/fhir/Observation/us-core-procedure-mammogram-jenny-m

Resource Procedure:

Generated Narrative

Resource "us-core-procedure-mammogram-jenny-m"

Profile: US Core Procedure Profile

status: COMPLETED

code: Mammography (procedure) (SNOMED CT#71651007)

subject: Patient/cancer-patient-jenny-m " M"

Performers

-	Actor
*	Practitioner/us-core-practitioner-jane-radiotech " RADIOLOGIST"

Entry 30 - Full URL = http://example.org/fhir/FamilyMemberHistory/family-member-history-aunt-jenny-m

Resource FamilyMemberHistory:

Generated Narrative

Resource "family-member-history-aunt-jenny-m"

status: COMPLETED

patient: Patient/cancer-patient-jenny-m " M"

relationship: maternal aunt (RoleCode#MAUNT)

Conditions

-	Code	Onset[x]
*	Malignant tumor of ovary (disorder) (SNOMED CT#363443007)	69 a (Details: UCUM code a = 'a')

Entry 31 - Full URL = http://example.org/fhir/Procedure/us-core-procedure-mammogram-jenny-m

Resource Procedure:

Generated Narrative

Resource "us-core-procedure-mammogram-jenny-m"

Profile: US Core Procedure Profile

status: COMPLETED

code: Mammography (procedure) (SNOMED CT#71651007)

subject: Patient/cancer-patient-jenny-m " M"

Performers

-	Actor
*	Practitioner/us-core-practitioner-jane-radiotech " RADIOLOGIST"

Entry 32 - Full URL = http://example.org/fhir/FamilyMemberHistory/family-member-history-uncle-jenny-m

Resource FamilyMemberHistory:

Generated Narrative

Resource "family-member-history-uncle-jenny-m"

status: COMPLETED

patient: Patient/cancer-patient-jenny-m " M"

relationship: paternal uncle (RoleCode#PUNCLE)

deceased: true

Conditions

-	Code	ContributedToDeath
*	Malignant tumor of pancreas (disorder) (SNOMED CT#363418001)	true

Entry 33 - Full URL = http://example.org/fhir/DiagnosticReport/us-core-diagnosticreport-lab-jenny-m

Resource DiagnosticReport:

Pathology report final diagnosis Narrative (Laboratory, Surgical Pathology)

Subject	Jenny M ?? 1965-01-01 ( Medical Record Number: MRN1234 (USUAL))
When For	2018-04-01T00:00:00Z
Reported	2018-04-05T00:00:00Z

Report Details

Code	Value	When For
Status of invasion by tumor	Negative (qualifier value)	2018-04-01T00:00:00Z
Margin involvement in Breast tumor	Uninvolved by invasive carcinoma	2018-04-01T00:00:00Z
Sentinel lymph nodes with metastasis [#] in Cancer specimen		2018-04-01T00:00:00Z
Size Tumor		2018-04-01T00:00:00Z
DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy	DCIS present with extensive intraductal component (EIC)	2018-04-01T00:00:00Z
HER2 [Interpretation] in Tissue	Negative	2018-03-10
Estrogen receptor Ag [Presence] in Breast cancer specimen by Immune stain	Positive	2018-03-10
Progesterone receptor Ag [Presence] in Breast cancer specimen by Immune stain	Negative	2018-03-10
Histologic grade [Score] in Breast cancer specimen Qualitative by Nottingham	Nottingham grade 2	2018-04-01T00:00:00Z

Entry 34 - Full URL = http://example.org/fhir/Observation/observation-smoking-pack-years-jenny-m

Resource Observation:

Generated Narrative

Resource "observation-smoking-pack-years-jenny-m"

status: FINAL

category: Social History (Observation Category Codes#social-history)

code: Cigarette pack-years (observable entity) (SNOMED CT#401201003)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-03-16

value: 20 Pack-Years (Details: UCUM code {PackYears} = '{PackYears}')

Entry 35 - Full URL = http://example.org/fhir/Observation/us-core-observation-lab-tumor-invasion-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-observation-lab-tumor-invasion-jenny-m"

Profile: US Core Laboratory Result Observation Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Status of invasion by tumor (SNOMED CT#370052007)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-01T00:00:00Z

value: Negative (qualifier value) (SNOMED CT#260385009)

specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 36 - Full URL = http://example.org/fhir/Observation/us-core-observation-lab-tumor-margins-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-observation-lab-tumor-margins-jenny-m"

Profile: US Core Laboratory Result Observation Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Margin involvement in Breast tumor (LOINC#44669-0)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-01T00:00:00Z

value: Uninvolved by invasive carcinoma (LOINC#LA27151-2)

specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 37 - Full URL = http://example.org/fhir/Observation/us-core-observation-lab-sentinel-nodes-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-observation-lab-sentinel-nodes-jenny-m"

Profile: US Core Laboratory Result Observation Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Sentinel lymph nodes with metastasis [#] in Cancer specimen (LOINC#92832-5)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-01T00:00:00Z

specimen: Specimen/tumor-specimen-left-breast-jenny-m

Components

-	Code	Value[x]
*	Lymph nodes examined [#] in Cancer specimen by Light microscopy (LOINC#92833-3)	3 Count (Details: UCUM code {Count} = '{Count}')

Entry 38 - Full URL = http://example.org/fhir/Observation/tumor-size-jenny-m

Resource Observation:

Generated Narrative

Resource "tumor-size-jenny-m"

Profile: Tumor Size Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: Size Tumor (LOINC#21889-1)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-01T00:00:00Z

method: Pathology report gross observation (LOINC#24419-4)

specimen: Specimen/tumor-specimen-left-breast-jenny-m

Components

-	Code	Value[x]
*	Size.maximum dimension in Tumor (LOINC#33728-7)	2.5 centimeters (Details: UCUM code cm = 'cm')

Entry 39 - Full URL = http://example.org/fhir/Observation/us-core-observation-lab-tumor-dcis-jenny-m

Resource Observation:

Generated Narrative

Resource "us-core-observation-lab-tumor-dcis-jenny-m"

Profile: US Core Laboratory Result Observation Profile

status: FINAL

category: Laboratory (Observation Category Codes#laboratory)

code: DCIS intraductal extension in Breast cancer specimen Qualitative by Light microscopy (LOINC#85336-6)

subject: Patient/cancer-patient-jenny-m " M"

effective: 2018-04-01T00:00:00Z

value: DCIS present with extensive intraductal component (EIC) (LOINC#LA27261-9)

specimen: Specimen/tumor-specimen-left-breast-jenny-m

Entry 40 - Full URL = http://example.org/fhir/Pracititioner/us-core-practitioner-owen-oncologist

Resource Practitioner:

Generated Narrative

Resource "us-core-practitioner-owen-oncologist"

Profile: US Core Practitioner Profile

identifier: id: 9988776655

name: Owen Oncologist

address: 123 Corporate Drive Anytown MA 12345 US (WORK)

gender: MALE

Qualifications

-	Code
*	Doctor of Medicine (degreeLicenseCertificate[2.7]#MD)

Entry 41 - Full URL = http://example.org/fhir/Pracititioner/us-core-practitioner-peter-pathologist

Resource Practitioner:

Generated Narrative

Resource "us-core-practitioner-peter-pathologist"

Profile: US Core Practitioner Profile

identifier: id: 1122334455

name: Peter Pathologist

address: 123 Corporate Drive Anytown MA 12345 US (WORK)

gender: FEMALE

Qualifications

-	Code
*	Doctor of Medicine (degreeLicenseCertificate[2.7]#MD)