FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Diagnosticreport-example-ghp.xml

Orders and Observations Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Device, Encounter, Patient, Practitioner

Raw XML (canonical form)

Jump past Narrative

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

<DiagnosticReport xmlns="http://hl7.org/fhir">
  <id value="ghp"/> 
  <meta> 
    <lastUpdated value="2015-08-16T10:35:23Z"/> 
  </meta> 
  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : ghp</p> <p> <b> meta</b> : </p> <p> <b> contained</b> : , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
         , , , , , , , , , , , </p> <p> <b> identifier</b> : ghp-example</p> <p> <b> status</b> : final</p> <p> <b> code</b> : General Health Profile <span> (Details : {http://acme.com/labs/reports code 'GHP' = 'GHP', given as 'General Health
           Profile'})</span> </p> <p> <b> subject</b> : <a> Patient/pat2</a> </p> <p> <b> effective</b> : 16/08/2015 6:40:17 AM</p> <p> <b> issued</b> : 17/08/2015 6:40:17 AM</p> <h3> Performers</h3> <table> <tr> <td> -</td> <td> <b> Actor</b> </td> </tr> <tr> <td> *</td> <td> <a> Acme Laboratory, Inc</a> </td> </tr> </table> <p> <b> specimen</b> : </p> <ul> <li> Red Top Tube. Generated Summary: id: rtt; 20150816-00124; Serum sample <span> (Details : {SNOMED CT code '119364003' = 'Serum specimen', given as 'Serum sample'})</span> ; ????</li> <li> Lavender Top Tube. Generated Summary: id: ltt; 20150816-00124; Blood specimen with EDTA
           <span> (Details : {SNOMED CT code '445295009' = 'Blood specimen with EDTA', given as 'Blood specimen
             with EDTA'})</span> ; ????</li> <li> Urine Sample. Generated Summary: id: urine; 20150816-00124; Urine specimen <span> (Details : {SNOMED CT code '122575003' = 'Urine specimen', given as 'Urine specimen'})</span> ; ????</li> </ul> <p> <b> result</b> : </p> <ul> <li> Chemistry Panel. Generated Summary: id: p1; status: final; Comprehensive metabolic 2000
           panel - Serum or Plasma <span> (Details : {LOINC code '24323-8' = 'Comprehensive metabolic 2000 panel - Serum or Plasma',
             given as 'Comprehensive metabolic 2000 panel - Serum or Plasma'})</span> ; effective: 16/08/2015 6:40:17 AM; issued: 17/08/2015 6:40:17 AM; Acme Laboratory, Inc</li> <li> CBC. Generated Summary: id: p2; status: final; Complete blood count (hemogram) panel -
           Blood by Automated count <span> (Details : {LOINC code '58410-2' = 'Complete blood count (hemogram) panel - Blood by Automated
             count', given as 'Complete blood count (hemogram) panel - Blood by Automated count'})</span> ; effective: 16/08/2015 6:40:17 AM; issued: 17/08/2015 6:40:17 AM; Acme Laboratory, Inc</li> <li> Urinalysis. Generated Summary: id: p3; status: final; Urinalysis macro (dipstick) panel
           - Urine <span> (Details : {LOINC code '24357-6' = 'Urinalysis macro (dipstick) panel - Urine', given
             as 'Urinalysis macro (dipstick) panel - Urine'})</span> ; effective: 16/08/2015 6:40:17 AM; issued: 17/08/2015 6:40:17 AM; Acme Laboratory, Inc</li> </ul> </div> </text> <contained> 
    <Specimen> 
      <id value="rtt"/> 
      <accessionIdentifier> 
        <system value="http://acme.com/labs/accession-ids"/> 
        <value value="20150816-00124"/> 
      </accessionIdentifier> 
      <type> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="119364003"/> 
          <display value="Serum sample"/> 
        </coding> 
      </type> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <collection> 
        <collector> 
          <reference value="Practitioner/f202"/> 
        </collector> 
        <collectedDateTime value="2015-08-16T06:40:17Z"/> 
      </collection> 
      <container> 
        <type> 
          <coding> 
            <system value="http://acme.com/labs"/> 
            <code value="SST"/> 
            <display value="Serum Separator Tube"/> 
          </coding> 
        </type> 
      </container> 
    </Specimen> 
  </contained> 
  <contained> 
    <Specimen> 
      <id value="ltt"/> 
      <accessionIdentifier> 
        <system value="http://acme.com/labs/accession-ids"/> 
        <value value="20150816-00124"/> 
      </accessionIdentifier> 
      <type> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="445295009"/> 
          <display value="Blood specimen with EDTA"/> 
        </coding> 
      </type> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <collection> 
        <collector> 
          <reference value="Practitioner/f202"/> 
        </collector> 
        <collectedDateTime value="2015-08-16T06:40:17Z"/> 
      </collection> 
      <container> 
        <type> 
          <coding> 
            <system value="http://acme.com/labs"/> 
            <code value="LTT"/> 
            <display value="Lavender Top Tube"/> 
          </coding> 
        </type> 
      </container> 
    </Specimen> 
  </contained> 
  <contained> 
    <Specimen> 
      <id value="urine"/> 
      <accessionIdentifier> 
        <system value="http://acme.com/labs/accession-ids"/> 
        <value value="20150816-00124"/> 
      </accessionIdentifier> 
      <type> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="122575003"/> 
          <display value="Urine specimen"/> 
        </coding> 
      </type> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <collection> 
        <collector> 
          <reference value="Practitioner/f202"/> 
        </collector> 
        <collectedDateTime value="2015-08-16T06:40:17Z"/> 
      </collection> 
      <container> 
        <type> 
          <coding> 
            <system value="http://acme.com/labs"/> 
            <code value="UCUP"/> 
            <display value="100mL sterile cup"/> 
          </coding> 
        </type> 
      </container> 
    </Specimen> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="p2"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="58410-2"/> 
          <display value="Complete blood count (hemogram) panel - Blood by Automated count"/> 
        </coding> 
      </code> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <specimen> 
        <reference value="#ltt"/> 
        <display value="Lavender Top Tube"/> 
      </specimen> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r1"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r2"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r3"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r4"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r5"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r6"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r7"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r8"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r9"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r10"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r11"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r12"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r13"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r14"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r15"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r16"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#r17"/> 
        </target> 
      </related> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r1"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="718-7"/> 
          <display value="Hemoglobin [Mass/volume] in Blood"/> 
        </coding> 
        <text value="Haemoglobin"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="176"/> 
        <unit value="g/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="g/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="135"/> 
          <unit value="g/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="g/L"/> 
        </low> 
        <high> 
          <value value="180"/> 
          <unit value="g/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="g/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r2"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="789-8"/> 
          <display value="Erythrocytes [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Red Cell Count"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="5.9"/> 
        <unit value="x10*12/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*12/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="4.2"/> 
          <unit value="x10*12/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*12/L"/> 
        </low> 
        <high> 
          <value value="6.0"/> 
          <unit value="x10*12/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*12/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r3"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="4544-3"/> 
          <display value="Hematocrit [Volume Fraction] of Blood by Automated count"/> 
        </coding> 
        <text value="Haematocrit"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="55"/> 
        <unit value="%"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="H"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="38"/> 
          <unit value="%"/> 
        </low> 
        <high> 
          <value value="52"/> 
          <unit value="%"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r4"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="787-2"/> 
          <display value="Erythrocyte mean corpuscular volume [Entitic volume] by Automated count"/> 
        </coding> 
        <text value="Mean Cell Volume"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="99"/> 
        <unit value="fL"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="fL"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="H"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="80"/> 
          <unit value="fL"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="fL"/> 
        </low> 
        <high> 
          <value value="98"/> 
          <unit value="fL"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="fL"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r5"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="785-6"/> 
          <display value="Erythrocyte mean corpuscular hemoglobin [Entitic mass] by Automated count"/> 
        </coding> 
        <text value="Mean Cell Haemoglobin"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="36"/> 
        <unit value="pg"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="pg"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="H"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="27"/> 
          <unit value="pg"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="pg"/> 
        </low> 
        <high> 
          <value value="35"/> 
          <unit value="pg"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="pg"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r6"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="777-3"/> 
          <display value="Platelets [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Platelet Count"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="444"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="150"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="450"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r7"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="6690-2"/> 
          <display value="Leukocytes [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="White Cell Count"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="4.6"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="4.0"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="11.0"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r8"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="770-8"/> 
          <display value="Neutrophils/100 leukocytes in Blood by Automated count"/> 
        </coding> 
        <text value="Neutrophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="20"/> 
        <unit value="%"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="%"/> 
      </valueQuantity> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r9"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="751-8"/> 
          <display value="Neutrophils [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Neutrophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.9"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="LL"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="2.0"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="7.5"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r10"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="736-9"/> 
          <display value="Lymphocytes/100 leukocytes in Blood by Automated count"/> 
        </coding> 
        <text value="Lymphocytes"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="20"/> 
        <unit value="%"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="%"/> 
      </valueQuantity> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r11"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="731-0"/> 
          <display value="Lymphocytes [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Lymphocytes"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.9"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="L"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="1.1"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="4.0"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r12"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="5905-5"/> 
          <display value="Monocytes/100 leukocytes in Blood by Automated count"/> 
        </coding> 
        <text value="Monocytes"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="20"/> 
        <unit value="%"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="%"/> 
      </valueQuantity> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r13"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="742-7"/> 
          <display value="Monocytes [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Monocytes"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.9"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0.2"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="1.0"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r14"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="713-8"/> 
          <display value="Eosinophils/100 leukocytes in Blood by Automated count"/> 
        </coding> 
        <text value="Eosinophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="20"/> 
        <unit value="%"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="%"/> 
      </valueQuantity> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r15"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="711-2"/> 
          <display value="Eosinophils [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Eosinophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.92"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="HH"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="0.04"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </low> 
        <high> 
          <value value="0.40"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r16"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="706-2"/> 
          <display value="Basophils/100 leukocytes in Blood by Automated count"/> 
        </coding> 
        <text value="Basophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="20"/> 
        <unit value="%"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="%"/> 
      </valueQuantity> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="r17"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="704-7"/> 
          <display value="Basophils [#/volume] in Blood by Automated count"/> 
        </coding> 
        <text value="Basophils"/> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.92"/> 
        <unit value="x10*9/L"/> 
        <system value="http://unitsofmeasure.org"/> 
        <code value="10*9/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <high> 
          <value value="0.21"/> 
          <unit value="x10*9/L"/> 
          <system value="http://unitsofmeasure.org"/> 
          <code value="10*9/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="p1"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="24323-8"/> 
          <display value="Comprehensive metabolic 2000 panel - Serum or Plasma"/> 
        </coding> 
      </code> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <specimen> 
        <reference value="#rtt"/> 
        <display value="Red Top Tube"/> 
      </specimen> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o1"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o2"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o3"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o4"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o5"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o6"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o7"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o8"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o9"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o10"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o11"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o12"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o13"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o14"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o15"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o16"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o17"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o18"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o19"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o20"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o21"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#o22"/> 
        </target> 
      </related> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o1"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2951-2"/> 
          <display value="Sodium [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="104934005"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="140"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="137"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="147"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o2"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2823-3"/> 
          <display value="Potassium [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="59573005"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="4.2"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="3.5"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="5.0"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o3"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2075-0"/> 
          <display value="Chloride [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="46511006"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="105"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="96"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="109"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o4"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="1963-8"/> 
          <display value="Bicarbonate [Moles/volume] in Serum"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="88645003"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="26"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="25"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="33"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o5"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="1863-0"/> 
          <display value="Anion gap 4 in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="271057005"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="13"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="4"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="17"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o6"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14749-6"/> 
          <display value="Glucose [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="36048009"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="7.4"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="3.0"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="7.7"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o7"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14937-7"/> 
          <display value="Urea nitrogen [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="273967009"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="4.7"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="2.0"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="7.0"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o8"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14682-9"/> 
          <display value="Creatinine [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="70901006"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.09"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0.04"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="0.11"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o9"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14933-6"/> 
          <display value="Urate [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="86228006"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="0.39"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="H"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="0.14"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="0.35"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o10"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14631-6"/> 
          <display value="Bilirubin.total [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="27171005"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="7"/> 
        <unit value="umol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="2"/> 
          <unit value="umol/L"/> 
        </low> 
        <high> 
          <value value="20"/> 
          <unit value="umol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o11"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14629-0"/> 
          <display value="Bilirubin.direct [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="39748002"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="3"/> 
        <unit value="umol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0"/> 
          <unit value="umol/L"/> 
        </low> 
        <high> 
          <value value="8"/> 
          <unit value="umol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o12"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="6768-6"/> 
          <display value="Alkaline phosphatase [Enzymatic activity/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="88810008"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="108"/> 
        <unit value="U/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="30"/> 
          <unit value="U/L"/> 
        </low> 
        <high> 
          <value value="115"/> 
          <unit value="U/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o13"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2324-2"/> 
          <display value="Gamma glutamyl transferase [Enzymatic activity/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="69480007"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="35"/> 
        <unit value="U/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0"/> 
          <unit value="U/L"/> 
        </low> 
        <high> 
          <value value="45"/> 
          <unit value="U/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o14"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="1742-6"/> 
          <display value="Alanine aminotransferase [Enzymatic activity/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="34608000"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="54"/> 
        <unit value="U/L"/> 
      </valueQuantity> 
      <interpretation> 
        <coding> 
          <system value="http://hl7.org/fhir/v2/0078"/> 
          <code value="H"/> 
        </coding> 
      </interpretation> 
      <referenceRange> 
        <low> 
          <value value="0"/> 
          <unit value="U/L"/> 
        </low> 
        <high> 
          <value value="45"/> 
          <unit value="U/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o15"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="1920-8"/> 
          <display value="Aspartate aminotransferase [Enzymatic activity/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="45896001"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="30"/> 
        <unit value="U/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0"/> 
          <unit value="U/L"/> 
        </low> 
        <high> 
          <value value="41"/> 
          <unit value="U/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o16"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2532-0"/> 
          <display value="Lactate dehydrogenase [Enzymatic activity/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="11274001"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="131"/> 
        <unit value="U/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="80"/> 
          <unit value="U/L"/> 
        </low> 
        <high> 
          <value value="250"/> 
          <unit value="U/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o17"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2000-8"/> 
          <display value="Calcium [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="71878006"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="2.38"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="2.25"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="2.65"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o18"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="13959-2"/> 
          <display value="Calcium.ionized [Moles/volume] in Serum or Plasma by calculation"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="166708003"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="2.39"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="2.25"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="2.65"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o19"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="14879-1"/> 
          <display value="Phosphate [Moles/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="104866001"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="1.5"/> 
        <unit value="mmol/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="0.8"/> 
          <unit value="mmol/L"/> 
        </low> 
        <high> 
          <value value="1.5"/> 
          <unit value="mmol/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o20"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2885-2"/> 
          <display value="Protein [Mass/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="74040009"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="67"/> 
        <unit value="g/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="60"/> 
          <unit value="g/L"/> 
        </low> 
        <high> 
          <value value="82"/> 
          <unit value="g/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o21"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="1751-7"/> 
          <display value="Albumin [Mass/volume] in Serum or Plasma"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="104485008"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="42"/> 
        <unit value="g/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="35"/> 
          <unit value="g/L"/> 
        </low> 
        <high> 
          <value value="50"/> 
          <unit value="g/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="o22"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="10834-0"/> 
          <display value="Globulin [Mass/volume] in Serum by calculation"/> 
        </coding> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="104979009"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="25"/> 
        <unit value="g/L"/> 
      </valueQuantity> 
      <referenceRange> 
        <low> 
          <value value="20"/> 
          <unit value="g/L"/> 
        </low> 
        <high> 
          <value value="40"/> 
          <unit value="g/L"/> 
        </high> 
      </referenceRange> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="p3"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="24357-6"/> 
          <display value="Urinalysis macro (dipstick) panel - Urine"/> 
        </coding> 
      </code> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u1"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u2"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u3"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u4"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u5"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u6"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u7"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u8"/> 
        </target> 
      </related> 
      <related> 
        <type value="has-member"/> 
        <target> 
          <reference value="#u9"/> 
        </target> 
      </related> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u1"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2756-5"/> 
          <display value="pH of Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="5.0"/> 
        <unit value="pH"/> 
      </valueQuantity> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u2"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2887-8"/> 
          <display value="Protein [Presence] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="260385009"/> 
          <display value="Negative"/> 
        </coding> 
      </valueCodeableConcept> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u3"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2965-2"/> 
          <display value="Specific gravity of Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="1.009"/> 
      </valueQuantity> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u4"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="33051-4"/> 
          <display value="Erythrocytes [Presence] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="260385009"/> 
          <display value="Negative"/> 
        </coding> 
      </valueCodeableConcept> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u5"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="2349-9"/> 
          <display value="Glucose [Presence] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="260385009"/> 
          <display value="Negative"/> 
        </coding> 
      </valueCodeableConcept> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u6"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="33052-2"/> 
          <display value="Leukocytes [Presence] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueCodeableConcept> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="260385009"/> 
          <display value="Negative"/> 
        </coding> 
      </valueCodeableConcept> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u7"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="30405-5"/> 
          <display value="Leukocytes [#/volume] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="1"/> 
        <unit value="/uL"/> 
      </valueQuantity> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u8"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="30391-7"/> 
          <display value="Erythocytes [#/volume] in Urine"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="1"/> 
        <comparator value="&lt;"/> 
        <unit value="/uL"/> 
      </valueQuantity> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <contained> 
    <Observation> 
      <id value="u9"/> 
      <status value="final"/> 
      <code> 
        <coding> 
          <system value="http://loinc.org"/> 
          <code value="13654-9"/> 
          <display value="Epithelial cells.squamous [#/volume] in Urine sediment"/> 
        </coding> 
      </code> 
      <subject> 
        <reference value="Patient/pat2"/> 
      </subject> 
      <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
      <issued value="2015-08-17T06:40:17Z"/> 
      <performer> 
        <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
        <display value="Acme Laboratory, Inc"/> 
      </performer> 
      <valueQuantity> 
        <value value="1"/> 
        <comparator value="&lt;"/> 
        <unit value="/mL"/> 
      </valueQuantity> 
      <specimen> 
        <reference value="#urine"/> 
        <display value="Urine Sample"/> 
      </specimen> 
    </Observation> 
  </contained> 
  <identifier> 
    <system value="http://acme.com/lab/reports"/> 
    <value value="ghp-example"/> 
  </identifier> 
  <status value="final"/> 
  <code> 
    <coding> 
      <system value="http://acme.com/labs/reports"/> 
      <code value="GHP"/> 
      <display value="General Health Profile"/> 
    </coding> 
  </code> 
  <subject> 
    <reference value="Patient/pat2"/> 
  </subject> 
  <effectiveDateTime value="2015-08-16T06:40:17Z"/> 
  <issued value="2015-08-17T06:40:17Z"/> 
  <performer> 
    <actor> 
      <reference value="Organization/1832473e-2fe0-452d-abe9-3cdb9879522f"/> 
      <display value="Acme Laboratory, Inc"/> 
    </actor> 
  </performer> 
  <specimen> 
    <reference value="#rtt"/> 
    <display value="Red Top Tube"/> 
  </specimen> 
  <specimen> 
    <reference value="#ltt"/> 
    <display value="Lavender Top Tube"/> 
  </specimen> 
  <specimen> 
    <reference value="#urine"/> 
    <display value="Urine Sample"/> 
  </specimen> 
  <result> 
    <reference value="#p1"/> 
    <display value="Chemistry Panel"/> 
  </result> 
  <result> 
    <reference value="#p2"/> 
    <display value="CBC"/> 
  </result> 
  <result> 
    <reference value="#p3"/> 
    <display value="Urinalysis"/> 
  </result> 
</DiagnosticReport>

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