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					<title>2026 Consolidated CDA</title>
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dose in 72 hrs if needed. </td><td align="center">Active</td></tr><tr><td><content ID = "Med5">amoxicillin 875 mg-potassium clavulanate 125 mg tablet, [RxNorm: 824194]</content></td><td align="center">03/30/2023</td><td align="right">TAKE 1 TABLET BY ORAL ROUTE EVERY 12 HOURS</td><td align="center">Active</td></tr><tr><td><content ID = "Med7">Medrol (Pak) 4 mg tablets in a dose pack, [RxNorm: 834023]</content></td><td align="center">03/30/2023</td><td align="right">TAKE BY ORAL ROUTE AS DIRECTED PER PACKAGE INSTRUCTIONS</td><td align="center">Active</td></tr><tr><td><content ID = "Med8">Wegovy 0.25 mg/0.5 mL subcutaneous pen injector, [RxNorm: 2553506]</content></td><td align="center">04/04/2023</td><td align="right">INJECT 0.25 MG BY SUBCUTANEOUS ROUTE ONCE WEEKLY ON THE SAME DAY OF EACH WEEK</td><td align="center">Active</td></tr><tr><td><content ID = "Med9">Duexis 800 mg-26.6 mg tablet, [RxNorm: 1100070]</content></td><td align="center">12/18/2022</td><td align="right">TAKE 1 TABLET BY ORAL ROUTE 3 TIMES PER DAY prn pain</td><td align="center">Active</td></tr><tr><td><content ID = "Med10">ondansetron HCl 4 mg tablet, [RxNorm: 104895]</content></td><td align="center">05/01/2023</td><td align="right">TAKE 1 tablet PO every 8 hrs as needed for N/V. </td><td align="center">Active</td></tr></tbody></table></text><entry typeCode="DRIV"><substanceAdministration classCode="SBADM" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.16" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.16"/><id root="198B884B-13B8-45DC-B7BB-A70A7ACB4733"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20230330"/></effectiveTime><doseQuantity value="2"/><consumable><manufacturedProduct classCode="MANU"><templateId root="2.16.840.1.113883.10.20.22.4.23" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.23"/><id root="20D37685-5A89-464D-8776-F8FE02CFE9BD"/><manufacturedMaterial><code 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codeSystemName="LOINC" displayName="History of encounters"/><title>ENCOUNTERS</title><text><table border="1" width="100%"><thead><tr><th>Encounter</th><th>Performer</th><th>Location</th><th>Date</th></tr></thead><tbody><tr><td ID="Encounter1">PHYSICAL EST PT 40-64 YRS.</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>Apr 04, 2023</td></tr><tr><td ID="Encounter2">NO CHARGE</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>May 03, 2023</td></tr><tr><td ID="Encounter3">NO CHARGE</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>May 04, 2023</td></tr><tr><td ID="Encounter4">NO CHARGE</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>May 05, 2023</td></tr><tr><td ID="Encounter5">NO CHARGE</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>May 10, 2023</td></tr><tr><td ID="Encounter6">NO CHARGE</td><td>Lindsey 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codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="ENCOUNTER DIAGNOSIS"/><statusCode code="active"/><effectiveTime><low value="20230512"/></effectiveTime><entryRelationship typeCode="SUBJ" inversionInd="false"><observation classCode="OBS" moodCode="EVN" negationInd="false"><templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.4"/><id root="1C1C036A-60A1-4134-8777-B7AA91B907BA"/><code code="409586006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Complaint"><translation code="75322-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Complaint"/></code><statusCode code="completed"/><effectiveTime><low value="20230512"/></effectiveTime><value xsi:type="CD" code="0" codeSystem="2.16.840.1.113883.6.96"/></observation></entryRelationship></act></entryRelationship></encounter></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.7.1" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.2.7.1"/><code code="47519-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HISTORY OF PROCEDURES"/><title>PROCEDURES</title><text><table border="1" width="100%"><thead><tr><th>Procedure</th><th>Date</th></tr></thead><tbody><tr><td ID = "procedure1">COMP METABOLIC PANEL (QUEST), [CPT-4: 10231]</td><td align="center">04/04/2023</td></tr><tr><td ID = "procedure2">LIPID PANEL (QUEST), [CPT-4: 7600]</td><td align="center">04/04/2023</td></tr><tr><td ID = "procedure3">TSH W/REFLEX T4, FREE (QUEST), [CPT-4: 36127]</td><td align="center">04/04/2023</td></tr><tr><td ID = "procedure4">HEP B Surface Antibody, QUANTITATIVE (QUEST), [CPT-4: 8475]</td><td align="center">05/04/2023</td></tr><tr><td ID = "procedure5">TDap, [CPT-4: 90715]</td><td align="center">05/03/2023</td></tr><tr><td ID = "procedure6">TB test - IPPD, [CPT-4: SP86580]</td><td align="center">05/10/2023</td></tr><tr><td ID = "procedure7">TB test - IPPD, [CPT-4: SP86580]</td><td align="center">08/10/2022</td></tr><tr><td ID = "procedure8">TB test - IPPD, [CPT-4: SP86580]</td><td align="center">05/03/2023</td></tr><tr><td ID = "procedure9">Immunization Injection Administration, [CPT-4: 90471]</td><td align="center">05/03/2023</td></tr><tr><td ID = "procedure10">Immunization Injection Administration, [CPT-4: 90471]</td><td align="center">05/10/2023</td></tr><tr><td ID = "procedure11">Influenza virus vaccine, [CPT-4: 90686]</td><td align="center">05/10/2023</td></tr></tbody></table></text><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="0397126C-77F1-4E13-8CEA-0A3846609D89"/><code code="10231" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="COMP METABOLIC PANEL (QUEST)"/><statusCode code="completed"/><effectiveTime value="20230404"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="30F737A2-EEBB-45C4-BF8A-EE95C3E33D84"/><code code="7600" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="LIPID PANEL (QUEST)"/><statusCode code="completed"/><effectiveTime value="20230404"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="ABFD06C6-C51C-4451-AED4-87E63872E2AE"/><code code="36127" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="TSH W/REFLEX T4, FREE (QUEST)"/><statusCode code="completed"/><effectiveTime value="20230404"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="8FF90B54-6AC6-4C5C-8705-A3BAFEFE9ABF"/><code code="8475" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="HEP B Surface Antibody, QUANTITATIVE (QUEST)"/><statusCode code="completed"/><effectiveTime value="20230504"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="167711F6-D843-4816-B40B-CD744F941EA1"/><code code="90715" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="TDap"/><statusCode code="completed"/><effectiveTime value="20230503"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="1CEC64FF-8B9F-4B22-8D6D-E61B5FD8DEFE"/><code code="SP86580" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="TB test - IPPD"/><statusCode code="completed"/><effectiveTime value="20230510"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="011B55A1-CD6D-4B5C-B4B4-4B110C0A793E"/><code code="SP86580" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="TB test - IPPD"/><statusCode code="completed"/><effectiveTime value="20220810"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="8CEB7D1E-3119-4C59-94E9-B00116E57F66"/><code code="SP86580" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="TB test - IPPD"/><statusCode code="completed"/><effectiveTime value="20230503"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="FEA89F99-0F26-4A9C-AF68-761E36574049"/><code code="90471" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Immunization Injection Administration"/><statusCode code="completed"/><effectiveTime value="20230503"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="FCDF1951-3C31-4A5C-9428-678D40C775C4"/><code code="90471" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Immunization Injection Administration"/><statusCode code="completed"/><effectiveTime value="20230510"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry><entry typeCode="DRIV"><procedure classCode="PROC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.14"/><id root="321E7D51-389F-4EE3-9DE4-BA337CE6AD4E"/><code code="90686" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Influenza virus vaccine"/><statusCode code="completed"/><effectiveTime value="20230510"/><methodCode nullFlavor="UNK"/><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456" extension="924"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="+1(334)244-3281"/><representedOrganization classCode="ORG"><id root="2.16.840.1.113883.19.5.9999.1393"/><name>Auburn Montgomery Warhawk Health Services</name><telecom use="WP" value="+1(334)244-3281"/><addr use="WP"><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer></procedure></entry></section>
            </component><component><section nullFlavor="NI"><templateId root="2.16.840.1.113883.10.20.22.2.23" extension="2014-06-09"/><code code="46264-8" codeSystem="2.16.840.1.113883.6.1" /><title>MEDICAL EQUIPMENT</title><text>Patient has no history of implantable devices</text></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.2.1" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.2.2.1"/><code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations"/><title>IMMUNIZATIONS</title><text><content ID="immunSect"/><table border="1" width="100%"><thead><tr><th>Name</th><th>Date</th><th>Status</th></tr></thead><tbody><tr><td ID = "immun1">TDap</td><td align="center">05/03/2023</td><td align="center">Completed</td></tr><tr><td ID = "immun2">Influenza virus vaccine</td><td align="center">05/10/2023</td><td align="center">Completed</td></tr></tbody></table></text><entry typeCode="DRIV"><substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false"><templateId root="2.16.840.1.113883.10.20.22.4.52" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.52"/><id root="AC8E8B13-84FF-4149-A0F3-0F5F7D26EA8D"/><text>TDap</text><statusCode code="completed"/><effectiveTime value="20230503"/><routeCode code="C28161" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="National Cancer Institute (NCI) Thesaurus" displayName="Intramuscular injection"/><doseQuantity value="5.0000000e-001"/><consumable><manufacturedProduct classCode="MANU"><templateId root="2.16.840.1.113883.10.20.22.4.54" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.54"/><manufacturedMaterial><code code="115" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX" displayName="TDap"/><lotNumberText>HA9CH</lotNumberText></manufacturedMaterial><manufacturerOrganization><name>GlaxoSmithKline</name></manufacturerOrganization></manufacturedProduct></consumable><performer><assignedEntity><id root="2.16.840.1.113883.19.5.9999.456"/><addr><streetAddressLine>7461 East Dr</streetAddressLine><city>Montgomery</city><state>AL</state><country>US</country></addr><telecom use="WP" value="tel:+1(334)244-3281"/><assignedPerson><name><given>Lindsey</given><family>Barton</family><suffix>CRNP</suffix></name></assignedPerson><representedOrganization><id root="2.16.840.1.113883.19.5.9999.1394"/><name>Auburn Montgomery Student Health Services</name><telecom use="WP" value="tel:+1(334)244-3281"/><addr><streetAddressLine>7461 East Dr</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>36117</postalCode><country>US</country></addr></representedOrganization></assignedEntity></performer><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></substanceAdministration></entry><entry typeCode="DRIV"><substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false"><templateId root="2.16.840.1.113883.10.20.22.4.52" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.52"/><id root="77870291-09AF-4B84-85D7-3845332B9103"/><text>Influenza virus vaccine</text><statusCode code="completed"/><effectiveTime value="20230510"/><routeCode code="C28161" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="National Cancer Institute (NCI) Thesaurus" displayName="Intramuscular injection"/><doseQuantity value="5.0000000e-001"/><consumable><manufacturedProduct classCode="MANU"><templateId root="2.16.840.1.113883.10.20.22.4.54" 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Pressure</th><th>Temperature</th><th>Pulse</th><th>Pulse Oximetry</th><th>Respiratory Rate</th><th>Inhaled Oxygen Concentration</th><th>Head Circumference Percentage</th><th>BMI Percentage</th><th>Weight to Length Percentage</th></tr></thead><tbody><tr><td ID = "vital_1">04/04/2023</td><td ID = "vital_1_height">163 cm</td><td ID = "vital_1_weight">72 kg</td><td ID = "vital_1_bmi">27.3</td><td ID = "vital_1_bp">153/91 mm[Hg]</td><td ID = "vital_1_temp">37 Cel</td><td ID = "vital_1_pulse">72 bpm</td><td ID = "vital_1_pulseox">98 pct</td><td ID = "vital_1_resp">16 bpm</td></tr></tbody></table></text><entry typeCode="DRIV"><organizer classCode="CLUSTER" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.26" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.26"/><id root="127ACF0C-1B0A-42BB-B593-5DC5C96D3A6F"/><code code="46680005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Vital signs"><translation code="74728-7" 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xsi:type="PQ" value="163" unit="cm"/><interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.27" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.27"/><id root="64E42869-2655-4349-999A-847F9DAF4A81"/><code code="29463-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Weight"/><text><reference value="#vital_1_weight"/></text><statusCode code="completed"/><effectiveTime value="20230404"/><value xsi:type="PQ" value="72" unit="kg"/><interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.27" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.27"/><id root="BD955369-C940-417C-852F-F0A7AC6D42DC"/><code code="39156-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="BMI"/><text><reference value="#vital_1_bmi"/></text><statusCode code="completed"/><effectiveTime value="20230404"/><value xsi:type="PQ" value="27.3"/><interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/><author><templateId 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value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.27" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.27"/><id root="04F4E76A-D422-4EB4-8DC2-673916D9F239"/><code code="8462-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="BP Diastolic"/><text><reference value="#vital_1_bp"/></text><statusCode code="completed"/><effectiveTime value="20230404"/><value xsi:type="PQ" value="91" unit="mm[Hg]"/><interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" 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(HIPAA)"/></assignedAuthor></author></observation></component><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.27" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.4.27"/><id root="85B24FE6-13DB-43E5-8008-F605114E2E2E"/><code code="9279-1" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Resp Rate"/><text><reference value="#vital_1_resp"/></text><statusCode code="completed"/><effectiveTime value="20230404"/><value xsi:type="PQ" value="16" unit="/min"/><interpretationCode code="N" codeSystem="2.16.840.1.113883.5.83"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.3.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.2.3.1"/><code code ="30954-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="RESULTS"/><title>RESULTS</title><text><table border="1" width="100%"><thead><tr><th>Result Type</th><th>Result Value</th><th>Date</th></tr></thead><tbody><tr><td ID="result1">TB Read Only</td><td>Negative</td><td align="center">08/12/2022</td></tr><tr><td ID="result2">TB Read Only</td><td>Negative</td><td align="center">05/05/2023</td></tr><tr><td ID="result3">TB Read Only</td><td>Negative</td><td align="center">05/12/2023</td></tr><tr><td ID="result4">HEPATITIS B SURFACE AB IMMUNITY, QN</td><td>136</td><td align="center">05/05/2023</td></tr><tr><td ID="result5">CHOLESTEROL, TOTAL</td><td>209</td><td align="center">04/05/2023</td></tr><tr><td ID="result6">HDL CHOLESTEROL</td><td>63</td><td align="center">04/05/2023</td></tr><tr><td ID="result7">TRIGLYCERIDES</td><td>127</td><td align="center">04/05/2023</td></tr><tr><td ID="result8">LDL-CHOLESTEROL</td><td>122</td><td align="center">04/05/2023</td></tr><tr><td ID="result9">CHOL/HDLC RATIO</td><td>3.3</td><td align="center">04/05/2023</td></tr><tr><td ID="result10">NON HDL CHOLESTEROL</td><td>146</td><td align="center">04/05/2023</td></tr><tr><td ID="result11">GLUCOSE</td><td>83</td><td align="center">04/05/2023</td></tr><tr><td ID="result12">UREA NITROGEN (BUN)</td><td>15</td><td align="center">04/05/2023</td></tr><tr><td ID="result13">CREATININE</td><td>0.82</td><td align="center">04/05/2023</td></tr><tr><td ID="result14">EGFR</td><td>92</td><td align="center">04/05/2023</td></tr><tr><td ID="result15">BUN/CREATININE RATIO</td><td>NOT APPLICABLE</td><td align="center">04/05/2023</td></tr><tr><td ID="result16">SODIUM</td><td>141</td><td align="center">04/05/2023</td></tr><tr><td ID="result17">POTASSIUM</td><td>3.9</td><td align="center">04/05/2023</td></tr><tr><td ID="result18">CHLORIDE</td><td>105</td><td align="center">04/05/2023</td></tr><tr><td ID="result19">CARBON DIOXIDE</td><td>27</td><td align="center">04/05/2023</td></tr><tr><td ID="result20">CALCIUM</td><td>9.4</td><td align="center">04/05/2023</td></tr><tr><td ID="result21">PROTEIN, TOTAL</td><td>6.8</td><td align="center">04/05/2023</td></tr><tr><td ID="result22">ALBUMIN</td><td>4.3</td><td align="center">04/05/2023</td></tr><tr><td ID="result23">GLOBULIN</td><td>2.5</td><td align="center">04/05/2023</td></tr><tr><td ID="result24">ALBUMIN/GLOBULIN RATIO</td><td>1.7</td><td align="center">04/05/2023</td></tr><tr><td ID="result25">BILIRUBIN, TOTAL</td><td>0.4</td><td align="center">04/05/2023</td></tr><tr><td ID="result26">ALKALINE PHOSPHATASE</td><td>55</td><td align="center">04/05/2023</td></tr><tr><td ID="result27">AST</td><td>9</td><td align="center">04/05/2023</td></tr><tr><td ID="result28">ALT</td><td>8</td><td align="center">04/05/2023</td></tr><tr><td ID="result29">TSH W/REFLEX TO FT4</td><td>1.22</td><td align="center">04/05/2023</td></tr></tbody></table></text><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="A5794217-883A-4C1B-AD7D-12791353A670"/><code code="55015300" displayName="HEPATITIS B SURFACE AB IMMUNITY, QN" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20230505"/><high value="20230505"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" 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value="8"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="83A37CB4-B406-4C87-96B5-41BF34300879"/><code code="55080410" displayName="TSH W/REFLEX TO FT4" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20230405"/><high value="20230405"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.2"/><id root="28284E70-6765-4BFF-8600-A9CCA52B9E4D"/><code code="55080410" displayName="TSH W/REFLEX TO FT4" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result29"/></originalText></code><text><reference value="#result29"/></text><statusCode code="completed"/><effectiveTime value="20230405"/><value xsi:type="PQ" value="1.22"/><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="A6283BA4-A46C-485E-89D1-5FF116363770"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20220812"/><high value="20220812"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.2"/><id root="12E776E6-383D-4FD4-87EF-05BA434B3F22"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result1"/></originalText></code><text><reference value="#result1"/></text><statusCode code="completed"/><effectiveTime value="20220812"/><value xsi:type="ST">Negative</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="1FABCEEA-C675-4112-9C37-04DCF9C45DCA"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20230505"/><high value="20230505"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.2"/><id root="BEF8C2D1-C883-40AC-B8D1-875512A2A581"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result2"/></originalText></code><text><reference value="#result2"/></text><statusCode code="completed"/><effectiveTime value="20230505"/><value xsi:type="ST">Negative</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="66871CB0-4DDD-44EF-A410-73251E3E3A5B"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20230512"/><high value="20230512"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.2"/><id root="BB45FCCB-0045-400A-926D-40A65AFF3F5F"/><code code="00000" displayName="TB Read Only" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result3"/></originalText></code><text><reference value="#result3"/></text><statusCode code="completed"/><effectiveTime value="20230512"/><value xsi:type="ST">Negative</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry><entry typeCode="DRIV"><organizer classCode="BATTERY" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.1"/><id root="8C577E71-A2E5-433A-ACCA-8F614F5FA6BB"/><code code="25000300" displayName="BUN/CREATININE RATIO" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20230405"/><high value="20230405"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author><component><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.2" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.2"/><id root="452D48A4-7BBC-475C-B41E-672617C9FD92"/><code code="25000300" displayName="BUN/CREATININE RATIO" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result15"/></originalText></code><text><reference value="#result15"/></text><statusCode code="completed"/><effectiveTime value="20230405"/><value xsi:type="ST">NOT APPLICABLE</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122504-0500"/><assignedAuthor><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)"/></assignedAuthor></author></observation></component></organizer></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.10" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.2.10"/><code code="18776-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Treatment plan"/><title>PLAN OF TREATMENT</title><text>No Treatment Plan Defined</text><entry><observation classCode="OBS" moodCode="RQO" negationInd="true"><templateId root="2.16.840.1.113883.10.20.22.4.39"/><code code="394089009" displayName="Treatment Plan" codeSystem="2.16.840.1.113883.6.96"/></observation></entry> </section></component><component><section nullFlavor="NI"><templateId root="2.16.840.1.113883.10.20.22.2.60"/><code code="61146-7" displayName="Goals" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/><title>Goals Section</title><text>No goal information</text></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.58" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.2.58" /><code code="75310-3" displayName="Health Concerns Document" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/><title>Health Concerns Section</title><text>No Known Health Concerns on </text><entry typeCode="COMP"><act classCode="ACT" moodCode="EVN" negationInd="true"><templateId root="2.16.840.1.113883.10.20.22.4.132" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.4.132"/><id root="4eab0e52-dd7d-4285-99eb-72d32ddb195d"/><code code="75310-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health Concern"/><statusCode code="active"/><effectiveTime value=""/></act></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.45"/><code code = "69730-0" codeSystem = "2.16.840.1.113883.6.1"/><title>INSTRUCTIONS</title><text>No Known Instructions/Patient Education</text><entry><act classCode="ACT" moodCode="INT" negationInd="true"><templateId root="2.16.840.1.113883.10.20.22.4.20"/><code code = "311401005" codeSystem = "2.16.840.1.113883.6.96"/><statusCode code = "completed"/></act></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.17" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.2.17"/><code code="29762-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Social History"/><title>SOCIAL HISTORY</title><text>No Social History Selected to be Displayed</text><entry typeCode="DRIV"><observation classCode="OBS" moodCode ="EVN" negationInd="true"><templateId root="2.16.840.1.113883.10.20.22.4.38" extension="2014-06-09"/><id root="AA4F7677-ED64-4B17-AE4B-D65BC835ABA9"/><code code="11367-0" codeSystem="2.16.840.1.113883.6.1"/><statusCode code="completed"/></observation></entry></section></component><component><section nullFlavor="NI"><templateId root="2.16.840.1.113883.10.20.22.2.14" extension="2014-06-09"/><templateId root="2.16.840.1.113883.10.20.22.2.14"/><code code="47420-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Functional Status"/><title>FUNCTIONAL STATUS</title><text>No information</text></section></component><component><section nullFlavor="NI"><templateId root="2.16.840.1.113883.10.20.22.2.56" extension="2015-08-01" /><code code="10190-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="MENTAL STATUS" /><title>MENTAL STATUS</title><text>No information</text></section></component></structuredBody> </component></ClinicalDocument>