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WEEK</td><td align="center">Active</td></tr><tr><td><content ID = "Med2">Trulicity 1.5 mg/0.5 mL subcutaneous pen injector, [RxNorm: 1551306]</content></td><td align="center">02/14/2023</td><td align="right">INJECT 3 MG ( two 1.5 pens each week) BY SUBCUTANEOUS ROUTE ONCE WEEKLY.</td><td align="center">Active</td></tr><tr><td><content ID = "Med3">Trulicity 3 mg/0.5 mL subcutaneous pen injector, [RxNorm: 2395779]</content></td><td align="center">12/16/2022</td><td align="right">INJECT 3 MG BY SUBCUTANEOUS ROUTE ONCE WEEKLY</td><td align="center">Active</td></tr><tr><td><content ID = "Med6">Farxiga 5 mg tablet, [RxNorm: 1486981]</content></td><td align="center">03/17/2023</td><td align="right">TAKE 1 TABLET (5 MG) BY ORAL ROUTE ONCE DAILY IN THE MORNING</td><td align="center">Active</td></tr><tr><td><content ID = "Med7">metoprolol succinate ER 50 mg tablet,extended release 24 hr, [RxNorm: 866438]</content></td><td align="center">03/17/2023</td><td align="right">TAKE 1 TABLET (50 MG) BY ORAL ROUTE ONCE DAILY</td><td align="center">Active</td></tr><tr><td><content ID = "Med9">fosinopril 20 mg tablet, [RxNorm: 857185]</content></td><td align="center">03/17/2023</td><td align="right">TAKE 1 TABLET(20 MG) BY MOUTH EVERY DAY</td><td align="center">Active</td></tr><tr><td><content ID = "Med10">metoprolol succinate ER 50 mg tablet,extended release 24 hr, [RxNorm: 866438]</content></td><td align="center">03/22/2023</td><td align="right">TAKE 1 TABLET(50 MG) BY MOUTH EVERY DAY</td><td align="center">Active</td></tr><tr><td><content ID = "Med11">gabapentin 300 mg capsule, [RxNorm: 2740839]</content></td><td align="center">12/16/2022</td><td align="right"></td><td align="center">Active</td></tr><tr><td><content ID = "Med12">fosinopril 20 mg tablet, [RxNorm: 857185]</content></td><td align="center">12/16/2022</td><td align="right">TAKE 1 TABLET (20 MG) BY ORAL ROUTE ONCE DAILY</td><td align="center">Active</td></tr><tr><td><content ID = "Med13">Farxiga 5 mg tablet, [RxNorm: 1486981]</content></td><td align="center">02/16/2023</td><td align="right">TAKE 1 TABLET (5 MG) BY ORAL ROUTE ONCE DAILY IN THE MORNING</td><td align="center">Active</td></tr><tr><td><content ID = "Med14">metoprolol succinate ER 50 mg tablet,extended release 24 hr, [RxNorm: 866438]</content></td><td align="center">12/16/2022</td><td align="right">TAKE 1 TABLET (50 MG) BY ORAL ROUTE ONCE DAILY</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="8F985B79-5EB2-4792-A8CC-41707D51BD2D"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20230215"/></effectiveTime><doseQuantity value="4"/><consumable><manufacturedProduct classCode="MANU"><templateId root="2.16.840.1.113883.10.20.22.4.23" 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(HIPAA)"/></assignedAuthor></author></substanceAdministration></entry><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="70C9D0B1-533A-4446-B904-9F513491E458"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20221216"/></effectiveTime><doseQuantity value="0"/><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="0D74EADB-0E2F-4132-AFE9-24EF4DE72943"/><manufacturedMaterial><code code="2740839" displayName="gabapentin 300 mg capsule" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/></manufacturedMaterial></manufacturedProduct></consumable><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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"><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="DE1E4124-76D1-4157-A219-FB4AA08FC999"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20221216"/></effectiveTime><doseQuantity value="0"/><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="8E7E1988-47D6-4838-BEC1-5313FD8D768B"/><manufacturedMaterial><code code="857185" displayName="fosinopril 20 mg tablet" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/></manufacturedMaterial></manufacturedProduct></consumable><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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"><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="6ACE0572-A19A-44C1-9BF9-EDD6483549B9"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20230216"/></effectiveTime><doseQuantity value="0"/><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="E97CEF47-659E-436A-ADB6-EAFC58567752"/><manufacturedMaterial><code code="1486981" displayName="Farxiga 5 mg tablet" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/></manufacturedMaterial></manufacturedProduct></consumable><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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"><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="A997703A-65B4-4020-926D-FFDEEBC33D2F"/><statusCode code="active"/><effectiveTime xsi:type="IVL_TS"><low value="20221216"/></effectiveTime><doseQuantity value="0"/><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="0316B428-1227-44D9-A01F-44BE5D1D3811"/><manufacturedMaterial><code code="866438" displayName="metoprolol succinate ER 50 mg tablet,extended release 24 hr" codeSystem="2.16.840.1.113883.6.88" codeSystemName="RxNorm"/></manufacturedMaterial></manufacturedProduct></consumable><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.5.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.2.5.1"/><code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="PROBLEM LIST"/><title>PROBLEMS</title><text ID="Concern_1"><content ID="problems1">No known <content ID="problemType1">health problems</content></content></text><entry typeCode="DRIV"><act classCode="ACT" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01" /><templateId root="2.16.840.1.113883.10.20.22.4.3" /><id root="5434F907-8F2F-49E4-8777-FAE546AE7177"/><code code="CONC" codeSystem="2.16.840.1.113883.5.6"/><text><reference value="#Concern_1"></reference></text><statusCode code="active"/><effectiveTime><low value="20260716"/></effectiveTime><entryRelationship typeCode="SUBJ"><observation classCode="OBS" moodCode="EVN" negationInd="true"><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="968C4405-E077-4017-973B-C0F24DDA8AD2"/><code code="55607006" displayName="Problem" codeSystemName="SNOMED-CT" codeSystem="2.16.840.1.113883.6.96"><translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem"/></code><text><reference value="#problems1"></reference></text><statusCode code="completed"/><effectiveTime><low value="20260716"/></effectiveTime><value xsi:type="CD" code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"><originalText><reference value="#problems1"></reference></originalText></value></observation></entryRelationship></act></entry></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.22.1" extension="2014-06-09"/><code code = "46240-8" codeSystem="2.16.840.1.113883.6.1" 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">NO CHARGE</td><td>Lindsey Barton</td><td>Auburn Montgomery Warhawk Health Services</td><td>Sep 08, 2023</td></tr></tbody></table></text><entry typeCode="DRIV"><encounter classCode="ENC" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.49" extension="2014-06-09"/><id root="52B7B107-1574-43B0-99FF-2CEB6778027C"/><code code="00000" displayName="NO CHARGE" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"><originalText><reference value="Encounter1"/></originalText><translation code="AMB" codeSystem="2.16.840.1.113883.5.4" displayName="Ambulatory" codeSystemName="HL7 ActEncounterCode"/></code><effectiveTime value="20230908"/><performer><assignedEntity><id extension="1215285879" root="2.16.840.1.113883.4.6"/><code code="59058001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="General Physician"/></assignedEntity></performer><participant typeCode="LOC"><participantRole classCode="SDLOC"><templateId root="2.16.840.1.113883.10.20.22.4.32"/><code code="1160-1" codeSystem="2.16.840.1.113883.6.259" codeSystemName="HL7 HealthcareServiceLocation" displayName="Auburn Montgomery Warhawk Health Services"/><addr><streetAddressLine>7461 East Dr STE 102</streetAddressLine><city>Montgomery</city><state>AL</state><postalCode>361178092</postalCode><country>US</country></addr><telecom use="WP" value="tel: +13342443281"/><playingEntity classCode="PLC"><name>Auburn Montgomery Warhawk Health Services</name></playingEntity></participantRole></participant><entryRelationship typeCode="RSON"><observation classCode="OBS" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.19" extension="2014-06-09"/><id root="B235B927-A532-4D82-B372-174BAA925F77" extension="30073870"/><code code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical finding"/><statusCode code="completed"/><effectiveTime><low value="20230908"/></effectiveTime><value xsi:type="CD" code="Z23" displayName="ENCOUNTER FOR IMMUNIZATION" codeSystem="2.16.840.1.113883.6.3"/></observation></entryRelationship><entryRelationship typeCode="SUBJ" inversionInd="false"><act classCode="ACT" moodCode="EVN"><templateId root="2.16.840.1.113883.10.20.22.4.80"/><id root="BA155253-354D-422B-BC07-6B265C9F9C51"/><code xsi:type="CE" code="29308-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="ENCOUNTER DIAGNOSIS"/><statusCode code="active"/><effectiveTime><low value="20230908"/></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="5C78024E-39D0-4E64-8B87-0842ADEC63EA"/><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="20230908"/></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">12/16/2022</td></tr><tr><td ID = "procedure2">CBC W/ DIFF (QUEST), [CPT-4: 6399]</td><td align="center">12/16/2022</td></tr><tr><td ID = "procedure3">Glucose, [CPT-4: 82947]</td><td align="center">12/16/2022</td></tr><tr><td ID = "procedure4">Immunization Injection Administration, [CPT-4: 90471]</td><td align="center">09/08/2023</td></tr><tr><td ID = "procedure5">Influenza virus vaccine, [CPT-4: 90686]</td><td align="center">08/29/2024</td></tr><tr><td ID = "procedure6">Influenza virus vaccine, [CPT-4: 90686]</td><td align="center">09/08/2023</td></tr><tr><td ID = "procedure7">HEMOGLOBIN A1c, [CPT-4: 496]</td><td align="center">12/16/2022</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="B138D103-2E72-4F96-BA52-EAEDE97859F6"/><code code="10231" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="COMP METABOLIC PANEL (QUEST)"/><statusCode code="completed"/><effectiveTime value="20221216"/><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="7A222BBC-B3F4-40D5-AF97-C745A5D69BC3"/><code code="6399" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="CBC W/ DIFF (QUEST)"/><statusCode code="completed"/><effectiveTime value="20221216"/><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="73FC01E4-DAD1-4ED3-BE90-01184FD32F5A"/><code code="82947" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Glucose"/><statusCode code="completed"/><effectiveTime value="20221216"/><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="243D4AF4-B7E7-46FC-AE8B-E9F52BECA5BE"/><code code="90471" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Immunization Injection Administration"/><statusCode code="completed"/><effectiveTime value="20230908"/><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="6AFE41D2-57C1-46E2-90FE-86D2CB643783"/><code code="90686" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Influenza virus vaccine"/><statusCode code="completed"/><effectiveTime value="20240829"/><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="AFB3D1EB-38BC-4E0C-8269-146AF4D6944B"/><code code="90686" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="Influenza virus vaccine"/><statusCode code="completed"/><effectiveTime value="20230908"/><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="1E035502-D7FD-4582-9859-3912B312D121"/><code code="496" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4" displayName="HEMOGLOBIN A1c"/><statusCode code="completed"/><effectiveTime value="20221216"/><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">Influenza virus vaccine</td><td align="center">09/08/2023</td><td align="center">Completed</td></tr><tr><td ID = "immun2">Influenza virus vaccine</td><td align="center">08/29/2024</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="AC60F4AC-1113-44E3-AD14-6E9924570F1E"/><text>Influenza virus vaccine</text><statusCode code="completed"/><effectiveTime value="20230908"/><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="150" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX" displayName="Influenza virus vaccine"/><lotNumberText>G2ML4</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>Maranda</given><family>Fain</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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="9C73AFB1-3F50-4D7B-9006-A057EB54E0D1"/><text>Influenza virus vaccine</text><statusCode code="completed"/><effectiveTime value="20240829"/><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="150" codeSystem="2.16.840.1.113883.12.292" codeSystemName="CVX" displayName="Influenza virus vaccine"/><lotNumberText>72RF2</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>Maranda</given><family>Fain</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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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></section></component><component><section><templateId root="2.16.840.1.113883.10.20.22.2.4.1" extension="2015-08-01"/><templateId root="2.16.840.1.113883.10.20.22.2.4.1"/><code code="8716-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="VITAL SIGNS"/><title>VITAL SIGNS</title><text><table border="1" width="100%"><thead><tr><th>Date</th><th>Height</th><th>Weight</th><th>BMI</th><th>Blood 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">12/16/2022</td><td ID = "vital_1_bp">147/85 mm[Hg]</td><td ID = "vital_1_temp">37 Cel</td><td ID = "vital_1_pulse">82 bpm</td><td ID = "vital_1_pulseox">96 pct</td><td ID = "vital_1_resp">16 bpm</td></tr><tr><td ID = "vital_2">03/17/2023</td><td ID = "vital_2_height">175 cm</td><td ID = "vital_2_weight">82 kg</td><td ID = "vital_2_bmi">26.56</td><td ID = "vital_2_bp">137/75 mm[Hg]</td><td ID = "vital_2_temp">36 Cel</td><td ID = "vital_2_pulse">81 bpm</td><td ID = "vital_2_pulseox">98 pct</td><td ID = "vital_2_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 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root="54FA1A9A-6B24-425F-9CE1-C8583A67B64F"/><code code="8480-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="BP Systolic"/><text><reference value="#vital_1_bp"/></text><statusCode code="completed"/><effectiveTime value="20221216"/><value xsi:type="PQ" value="147" 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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="1D2B0AEB-4D04-4296-88E1-5CF060061E64"/><code code="8462-4" 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Temperature"/><text><reference value="#vital_1_temp"/></text><statusCode code="completed"/><effectiveTime value="20221216"/><value xsi:type="PQ" value="37" unit="Cel"/><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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="1E45A8BC-BD8A-451E-9B7D-1F35E875131A"/><code code="8867-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Pulse"/><text><reference value="#vital_1_pulse"/></text><statusCode code="completed"/><effectiveTime value="20221216"/><value xsi:type="PQ" value="82" 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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="35D2F27D-95BF-48ED-AE3E-47E20CCD0856"/><code code="59408-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="PulseOx"/><text><reference value="#vital_1_pulseox"/></text><statusCode code="completed"/><effectiveTime value="20221216"/><value xsi:type="PQ" value="96" unit="%"/><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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="5D372DA9-819E-48FF-BE93-0F3CFBC72118"/><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="20221216"/><value xsi:type="PQ" value="16" unit="/min"/><interpretationCode code="N" 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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="0566B122-A16C-4073-91C4-C2D5205FA11D"/><code code="39156-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="BMI"/><text><reference value="#vital_2_bmi"/></text><statusCode code="completed"/><effectiveTime value="20230317"/><value xsi:type="PQ" value="26.56"/><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="20260716122052-0500"/><assignedAuthor><id extension="1265085633" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" 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(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">Glucose</td><td>Negative</td><td align="center">12/16/2022</td></tr><tr><td ID="result2">GLUCOSE</td><td>98</td><td align="center">12/17/2022</td></tr><tr><td ID="result3">UREA NITROGEN (BUN)</td><td>12</td><td align="center">12/17/2022</td></tr><tr><td ID="result4">CREATININE</td><td>0.63</td><td align="center">12/17/2022</td></tr><tr><td ID="result5">EGFR</td><td>103</td><td align="center">12/17/2022</td></tr><tr><td ID="result6">BUN/CREATININE RATIO</td><td>NOT APPLICABLE</td><td align="center">12/17/2022</td></tr><tr><td ID="result7">SODIUM</td><td>140</td><td align="center">12/17/2022</td></tr><tr><td ID="result8">POTASSIUM</td><td>3.9</td><td align="center">12/17/2022</td></tr><tr><td ID="result9">CHLORIDE</td><td>104</td><td align="center">12/17/2022</td></tr><tr><td ID="result10">CARBON DIOXIDE</td><td>26</td><td align="center">12/17/2022</td></tr><tr><td ID="result11">CALCIUM</td><td>9.1</td><td align="center">12/17/2022</td></tr><tr><td ID="result12">PROTEIN, TOTAL</td><td>6.7</td><td align="center">12/17/2022</td></tr><tr><td ID="result13">ALBUMIN</td><td>4.2</td><td align="center">12/17/2022</td></tr><tr><td ID="result14">GLOBULIN</td><td>2.5</td><td align="center">12/17/2022</td></tr><tr><td ID="result15">ALBUMIN/GLOBULIN RATIO</td><td>1.7</td><td align="center">12/17/2022</td></tr><tr><td ID="result16">BILIRUBIN, TOTAL</td><td>0.3</td><td align="center">12/17/2022</td></tr><tr><td ID="result17">ALKALINE PHOSPHATASE</td><td>138</td><td align="center">12/17/2022</td></tr><tr><td ID="result18">AST</td><td>16</td><td align="center">12/17/2022</td></tr><tr><td ID="result19">ALT</td><td>11</td><td align="center">12/17/2022</td></tr><tr><td ID="result20">HEMOGLOBIN A1C</td><td>5.2</td><td align="center">12/17/2022</td></tr><tr><td ID="result21">WHITE BLOOD CELL COUNT</td><td>10.2</td><td align="center">12/17/2022</td></tr><tr><td ID="result22">RED BLOOD CELL COUNT</td><td>5.06</td><td align="center">12/17/2022</td></tr><tr><td ID="result23">HEMOGLOBIN</td><td>13.3</td><td align="center">12/17/2022</td></tr><tr><td ID="result24">HEMATOCRIT</td><td>40.0</td><td align="center">12/17/2022</td></tr><tr><td ID="result25">MCV</td><td>79.1</td><td align="center">12/17/2022</td></tr><tr><td ID="result26">MCH</td><td>26.3</td><td align="center">12/17/2022</td></tr><tr><td ID="result27">MCHC</td><td>33.3</td><td align="center">12/17/2022</td></tr><tr><td ID="result28">RDW</td><td>13.6</td><td align="center">12/17/2022</td></tr><tr><td ID="result29">PLATELET COUNT</td><td>174</td><td align="center">12/17/2022</td></tr><tr><td ID="result30">MPV</td><td>12.1</td><td align="center">12/17/2022</td></tr><tr><td ID="result31">ABSOLUTE NEUTROPHILS</td><td>5539</td><td align="center">12/17/2022</td></tr><tr><td ID="result32">ABSOLUTE LYMPHOCYTES</td><td>3274</td><td align="center">12/17/2022</td></tr><tr><td ID="result33">ABSOLUTE MONOCYTES</td><td>989</td><td align="center">12/17/2022</td></tr><tr><td ID="result34">ABSOLUTE EOSINOPHILS</td><td>326</td><td align="center">12/17/2022</td></tr><tr><td ID="result35">ABSOLUTE BASOPHILS</td><td>71</td><td align="center">12/17/2022</td></tr><tr><td ID="result36">NEUTROPHILS</td><td>54.3</td><td align="center">12/17/2022</td></tr><tr><td ID="result37">LYMPHOCYTES</td><td>32.1</td><td align="center">12/17/2022</td></tr><tr><td ID="result38">MONOCYTES</td><td>9.7</td><td align="center">12/17/2022</td></tr><tr><td ID="result39">EOSINOPHILS</td><td>3.2</td><td align="center">12/17/2022</td></tr><tr><td ID="result40">BASOPHILS</td><td>0.7</td><td align="center">12/17/2022</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="143CA205-CE22-44CF-9535-04CEBEB62C44"/><code code="25000000" displayName="GLUCOSE" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20221217"/><high value="20221217"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" root="2.16.840.1.113883.4.6"/><code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.6.101" 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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="20221216"/><value xsi:type="ST">Negative</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="B8F7EFFE-4A87-45A3-A04C-579C17B83899"/><code code="25000300" displayName="BUN/CREATININE RATIO" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"/><statusCode code="completed"/><effectiveTime><low value="20221217"/><high value="20221217"/></effectiveTime><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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="5464F5C0-8D79-448A-9BB0-91271969AB3B"/><code code="25000300" displayName="BUN/CREATININE RATIO" codeSystem="2.16.840.1.113883.6.12" codeSystemName="CPT-4"><originalText><reference value="#result6"/></originalText></code><text><reference value="#result6"/></text><statusCode code="completed"/><effectiveTime value="20221217"/><value xsi:type="ST">NOT APPLICABLE</value><author><templateId root="2.16.840.1.113883.10.20.22.4.119"/><time value="20260716122052-0500"/><assignedAuthor><id extension="1265085633" 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>