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add project qrda
2024-08-02 10:05:09 -04:00
<?xml version="1.0" encoding="utf-8"?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:voc="urn:hl7-org:v3/voc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="urn:hl7-org:v3 CDA.xsd">
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<code code="55182-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Quality Measure Report"/>
<title>QRDA Incidence Report</title>
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<addr use="H">
<streetAddressLine>Any Street</streetAddressLine>
<city>Any Town</city>
<state/>
<postalCode/>
</addr>
<telecom/>
<patient>
<name>
<given>OUTPATIENT</given>
<family>SIXTYNINE</family>
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</patient>
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<!-- NPI for the provider and this is a real number-->
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<name>WorldVistA Test Clinic</name>
<!--WVV Address of organization is optional except for the STATE-->
<addr>
<state>MD</state>
<postalCode>20877</postalCode>
</addr>
<!--WVP required asOrganizationPartOf added to sample-->
<asOrganizationPartOf>
<wholeOrganization>
<!-- Tax ID is the extension and this is a dummy numbers-->
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<name>
<given>Nancy</given>
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</name>
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<name>World VistA Test Clinic</name>
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<custodian>
<assignedCustodian>
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<name>WorldVistA Test Clinic</name>
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<name>
<given>Nancy</given>
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<suffix>MD</suffix>
</name>
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<representedOrganization>
<id root="2.16.840.1.113883.3.543" extension="1558574526"/>
<name>WorldVistA Test Clinic</name>
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<associatedPerson>
<name>
<prefix>Dr.</prefix>
<given>Nancy</given>
<family>Anthracite</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<documentationOf>
<serviceEvent>
<code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) an Expanded History, an Exam and Medical Decision Making of Low Complexity (CPT-4 99213)" code="99213" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
<effectiveTime>
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<performer typeCode="PRF">
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<code code="62247001" codeSystem="2.16.840.1.113883.6.69" codeSystemName="SNM CT" displayName="Internal Medician Specialist"/>
<addr>
<streetAddressLine>123 Maple Ave</streetAddressLine>
<city>Gaithersburg</city>
<state>MD</state>
<postalCode>20877</postalCode>
</addr>
<assignedPerson>
<name>
<given>Nancy</given>
<family>Anthracite</family>
<suffix>MD</suffix>
</name>
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</documentationOf>
<documentationOf>
<serviceEvent>
<code displayName="Office/Outpatient Visit of an Established Patient requiring (2 of 3) a Detailed History, an Exam and Medical Decision Making of Moderate Complexity (CPT-4 99214)" code="99214" codeSystemName="CPT-4" codeSystem="2.16.840.1.113883.6.12"/>
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<performer typeCode="PRF">
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<addr>
<streetAddressLine>123 Maple Ave</streetAddressLine>
<city>Gaithersburg</city>
<state>MD</state>
<postalCode>20877</postalCode>
</addr>
<assignedPerson>
<name>
<given>Nancy</given>
<family>Anthracite</family>
<suffix>MD</suffix>
</name>
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<component>
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<code code="55185-3" codeSystem="2.16.840.1.113883.6.1"/>
<title>Measure set: CMS EHR Measure Set</title>
<text>2010 Measures Set Measures</text>
<component>
<section>
<templateId root="2.16.840.1.113883.3.249.11.2"/>
<code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
<title>Measure Section</title>
<text>
<list>
<item>CMS Measure #1: Diabetes Mellitus: Hemoglobin A1c Poor Control in Diabetes Mellitus</item>
</list>
</text>
<entry typeCode="DRIV">
<act classCode="ACT" moodCode="DEF">
<id root="2.16.840.1.113883.3.249.11.2"/>
<code code="PQRI-1" codeSystem="2.16.840.1.113883.3.249.12" displayName="Hemoglobin A1c Poor Control in Diabetes Mellitus"/>
<text>Percentage of patients 18 through 75 years with diabetes mellitus who had most recent hemoglobin A1C greater than 9.0%</text>
<statusCode code="completed"/>
</act>
</entry>
<component>
<section>
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<title>Reporting Parameters</title>
<text>
<list>
<item>Reporting Period Jan 1, 2010 to Dec 31, 2010</item>
</list>
</text>
<entry>
<act classCode="ACT" moodCode="EVN">
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<low value="20100101"/>
<high value="20101231"/>
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</entry>
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</component>
<component>
<section>
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<title>Patient Data</title>
</section>
</component>
<component>
<section>
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<code code="11450-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem list"/>
<title>Problems</title>
<text/>
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<id root="PROBLEM1" extension="CCRObjectID"/>
<code nullFlavor="NA"/>
<performer typeCode="PRF">
<assignedEntity>
<id extension="ACTORPROVIDER_10000000183" root="CCRActorID"/>
<addr use="WP">
<streetAddressLine>VA MEDICAL CENTER</streetAddressLine>
<city>ALBANY</city>
<state>NY</state>
<postalCode>12180</postalCode>
</addr>
<telecom/>
<assignedPerson>
<name>
<given>MATTHEW</given>
<given>M</given>
<family>KING</family>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<entryRelationship typeCode="SUBJ">
<observation classCode="OBS" moodCode="EVN">
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<id root="PROBLEM1" extension="CCRObjectID"/>
<code code="55607006" displayName="Problem" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNM"/>
<statusCode code="completed"/>
<effectiveTime>
<low value="20100916"/>
<high value="20100916"/>
</effectiveTime>
<value xsi:type="CD" displayName="Diabetes Mellitus without mention of Complication, type II or unspecified type," code="250.00" codeSystemName="I9" codeSystem="2.16.840.1.113883.6.103"/>
<entryRelationship typeCode="REFR">
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<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
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<value xsi:type="CE" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" codeSystemName="SNM" />
</observation>
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<section>
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<code code="48768-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Payment Sources"/>
<title>Payers</title>
<text/>
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<id root="dbbb6311-8a4d-11df-a4ee-0800200c9c66"/>
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<participant typeCode="COV">
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</structuredBody>
</component>
</ClinicalDocument>