<?xml version="1.0" encoding="UTF-8"?>

<GuidanceResponse xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <contained>
    <Parameters>
      <id value="outputParameters1"/>
      <parameter>
        <name value="score"/>
        <valueDecimal value="7"/>
      </parameter>
      <parameter>
        <name value="item-assessed"/>
        <valueCodeableConcept>
          <coding>
            <system value="http://www.ama-assn.org/go/cpt"/>
            <code value="70450"/>
            <display value="Computed tomography, head or brain; without contrast material"/>
          </coding>
        </valueCodeableConcept>
      </parameter>
      <parameter>
        <name value="device"/>
        <valueReference>
          <reference value="Device/software"/>
        </valueReference>
      </parameter>
      <parameter>
        <name value="guideline-followed"/>
        <valueUri value="http://someguidelineprovider.org/radiology-appropriateness-guidelines.html"/>
      </parameter>
    </Parameters>
  </contained>
  <requestIdentifier>
    <system value="http://example.org"/>
    <value value="guidanceRequest1"/>
  </requestIdentifier>
  <identifier>
    <system value="http://example.org"/>
    <value value="guidanceResponse1"/>
  </identifier>
  <moduleUri value="http://someguidelineprovider.org/radiology-appropriateness-guidelines.html"/>
  <status value="success"/>
  <subject>
    <reference value="Patient/example"/>
  </subject>
  <encounter>
    <reference value="Encounter/example"/>
  </encounter>
  <occurrenceDateTime value="2017-03-10T16:02:00Z"/>
  <performer>
    <reference value="Device/software"/>
  </performer>
  <reason>
    <concept>
      <text value="Guideline Appropriate Ordering Assessment"/>
    </concept>
  </reason>
  <outputParameters>
    <reference value="#outputParameters1"/>
  </outputParameters>
</GuidanceResponse>