Genomics Reporting Implementation Guide
4.0.0-cibuild - CI Build

Genomics Reporting Implementation Guide, published by HL7 International / Clinical Genomics. This guide is not an authorized publication; it is the continuous build for version 4.0.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/genomics-reporting/ and changes regularly. See the Directory of published versions

## : bundle-cgexample - XML Representation

Raw xml | Download

    <Bundle xmlns="http://hl7.org/fhir">
      <id value="bundle-cgexample"/>
      <type value="collection"/>
      <entry>
        <fullUrl value="http://example.org/fhir/DiagnosticReport/report"/>
        <resource>
          <DiagnosticReport>
            <id value="report"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genomic-report"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="DiagnosticReport_report"> </a><p class="res-header-id"><b>Generated Narrative: DiagnosticReport report</b></p><a name="report"> </a><a name="hcreport"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-genomic-report.html">Genomic Report</a></p></div><h2><span title="Codes:{http://loinc.org 51969-4}">Genetic analysis report</span> (<span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span>) </h2><table class="grid"><tr><td>Subject</td><td>Anonymous Patient (no stated gender), DoB Unknown</td></tr><tr><td>When For</td><td>2016</td></tr><tr><td>Reported</td><td>2016-09-06 00:00:00-0500</td></tr><tr><td>Performer</td><td> <a href="Organization-ExampleLab.html">Organization Some lab</a></td></tr></table><p><b>Report Details</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>Value</b></td><td><b>Flags</b></td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_discrete-variant"><span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></a></td><td><span title="Codes:{http://loinc.org LA9633-4}">Present</span></td><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_dis-path"><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}">Diagnostic Implication</span></a></td><td/><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_complex-variant"><span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></a></td><td><span title="Codes:{http://loinc.org LA9633-4}">Present</span></td><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_complex-dis-path"><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}">Diagnostic Implication</span></a></td><td/><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_haplotype"><span title="Codes:{http://loinc.org 84414-2}">Haplotype name</span></a></td><td><span title="Codes:{http://www.ebi.ac.uk/ipd/imgt/hla *2}">*2</span></td><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_genotype"><span title="Codes:{http://loinc.org 84413-4}">Genotype display name</span></a></td><td><span title="Codes:{http://www.pharmvar.org CYP2C9 *2/*5}">CYP2C9 *2/*5</span></td><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_metab"><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></a></td><td/><td>Final</td></tr><tr><td><a href="Bundle-bundle-cgexample.html#Observation_efficacy"><span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></a></td><td/><td>Final</td></tr></table><p><b>Coded Conclusions:</b></p><ul><li><span title="Codes:{http://loinc.org LA6576-8}">Positive</span></li><li><span title="Codes:{http://snomed.info/sct 10828004}">Positive</span></li></ul></div>
            </text>
            <basedOn>🔗
              <reference value="ServiceRequest/ExampleServiceRequest"/>
            </basedOn>
            <status value="final"/>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="51969-4"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <result>
              <reference value="Observation/discrete-variant"/>
            </result>
            <result>
              <reference value="Observation/dis-path"/>
            </result>
            <result>
              <reference value="Observation/complex-variant"/>
            </result>
            <result>
              <reference value="Observation/complex-dis-path"/>
            </result>
            <result>
              <reference value="Observation/haplotype"/>
            </result>
            <result>
              <reference value="Observation/genotype"/>
            </result>
            <result>
              <reference value="Observation/metab"/>
            </result>
            <result>
              <reference value="Observation/efficacy"/>
            </result>
            <conclusionCode>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA6576-8"/>
                <display value="Positive"/>
              </coding>
            </conclusionCode>
            <conclusionCode>
              <coding>
                <system value="http://snomed.info/sct"/>
                <code value="10828004"/>
                <display value="Positive"/>
              </coding>
            </conclusionCode>
            <presentedForm>
              <contentType value="text/plain"/>
              <data value="UHV0IHRoZSByZXBvcnQgdGV4dCBoZXJlIC0gbWltZS1lbmNvZGVk"/>
            </presentedForm>
          </DiagnosticReport>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Patient/ExamplePatient"/>
        <resource>
          <Patient>
            <id value="ExamplePatient"/>
            <text>
              <status value="additional"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_ExamplePatient"> </a>This would contain patient identifiers, demographics, etc.</div>
            </text>
          </Patient>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Specimen/ExampleSpecimen"/>
        <resource>
          <Specimen>
            <id value="ExampleSpecimen"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Specimen_ExampleSpecimen"> </a><p class="res-header-id"><b>Generated Narrative: Specimen ExampleSpecimen</b></p><a name="ExampleSpecimen"> </a><a name="hcExampleSpecimen"> </a><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p></div>
            </text>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
          </Specimen>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Organization/ExampleLab"/>
        <resource>
          <Organization>
            <id value="ExampleLab"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_ExampleLab"> </a><p class="res-header-id"><b>Generated Narrative: Organization ExampleLab</b></p><a name="ExampleLab"> </a><a name="hcExampleLab"> </a><p><b>name</b>: Some lab</p></div>
            </text>
            <name value="Some lab"/>
          </Organization>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/fhir/ServiceRequest/ExampleServiceRequest"/>
        <resource>
          <ServiceRequest>
            <id value="ExampleServiceRequest"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_ExampleServiceRequest"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest ExampleServiceRequest</b></p><a name="ExampleServiceRequest"> </a><a name="hcExampleServiceRequest"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Original Order</p><p><b>code</b>: <span title="Codes:{http://loinc.org 51969-4}">Genetic analysis report</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>reasonCode</b>: <span title="Codes:">Worried about family planning</span></p></div>
            </text>
            <status value="active"/>
            <intent value="original-order"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="51969-4"/>
                <display value="Genetic analysis report"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <reasonCode>
              <text value="Worried about family planning"/>
            </reasonCode>
          </ServiceRequest>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/discrete-variant"/>
        <resource>
          <Observation>
            <id value="discrete-variant"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_discrete-variant"> </a><p class="res-header-id"><b>Generated Narrative: Observation discrete-variant</b></p><a name="discrete-variant"> </a><a name="hcdiscrete-variant"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-variant.html">Variant</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA9633-4}">Present</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/clinvar 30880}">NM_014049.4(ACAD9):c.1249C&gt;T (p.Arg417Cys)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48018-6}">Gene studied [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.genenames.org HGNC:21497}">ACAD9</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51958-7}">Transcript reference sequence [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/refseq NM_014049.4}">NM_014049.4</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48013-7}">Genomic reference sequence [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/refseq NG_017064.1}">NG_017064.1</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81290-9}">Genomic DNA change (gHGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NC_000003.11:g.128625063C&gt;T}">NC_000003.11:g.128625063C&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/projects/SNP rs368949613}">rs368949613</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48004-6}">DNA change (c.HGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NM_014049.4:c.1249C&gt;T}">NM_014049.4:c.1249C&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48005-3}">Amino acid change (pHGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NP_054768.2:p.Arg417Cys}">NP_054768.2:p.Arg417Cys</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48019-4}">DNA change type</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6690-7}">Substitution</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69547-8}">Genomic ref allele [ID]</span></p><p><b>value</b>: C</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81254-5}">Genomic allele start-end</span></p><p><b>value</b>: 31731-31731</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69551-0}">Genomic alt allele [ID]</span></p><p><b>value</b>: T</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48001-2}">Cytogenetic (chromosome) location</span></p><p><b>value</b>: <span title="Codes:">3q21</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48002-0}">Genomic source class [Type]</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6683-2}">Germline</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 53034-5}">Allelic state</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6706-1}">Heterozygous</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81258-6}">Sample variant allelic frequency [NFr]</span></p><p><b>value</b>: 47 %<span style="background: LightGoldenRodYellow"> (Details: UCUM  code% = '%')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 82121-5}">Allelic read depth</span></p><p><b>value</b>: 208 1<span style="background: LightGoldenRodYellow"> (Details: UCUM  code1 = '1')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 82155-3}">Genomic structural variant copy number</span></p><p><b>value</b>: 1 1<span style="background: LightGoldenRodYellow"> (Details: UCUM  code1 = '1')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81299-0}">Structural variant reported arrCGH [Ratio]</span></p><p><b>value</b>: 0.48</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81300-6}">Structural variant [Length]</span></p><p><b>value</b>: 1396929 1<span style="background: LightGoldenRodYellow"> (Details: UCUM  code1 = '1')</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81301-4}">Structural variant outer start and end</span></p><p><b>value</b>: 13200589-15592000</p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81302-2}">Structural variant inner start and end</span></p><p><b>value</b>: 14184616-15581544</p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="69548-6"/>
                <display value="Genetic variant assessment"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA9633-4"/>
                <display value="Present"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81252-9"/>
                  <display value="Discrete genetic variant"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
                  <code value="30880"/>
                  <display value="NM_014049.4(ACAD9):c.1249C&gt;T (p.Arg417Cys)"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48018-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.genenames.org"/>
                  <code value="HGNC:21497"/>
                  <display value="ACAD9"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51958-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/refseq"/>
                  <code value="NM_014049.4"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48013-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/refseq"/>
                  <code value="NG_017064.1"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81290-9"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NC_000003.11:g.128625063C&gt;T"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81252-9"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/projects/SNP"/>
                  <version value="137"/>
                  <code value="rs368949613"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48004-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NM_014049.4:c.1249C&gt;T"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48005-3"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NP_054768.2:p.Arg417Cys"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48019-4"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6690-7"/>
                  <display value="Substitution"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="69547-8"/>
                </coding>
              </code>
              <valueString value="C"/>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81254-5"/>
                </coding>
              </code>
              <valueRange>
                <low>
                  <value value="31731"/>
                </low>
                <high>
                  <value value="31731"/>
                </high>
              </valueRange>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="69551-0"/>
                </coding>
              </code>
              <valueString value="T"/>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48001-2"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <text value="3q21"/>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48002-0"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6683-2"/>
                  <display value="Germline"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="53034-5"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6706-1"/>
                  <display value="Heterozygous"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81258-6"/>
                </coding>
              </code>
              <valueQuantity>
                <value value="47"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="%"/>
              </valueQuantity>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="82121-5"/>
                </coding>
              </code>
              <valueQuantity>
                <value value="208"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="1"/>
              </valueQuantity>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="82155-3"/>
                </coding>
              </code>
              <valueQuantity>
                <value value="1"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="1"/>
              </valueQuantity>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81299-0"/>
                </coding>
              </code>
              <valueQuantity>
                <value value="0.48"/>
              </valueQuantity>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81300-6"/>
                </coding>
              </code>
              <valueQuantity>
                <value value="1396929"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="1"/>
              </valueQuantity>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81301-4"/>
                </coding>
              </code>
              <valueRange>
                <low>
                  <value value="13200589"/>
                </low>
                <high>
                  <value value="15592000"/>
                </high>
              </valueRange>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81302-2"/>
                </coding>
              </code>
              <valueRange>
                <low>
                  <value value="14184616"/>
                </low>
                <high>
                  <value value="15581544"/>
                </high>
              </valueRange>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/dis-path"/>
        <resource>
          <Observation>
            <id value="dis-path"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_dis-path"> </a><p class="res-header-id"><b>Generated Narrative: Observation dis-path</b></p><a name="dis-path"> </a><a name="hcdis-path"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-diagnostic-implication.html">Diagnostic Implication</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}">Diagnostic Implication</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_discrete-variant">Observation Genetic variant assessment</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 53037-8}">Genetic variation clinical significance [Imp]</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6668-3}">Pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81259-4}">Associated phenotype</span></p><p><b>value</b>: <span title="Codes:{http://purl.obolibrary.org/obo/mondo.owl MONDO:0012624}">acyl-CoA dehydrogenase 9 deficiency</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="diagnostic-implication"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <derivedFrom>
              <reference value="Observation/discrete-variant"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="53037-8"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6668-3"/>
                  <display value="Pathogenic"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81259-4"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://purl.obolibrary.org/obo/mondo.owl"/>
                  <code value="MONDO:0012624"/>
                  <display value="acyl-CoA dehydrogenase 9 deficiency"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/complex-variant"/>
        <resource>
          <Observation>
            <id value="complex-variant"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_complex-variant"> </a><p class="res-header-id"><b>Generated Narrative: Observation complex-variant</b></p><a name="complex-variant"> </a><a name="hccomplex-variant"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-variant.html">Variant</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA9633-4}">Present</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><p><b>hasMember</b>: </p><ul><li><a href="Bundle-bundle-cgexample.html#Observation_complex-component-D">Observation Genetic variant assessment</a></li><li><a href="Bundle-bundle-cgexample.html#Observation_complex-component-E">Observation Genetic variant assessment</a></li></ul></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="69548-6"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA9633-4"/>
                <display value="Present"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <hasMember>
              <reference value="Observation/complex-component-D"/>
            </hasMember>
            <hasMember>
              <reference value="Observation/complex-component-E"/>
            </hasMember>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/complex-dis-path"/>
        <resource>
          <Observation>
            <id value="complex-dis-path"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/diagnostic-implication"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_complex-dis-path"> </a><p class="res-header-id"><b>Generated Narrative: Observation complex-dis-path</b></p><a name="complex-dis-path"> </a><a name="hccomplex-dis-path"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-diagnostic-implication.html">Diagnostic Implication</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs diagnostic-implication}">Diagnostic Implication</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_complex-variant">Observation Genetic variant assessment</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 53037-8}">Genetic variation clinical significance [Imp]</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6668-3}">Pathogenic</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81259-4}">Associated phenotype</span></p><p><b>value</b>: <span title="Codes:{http://snomed.info/sct 293498008}">Debrisoquine adverse reaction (disorder)</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="diagnostic-implication"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <derivedFrom>
              <reference value="Observation/complex-variant"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="53037-8"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6668-3"/>
                  <display value="Pathogenic"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81259-4"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://snomed.info/sct"/>
                  <code value="293498008"/>
                  <display value="Debrisoquine adverse reaction (disorder)"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/complex-component-D"/>
        <resource>
          <Observation>
            <id value="complex-component-D"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_complex-component-D"> </a><p class="res-header-id"><b>Generated Narrative: Observation complex-component-D</b></p><a name="complex-component-D"> </a><a name="hccomplex-component-D"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-variant.html">Variant</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA9633-4}">Present</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/clinvar 31934}">NM_000106.5(CYP2D6):c.886C&gt;T (p.Arg296Cys)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51958-7}">Transcript reference sequence [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/refseq NM_000106.5}">NM_000106.5</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48004-6}">DNA change (c.HGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NM_000106.5:c.886C&gt;T}">NM_000106.5:c.886C&gt;T</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48005-3}">Amino acid change (pHGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NP_000097.3:p.Arg296Cys}">NP_000097.3:p.Arg296Cys</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48019-4}">DNA change type</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6690-7}">Substitution</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="69548-6"/>
                <display value="Genetic variant assessment"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA9633-4"/>
                <display value="Present"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81252-9"/>
                  <display value="Discrete genetic variant"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
                  <code value="31934"/>
                  <display value="NM_000106.5(CYP2D6):c.886C&gt;T (p.Arg296Cys)"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51958-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/refseq"/>
                  <code value="NM_000106.5"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48004-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NM_000106.5:c.886C&gt;T"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48005-3"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NP_000097.3:p.Arg296Cys"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48019-4"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6690-7"/>
                  <display value="Substitution"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/complex-component-E"/>
        <resource>
          <Observation>
            <id value="complex-component-E"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/variant"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_complex-component-E"> </a><p class="res-header-id"><b>Generated Narrative: Observation complex-component-E</b></p><a name="complex-component-E"> </a><a name="hccomplex-component-E"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-variant.html">Variant</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 69548-6}">Genetic variant assessment</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA9633-4}">Present</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 81252-9}">Discrete genetic variant</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/clinvar 38486}">NM_000106.5(CYP2D6):c.1457G&gt;C (p.Ser486Thr)</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51958-7}">Transcript reference sequence [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.ncbi.nlm.nih.gov/refseq NM_000106.5}">NM_000106.5</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48004-6}">DNA change (c.HGVS)</span></p><p><b>value</b>: <span title="Codes:{http://varnomen.hgvs.org NM_000106.5:c.1457G&gt;C}">NM_000106.5:c.1457G&gt;C</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="69548-6"/>
                <display value="Genetic variant assessment"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA9633-4"/>
                <display value="Present"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="81252-9"/>
                  <display value="Discrete genetic variant"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/clinvar"/>
                  <version value="???"/>
                  <code value="38486"/>
                  <display
                           value="NM_000106.5(CYP2D6):c.1457G&gt;C (p.Ser486Thr)"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51958-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.ncbi.nlm.nih.gov/refseq"/>
                  <code value="NM_000106.5"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48004-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://varnomen.hgvs.org"/>
                  <code value="NM_000106.5:c.1457G&gt;C"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/haplotype"/>
        <resource>
          <Observation>
            <id value="haplotype"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/haplotype"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_haplotype"> </a><p class="res-header-id"><b>Generated Narrative: Observation haplotype</b></p><a name="haplotype"> </a><a name="hchaplotype"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-haplotype.html">Haplotype</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 84414-2}">Haplotype name</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://www.ebi.ac.uk/ipd/imgt/hla *2}">*2</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_discrete-variant">Observation Genetic variant assessment</a></p></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="84414-2"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://www.ebi.ac.uk/ipd/imgt/hla"/>
                <code value="*2"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <derivedFrom>
              <reference value="Observation/discrete-variant"/>
            </derivedFrom>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/genotype"/>
        <resource>
          <Observation>
            <id value="genotype"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/genotype"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_genotype"> </a><p class="res-header-id"><b>Generated Narrative: Observation genotype</b></p><a name="genotype"> </a><a name="hcgenotype"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-genotype.html">Genotype</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://loinc.org 84413-4}">Genotype display name</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>value</b>: <span title="Codes:{http://www.pharmvar.org CYP2C9 *2/*5}">CYP2C9 *2/*5</span></p><p><b>specimen</b>: <a href="Specimen-ExampleSpecimen.html">Specimen</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_haplotype">Observation Haplotype name</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48018-6}">Gene studied [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.genenames.org HGNC:2623}">CYP2C9</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 48018-6}">Gene studied [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.genenames.org HGNC:23663}">VKORC1</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="84413-4"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <valueCodeableConcept>
              <coding>
                <system value="http://www.pharmvar.org"/>
                <code value="CYP2C9 *2/*5"/>
                <display value="CYP2C9 *2/*5"/>
              </coding>
            </valueCodeableConcept>
            <specimen>🔗
              <reference value="Specimen/ExampleSpecimen"/>
            </specimen>
            <derivedFrom>
              <reference value="Observation/haplotype"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48018-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.genenames.org"/>
                  <code value="HGNC:2623"/>
                  <display value="CYP2C9"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="48018-6"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.genenames.org"/>
                  <code value="HGNC:23663"/>
                  <display value="VKORC1"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/metab"/>
        <resource>
          <Observation>
            <id value="metab"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_metab"> </a><p class="res-header-id"><b>Generated Narrative: Observation metab</b></p><a name="metab"> </a><a name="hcmetab"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_genotype">Observation Genotype display name</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51963-7}">Medication assessed [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 11289}">Warfarin</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA25390-8}">Rapid metabolizer</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="therapeutic-implication"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <derivedFrom>
              <reference value="Observation/genotype"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51963-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                  <code value="11289"/>
                  <display value="Warfarin"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system
                          value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                  <code value="therapeutic-implication"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA25390-8"/>
                  <display value="Rapid metabolizer"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/efficacy"/>
        <resource>
          <Observation>
            <id value="efficacy"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_efficacy"> </a><p class="res-header-id"><b>Generated Narrative: Observation efficacy</b></p><a name="efficacy"> </a><a name="hcefficacy"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_genotype">Observation Genotype display name</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA6676-6}">Resistant</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51963-7}">Medication assessed [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 11289}">Warfarin</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="therapeutic-implication"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <derivedFrom>
              <reference value="Observation/genotype"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system
                          value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                  <code value="therapeutic-implication"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA6676-6"/>
                  <display value="Resistant"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51963-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                  <code value="11289"/>
                  <display value="Warfarin"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Observation/highrisk"/>
        <resource>
          <Observation>
            <id value="highrisk"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/therapeutic-implication"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Observation_highrisk"> </a><p class="res-header-id"><b>Generated Narrative: Observation highrisk</b></p><a name="highrisk"> </a><a name="hchighrisk"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-therapeutic-implication.html">Therapeutic Implication</a></p></div><p><b>status</b>: Final</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/observation-category laboratory}">Laboratory</span>, <span title="Codes:{http://terminology.hl7.org/CodeSystem/v2-0074 GE}">Genetics</span></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>subject</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>effective</b>: 2016</p><p><b>issued</b>: 2016-09-06 00:00:00-0500</p><p><b>performer</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>derivedFrom</b>: <a href="Bundle-bundle-cgexample.html#Observation_genotype">Observation Genotype display name</a></p><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs therapeutic-implication}">Therapeutic Implication</span></p><p><b>value</b>: <span title="Codes:{http://loinc.org LA19542-2}">Low risk</span></p></blockquote><blockquote><p><b>component</b></p><p><b>code</b>: <span title="Codes:{http://loinc.org 51963-7}">Medication assessed [ID]</span></p><p><b>value</b>: <span title="Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 11289}">Warfarin</span></p></blockquote></div>
            </text>
            <status value="final"/>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/observation-category"/>
                <code value="laboratory"/>
              </coding>
            </category>
            <category>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0074"/>
                <code value="GE"/>
              </coding>
            </category>
            <code>
              <coding>
                <system
                        value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                <code value="therapeutic-implication"/>
              </coding>
            </code>
            <subject>🔗
              <reference value="Patient/ExamplePatient"/>
            </subject>
            <effectiveDateTime value="2016"/>
            <issued value="2016-09-06T00:00:00-05:00"/>
            <performer>🔗
              <reference value="Organization/ExampleLab"/>
            </performer>
            <derivedFrom>
              <reference value="Observation/genotype"/>
            </derivedFrom>
            <component>
              <code>
                <coding>
                  <system
                          value="http://hl7.org/fhir/uv/genomics-reporting/CodeSystem/tbd-codes-cs"/>
                  <code value="therapeutic-implication"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="LA19542-2"/>
                  <display value="Low risk"/>
                </coding>
              </valueCodeableConcept>
            </component>
            <component>
              <code>
                <coding>
                  <system value="http://loinc.org"/>
                  <code value="51963-7"/>
                </coding>
              </code>
              <valueCodeableConcept>
                <coding>
                  <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                  <code value="11289"/>
                  <display value="Warfarin"/>
                </coding>
              </valueCodeableConcept>
            </component>
          </Observation>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/fhir/Task/usage"/>
        <resource>
          <Task>
            <id value="usage"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/uv/genomics-reporting/StructureDefinition/medication-recommendation"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Task_usage"> </a><p class="res-header-id"><b>Generated Narrative: Task usage</b></p><a name="usage"> </a><a name="hcusage"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-medication-recommendation.html">Medication Recommendation</a></p></div><p><b>status</b>: Requested</p><p><b>intent</b>: proposal</p><p><b>code</b>: <span title="Codes:{http://loinc.org LA26423-6}">May need higher dosage than usual.</span></p><p><b>focus</b>: <a href="MedicationStatement-MedicationStatementWarfarin.html">MedicationStatement: status = unknown; medication[x] = Warfarin</a></p><p><b>for</b>: <a href="Patient-ExamplePatient.html">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>requester</b>: <a href="Organization-ExampleLab.html">Organization Some lab</a></p><p><b>reasonReference</b>: <a href="Bundle-bundle-cgexample.html#Observation_metab">Observation Therapeutic Implication</a></p></div>
            </text>
            <status value="requested"/>
            <intent value="proposal"/>
            <code>
              <coding>
                <system value="http://loinc.org"/>
                <code value="LA26423-6"/>
                <display value="Increase dose"/>
              </coding>
              <text value="May need higher dosage than usual."/>
            </code>
            <focus>🔗
              <reference value="MedicationStatement/MedicationStatementWarfarin"/>
            </focus>
            <for>🔗
              <reference value="Patient/ExamplePatient"/>
            </for>
            <requester>🔗
              <reference value="Organization/ExampleLab"/>
            </requester>
            <reasonReference>
              <reference value="Observation/metab"/>
            </reasonReference>
          </Task>
        </resource>
      </entry>
    </Bundle>