Consolidated CDA (C-CDA), published by Health Level Seven. This guide is not an authorized publication; it is the continuous build for version 4.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/CDA-ccda/ and changes regularly. See the Directory of published versions
<ClinicalDocument xmlns="urn:hl7-org:v3">
<realmCode code="US"/>
<typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2024-05-01"/>
<templateId root="2.16.840.1.113883.10.20.29.1" extension="2024-05-01"/>
<id root="2c1e0e12-b0ae-4456-a526-c11d5e69e77c"/>
<code displayName="Discharge summary note" codeSystemName="LOINC"
codeSystem="2.16.840.1.113883.6.1" code="68831-7"/>
<title>Patient Discharge Summary</title>
<effectiveTime value="20130815103000-0800"/>
<confidentialityCode displayName="normal" codeSystemName="Confidentiality"
codeSystem="2.16.840.1.113883.5.25" code="N"/>
<languageCode code="en-US"/>
<recordTarget>
<patientRole>
<id root="2.16.840.1.113883.4.1" extension="444222222"/>
<!-- Example Social Security Number using the actual SSN OID. -->
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
<addr use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-2003" use="HP"/>
<!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<patient>
<name use="L">
<given>Adam</given>
<family>Everyman</family>
</name>
<administrativeGenderCode displayName="Male"
codeSystemName="AdministrativeGender" codeSystem="2.16.840.1.113883.5.1"
code="M"/>
<birthTime value="19750501"/>
<religiousAffiliationCode
displayName="Christian (non-Catholic, non-specific)" codeSystemName="HL7 Religious Affiliation"
codeSystem="2.16.840.1.113883.5.1076" code="1013"/>
<raceCode displayName="White"
codeSystemName="Race & Ethnicity - CDC" codeSystem="2.16.840.1.113883.6.238" code="2106-3"/>
<ethnicGroupCode displayName="Not Hispanic or Latino"
codeSystemName="Race & Ethnicity - CDC" codeSystem="2.16.840.1.113883.6.238" code="2186-5"/>
<birthplace>
<place>
<addr use="H">
<streetAddressLine>4444 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
</place>
</birthplace>
<languageCommunication>
<languageCode code="en"/>
<!-- "en" is ISO 639-1 alpha-2 code for "English" -->
<modeCode displayName="Expressed spoken"
codeSystemName="LanguageAbilityMode" codeSystem="2.16.840.1.113883.5.60" code="ESP"/>
<proficiencyLevelCode displayName="Good"
codeSystemName="LanguageAbilityProficiency" codeSystem="2.16.840.1.113883.5.61" code="G"/>
<!-- Patient's preferred language -->
<preferenceInd value="true"/>
</languageCommunication>
</patient>
</patientRole>
</recordTarget>
<author>
<time value="20130815103000-0800"/>
<assignedAuthor>
<id root="2.16.840.1.113883.4.6" extension="5555555555"/>
<code displayName="Adult Medicine Physician"
codeSystemName="Healthcare Provider Taxonomy (HIPAA)" codeSystem="2.16.840.1.113883.6.101" code="207QA0505X"/>
<addr use="WP">
<streetAddressLine>1004 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-1004" use="WP"/>
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id root="2.16.840.1.113883.4.6" extension="321CX"/>
<name>Good Health HIE</name>
<telecom value="tel:+1(555)555-1009" use="WP"/>
<addr use="WP">
<streetAddressLine>1009 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
<!-- The document is intended for multiple recipients, Adam himself and his PCP physician. -->
<informationRecipient>
<intendedRecipient>
<!-- Identifier based on the person's Direct Address which is a secure and trusted mechanism for identifying
a person discretely. The root of the id is the OID of the HISP Assigning Authority for the Direct Address -->
<id root="2.16.123.123.12345.1234"
extension="adameveryman@direct.sampleHISP.com"/>
<informationRecipient>
<name>
<given>Adam</given>
<family>Everyman</family>
</name>
</informationRecipient>
<receivedOrganization>
<!-- id using HL7 example OID. -->
<id root="2.16.840.1.113883.19" extension="999.3"/>
<name>MyPersonalHealthRecord.Com</name>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<informationRecipient>
<intendedRecipient>
<!-- Unique/Trusted id using HL7 example OID. -->
<id root="2.16.840.1.113883.19" extension="999.4"/>
<!-- The physician's NPI number -->
<id root="2.16.840.1.113883.4.6" extension="1122334455"/>
<!-- The physician's Direct Address -->
<!-- Identifier based on the person's Direct Address which is a secure and trusted mechanism for identifying
a person discretely. The root of the id is the OID of the HISP Assigning Authority for the Direct Address -->
<id root="2.16.123.123.12345.4321"
extension="DrP@direct.sampleHISP2.com"/>
<telecom value="tel:(781)555-1212" use="WP"/>
<telecom value="mailto:DrP@direct.sampleHISP2.com" use="WP"/>
<informationRecipient>
<name>
<prefix>Dr.</prefix>
<given>Patricia</given>
<family>Primary</family>
</name>
</informationRecipient>
<receivedOrganization>
<!-- Unique/Trusted id using HL7 example OID. -->
<id root="2.16.840.1.113883.19" extension="999.2"/>
<!-- NPI for the organization -->
<id root="2.16.840.1.113883.4.6" extension="1234567890"/>
<name>Good Health Internal Medicine</name>
<telecom value="tel:(781)555-1212" use="WP"/>
<addr>
<streetAddressLine>100 Health Drive</streetAddressLine>
<city>Boston</city>
<state>MA</state>
<postalCode>02368</postalCode>
<country>USA</country>
</addr>
</receivedOrganization>
</intendedRecipient>
</informationRecipient>
<legalAuthenticator>
<time value="20130801223615-0800"/>
<signatureCode code="S"/>
<assignedEntity>
<id root="2.16.840.1.113883.4.6" extension="555555555"/>
<code displayName="Adult Medicine Physician"
codeSystemName="Healthcare Provider Taxonomy (HIPAA)" codeSystem="2.16.840.1.113883.6.101" code="207QA0505X"/>
<addr>
<streetAddressLine>1004 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)-1004" use="WP"/>
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
<component>
<structuredBody>
<component>
<section/>
</component>
</structuredBody>
</component>
</ClinicalDocument>