@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Questionnaire ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "MNACQuestionnaire"] ; # fhir:language [ fhir:v "en"] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "

Generated Narrative: Questionnaire MNACQuestionnaire

Structure#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n#xD;\n
LinkIDTextCardinalityTypeDescription & Constraints\"doco\"
\".\"\".\" MNACQuestionnaireThis is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form.Questionnairehttp://hl7.org/fhir/us/cql/Questionnaire/MNACQuestionnaire#2.0.0-cibuild
\".\"\".\"\".\" request-infoRequest Information0..1group
\".\"\".\"\".\"\".\" request-info|date-of-requestDATE OF REQUEST0..1date
\".\"\".\"\".\" diagnosis-infoDiagnosis Information0..1group
\".\"\".\"\".\"\".\" diagnosis-info|diagnosisDiagnosis0..1string
\".\"\".\"\".\" item-requestedItem Requested0..1group
\".\"\".\"\".\"\".\" item-requested|itemItem requested0..1string
\".\"\".\"\".\" uti-historyUTI History0..1group
\".\"\".\"\".\"\".\" uti-history|uti-last-yearThe patient has|had documented recurrent urinary tract infections while on a program of clean cathing, twice within a 12 month period prior to beginning sterile cathing0..1boolean
\".\"\".\"\".\"\".\" uti-history|uti-datesDates of UTIs in the last year0..1stringEnable When: uti-history|uti-last-year = true
\".\"\".\"\".\"\".\" uti-history|antibiotics-usedAntibiotics used for UTIs in the last year0..1stringEnable When: uti-history|uti-last-year = true
\".\"\".\"\".\" symptoms-infoSymptoms Information0..1group
\".\"\".\"\".\"\".\" symptoms-info|symptomsCheck those that apply to your patient0..*choiceOptions: 7 options
\".\"\".\"\".\"\".\" symptoms-info|fever-temperatureIf fever, state temperature in degrees0..1decimalEnable When: symptoms-info|symptoms = Fever (MNACQuestionnaire-symptoms-info-symptoms#Fever)
\".\"\".\"\".\" catheterization-frequencyCatheterization Frequency0..1group
\".\"\".\"\".\"\".\" catheterization-frequency|frequencyHow many times per day does the patient catheterize?0..1choiceOptions: 4 options
\".\"\".\"\".\" additional-commentsAdditional Comments0..1group
\".\"\".\"\".\"\".\" additional-comments|commentsAdditional Comment0..1string
\".\"\".\"\".\" physician-infoPhysician Information0..1group
\".\"\".\"\".\"\".\" physician-info|namePhysician's Name0..1string
\".\"\".\"\".\"\".\" physician-info|mobileTelephone0..1string
\".\"\".\"\".\"\".\" physician-info|faxFAX0..1string
\".\"\".\"\".\"\".\" physician-info|signaturePhysician's Signature0..1attachment
\".\"\".\"\".\"\".\" physician-info|phone-referringReferring Physician Telephone0..1string
\".\"\".\"\".\"\".\" physician-info|dateDate0..1string

\"doco\" Documentation for this format

Options Sets

Answer options for symptoms-info|symptoms

  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Fever (\"Fever; state temperature in degree\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#UrinaryUrgencyFrequency (\"Change in urinary urgency, frequency, or incontinence\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#AutonomicDysreflexia (\"Appearance of new or increase in autonomic dysreflexia\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#PhysicalSignsProstatitis (\"Physical signs of prostatitis, epididymitis, orchitis\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Immunosuppressed (\"The patient is immunosuppressed\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#Pyuria (\"Pyuria\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms#SystemicLeukocytosis (\"Systemic leukocytosis\")

Answer options for catheterization-frequency|frequency

  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#2-4Times (\"2-4 times\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#4-6Times (\"4-6 times\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#6-8Times (\"6-8 times\")
  • http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency#8TimesOrMore (\"8 times or more\")

Contained Resources

\n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n \n \n \n \n\n\n\n\n \n \n \n\n\n\n \n \n \n \n \n\n\n\n\n \n \n \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n \n\n\n \n
Metadata
Type\n module-definition from http://terminology.hl7.org/CodeSystem/library-type \n\n\n
Dependency\n \n Description: USCore model information\n \n
\n \n \n \n \n \n \n Resource: US Core Model Informationversion: null6.1.0-derived)\n
\n Canonical URL: http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived\n \n \n \n
Dependency\n \n Description: FHIR model information\n \n
\n \n \n \n \n \n \n Resource: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n
\n Canonical URL: http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1\n \n \n \n
Parameters
ParameterNone
Generated using version 0.5.3-cibuild of the sample-content-ig Liquid templates
\n
"^^rdf:XMLLiteral ] ] ; # fhir:contained ( [ a fhir:Library ; fhir:id [ fhir:v "effective-data-requirements" ] ; fhir:name [ fhir:v "EffectiveDataRequirements" ] ; fhir:status [ fhir:v "active" ] ; fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/library-type"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "module-definition" ] ] ) ] ; fhir:relatedArtifact ( [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "USCore model information" ] ; fhir:resource [ fhir:v "http://hl7.org/fhir/us/cql/Library/USCore-ModelInfo|6.1.0-derived"^^xsd:anyURI ; fhir:l ] ] [ fhir:type [ fhir:v "depends-on" ] ; fhir:display [ fhir:v "FHIR model information" ] ; fhir:resource [ fhir:v "http://hl7.org/fhir/uv/cql/Library/FHIR-ModelInfo|4.0.1"^^xsd:anyURI ; fhir:l ] ] ) ] ) ; # fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-library"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Canonical ; fhir:v "http://hl7.org/fhir/us/cql/Library/MNACInitialExpressions"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://hl7.org/fhir/uv/sdc/CodeSystem/launchContext"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "patient" ] ; fhir:display [ fhir:v "Patient" ] ] ] [ fhir:url [ fhir:v "type"^^xsd:anyURI ; fhir:l fhir:type ] ; fhir:value [ a fhir:Code ; fhir:v "Patient" ] ] [ fhir:url [ fhir:v "description"^^xsd:anyURI ; fhir:l fhir:description ] ; fhir:value [ a fhir:String ; fhir:v "The patient that is to be used to pre-populate the form" ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"^^xsd:anyURI ; fhir:l ] ] [ fhir:extension ( [ fhir:url [ fhir:v "name"^^xsd:anyURI ; fhir:l fhir:name ] ; fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/additionalLaunchContext"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "ServiceRequest" ] ; fhir:display [ fhir:v "ServiceRequest" ] ] ] [ fhir:url [ fhir:v "type"^^xsd:anyURI ; fhir:l fhir:type ] ; fhir:value [ a fhir:Code ; fhir:v "ServiceRequest" ] ] [ fhir:url [ fhir:v "description"^^xsd:anyURI ; fhir:l fhir:description ] ; fhir:value [ a fhir:String ; fhir:v "The ServiceRequest that is to be used to pre-populate the form" ] ] ) ; fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-launchContext"^^xsd:anyURI ; fhir:l ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Code ; fhir:v "cds" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Canonical ; fhir:v "#effective-data-requirements"^^xsd:anyURI ; fhir:l <#effective-data-requirements> ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Code ; fhir:v "informative" ; fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Canonical ; fhir:v "http://hl7.org/fhir/us/cql/ImplementationGuide/hl7.fhir.us.cql"^^xsd:anyURI ; fhir:l ] ] ) ] ] ) ; # fhir:url [ fhir:v "http://hl7.org/fhir/us/cql/Questionnaire/MNACQuestionnaire"^^xsd:anyURI ; fhir:l ] ; # fhir:version [ fhir:v "2.0.0-cibuild"] ; # fhir:name [ fhir:v "MNACQuestionnaire"] ; # fhir:title [ fhir:v "Example Medical Necessity For Authorization Of Catheters Questionnaire"] ; # fhir:status [ fhir:v "active"] ; # fhir:experimental [ fhir:v true] ; # fhir:date [ fhir:v "2024-01-17T00:00:00+00:00"^^xsd:dateTime] ; # fhir:publisher [ fhir:v "HL7 International / Clinical Decision Support"] ; # fhir:contact ( [ fhir:telecom ( [ fhir:system [ fhir:v "url" ] ; fhir:value [ fhir:v "http://www.hl7.org/Special/committees/dss" ] ] ) ] ) ; # fhir:description [ fhir:v "This is an example of a prior authorization questionnaire developed based on an existing industry prior-authorization form."] ; # fhir:jurisdiction ( [ fhir:coding ( [ fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "US" ] ; fhir:display [ fhir:v "United States of America" ] ] ) ] ) ; # fhir:copyright [ fhir:v "This content is informed by the following source, used with permission: https://www.hca.wa.gov/assets/billers-and-providers/13-760.pdf"] ; # fhir:item ( [ fhir:linkId [ fhir:v "request-info" ] ; fhir:text [ fhir:v "Request Information" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Date of Request" ] ] ] ) ; fhir:linkId [ fhir:v "request-info|date-of-request" ] ; fhir:text [ fhir:v "DATE OF REQUEST" ] ; fhir:type [ fhir:v "date" ] ] ) ] [ fhir:linkId [ fhir:v "diagnosis-info" ] ; fhir:text [ fhir:v "Diagnosis Information" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Diagnosis" ] ] ] ) ; fhir:linkId [ fhir:v "diagnosis-info|diagnosis" ] ; fhir:text [ fhir:v "Diagnosis" ] ; fhir:type [ fhir:v "string" ] ] ) ] [ fhir:linkId [ fhir:v "item-requested" ] ; fhir:text [ fhir:v "Item Requested" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Item Requested" ] ] ] ) ; fhir:linkId [ fhir:v "item-requested|item" ] ; fhir:text [ fhir:v "Item requested" ] ; fhir:type [ fhir:v "string" ] ] ) ] [ fhir:linkId [ fhir:v "uti-history" ] ; fhir:text [ fhir:v "UTI History" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "UTI in Last Year" ] ] ] ) ; fhir:linkId [ fhir:v "uti-history|uti-last-year" ] ; fhir:text [ fhir:v "The patient has|had documented recurrent urinary tract infections while on a program of clean cathing, twice within a 12 month period prior to beginning sterile cathing" ] ; fhir:type [ fhir:v "boolean" ] ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Dates of UTIs" ] ] ] ) ; fhir:linkId [ fhir:v "uti-history|uti-dates" ] ; fhir:text [ fhir:v "Dates of UTIs in the last year" ] ; fhir:type [ fhir:v "string" ] ; fhir:enableWhen ( [ fhir:question [ fhir:v "uti-history|uti-last-year" ] ; fhir:operator [ fhir:v "=" ] ; fhir:answer [ a fhir:Boolean ; fhir:v true ] ] ) ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Antibiotics Used" ] ] ] ) ; fhir:linkId [ fhir:v "uti-history|antibiotics-used" ] ; fhir:text [ fhir:v "Antibiotics used for UTIs in the last year" ] ; fhir:type [ fhir:v "string" ] ; fhir:enableWhen ( [ fhir:question [ fhir:v "uti-history|uti-last-year" ] ; fhir:operator [ fhir:v "=" ] ; fhir:answer [ a fhir:Boolean ; fhir:v true ] ] ) ] ) ] [ fhir:linkId [ fhir:v "symptoms-info" ] ; fhir:text [ fhir:v "Symptoms Information" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Check Symptoms" ] ] ] ) ; fhir:linkId [ fhir:v "symptoms-info|symptoms" ] ; fhir:text [ fhir:v "Check those that apply to your patient" ] ; fhir:type [ fhir:v "choice" ] ; fhir:repeats [ fhir:v true ] ; fhir:answerOption ( [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "Fever" ] ; fhir:display [ fhir:v "Fever; state temperature in degree" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "UrinaryUrgencyFrequency" ] ; fhir:display [ fhir:v "Change in urinary urgency, frequency, or incontinence" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "AutonomicDysreflexia" ] ; fhir:display [ fhir:v "Appearance of new or increase in autonomic dysreflexia" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "PhysicalSignsProstatitis" ] ; fhir:display [ fhir:v "Physical signs of prostatitis, epididymitis, orchitis" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "Immunosuppressed" ] ; fhir:display [ fhir:v "The patient is immunosuppressed" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "Pyuria" ] ; fhir:display [ fhir:v "Pyuria" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "SystemicLeukocytosis" ] ; fhir:display [ fhir:v "Systemic leukocytosis" ] ] ] ) ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Fever Temperature" ] ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/questionnaire-unit"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "deg" ] ; fhir:display [ fhir:v "deg" ] ] ] ) ; fhir:linkId [ fhir:v "symptoms-info|fever-temperature" ] ; fhir:text [ fhir:v "If fever, state temperature in degrees" ] ; fhir:type [ fhir:v "decimal" ] ; fhir:enableWhen ( [ fhir:question [ fhir:v "symptoms-info|symptoms" ] ; fhir:operator [ fhir:v "=" ] ; fhir:answer [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-symptoms-info-symptoms"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "Fever" ] ] ] ) ] ) ] [ fhir:linkId [ fhir:v "catheterization-frequency" ] ; fhir:text [ fhir:v "Catheterization Frequency" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Catheterization Frequency" ] ] ] ) ; fhir:linkId [ fhir:v "catheterization-frequency|frequency" ] ; fhir:text [ fhir:v "How many times per day does the patient catheterize?" ] ; fhir:type [ fhir:v "choice" ] ; fhir:answerOption ( [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "2-4Times" ] ; fhir:display [ fhir:v "2-4 times" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "4-6Times" ] ; fhir:display [ fhir:v "4-6 times" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "6-8Times" ] ; fhir:display [ fhir:v "6-8 times" ] ] ] [ fhir:value [ a fhir:Coding ; fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/MNACQuestionnaire-catheterization-frequency-frequency"^^xsd:anyURI ; fhir:l ] ; fhir:code [ fhir:v "8TimesOrMore" ] ; fhir:display [ fhir:v "8 times or more" ] ] ] ) ] ) ] [ fhir:linkId [ fhir:v "additional-comments" ] ; fhir:text [ fhir:v "Additional Comments" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Additional Comment" ] ] ] ) ; fhir:linkId [ fhir:v "additional-comments|comments" ] ; fhir:text [ fhir:v "Additional Comment" ] ; fhir:type [ fhir:v "string" ] ] ) ] [ fhir:linkId [ fhir:v "physician-info" ] ; fhir:text [ fhir:v "Physician Information" ] ; fhir:type [ fhir:v "group" ] ; fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Physician Name" ] ] ] ) ; fhir:linkId [ fhir:v "physician-info|name" ] ; fhir:text [ fhir:v "Physician's Name" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Physician Telephone" ] ] ] ) ; fhir:linkId [ fhir:v "physician-info|mobile" ] ; fhir:text [ fhir:v "Telephone" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Physician Fax" ] ] ] ) ; fhir:linkId [ fhir:v "physician-info|fax" ] ; fhir:text [ fhir:v "FAX" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:linkId [ fhir:v "physician-info|signature" ] ; fhir:text [ fhir:v "Physician's Signature" ] ; fhir:type [ fhir:v "attachment" ] ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Referring Physician Telephone" ] ] ] ) ; fhir:linkId [ fhir:v "physician-info|phone-referring" ] ; fhir:text [ fhir:v "Referring Physician Telephone" ] ; fhir:type [ fhir:v "string" ] ] [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-initialExpression"^^xsd:anyURI ; fhir:l ] ; fhir:value [ a fhir:Expression ; fhir:language [ fhir:v "text/cql-identifier" ] ; fhir:expression [ fhir:v "Date" ] ] ] ) ; fhir:linkId [ fhir:v "physician-info|date" ] ; fhir:text [ fhir:v "Date" ] ; fhir:type [ fhir:v "string" ] ] ) ] ) . # # -------------------------------------------------------------------------------------