The following content has been modified for better visualization. Validation will be performed on original content
| 1 |
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
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| 2 |
<realmCode code="UV"/>
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| 3 |
<typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
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<id extension="IPS_2025015763_3" root="2.16.840.1.113883.4.292.20.1.1.1.23"/>
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<code code="60591-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Patient Summary"/>
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| 8 |
<title>International Patient Summary.</title>
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| 9 |
<effectiveTime value="202506191107+0200"/>
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<confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
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<languageCode code="en-GB"/>
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<recordTarget>
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<patientRole>
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<id extension="2025015763" root="2.16.840.1.113883.4.292.20.1.1.20.1"/>
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<id extension="EUR01P0013" root="2.16.840.1.113883.4.330"/>
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<addr>
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<streetAddressLine>LANDSTRASSE, 4</streetAddressLine>
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<city>VIENNA</city>
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| 19 |
<state>VIENNA</state>
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| 20 |
<postalCode>22181</postalCode>
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| 21 |
<country>AT</country>
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| 22 |
</addr>
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| 23 |
<telecom value="tel:34628901083"/>
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| 24 |
<patient>
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| 25 |
<name>
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| 26 |
<given>ALLEN</given>
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| 27 |
<family>PEROT</family>
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| 28 |
<family>.</family>
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| 29 |
</name>
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<administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1"/>
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<birthTime value="19630218"/>
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</patient>
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</patientRole>
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</recordTarget>
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<author>
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<time value="202506191107+0200"/>
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<assignedAuthor>
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<id extension="RICSAB" root="2.16.840.1.113883.4.292.20.1.1.14.1"/>
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<id extension="080837292" root="2.16.840.1.113883.2.19.10.8"/>
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<code code="207V00000X" codeSystem="2.16.840.1.113883.6.101"/>
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| 41 |
<addr use="WP">
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<streetAddressLine>Gran Via de Carles III 71-75</streetAddressLine>
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| 43 |
<city>BARCELONA</city>
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| 44 |
<state>BARCELONA</state>
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| 45 |
<postalCode>08028</postalCode>
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| 46 |
<country>ES</country>
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| 47 |
</addr>
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| 48 |
<telecom use="WP" value="mailto:ricsab@dexeus.com"/>
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| 49 |
<assignedPerson>
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| 50 |
<name>
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| 51 |
<given>Ricard</given>
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| 52 |
<family>Sabartés</family>
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| 53 |
<family>Fortuny</family>
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| 54 |
</name>
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| 55 |
</assignedPerson>
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| 56 |
</assignedAuthor>
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</author>
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<custodian>
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<assignedCustodian classCode="ASSIGNED">
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<representedCustodianOrganization classCode="ORG" determinerCode="INSTANCE">
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<id root="2.16.840.1.113883.4.292.20.1.1"/>
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| 62 |
<name>Dexeus Mujer Barcelona</name>
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| 63 |
<telecom use="WP" value="tel:932274727"/>
|
| 64 |
<addr use="WP">
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| 65 |
<streetAddressLine>Gran Via Carles III, 71-75</streetAddressLine>
|
| 66 |
<city>Barcelona</city>
|
| 67 |
<state>Barcelona</state>
|
| 68 |
<postalCode>08028</postalCode>
|
| 69 |
<country>ES</country>
|
| 70 |
</addr>
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| 71 |
</representedCustodianOrganization>
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| 72 |
</assignedCustodian>
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| 73 |
</custodian>
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| 74 |
<legalAuthenticator>
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| 75 |
<time value="202506191107+0200"/>
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| 76 |
<signatureCode code="S"/>
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| 77 |
<assignedEntity>
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<id extension="RICSAB" root="2.16.840.1.113883.4.292.20.1.1.14.1"/>
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<id extension="080837292" root="2.16.840.1.113883.2.19.10.8"/>
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<code code="207V00000X" codeSystem="2.16.840.1.113883.6.101"/>
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<addr nullFlavor="UNK"/>
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<telecom nullFlavor="UNK"/>
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| 83 |
<assignedPerson>
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| 84 |
<name>
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| 85 |
<given>Ricard</given>
|
| 86 |
<family>Sabartés</family>
|
| 87 |
<family>Fortuny</family>
|
| 88 |
</name>
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| 89 |
</assignedPerson>
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<representedOrganization classCode="ORG" determinerCode="INSTANCE">
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<id root="2.16.840.1.113883.4.292.20.1.1"/>
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| 92 |
<name>Dexeus Mujer Barcelona</name>
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| 93 |
<telecom use="WP" value="tel:932274727"/>
|
| 94 |
<addr use="WP">
|
| 95 |
<streetAddressLine>Gran Via Carles III, 71-75</streetAddressLine>
|
| 96 |
<city>Barcelona</city>
|
| 97 |
<state>Barcelona</state>
|
| 98 |
<postalCode>08028</postalCode>
|
| 99 |
<country>ES</country>
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| 100 |
</addr>
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| 101 |
</representedOrganization>
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| 102 |
</assignedEntity>
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| 103 |
</legalAuthenticator>
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<documentationOf>
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<serviceEvent classCode="PCPR" moodCode="EVN">
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<effectiveTime value="202506191107+0200">
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<low nullFlavor="NA"/>
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<high nullFlavor="NA"/>
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</effectiveTime>
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<performer typeCode="PRF">
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<templateId root="1.3.6.1.4.1.19376.1.5.3.1.2.3"/>
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<functionCode code="PP" codeSystem="2.16.840.1.113883.12.443" codeSystemName="HL7 ProviderRole" displayName="Primary Care Provider">
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| 113 |
<originalText>Primary Care Provider</originalText>
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</functionCode>
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| 115 |
<time>
|
| 116 |
<low value="202506191107+0200"/>
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<high nullFlavor="NA"/>
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</time>
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<assignedEntity>
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<id extension="RICSAB" root="2.16.840.1.113883.4.292.20.1.1.14.1"/>
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<id extension="080837292" root="2.16.840.1.113883.2.19.10.8"/>
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<code code="2.16.840.1.113883.4.292.20.1.1.2.2" codeSystem="2.16.840.1.113883.6.101"/>
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<addr nullFlavor="UNK"/>
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| 124 |
<telecom nullFlavor="UNK"/>
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| 125 |
<assignedPerson>
|
| 126 |
<name>
|
| 127 |
<given>Ricard</given>
|
| 128 |
<family>Sabartés</family>
|
| 129 |
<family>Fortuny</family>
|
| 130 |
</name>
|
| 131 |
</assignedPerson>
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| 132 |
<representedOrganization classCode="ORG" determinerCode="INSTANCE">
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<id root="2.16.840.1.113883.4.292.20.1.1"/>
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| 134 |
<name>Dexeus Mujer Barcelona</name>
|
| 135 |
<telecom use="WP" value="tel:932274727"/>
|
| 136 |
<addr use="WP">
|
| 137 |
<streetAddressLine>Gran Via Carles III, 71-75</streetAddressLine>
|
| 138 |
<city>Barcelona</city>
|
| 139 |
<state>Barcelona</state>
|
| 140 |
<postalCode>08028</postalCode>
|
| 141 |
<country>ES</country>
|
| 142 |
</addr>
|
| 143 |
</representedOrganization>
|
| 144 |
</assignedEntity>
|
| 145 |
</performer>
|
| 146 |
</serviceEvent>
|
| 147 |
</documentationOf>
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| 148 |
<relatedDocument typeCode="RPLC">
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| 149 |
<parentDocument>
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<id extension="IPS_2025015763_2" root="2.16.840.1.113883.4.292.20.1.1.1.23"/>
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| 151 |
</parentDocument>
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| 152 |
</relatedDocument>
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| 153 |
<component>
|
| 154 |
<structuredBody>
|
| 155 |
<component>
|
| 156 |
<section classCode="DOCSECT">
|
| 157 |
<templateId root="2.16.840.1.113883.10.22.3.1"/>
|
| 158 |
<id root="730A0C71-8928-4010-A568-4351A5E934DD"/>
|
| 159 |
<code code="10160-0" codeSystem="2.16.840.1.113883.6.1" displayName="Medication Summary"/>
|
| 160 |
<title>Medication Summary</title>
|
| 161 |
<text>
|
| 162 |
<paragraph>
|
| 163 |
<content styleCode="Bold">Currently active medications</content>
|
| 164 |
</paragraph>
|
| 165 |
<table>
|
| 166 |
<tbody>
|
| 167 |
<tr>
|
| 168 |
<th>
|
| 169 |
<content>Product and</content>
|
| 170 |
<br/>
|
| 171 |
<content>dose form</content>
|
| 172 |
</th>
|
| 173 |
<th>
|
| 174 |
<content>Dose and</content>
|
| 175 |
<br/>
|
| 176 |
<content>frequency</content>
|
| 177 |
</th>
|
| 178 |
<th>Route</th>
|
| 179 |
<th>Duration</th>
|
| 180 |
<th>Comments</th>
|
| 181 |
</tr>
|
| 182 |
<tr ID="MED.1901878">
|
| 183 |
<td>
|
| 184 |
<content>CITALOPRAM CINFA EFG</content>
|
| 185 |
<br/>
|
| 186 |
<content>Tablet</content>
|
| 187 |
</td>
|
| 188 |
<td>
|
| 189 |
<content>1 Tablet</content>
|
| 190 |
<br/>
|
| 191 |
<content>each 1 day</content>
|
| 192 |
</td>
|
| 193 |
<td>
|
| 194 |
<content>Oral use</content>
|
| 195 |
</td>
|
| 196 |
<td>
|
| 197 |
<content>2025-06-06</content>
|
| 198 |
<br/>
|
| 199 |
<content>2026-04-17</content>
|
| 200 |
</td>
|
| 201 |
<td/>
|
| 202 |
</tr>
|
| 203 |
<tr ID="MED.1901877">
|
| 204 |
<td>
|
| 205 |
<content>CETIRIZINA NORMON EFG</content>
|
| 206 |
<br/>
|
| 207 |
<content>Tablet</content>
|
| 208 |
</td>
|
| 209 |
<td>
|
| 210 |
<content>1 Tablet</content>
|
| 211 |
<br/>
|
| 212 |
<content>each 1 day</content>
|
| 213 |
</td>
|
| 214 |
<td>
|
| 215 |
<content>Oral use</content>
|
| 216 |
</td>
|
| 217 |
<td>
|
| 218 |
<content>2025-06-06</content>
|
| 219 |
<br/>
|
| 220 |
<content>2025-09-19</content>
|
| 221 |
</td>
|
| 222 |
<td/>
|
| 223 |
</tr>
|
| 224 |
<tr ID="MED.1901874">
|
| 225 |
<td>
|
| 226 |
<content>PARACETAMOL MABOGEN EFG</content>
|
| 227 |
<br/>
|
| 228 |
<content>Tablet</content>
|
| 229 |
</td>
|
| 230 |
<td>
|
| 231 |
<content>1 Tablet</content>
|
| 232 |
<br/>
|
| 233 |
<content>each 8 hour</content>
|
| 234 |
</td>
|
| 235 |
<td>
|
| 236 |
<content>Oral use</content>
|
| 237 |
</td>
|
| 238 |
<td>
|
| 239 |
<content>2025-06-06</content>
|
| 240 |
<br/>
|
| 241 |
<content>2025-09-19</content>
|
| 242 |
</td>
|
| 243 |
<td/>
|
| 244 |
</tr>
|
| 245 |
</tbody>
|
| 246 |
</table>
|
| 247 |
</text>
|
| 248 |
<entry typeCode="DRIV">
|
| 249 |
<substanceAdministration classCode="SBADM" moodCode="INT">
|
| 250 |
<templateId root="2.16.840.1.113883.10.22.4.4"/>
|
| 251 |
<id extension="PENDENT" root="2.16.840.1.113883.4.292.20.1.1.1.17"/>
|
| 252 |
<code code="DRUG" codeSystem="2.16.840.1.113883.5.4"/>
|
| 253 |
<text>
|
| 254 |
<reference value="#MED.1901878"/>
|
| 255 |
</text>
|
| 256 |
|
| 257 |
<statusCode code="active"/>
|
| 258 |
|
| 259 |
|
| 260 |
<effectiveTime xsi:type="IVL_TS">
|
| 261 |
<low value="20250606"/>
|
| 262 |
<high value="20260417"/>
|
| 263 |
</effectiveTime>
|
| 264 |
|
| 265 |
<routeCode code="20053000" codeSystem="0.4.0.127.0.16.1.1.2.1" codeSystemName="IPSRouteOfAdmin"/>
|
| 266 |
|
| 267 |
<consumable typeCode="CSM">
|
| 268 |
<manufacturedProduct classCode="MANU">
|
| 269 |
<templateId root="2.16.840.1.113883.10.22.4.2"/>
|
| 270 |
<manufacturedMaterial classCode="MMAT" determinerCode="KIND">
|
| 271 |
<templateId root="2.16.840.1.113883.10.22.4.3"/>
|
| 272 |
<code code="232493" codeSystem="2.16.724.4.21.5.15.4" displayName="CITALOPRAM CINFA EFG 20 mg 56 COMPRIMIDOS RECUBIERTOS"/>
|
| 273 |
<name>CITALOPRAM CINFA EFG 20 mg 56 COMPRIMIDOS RECUBIERTOS</name>
|
| 274 |
<pharm:formCode xmlns:pharm="urn:hl7-org:pharm" code="10219000" codeSystem="2.16.840.1.113883.11.22.25" codeSystemName="EDQM" displayName="Tablet "/>
|
| 275 |
<pharm:asSpecializedKind xmlns:pharm="urn:hl7-org:pharm" classCode="GRIC">
|
| 276 |
<pharm:generalizedMaterialKind classCode="MMAT" determinerCode="KIND">
|
| 277 |
<pharm:code code="N06AB" codeSystem="2.16.840.1.113883.6.73" codeSystemName="WHO ATC" displayName="INHIBIDORES SELECTIVOS DE LA RECAPTACION DE SEROTONINA"/>
|
| 278 |
</pharm:generalizedMaterialKind>
|
| 279 |
</pharm:asSpecializedKind>
|
| 280 |
|
| 281 |
<pharm:ingredient xmlns:pharm="urn:hl7-org:pharm" classCode="ACTI">
|
| 282 |
<pharm:quantity>
|
| 283 |
<numerator unit="mg" value="20.0" xsi:type="PQ"/>
|
| 284 |
<denominator unit="mg" value="1" xsi:type="PQ"/>
|
| 285 |
</pharm:quantity>
|
| 286 |
<pharm:ingredientSubstance classCode="MMAT" determinerCode="KIND">
|
| 287 |
<pharm:code code="4635.0" codeSystem="2.16.724.4.21.5.15.5" codeSystemName="Diccionario Descripción Clínica de Sustancia Activa (DCSA)"/>
|
| 288 |
<pharm:name>CITALOPRAM</pharm:name>
|
| 289 |
</pharm:ingredientSubstance>
|
| 290 |
</pharm:ingredient>
|
| 291 |
</manufacturedMaterial>
|
| 292 |
</manufacturedProduct>
|
| 293 |
</consumable>
|
| 294 |
<entryRelationship typeCode="COMP">
|
| 295 |
<substanceAdministration classCode="SBADM" moodCode="INT">
|
| 296 |
<templateId root="2.16.840.1.113883.10.22.4.33"/>
|
| 297 |
<statusCode code="active"/>
|
| 298 |
|
| 299 |
<effectiveTime institutionSpecified="true" xsi:type="PIVL_TS">
|
| 300 |
<period unit="d" value="1"/>
|
| 301 |
</effectiveTime>
|
| 302 |
|
| 303 |
<doseQuantity unit="{tablet}" value="1"/>
|
| 304 |
<consumable>
|
| 305 |
<manufacturedProduct>
|
| 306 |
<manufacturedMaterial nullFlavor="NA"/>
|
| 307 |
</manufacturedProduct>
|
| 308 |
</consumable>
|
| 309 |
</substanceAdministration>
|
| 310 |
</entryRelationship>
|
| 311 |
</substanceAdministration>
|
| 312 |
</entry>
|
| 313 |
<entry typeCode="DRIV">
|
| 314 |
<substanceAdministration classCode="SBADM" moodCode="INT">
|
| 315 |
<templateId root="2.16.840.1.113883.10.22.4.4"/>
|
| 316 |
<id extension="PENDENT" root="2.16.840.1.113883.4.292.20.1.1.1.17"/>
|
| 317 |
<code code="DRUG" codeSystem="2.16.840.1.113883.5.4"/>
|
| 318 |
<text>
|
| 319 |
<reference value="#MED.1901877"/>
|
| 320 |
</text>
|
| 321 |
|
| 322 |
<statusCode code="active"/>
|
| 323 |
|
| 324 |
|
| 325 |
<effectiveTime xsi:type="IVL_TS">
|
| 326 |
<low value="20250606"/>
|
| 327 |
<high value="20250919"/>
|
| 328 |
</effectiveTime>
|
| 329 |
|
| 330 |
<routeCode code="20053000" codeSystem="0.4.0.127.0.16.1.1.2.1" codeSystemName="IPSRouteOfAdmin"/>
|
| 331 |
|
| 332 |
<consumable typeCode="CSM">
|
| 333 |
<manufacturedProduct classCode="MANU">
|
| 334 |
<templateId root="2.16.840.1.113883.10.22.4.2"/>
|
| 335 |
<manufacturedMaterial classCode="MMAT" determinerCode="KIND">
|
| 336 |
<templateId root="2.16.840.1.113883.10.22.4.3"/>
|
| 337 |
<code code="202474" codeSystem="2.16.724.4.21.5.15.4" displayName="CETIRIZINA NORMON EFG 10 mg 20 COMPRIMIDOS RECUBIERTOS"/>
|
| 338 |
<name>CETIRIZINA NORMON EFG 10 mg 20 COMPRIMIDOS RECUBIERTOS</name>
|
| 339 |
<pharm:formCode xmlns:pharm="urn:hl7-org:pharm" code="10219000" codeSystem="2.16.840.1.113883.11.22.25" codeSystemName="EDQM" displayName="Tablet "/>
|
| 340 |
<pharm:asSpecializedKind xmlns:pharm="urn:hl7-org:pharm" classCode="GRIC">
|
| 341 |
<pharm:generalizedMaterialKind classCode="MMAT" determinerCode="KIND">
|
| 342 |
<pharm:code code="R06AE" codeSystem="2.16.840.1.113883.6.73" codeSystemName="WHO ATC" displayName="DERIVADOS DE LA PIPERAZINA"/>
|
| 343 |
</pharm:generalizedMaterialKind>
|
| 344 |
</pharm:asSpecializedKind>
|
| 345 |
|
| 346 |
<pharm:ingredient xmlns:pharm="urn:hl7-org:pharm" classCode="ACTI">
|
| 347 |
<pharm:quantity>
|
| 348 |
<numerator unit="mg" value="10.0" xsi:type="PQ"/>
|
| 349 |
<denominator unit="mg" value="1" xsi:type="PQ"/>
|
| 350 |
</pharm:quantity>
|
| 351 |
<pharm:ingredientSubstance classCode="MMAT" determinerCode="KIND">
|
| 352 |
<pharm:code code="4290.0" codeSystem="2.16.724.4.21.5.15.5" codeSystemName="Diccionario Descripción Clínica de Sustancia Activa (DCSA)"/>
|
| 353 |
<pharm:name>CETIRIZINA</pharm:name>
|
| 354 |
</pharm:ingredientSubstance>
|
| 355 |
</pharm:ingredient>
|
| 356 |
</manufacturedMaterial>
|
| 357 |
</manufacturedProduct>
|
| 358 |
</consumable>
|
| 359 |
<entryRelationship typeCode="COMP">
|
| 360 |
<substanceAdministration classCode="SBADM" moodCode="INT">
|
| 361 |
<templateId root="2.16.840.1.113883.10.22.4.33"/>
|
| 362 |
<statusCode code="active"/>
|
| 363 |
|
| 364 |
<effectiveTime institutionSpecified="true" xsi:type="PIVL_TS">
|
| 365 |
<period unit="d" value="1"/>
|
| 366 |
</effectiveTime>
|
| 367 |
|
| 368 |
<doseQuantity unit="{tablet}" value="1"/>
|
| 369 |
<consumable>
|
| 370 |
<manufacturedProduct>
|
| 371 |
<manufacturedMaterial nullFlavor="NA"/>
|
| 372 |
</manufacturedProduct>
|
| 373 |
</consumable>
|
| 374 |
</substanceAdministration>
|
| 375 |
</entryRelationship>
|
| 376 |
</substanceAdministration>
|
| 377 |
</entry>
|
| 378 |
<entry typeCode="DRIV">
|
| 379 |
<substanceAdministration classCode="SBADM" moodCode="INT">
|
| 380 |
<templateId root="2.16.840.1.113883.10.22.4.4"/>
|
| 381 |
<id extension="PENDENT" root="2.16.840.1.113883.4.292.20.1.1.1.17"/>
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<name>PARACETAMOL MABOGEN EFG 1 g 40 COMPRIMIDOS</name>
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<tbody>
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<th>
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<th>
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<th>Comments</th>
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<td>
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<content>2025-06-06</content>
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<td>
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<content>Látex</content>
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</td>
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<td>
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<content/>
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<name>Dexeus Mujer Barcelona</name>
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<addr use="WP">
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<city>Barcelona</city>
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<state>Barcelona</state>
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<country>ES</country>
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| 536 |
<title>Active Problems</title>
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| 537 |
<text>
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| 538 |
<table border="1PX">
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| 539 |
<tbody>
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| 540 |
<tr>
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| 541 |
<th>Problem</th>
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| 542 |
<th>Onset time</th>
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| 543 |
</tr>
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| 544 |
<tr>
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| 545 |
<td ID="APRO.10820">Cardiopathy</td>
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| 546 |
<td>2013-12-22</td>
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| 547 |
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<tr>
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| 549 |
<td ID="APRO.10821">Rheumatoid arthritis</td>
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| 550 |
<td>2024-11-17</td>
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<tr>
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<td ID="APRO.10822">Cataract</td>
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<td>2023-04-05</td>
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<td ID="APRO.10823">Diabetes type 1</td>
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<td>2018-08-08</td>
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<tr>
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| 561 |
<td ID="APRO.10824">Sleep disorder</td>
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| 562 |
<td>2005-10-20</td>
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| 725 |
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| 728 |
<code code="11369-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="History of immunizations"/>
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| 729 |
<title>Immunizations</title>
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| 730 |
<text>
|
| 731 |
|
| 732 |
<table>
|
| 733 |
<tbody>
|
| 734 |
<tr>
|
| 735 |
<th>
|
| 736 |
<content>Date</content>
|
| 737 |
</th>
|
| 738 |
<th>
|
| 739 |
<content>Vaccine</content>
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| 740 |
</th>
|
| 741 |
<th>
|
| 742 |
<content>Dose</content>
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| 743 |
</th>
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| 744 |
<th>
|
| 745 |
<content>Reference</content>
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| 746 |
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| 747 |
<th>
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| 748 |
<content>Lot</content>
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| 749 |
</th>
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| 750 |
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| 751 |
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| 752 |
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| 753 |
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| 754 |
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<td>
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| 756 |
<content>Gripe ()</content>
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| 757 |
</td>
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| 758 |
<td>
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| 759 |
<content>1</content>
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| 760 |
</td>
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| 761 |
<td>
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| 762 |
<content>MNX2961</content>
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| 763 |
</td>
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| 764 |
<td>
|
| 765 |
<content>463715</content>
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| 766 |
</td>
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| 767 |
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<tr ID="VAC.72902">
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| 769 |
<td>
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| 770 |
<content>2021-02-16</content>
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| 771 |
</td>
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| 772 |
<td>
|
| 773 |
<content>Covid-19 ()</content>
|
| 774 |
</td>
|
| 775 |
<td>
|
| 776 |
<content>1</content>
|
| 777 |
</td>
|
| 778 |
<td>
|
| 779 |
<content>AN545142</content>
|
| 780 |
</td>
|
| 781 |
<td>
|
| 782 |
<content>32678548</content>
|
| 783 |
</td>
|
| 784 |
</tr>
|
| 785 |
</tbody>
|
| 786 |
</table>
|
| 787 |
</text>
|
| 788 |
<entry typeCode="DRIV">
|
| 789 |
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
|
| 790 |
<templateId root="2.16.840.1.113883.10.22.4.15"/>
|
| 791 |
<id extension="#VAC.72903" root="4A9C441D-DDDE-4ACF-9140-8071B08E4190"/>
|
| 792 |
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="Act Code" displayName="Immunizations">
|
| 793 |
<originalText>
|
| 794 |
|
| 795 |
<reference value="#VAC.72903"/>
|
| 796 |
</originalText>
|
| 797 |
</code>
|
| 798 |
<statusCode code="completed"/>
|
| 799 |
|
| 800 |
<effectiveTime value="20250217"/>
|
| 801 |
<doseQuantity nullFlavor="UNK"/>
|
| 802 |
<consumable typeCode="CSM">
|
| 803 |
<templateId root="2.16.840.1.113883.10.22.4.16"/>
|
| 804 |
<manufacturedProduct classCode="MANU">
|
| 805 |
<templateId root="2.16.840.1.113883.10.22.4.16"/>
|
| 806 |
<manufacturedMaterial classCode="MMAT" determinerCode="KIND">
|
| 807 |
|
| 808 |
<code code="86198006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Administration of influenza vaccine"/>
|
| 809 |
</manufacturedMaterial>
|
| 810 |
</manufacturedProduct>
|
| 811 |
</consumable>
|
| 812 |
<entryRelationship typeCode="SUBJ">
|
| 813 |
<observation classCode="OBS" moodCode="EVN">
|
| 814 |
<id root="2.16.840.1.113883.10.20.1.46"/>
|
| 815 |
<code code="30973-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Dose Number"/>
|
| 816 |
<statusCode code="completed"/>
|
| 817 |
|
| 818 |
<value value="1" xsi:type="INT"/>
|
| 819 |
</observation>
|
| 820 |
</entryRelationship>
|
| 821 |
</substanceAdministration>
|
| 822 |
</entry>
|
| 823 |
<entry typeCode="DRIV">
|
| 824 |
<substanceAdministration classCode="SBADM" moodCode="EVN" negationInd="false">
|
| 825 |
<templateId root="2.16.840.1.113883.10.22.4.15"/>
|
| 826 |
<id extension="#VAC.72902" root="4A9C441D-DDDE-4ACF-9140-8071B08E4190"/>
|
| 827 |
<code code="IMMUNIZ" codeSystem="2.16.840.1.113883.5.4" codeSystemName="Act Code" displayName="Immunizations">
|
| 828 |
<originalText>
|
| 829 |
|
| 830 |
<reference value="#VAC.72902"/>
|
| 831 |
</originalText>
|
| 832 |
</code>
|
| 833 |
<statusCode code="completed"/>
|
| 834 |
|
| 835 |
<effectiveTime value="20210216"/>
|
| 836 |
<doseQuantity nullFlavor="UNK"/>
|
| 837 |
<consumable typeCode="CSM">
|
| 838 |
<templateId root="2.16.840.1.113883.10.22.4.16"/>
|
| 839 |
<manufacturedProduct classCode="MANU">
|
| 840 |
<templateId root="2.16.840.1.113883.10.22.4.16"/>
|
| 841 |
<manufacturedMaterial classCode="MMAT" determinerCode="KIND">
|
| 842 |
|
| 843 |
<code code="840534001" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Administration of SARS-CoV-2 antigen vaccine"/>
|
| 844 |
</manufacturedMaterial>
|
| 845 |
</manufacturedProduct>
|
| 846 |
</consumable>
|
| 847 |
<entryRelationship typeCode="SUBJ">
|
| 848 |
<observation classCode="OBS" moodCode="EVN">
|
| 849 |
<id root="2.16.840.1.113883.10.20.1.46"/>
|
| 850 |
<code code="30973-2" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Dose Number"/>
|
| 851 |
<statusCode code="completed"/>
|
| 852 |
|
| 853 |
<value value="1" xsi:type="INT"/>
|
| 854 |
</observation>
|
| 855 |
</entryRelationship>
|
| 856 |
</substanceAdministration>
|
| 857 |
</entry>
|
| 858 |
</section>
|
| 859 |
</component>
|
| 860 |
<component>
|
| 861 |
<section>
|
| 862 |
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.14"/>
|
| 863 |
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.3.15"/>
|
| 864 |
<id root="02F4688B-EEF2-4CED-9693-062E87EF3E8B"/>
|
| 865 |
<code code="10157-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="HISTORY OF FAMILY MEMBER DISEASES"/> 2415
|
| 866 |
<text>
|
| 867 |
Text as described above
|
| 868 |
</text>
|
| 869 |
|
| 870 |
|
| 871 |
|
| 872 |
|
| 873 |
|
| 874 |
</section>
|
| 875 |
</component>
|
| 876 |
</structuredBody>
|
| 877 |
</component>
|
| 878 |
</ClinicalDocument>
|