<?xml version="1.0" encoding="UTF-8"?>
    
<!--
 Title:        Care Plan
 Filename:     09 Authenticator - Signed.xml 
 Created by:   HL7
 Initial Publish Date: 10/31/2019 
 $LastChangedDate: 10/31/2019 $
  
 ********************************************************
Disclaimer: The data in this sample file is not intended to represent real patients, people or clinical events. The file depicts a fictional character's health data. 
Any resemblance to a real person is coincidental. To illustrate as many data elements as possible, the clinical scenario may not be plausible. Dates and times also may not coorelate well from a temporal perspective.

This sample is designed to be used in conjunction with the HL7 CDA® R2 IG: C-CDA Templates for Clinical Notes R2.1 Companion Guide, Release 2.

It demonstrates the digital signing of a CDA document by a Legal Authenticator using the HL7 Digitial Signature Specification.  The presence
of the digital signature is visible in the supplied CDA Stylesheet as a small thumbnail icon.  To see the full contents of the digital
signature and to evaluate the authenticity of the certificate backed digital signature, view the sample document by going to
https://www.maxmddirect.com/direct/CCDViewer. This is a publically available C-CDA Viewer that offers signature certificate lookup.

********************************************************
 Note about the Care Plan document type: The C-CDA Care Plan represents an instance of a dynamic Care Plan at a point in time. 
 THE C-CDA  CARE PLAN DOCUMENT IS NOT DYNAMIC, BUT RATHER A SNAPSHOT IN TIME OF A DYNAMIC CARE PLAN.. 
 
 A dynamic Care Plan within a live health system record is a consensus-driven dynamic plan that represents a patient’s and Care Team Members’ prioritized concerns, goals, and planned interventions. 
 It serves as a blueprint shared by all Care Team Members (including the patient, their caregivers and providers), to guide the patient’s care. 
 A dynamic Care Plan integrates multiple interventions proposed by multiple providers and disciplines for multiple conditions.
 
 This Care Plan sample file entries are intentionally brief, showing how one health concern, one problem (diagnosis), one goal and one (actual) outcome/evaluation relate to each other.
 -->
<?xml-stylesheet type="text/xsl" href="../../xsl/CDA.xsl"?>
<ClinicalDocument xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" classCode="DOCCLIN" moodCode="EVN">
    <realmCode code="US"/>
    <typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3"/>
    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.1.15"/>
    <templateId root="2.16.840.1.113883.10.20.22.1.15"/>
    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.1.1"/>
    <templateId root="2.16.840.1.113883.10.20.22.1.1"/>
    <id extension="201808010952453945" root="1.3.6.1.4.1.22812.4.222.334.1"/>
    <!--Notes about LOINC Care Plan document codes:
        Origionally, C-CDA defined only one code for the Care Plan documentType code: LOINC "52521-2" "Overall Plan of Care/Advance Care Directives", with the intention, as need arose, to create a value set of appropriate LOINC codes. 
        The 52521-2 code has since been retired by LOINC. It is still available in the 2018-02-01 value set expansion for purposes of querying and validation. LOINC now recommends "18776-5 Plan of care note" as the most general 
        Care Plan docuument code: (https://loinc.org/18776-5/), This code is also used the Treatment Plan (Plan) section code in CCD. The rationale for this and other details can be seen 
        here: (https://loinc.org/18776-5/) and here: (https://loinc.org/81215-6/). Note that the 81215-6 LOINC code is a Panel code used in LOINC to organize the set of section codes recommended in the C-CDA IGs. 
        81215-6 LOINC panel code organizes the LOINC codes recomended for C-CDA Care Plan sections. It is not to be used as a code in exchanged documents.
        It is not to be used as a docuement or a code for a section. The current value set is available in VSAC: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1099.10/expansion
    -->
    <code code="18776-5" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Plan of care note"/>
    <!-- Title of this document -->
    <title>CARE PLAN</title>
    <effectiveTime value="20180801095245-0400"/>
    <confidentialityCode code="N" codeSystem="2.16.840.1.113883.5.25"/>
    <languageCode code="en-US"/>
    <setId extension="sTT998" root="2.16.840.1.113883.19.5.99999.19"/>
    <!-- Version of this document -->
    <versionNumber value="1"/>
    <recordTarget>
        <patientRole>
            <id extension="123ABC" root="1.3.6.1.4.1.22812.4.222.334"/>
            <addr use="HP">
                <!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
                <streetAddressLine>6666 Home Street</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
                <!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
            
            </addr>
            <telecom use="HP" value="tel:+1(555)555-2003"/>
            <patient>
                <name use="L">
                    <family>Nuclear</family>
                    <given>Neville</given>
                </name>
                <administrativeGenderCode code="M" codeSystem="2.16.840.1.113883.5.1" codeSystemName="AdministrativeGender" displayName="Male"/>
                <!-- Date of birth need only be precise to the day -->
                <birthTime value="19750111"/>
                <maritalStatusCode code="S" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatusCode" displayName="Single"/>
                <religiousAffiliationCode code="1013" codeSystem="2.16.840.1.113883.5.1076" codeSystemName="HL7 Religious Affiliation" displayName="Christian (non-Catholic, non-specific)"/>
                <!-- CDC Race and Ethnicity code set contains the five minimum race and ethnicity 
					categories defined by OMB Standards -->
                <raceCode code="2106-3" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="White"/>
                <ethnicGroupCode code="2186-5" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race &amp; Ethnicity - CDC" displayName="Not Hispanic or Latino"/>
                <!-- This patient's mother is identified as his legal guardian even though he is 43 due to his compromised health and mental status. -->
                <guardian>
                    <code code="POWATT" codeSystem="2.16.840.1.113883.5.111" codeSystemName="ResponsibleParty" displayName="Power of Attorney"/>
                    <addr>
                        <streetAddressLine>6666 Home Street</streetAddressLine>
                        <city>Beaverton</city>
                        <state>MD</state>
                        <postalCode>21014</postalCode>
                        <country>US</country>
                    </addr>
                    <telecom use="WP" value="tel:(999)555-1212"/>
                    <guardianPerson>
                        <name>
                            <prefix>Mrs.</prefix>
                            <given>Martha</given>
                            <family>Mumm</family>
                        </name>
                    </guardianPerson>
                </guardian>
                <languageCommunication>
                    <languageCode code="en"/>
                    <!-- "en" is ISO 639-1 alpha-2 code for "English" -->
                    <modeCode code="ESP" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode" displayName="Expressed spoken"/>
                    <proficiencyLevelCode code="G" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency" displayName="Good"/>
                    <!-- Patient's preferred language -->
                    <preferenceInd value="true"/>
                </languageCommunication>
            </patient>
            <providerOrganization>
                <id extension="334" root="1.3.6.1.4.1.22812.4.222.334"/>
                <name>The DoctorsTogether Physician Group</name>
                <telecom use="WP" value="tel:+1(555)555-1000"/>
                <addr>
                    <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                    <city>Beaverton</city>
                    <state>MD</state>
                    <postalCode>21014</postalCode>
                    <country>US</country>
                </addr>
            </providerOrganization>
        </patientRole>
    </recordTarget>
    <!-- The author represents the person who provides the content in the document   -->
    <author>
        <time value="20180801095245-0400"/>
        <assignedAuthor>
            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
            <addr>
                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:+1(555)555-1004"/>
            <assignedPerson>
                <name>
                    <family>Hippocrates</family>
                    <given>Harold</given>
                    <given>A</given>
                    <suffix>MD</suffix>
                </name>
            </assignedPerson>
        </assignedAuthor>
    </author>
    <!-- This author represents an author that is a DEVICE. Care Plan Notes might be partially generated by a device and partially crafted by a human -->
    <author>
        <time value="20180801095245-0400"/>
        <assignedAuthor>
            <id extension="334" root="1.3.6.1.4.1.22812.4.222.334.3.3"/>
            <addr>
                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:+1(555)555-1000"/>
            <assignedAuthoringDevice>
                <manufacturerModelName>Professional EHR 299.0.0.1215</manufacturerModelName>
                <softwareName>Professional EHR 299.0.0.1215</softwareName>
            </assignedAuthoringDevice>
            <representedOrganization>
                <id extension="334" root="1.3.6.1.4.1.22812.4.222.334"/>
                <name>The DoctorsTogether Physician Group</name>
                <telecom use="WP" value="tel:+1(555)555-1004"/>
                <addr>
                    <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                    <city>Beaverton</city>
                    <state>MD</state>
                    <postalCode>21014</postalCode>
                    <country>US</country>
                </addr>
            </representedOrganization>
        </assignedAuthor>
    </author>
    <!-- The custodian represents the organization charged with maintaining the original source document -->
    <custodian>
        <assignedCustodian>
            <representedCustodianOrganization>
                <id extension="321CX" root="2.16.840.1.113883.4.6"/>
                <name>The DoctorsTogether Physician Group</name>
                <telecom use="WP" value="tel:+1(555)555-1009"/>
                <addr use="WP">
                    <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                    <city>Beaverton</city>
                    <state>MD</state>
                    <postalCode>21014</postalCode>
                    <country>US</country>
                </addr>
            </representedCustodianOrganization>
        </assignedCustodian>
    </custodian>
    <!-- The informationRecipient represents the intended recipient of the document -->
    <informationRecipient>
        <intendedRecipient>
            <id extension="123321" root="2.16.840.1.113883.4.6"/>
            <informationRecipient>
                <name>
                    <given>Sara</given>
                    <family>Specialize</family>
                    <suffix qualifier="AC">M.D.</suffix>
                </name>
            </informationRecipient>
            <receivedOrganization>
                <name>The DoctorsApart Physician Group</name>
            </receivedOrganization>
        </intendedRecipient>
    </informationRecipient>
    <!-- The legalAuthenticator represents the individual who is responsible for the document -->
    <legalAuthenticator>
        <time value="20150625150000-0500"/>
        <signatureCode code="S"/>
        <assignedEntity>
            <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
            <code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)" displayName="Adult Medicine"/>
            <addr>
                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:+1(555)555-1009"/>
            <assignedPerson>
                <name>
                    <given>Linda</given>
                    <family>Leader</family>
                    <suffix qualifier="AC">M.D.</suffix>
                </name>
            </assignedPerson>
        </assignedEntity>
    </legalAuthenticator>
    <!-- The authenticator represents the individual attesting to the accuracy of information in the document-->
    <authenticator>
        <time value="20150625150000-0500"/>
        <signatureCode code="S"/>
        <assignedEntity>
            <id extension="5555555555" root="2.16.840.1.113883.4.6"/>
            <code code="207QA0505X" codeSystem="2.16.840.1.113883.6.101" codeSystemName="Healthcare Provider Taxonomy (HIPAA)" displayName="Adult Medicine"/>
            <addr>
                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:+1(555)555-1009"/>
            <assignedPerson>
                <name>
                    <given>Linda</given>
                    <family>Leader</family>
                    <suffix qualifier="AC">M.D.</suffix>
                </name>
            </assignedPerson>
        </assignedEntity>
    </authenticator>
    <authenticator typeCode="AUTHEN" xmlns="urn:hl7-org:v3" xmlns:sdtc="urn:hl7-org:sdtc">
        <time value="20191022090036-0500"/>
        <signatureCode code="S"/>
        <assignedEntity>
            <id extension="ywang@direct.eval.md" root="2.16.840.1.113883.3.4988.102.2.1.1"/>
            <assignedPerson>
                <name>
                    <family>Wang</family>
                    <given>Yan</given>
                </name>
            </assignedPerson>
        </assignedEntity>
        <sdtc:signatureText mediaType="text/xml" representation="B64">
            <thumbnail>Signed by Yan Wang (ywang@direct.eval.md) at Tue Oct 22 09:00:36 CDT 2019</thumbnail>
            <digitalSignature>
                <authorizedSigner Id="6feb1a6f-6ebd-4f57-ba01-2281dae19d4d">
                    <ds:Signature xmlns:ds="http://www.w3.org/2000/09/xmldsig#" Id="xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7">
                        <ds:SignedInfo>
                            <ds:CanonicalizationMethod Algorithm="http://www.w3.org/2001/10/xml-exc-c14n#"/>
                            <ds:SignatureMethod Algorithm="http://www.w3.org/2001/04/xmldsig-more#rsa-sha512"/>
                            <ds:Reference Id="xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7-ref0">
                                <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha512"/>
                                <ds:DigestValue>wLBll92m13ubTxozVlE5VgWpr3SUI6/lPGhV0lbXmw6AnBT1CqMRGzfB30KRUGuTDORevE/MzV+u
caFr2m6zZw==</ds:DigestValue>
                            </ds:Reference>
                            <ds:Reference Type="http://uri.etsi.org/01903#SignedProperties" URI="#xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7-signedprops">
                                <ds:Transforms>
                                    <ds:Transform Algorithm="http://www.w3.org/2001/10/xml-exc-c14n#"/>
                                </ds:Transforms>
                                <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha512"/>
                                <ds:DigestValue>PlsIt7fXXsuNQDipACEv/Uw4sDxUNK542HCi9YfLCBvPHHaZN0q1sA5uylEpo7zyoNcZRJWSza1H
6tDQ510UZw==</ds:DigestValue>
                            </ds:Reference>
                        </ds:SignedInfo>
                        <ds:SignatureValue Id="xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7-sigvalue">
YsM561CNza+rkszWETTsxURpWEC9BUPkB2BjraieV/GbxJvZV/NLUFqXz0I5kCYwnj7IzFYwhOyx
+oBID1H//frWBbyv2c8SRY0hB1L1gz/LoT8w8UBDd8UD5Vsm36dnrALxabyh8SV6kKrJ3a48xqsP
HbfADqB1ZP4RTrFwjOtz6zpMeCg7XjayPU7zzfdmjX52lpKhMsQh/XJefv9yoWEFFRpNqzFMcHPg
3pMdfHzBmNWafIjC/xgpLCieVTrJ8MpAzRxGE38LgXWr44nJufSH8dJ0sVzUXQki6F5su7AFdPWc
QR5EAOGpKXXU4NtCm3MvsZlcJjjMKFc0hqQxYK+XX+4vyTcgPsfj+1IcHYW+rJoJZxek9iEFArJl
3GffR5DisUO35tuZSh1Tqi+hrjL9F25iXtuf3wHZm9hjNyZ1yCQawm3B/bW0T7/+0eCqk4kfsJy+
jTrRCGMd2gGpVuhN/tpXmYLTs0yWMXA9Wtzt35wi/I+cFJZiW/SBcv2A
</ds:SignatureValue>
                        <ds:KeyInfo xmlns:ds="http://www.w3.org/2000/09/xmldsig#">
                            <ds:X509Data>
                                <ds:X509Certificate>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</ds:X509Certificate>
                                <ds:X509IssuerSerial>
                                    <ds:X509IssuerName>cn=MaxSignatures Staging CA G2,o=MaxMD,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                    <ds:X509SerialNumber>272357736004157203292878124462297745375</ds:X509SerialNumber>
                                </ds:X509IssuerSerial>
                                <ds:X509SubjectName>cn=ywang@direct.eval.md,ou=Yan Wang Signature Cert</ds:X509SubjectName>
                            </ds:X509Data>
                        </ds:KeyInfo>
                        <ds:Object>
                            <xades:QualifyingProperties xmlns:xades="http://uri.etsi.org/01903/v1.3.2#" xmlns:xades141="http://uri.etsi.org/01903/v1.4.1#" Target="#xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7">
                                <xades:SignedProperties Id="xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7-signedprops">
                                    <xades:SignedSignatureProperties>
                                        <xades:SigningTime>2019-10-22T09:00:36.519-05:00</xades:SigningTime>
                                        <xades:SigningCertificate>
                                            <xades:Cert>
                                                <xades:CertDigest>
                                                    <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                    <ds:DigestValue>LmkYNDNQDu7qhA44ocsO7JbNJS/1/HP7i+rlrEbdsJA=</ds:DigestValue>
                                                </xades:CertDigest>
                                                <xades:IssuerSerial>
                                                    <ds:X509IssuerName>cn=MaxSignatures Staging CA G2,o=MaxMD,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                    <ds:X509SerialNumber>272357736004157203292878124462297745375</ds:X509SerialNumber>
                                                </xades:IssuerSerial>
                                            </xades:Cert>
                                            <xades:Cert>
                                                <xades:CertDigest>
                                                    <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                    <ds:DigestValue>uF2FhQLz65mJvjXFexoUncNvh0vTMj4Pw8IfV0aOKCQ=</ds:DigestValue>
                                                </xades:CertDigest>
                                                <xades:IssuerSerial>
                                                    <ds:X509IssuerName>cn=MaxMD Root CA v1.0,o=MaxMD,l=Fort Lee,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                    <ds:X509SerialNumber>1537211545487</ds:X509SerialNumber>
                                                </xades:IssuerSerial>
                                            </xades:Cert>
                                            <xades:Cert>
                                                <xades:CertDigest>
                                                    <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                    <ds:DigestValue>9RUacCjZG6t1qyyXGpyRaIZdVsIvyc4RwNk5cPKfTyc=</ds:DigestValue>
                                                </xades:CertDigest>
                                                <xades:IssuerSerial>
                                                    <ds:X509IssuerName>cn=MaxMD Root CA v1.0,o=MaxMD,l=Fort Lee,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                    <ds:X509SerialNumber>1502994895133</ds:X509SerialNumber>
                                                </xades:IssuerSerial>
                                            </xades:Cert>
                                        </xades:SigningCertificate>
                                        <xades:SignaturePolicyIdentifier>
                                            <xades:SignaturePolicyImplied/>
                                        </xades:SignaturePolicyIdentifier>
                                        <xades:SignerRole>
                                            <xades:ClaimedRoles>
                                                <xades:ClaimedRole>AUTHEN</xades:ClaimedRole>
                                            </xades:ClaimedRoles>
                                        </xades:SignerRole>
                                        <xades:SignaturePurpose>Authorized Signer Signature</xades:SignaturePurpose>
                                    </xades:SignedSignatureProperties>
                                </xades:SignedProperties>
                                <xades:UnsignedProperties>
                                    <xades:UnsignedSignatureProperties>
                                        <xades:SignatureTimeStamp>
                                            <ds:CanonicalizationMethod Algorithm="http://www.w3.org/2001/10/xml-exc-c14n#"/>
                                            <xades:EncapsulatedTimeStamp>MIAGCSqGSIb3DQEHAqCAMIIP9AIBAzELMAkGBSsOAwIaBQAwbwYLKoZIhvcNAQkQAQSgYAReMFwC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</xades:EncapsulatedTimeStamp>
                                        </xades:SignatureTimeStamp>
                                        <xades:CompleteCertificateRefs Id="xmldsig-ecb3d509-4787-4e6e-be39-9a921de48dac-CompleteCertificateRefs">
                                            <xades:CertRefs>
                                                <xades:Cert>
                                                    <xades:CertDigest>
                                                        <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                        <ds:DigestValue>LmkYNDNQDu7qhA44ocsO7JbNJS/1/HP7i+rlrEbdsJA=</ds:DigestValue>
                                                    </xades:CertDigest>
                                                    <xades:IssuerSerial>
                                                        <ds:X509IssuerName>cn=MaxSignatures Staging CA G2,o=MaxMD,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                        <ds:X509SerialNumber>272357736004157203292878124462297745375</ds:X509SerialNumber>
                                                    </xades:IssuerSerial>
                                                </xades:Cert>
                                                <xades:Cert>
                                                    <xades:CertDigest>
                                                        <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                        <ds:DigestValue>uF2FhQLz65mJvjXFexoUncNvh0vTMj4Pw8IfV0aOKCQ=</ds:DigestValue>
                                                    </xades:CertDigest>
                                                    <xades:IssuerSerial>
                                                        <ds:X509IssuerName>cn=MaxMD Root CA v1.0,o=MaxMD,l=Fort Lee,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                        <ds:X509SerialNumber>1537211545487</ds:X509SerialNumber>
                                                    </xades:IssuerSerial>
                                                </xades:Cert>
                                                <xades:Cert>
                                                    <xades:CertDigest>
                                                        <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                        <ds:DigestValue>9RUacCjZG6t1qyyXGpyRaIZdVsIvyc4RwNk5cPKfTyc=</ds:DigestValue>
                                                    </xades:CertDigest>
                                                    <xades:IssuerSerial>
                                                        <ds:X509IssuerName>cn=MaxMD Root CA v1.0,o=MaxMD,l=Fort Lee,st=NEW JERSEY,c=US</ds:X509IssuerName>
                                                        <ds:X509SerialNumber>1502994895133</ds:X509SerialNumber>
                                                    </xades:IssuerSerial>
                                                </xades:Cert>
                                            </xades:CertRefs>
                                        </xades:CompleteCertificateRefs>
                                        <xades:CompleteRevocationRefs>
                                            <xades:CRLRefs>
                                                <xades:CRLRef>
                                                    <xades:DigestAlgAndValue>
                                                        <ds:DigestMethod Algorithm="http://www.w3.org/2001/04/xmlenc#sha256"/>
                                                        <ds:DigestValue>PhTYeqeOFrlRYSthZicYkJ4U2eEl6Vm4jxK/rHQHFeM=</ds:DigestValue>
                                                    </xades:DigestAlgAndValue>
                                                    <xades:CRLIdentifier>
                                                        <xades:Issuer>cn=MaxSignatures Staging CA G2,o=MaxMD,st=NEW JERSEY,c=US</xades:Issuer>
                                                        <xades:IssueTime>2019-04-30T08:40:02.000-05:00</xades:IssueTime>
                                                        <xades:Number>4</xades:Number>
                                                    </xades:CRLIdentifier>
                                                </xades:CRLRef>
                                            </xades:CRLRefs>
                                        </xades:CompleteRevocationRefs>
                                        <xades:CertificateValues>
                                            <xades:EncapsulatedX509Certificate>MIIGrDCCBJSgAwIBAgIRAMzmMSKw4o4xSquQd5fGh98wDQYJKoZIhvcNAQELBQAwWDELMAkGA1UE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</xades:EncapsulatedX509Certificate>
                                            <xades:EncapsulatedX509Certificate>MIIGszCCBJugAwIBAgIGAWXo8rePMA0GCSqGSIb3DQEBCwUAMGIxCzAJBgNVBAYTAlVTMRMwEQYD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</xades:EncapsulatedX509Certificate>
                                            <xades:EncapsulatedX509Certificate>MIIGADCCA+igAwIBAgIGAV3xehEdMA0GCSqGSIb3DQEBCwUAMGIxCzAJBgNVBAYTAlVTMRMwEQYD
VQQIEwpORVcgSkVSU0VZMREwDwYDVQQHEwhGb3J0IExlZTEOMAwGA1UEChMFTWF4TUQxGzAZBgNV
BAMTEk1heE1EIFJvb3QgQ0EgdjEuMDAeFw0xNzA4MTcxODM0NTVaFw0zNzA4MTYxODM0NTVaMGIx
CzAJBgNVBAYTAlVTMRMwEQYDVQQIDApORVcgSkVSU0VZMREwDwYDVQQHDAhGb3J0IExlZTEOMAwG
A1UECgwFTWF4TUQxGzAZBgNVBAMMEk1heE1EIFJvb3QgQ0EgdjEuMDCCAiIwDQYJKoZIhvcNAQEB
BQADggIPADCCAgoCggIBAKxNCBFKNZrAIfMaTgyDssrvyLPlSmpRS6lcJNeroDzMWlA1vBNMNOQH
E+AUWwyYW3p9kOS93WgHAjwYAQr6a9rmS3B6UECtuYf163cC45uzlQOE0JMciiHHVw0BnvfQrV1L
/HDWK7AKyKt9YFTygk2BFqrS4wBw3jRURisDM+ST27QkwzTdMEpXEiLzGuLuMcMYug7bOc8G98QQ
+CmnejLIVjaO2u+fEOEUZtgXKb1ij3CIhyu2hq4m19pHWQJkNTNeNG0TjmiBOvAD7KO2zJGdxeQp
Q+B8+aOUgDsYDl/7KPYViHn7Rh5jkWhDQvpsbqP5vcGbMx+3Uu4iLHCT3JqrUYwVFBhAvBquNzdi
jo88CikROod3cU72g/72DBFUuncZpxttubvO14IR1sRGm9uWjd6v6aDZA5TVAWyJribSDf16DB+X
GRPxKM22TpQXM1WCEBWxl9HQMinB96cTvFR1oMKDZNXhbWZ2M9ZOVvHK5C52IxO0rAxXi8u0IDTe
eVloe/QCQF/JnhAl4eYkstnxCVnA5AA7SzqP2EC7f3nwIGZypiFTRbdYwdPT802KfVmDtCPfFF6V
0gJnf1efFNU4m4xyGoVWzIss/3G4ILsW36mnG1pl134ZdIQINra+mt/EVBj/m1hf5tY/Ba4IipKj
pmRmC+JzimlvAyOixOOjAgMBAAGjgbswgbgwDgYDVR0PAQH/BAQDAgGGMA8GA1UdEwEB/wQFMAMB
Af8wHQYDVR0OBBYEFGe1sgF8T0PoFZ1WP4kocmZTnAaAMB8GA1UdIwQYMBaAFGe1sgF8T0PoFZ1W
P4kocmZTnAaAMFUGA1UdIAROMEwwSgYEVR0gADBCMEAGCCsGAQUFBwIBFjRodHRwczovL3d3dy5k
aXJlY3RtZGVtYWlsLmNvbS9kb2N1bWVudHMvRGlyZWN0UG9saWN5MA0GCSqGSIb3DQEBCwUAA4IC
AQCltEgGQugSclYk5Q/WnIaY55FVq+fiBFnqILvHnF7lMLkhhOIu7zb7mf4ghbVfb8Col4xn6dAC
/aiaw13Ojwe9K0Atfo8fnSaJ16move3MND46M730qejD20e14ORAeJ5dDhq/oFo0aXqJRHT9EF8W
8ljBvbU5cWdWRU41MVF5kkxS6KRR1cNO3oQY4Bwh9JzNwP+ncdLzt9fm2cr6OSZAHGAsKTSnJFmk
8DMaSWGSUyIs7+0pAKN/+gQJgwwXqnhOlqXRL+zsVZZs+gzRj3TWByjc6ZOCzo+dDVBUhFyKROFn
KfveAyPGC19jGqbjLDesESuX+AM6VrAOqZd+1nQv1UR2c4QsBlXpE0hpD0uMGwtfR4zaw54H8Lhf
GzLI0ZGpTh3Amj6phiKMrV9TLamRWUMfkprLUl7AJl+pm+rLNT7Fu4hhoTaltGBI2UdTmvOmuUxw
51zlKjUZgY/oiO4YFOEoodQsyGUYfmkNXd7GRRF5SkePjex15sv9LoTCz6Ft5mYS2G2p5+io2Smx
hK/QFsw3Ey0wUaKCUWwLl7tWDZlq1fldMe/GzBkdtUuz9rIyvaMCcnzvKgMJSVvXbqUwGY9UN+1z
kOzG7XteAHOAfRYshq5n59YgSF2Yb9GNW8uVzSZausB5FELM6cONAzs6tmbKP+PGpht8UJCO9jDS
4g==</xades:EncapsulatedX509Certificate>
                                        </xades:CertificateValues>
                                        <xades:RevocationValues>
                                            <xades:CRLValues>
                                                <xades:EncapsulatedCRLValue>MIIDHDCCAQQCAQEwDQYJKoZIhvcNAQELBQAwWDELMAkGA1UEBhMCVVMxEzARBgNVBAgMCk5FVyBK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</xades:EncapsulatedCRLValue>
                                            </xades:CRLValues>
                                        </xades:RevocationValues>
                                        <xades:SigAndRefsTimeStamp>
                                            <xades:Include URI="#xmldsig-230859fe-49cc-4542-9a7e-432028fa5fa7-sigvalue" referencedData="true"/>
                                            <xades:Include URI="#xmldsig-ecb3d509-4787-4e6e-be39-9a921de48dac-CompleteCertificateRefs" referencedData="true"/>
                                            <xades:Include URI="#xmldsig-17a7f4c6-a43f-4612-97d3-21dfd16a7cc1-CompleteRevocationRefs" referencedData="true"/>
                                            <ds:CanonicalizationMethod Algorithm="http://www.w3.org/TR/2001/REC-xml-c14n-20010315"/>
                                            <xades:EncapsulatedTimeStamp>MIAGCSqGSIb3DQEHAqCAMIIVDgIBAzELMAkGBSsOAwIaBQAwggFDBgsqhkiG9w0BCRABBKCCATIE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==</xades:EncapsulatedTimeStamp>
                                        </xades:SigAndRefsTimeStamp>
                                    </xades:UnsignedSignatureProperties>
                                </xades:UnsignedProperties>
                            </xades:QualifyingProperties>
                        </ds:Object>
                    </ds:Signature>
                </authorizedSigner>
            </digitalSignature>
        </sdtc:signatureText>
    </authenticator>
    <!-- This verifier participant represents an individual who has reviewed the Care Plan and verified its accuracy and appropriateness for the patient.
   Health Care Institutions often require review of patient care plans at varying frquencies depending on the care setting  -->
    <!-- typeCode "VRF" represents a "Verifier" "A person who verifies the correctness and appropriateness of the service plan. -->
    <!-- If the date in the time element is in the past,then this review has already taken place. If the date in the time element is in the future, then this is the date of the next scheduled review.
      This example shows a review was done on the day the document was generated at 7 am.
    -->
    <participant typeCode="VRF">
        <functionCode code="425268008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Review of Care Plan"/>
        <time value="201808010700-0400"/>
        <associatedEntity classCode="ASSIGNED">
            <id root="20cf14fb-b65c-4c8c-a54d-b0cca834c18c"/>
            <addr use="HP">
                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:+1(555)555-1009"/>
            <associatedPerson>
                <name>
                    <given>Nancy</given>
                    <family>Nurse</family>
                    <suffix qualifier="AC">RN</suffix>
                </name>
            </associatedPerson>
        </associatedEntity>
    </participant>
    <!-- This partipant can represent the patients primary caregiver as defined in the C-CDA Care Plan header-->
    <!-- Note: New Best practice for including documentation of a patient's care team members is to use the Care Teams Section. Care team member roles can be more fully expressed than is possible in the header -->
    <participant typeCode="IND">
        <functionCode code="407543004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" displayName="Primary Carer"/>
        <!-- Caregiver -->
        <associatedEntity classCode="CAREGIVER">
            <code code="MTH" codeSystem="2.16.840.1.113883.5.111"/>
            <addr>
                <streetAddressLine>6666 Home Street</streetAddressLine>
                <city>Beaverton</city>
                <state>MD</state>
                <postalCode>21014</postalCode>
                <country>US</country>
            </addr>
            <telecom use="WP" value="tel:(999)555-1212"/>
            <associatedPerson>
                <name>
                    <prefix>Mrs.</prefix>
                    <given>Martha</given>
                    <family>Mumm</family>
                </name>
            </associatedPerson>
        </associatedEntity>
    </participant>
    <documentationOf>
        <serviceEvent classCode="PCPR">
            <!-- The effectiveTime reflects the provision of care summarized in the document.  -->
            <!-- In a Care Plan, this time should capture the time span from when the dynamic care plan in a system first went into effect until the date the document was generated -->
            <effectiveTime>
                <!-- The low value represents when the dynamic Care Plan was instituted in a system.  -->
                <low value="20140901095245-0400"/>
                <!-- The high value equals the document.efffectiveTime - The time the document was generated -->
                <high value="20180801095245-0400"/>
            </effectiveTime>
            <performer typeCode="PRF">
                <functionCode code="ATTPHYS" codeSystem="2.16.840.1.113883.5.88" codeSystemName="ParticipationFunction" displayName="attending physician">
                    <originalText>Attending Physician</originalText>
                </functionCode>
                <assignedEntity classCode="ASSIGNED">
                    <id extension="811111111" root="2.16.840.1.113883.4.6"/>
                    <addr>
                        <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                        <city>Beaverton</city>
                        <state>MD</state>
                        <postalCode>21014</postalCode>
                        <country>US</country>
                    </addr>
                    <telecom use="WP" value="tel:+1(555)555-1009"/>
                    <assignedPerson>
                        <name>
                            <given>Linda</given>
                            <family>Leader</family>
                        </name>
                    </assignedPerson>
                    <representedOrganization classCode="ORG">
                        <id extension="321CX" root="2.16.840.1.113883.4.6"/>
                        <name>The DoctorsTogether Physician Group</name>
                        <telecom use="WP" value="tel:+1(555)555-1009"/>
                        <addr>
                            <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                            <city>Beaverton</city>
                            <state>MD</state>
                            <postalCode>21014</postalCode>
                            <country>US</country>
                        </addr>
                    </representedOrganization>
                </assignedEntity>
            </performer>
        </serviceEvent>
    </documentationOf>
    <!-- Since this care plan represents  snapshot in time of a care plan the patient has had for many years - this encompassingEncounter represents the encounter during which this document was generated -->
    <componentOf>
        <encompassingEncounter>
            <id extension="100411330" root="1.3.6.1.4.1.22812.4.222.334"/>
            <effectiveTime xsi:type="IVL_TS">
                <low value="20180801090045-0400"/>
                <high value="20180801095245-0400"/>
            </effectiveTime>
        </encompassingEncounter>
    </componentOf>
    <!-- ******************************************************** CDA Body ******************************************************** -->
    <component>
        <structuredBody>
            <!-- ******************** HEALTH CONCERNS SECTION ************************ -->
            <!-- This section contains data describing Health Concern(s). A Health concern is a health related matter that is of interest, importance or worry to someone, 
                who may be the patient, patient's family or patient's health care provider. Problem Concerns (and problem observations )are a subset of Health Concerns 
                that have risen to the level of importance that they typically would belong on a classic “Problem List”. 
                Health concerns can be medical, surgical, nursing, allied health or patient-reported concerns. -->
            <component>
                <section>
                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.2.58"/>
                    <templateId root="2.16.840.1.113883.10.20.22.2.58"/>
                    <code code="75310-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health concerns Doc"/>
                    <title>Health Concerns</title>
                    <text>
                        <table>
                            <caption>Health Status</caption>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody>
                                <tr ID="_7dd0babf-0300-4bb6-b936-0f92ad977df1">
                                    <td>
                                        <content ID="_ac87cb62-c3ce-4094-ae6a-00f3ac139ad0">Chronically ill</content>
                                    </td>
                                    <td>
                                        <content styleCode="xSecondary">Since May-1972</content>
                                    </td>
                                    <td/>
                                </tr>
                            </tbody>
                        </table>
                        <table>
                            <caption>Health Concerns</caption>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody ID="_c160e2eb-ef19-4a7b-a44d-029afbc6fb2e" styleCode="xRowGroup">
                                <tr>
                                    <td>
                                        <content> </content>
                                        <content ID="_HealthConcern1">Social isolation: aloneness experienced by the individual
                                            and perceived as imposed by others and as a negative or threatened state
                                        </content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel">Start: </content>
                                        <content>1-July-2018</content>
                                        <br/>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel">Status: </content>
                                        <content>Active</content>
                                        <br/>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="Italics">Related To: </content>
                                    </td>
                                </tr>
                                <tr ID="_de1ab32d-dd06-40c0-b7c2-5fed94e4ecd6">
                                    <td>
                                        <content styleCode="xIndent"> •</content>
                                        <content ID="ProblemObs1" styleCode="xSecondary xContentWrapping">Gaucher's disease, type III</content>
                                    </td>
                                    <td> </td>
                                    <td>
                                        <content ID="ProblemObs_1_PS1" styleCode="xLabel xSecondary">Status: </content>
                                        <content styleCode="xSecondary">Active</content>
                                    </td>
                                </tr>
                            </tbody>
                            <tbody ID="_c160e2eb-ef19-4a7b-a44d-029afbc7fb2e" styleCode="xRowGroup">
                                <tr>
                                    <td>
                                        <content> </content>
                                        <content ID="_HealthConcern2">Increase in early satiety, bloating, and episodes of nausea and vomiting
                                        </content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel">Start: </content>
                                        <content>15-July-2018</content>
                                        <br/>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel">Status: </content>
                                        <content>Active</content>
                                        <br/>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="Italics">Related To: </content>
                                    </td>
                                </tr>
                                <tr ID="_de1ab32d-dd06-40c0-b7c2-5fed94e4ecd7">
                                    <td>
                                        <content styleCode="xIndent"> •</content>
                                        <content ID="_ProblemObs2" styleCode="xSecondary xContentWrapping">Gaucher's disease, type III</content>
                                    </td>
                                    <td> </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Status: </content>
                                        <content styleCode="xSecondary">Active</content>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <!-- The Health Status Observation represents information about the overall health status of the patient. -->
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.5"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.5"/>
                            <id extension="HlthStat67544" root="1.3.6.1.4.1.22812.4.222.334.4.15"/>
                            <code code="11323-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="General health Reported"/>
                            <text>
                                <reference value="#_7dd0babf-0300-4bb6-b936-0f92ad977df1"/>
                            </text>
                            <statusCode code="completed"/>
                            <effectiveTime>
                                <!-- This time represents just the year and the month - when the patient was about 2 years old.
                                This patient STARTED his state of chonic illness when he was 2 years old.-->
                                <low value="197205"/>
                            </effectiveTime>
                            <value code="161901003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Chronic sick (finding)" xsi:type="CD">
                                <originalText>
                                    <reference value="#_ac87cb62-c3ce-4094-ae6a-00f3ac139ad0"/>
                                </originalText>
                            </value>
                        </observation>
                    </entry>
                    <entry>
                        <!-- The Health Concern act  -->
                        <!-- The Health Concern act wraps any single problem, situation, issue, or other observation and identifies it as health concern (non-optimal physical or psychological situations) -->
                        <act classCode="ACT" moodCode="EVN">
                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.132"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.132"/>
                            <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                            <code code="75310-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health concerns Document">
                                <originalText>
                                    <reference value="#_e2cedfb2-01e3-46d6-99bb-541dd15a340c"/>
                                </originalText>
                            </code>
                            <text>
                                <reference value="#_c160e2eb-ef19-4a7b-a44d-029afbc6fb2e"/>
                            </text>
                            <!-- When the underlying condition is of concern (i.e., as long as the condition, whether active or resolved, is of ongoing concern and interest), the statusCode is “active”. 
                                Only when the underlying condition is no longer of concern is the statusCode set to “completed”. -->
                            <statusCode code="active"/>
                            <!-- Since each health concern act wraps only one problem, situation, issue, or other observation, the effecitve time should equal the effectiveTime of the contained obervation  -->
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="20180701"/>
                                <!-- The high value has a nullFlacor of "NI" (No Informmation) because it is an ongoing health concern -->
                                <high nullFlavor="NI"/>
                            </effectiveTime>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/IDs  -->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <entryRelationship typeCode="REFR">
                                <!-- The Health Concern's Problem Observation wrapped by the Health Concern act -->
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.1.2.1"/>
                                    <code code="404684003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Clinical Finding (finding)">
                                        <translation code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical Finding"/>
                                    </code>
                                    <text>
                                        <reference value="#_de1ab32d-dd06-40c0-b7c2-5fed94e4ecd6"/>
                                    </text>
                                    <statusCode code="completed"/>
                                    <effectiveTime xsi:type="IVL_TS">
                                        <low value="20180701"/>
                                        <!-- The high value has a nullFlavor of "NI" (No Informmation) because it is an ongoing finding -->
                                        <high nullFlavor="NI"/>
                                    </effectiveTime>
                                    <value code="422650009 " codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Social isolation (finding)" xsi:type="CD">
                                        <originalText>
                                            <reference value="#_HealthConcern1"/>
                                        </originalText>
                                    </value>
                                    <author>
                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                        <time value="20180801095235-0400"/>
                                        <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                        <assignedAuthor>
                                            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                        </assignedAuthor>
                                    </author>
                                    <!-- Problem Status -->
                                    <entryRelationship typeCode="REFR">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"/>
                                            <statusCode code="completed"/>
                                            <value code="55561003" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD">
                                                <originalText>Active</originalText>
                                            </value>
                                        </observation>
                                    </entryRelationship>
                                    <!-- The Health Concern act  -->
                                    <!-- The Health Concern act wraps any single problem, situation, issue, or other observation and identifies it as health concern (non-optimal physical or psychological situations) 
                                         This Health Cooncern represents the medical problem (Gaucher's Disease) that would also be found on the Problem list
                                    -->
                                    <entryRelationship typeCode="REFR">
                                        <act classCode="ACT" moodCode="EVN">
                                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.132"/>
                                            <templateId root="2.16.840.1.113883.10.20.22.4.132"/>
                                            <!-- The Medical problem's Health concern's ID that is referenced from other entries in the Care Plan -->
                                            <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                                            <code code="75310-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health concerns Document">
                                                <originalText>
                                                    <reference value="#_e2cedfb2-01e3-46d6-99bb-541dd15a340c"/>
                                                </originalText>
                                            </code>
                                            <statusCode code="active"/>
                                            <effectiveTime nullFlavor="NI"/>
                                            <entryRelationship inversionInd="false" typeCode="SUBJ">
                                                <!-- (Medical) Problem Observation -->
                                                <observation classCode="OBS" moodCode="EVN">
                                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>
                                                    <id extension="68993" root="1.2.840.114350.1.13.6289.1.7.2.768076"/>
                                                    <id extension="1.1" root="093A5380-00CE-11E6-B4C5-0050568B000B"/>
                                                    <code code="55607006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Problem">
                                                        <originalText>
                                                            <reference value="#ProblemObs_1_PT1"/>
                                                        </originalText>
                                                        <translation code="75326-9" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Problem"/>
                                                    </code>
                                                    <statusCode code="completed"/>
                                                    <effectiveTime>
                                                        <low value="20140909"/>
                                                    </effectiveTime>
                                                    <value code="5963005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Subacute neuronopathic Gaucher's disease (disorder)" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:type="CD">
                                                        <originalText>
                                                            <reference value="#ProblemObs1"/>
                                                        </originalText>
                                                    </value>
                                                    <author>
                                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                                        <time value="20180801095235-0400"/>
                                                        <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID -->
                                                        <assignedAuthor>
                                                            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                                            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                                            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                                        </assignedAuthor>
                                                    </author>
                                                    <entryRelationship typeCode="REFR">
                                                        <observation classCode="OBS" moodCode="EVN">
                                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
                                                            <text>
                                                                <reference value="#ProblemObs_1_PS1"/>
                                                            </text>
                                                            <statusCode code="completed"/>
                                                            <effectiveTime>
                                                                <low value="20140909"/>
                                                            </effectiveTime>
                                                            <value code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="Active" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:type="CD"/>
                                                        </observation>
                                                    </entryRelationship>
                                                </observation>
                                            </entryRelationship>
                                        </act>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry>
                        <!-- The Health Concern act  -->
                        <!-- The Health Concern act wraps any single problem, situation, issue, or other observation and identifies it as health concern (non-optimal physical or psychological situations) -->
                        <act classCode="ACT" moodCode="EVN">
                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.132"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.132"/>
                            <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                            <code code="75310-3" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Health concerns Document">
                                <originalText>
                                    <reference value="#_e2cedfb2-01e3-46d6-99bb-541dd15a340c"/>
                                </originalText>
                            </code>
                            <text>
                                <reference value="#_c160e2eb-ef19-4a7b-a44d-029afbc6fb2e"/>
                            </text>
                            <!-- When the underlying condition is of concern (i.e., as long as the condition, whether active or resolved, is of ongoing concern and interest), the statusCode is “active”. 
                                Only when the underlying condition is no longer of concern is the statusCode set to “completed”. -->
                            <statusCode code="active"/>
                            <!-- Since each health concern act wraps only one problem, situation, issue, or other observation, the effecitve time should equal the effectiveTime of the contained obervation  -->
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="20180715"/>
                                <!-- The high value has a nullFlacor of "NI" (No Informmation) because it is an ongoing health concern -->
                                <high nullFlavor="NI"/>
                            </effectiveTime>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/IDs  -->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <entryRelationship typeCode="REFR">
                                <!-- The Health Concern's Problem Observation wrapped by health concern act -->
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <templateId root="2.16.840.1.113883.10.20.22.4.4"/>
                                    <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.1.2.1"/>
                                    <code code="404684003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Clinical Finding (finding)">
                                        <translation code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical Finding"/>
                                    </code>
                                    <text>
                                        <reference value="#_de1ab32d-dd06-40c0-b7c2-5fed94e4ecd6"/>
                                    </text>
                                    <statusCode code="completed"/>
                                    <effectiveTime xsi:type="IVL_TS">
                                        <low value="20180715"/>
                                        <!-- The high value has a nullFlavor of "NI" (No Informmation) because it is an ongoing finding -->
                                        <high nullFlavor="NI"/>
                                    </effectiveTime>
                                    <value code="73335002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Increased nausea and vomiting (disorder)" xsi:type="CD">
                                        <originalText>
                                            <reference value="#_HealthConcern2"/>
                                        </originalText>
                                    </value>
                                    <author>
                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                        <time value="20180801095235-0400"/>
                                        <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                        <assignedAuthor>
                                            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                        </assignedAuthor>
                                    </author>
                                    <!-- Problem Status -->
                                    <entryRelationship typeCode="REFR">
                                        <observation classCode="OBS" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.6"/>
                                            <code code="33999-4" codeSystem="2.16.840.1.113883.6.1"/>
                                            <statusCode code="completed"/>
                                            <value code="55561003" codeSystem="2.16.840.1.113883.6.96" xsi:type="CD">
                                                <originalText>Active</originalText>
                                            </value>
                                        </observation>
                                    </entryRelationship>
                                    <entryRelationship typeCode="REFR">
                                        <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                            In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                        <act classCode="ACT" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                            <!-- This ID equals the Health Concern Act ID of the Medical Problem (Gaucher's Disease) -->
                                            <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                                            <!-- The code is nulled to "NP" Not Present" -->
                                            <code nullFlavor="NP"/>
                                            <statusCode code="completed"/>
                                        </act>
                                    </entryRelationship>
                                </observation>
                            </entryRelationship>
                        </act>
                    </entry>
                </section>
            </component>
            <!-- ******************** GOALS SECTION ************************ -->
            <!-- This section contains patient Goals. A goal is a defined outcome or condition to be achieved in the process of patient care. -->
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.10.20.22.2.60"/>
                    <!--                  <templateId root="2.16.840.1.113883.10.20.22.2.60" extension="2015-08-01"/>-->
                    <!-- This should be reported as an errata. -->
                    <code code="61146-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Goals"/>
                    <title>Goals</title>
                    <text>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td>
                                        <content ID="_Goal-1">Patient will experience decreased nausea and vomiting within 2 weeks of the increased 
                                            recombinant GCase enzyme infusion imiglucerase (Cerezyme)</content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Goal Desired Achievement Date: </content>
                                        <content styleCode="xSecondary">14-Aug-2018 </content>
                                    </td>
                                    <td>
                                        <content styleCode="xSecondary">Provider Goal</content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xLabel">Related To:</content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content ID="_ConditionRef-1" styleCode="xSecondary">CONDITION: Gaucher's disease, type III </content>
                                        </content>
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content ID="_InterventionRef-1" styleCode="xSecondary">INTERVENTION: Recombinant GCase enzyme infusion imiglucerase (Cerezyme)</content>
                                        </content>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td>
                                        <content ID="_Goal-2">Patient will experience decreased social isolation within one month</content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Goal Desired Achievement Date: </content>
                                        <content styleCode="xSecondary">1-Sep-2018 </content>
                                    </td>
                                    <td>
                                        <content styleCode="xSecondary">Provider Goal</content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xLabel">Related To:</content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content ID="_ConditionRef-2" styleCode="xSecondary">CONDITION: Gaucher's disease, type III </content>
                                        </content>
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content ID="_InterventionRef-2" styleCode="xSecondary">INTERVENTION: Referall to support group</content>
                                        </content>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <!-- Goal #1 observation (Decreased Nausea and Vomiting) -->
                    <!-- A goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. 
                        If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal.
                        A goal usually has a related health concern and/or risk. The goal can also refrence the related intervention initiated to achieve that goal-->
                    <entry>
                        <observation classCode="OBS" moodCode="GOL">
                            <!--                       <templateId root="2.16.840.1.113883.10.20.22.4.121" extension="2015-08-01"/>-->
                            <!-- This should be reported as an errata. -->
                            <templateId root="2.16.840.1.113883.10.20.22.4.121"/>
                            <id extension="1074100" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                            <!-- The standard advises that observation/code SHOULD be from LOINC. This particularly true when the goal is a measurement (PQ), such as a PulseOx (observation/code) 
                                where the actual goal is a certain %, such as (95%) which would be held in observation/value. Here the example is from the Problem Type value set
                            -->
                            <code code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical Finding">
                            </code>
                            <text>
                                <reference value="#_Goal-1"/>
                            </text>
                            <statusCode code="active"/>
                            <effectiveTime xsi:type="IVL_TS">
                                <!-- The effectiveTime/low indicates the desired "Achieve by" date -->
                                <low value="20180814"/>
                                <high nullFlavor="NI"/>
                            </effectiveTime>
                            <value code="33841007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Decreased nausea and vomiting (disorder)" xsi:type="CD"/>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the provider, so this is a provider goal. This is the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <!--   Priority Preference represents importance of preferences chosen by a patient or a care provider.
                            In this case the decreased nausea and vomiting is the most important goal according to the provider-->
                            <entryRelationship typeCode="REFR">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.143"/>
                                    <id root="7d66f448-ba82-4291-a9da-9e5db5e58803"/>
                                    <code code="225773000" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="preference"/>
                                    <value code="394849002" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="High priority" xsi:type="CD"/>
                                    <author>
                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                        <time value="20180801095235-0400"/>
                                        <!-- The author is Harold Hippocrates, the provider, so this is a provider goal. This is the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                        <assignedAuthor>
                                            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                        </assignedAuthor>
                                    </author>
                                </observation>
                            </entryRelationship>
                            <entryRelationship typeCode="REFR">
                                <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                            In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This ID equals the Concern Act ID of the Problem List Problem (Gaucher's Disease) -->
                                    <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                                    <!-- The code is nulled to "NP" Not Present" -->
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_ConditionRef-1"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                            <entryRelationship typeCode="REFR">
                                <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                            In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This ID equals the ID of the INTERVENTION: Referal to Cerezyme Infusion  -->
                                    <id extension="88888" root="1.2.840.114350.1.13.6289.1.7.2.768076"/>
                                    <!-- The code is nulled to "NP" Not Present" -->
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_InterventionRef-1"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                        </observation>
                    </entry>
                    <!-- Goal #2 observation (Decreased Social Isolation) -->
                    <!-- A goal may be a patient or provider goal. If the author is set to the recordTarget (patient), this is a patient goal. 
                        If the author is set to a provider, this is a provider goal. If both patient and provider are set as authors, this is a negotiated goal.
                        A goal usually has a related health concern and/or risk. The goal can also refrence the related intervention initiated to achieve that goal-->
                    <entry>
                        <observation classCode="OBS" moodCode="GOL">
                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.121"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.121"/>
                            <id extension="abcd" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                            <!-- The standard advises that observation/code SHOULD be from LOINC. This partiularly true when the goal is a measurement (PQ), such as a PulseOx (observation/code) 
                                where the actual goal is a certain %, such as (95%) which would be held in observation/value. Here the example is hold the "ASSERTION" code from the HL7 code system.
                                One could also use a member from the Problem Type value set
                            -->
                            <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4">
                            </code>
                            <text>
                                <reference value="#_Goal-2"/>
                            </text>
                            <statusCode code="active"/>
                            <effectiveTime xsi:type="IVL_TS">
                                <low value="20180901"/>
                                <high nullFlavor="NI"/>
                            </effectiveTime>
                            <value code="733817003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Decreased social isolation (finding)" xsi:type="CD"/>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <entryRelationship typeCode="REFR">
                                <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                            In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This ID equals the Health Concern Act ID of the Problem List Problem (Gaucher's Disease) -->
                                    <id extension="1148128" root="1.3.6.1.4.1.22812.4.222.334.4.32"/>
                                    <!-- The code is nulled to "NP" Not Present" -->
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_ConditionRef-2"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                            <entryRelationship typeCode="REFR">
                                <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                            In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This ID equals the ID of the INTERVENTION: Referal to support group  -->
                                    <id extension="99999" root="1.2.840.114350.1.13.6289.1.7.2.768076"/>
                                    <!-- The code is nulled to "NP" Not Present" -->
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_InterventionRef-2"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                        </observation>
                    </entry>
                </section>
            </component>
            <!-- ******************** INTERVENTIONS SECTION ************************ -->
            <!-- This section contians Interventions. Interventions are actions taken to maximize the prospects of the goals of care for the patient, including the removal of barriers to success. 
                Interventions can be planned, ordered, historical, etc. -->
            <component>
                <section>
                    <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.21.2.3"/>
                    <templateId root="2.16.840.1.113883.10.20.21.2.3"/>
                    <code code="62387-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Interventions Narrative"/>
                    <title>INTERVENTIONS</title>
                    <text>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Intervention For: </content>
                                            <content>Increase in early satiety, bloating, and episodes of nausea and vomiting </content>
                                        </content>
                                    </td>
                                </tr>
                            </tbody>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Related to: </content>
                                            <content>Gaucher's disease, type III </content>
                                        </content>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                        <table border="1" width="100%">
                            <colgroup>
                                <col width="11%"/>
                                <col width="11%"/>
                                <col width="11%"/>
                                <col width="6%"/>
                                <col width="8%"/>
                            </colgroup>
                            <thead>
                                <tr>
                                    <th>Medication</th>
                                    <th>Dose</th>
                                    <th>Dates</th>
                                    <th>Status</th>
                                    <th>Performer</th>
                                    <th>Care Provider</th>
                                </tr>
                            </thead>
                            <tbody>
                                <tr ID="medications1">
                                    <td>imiglucerase [Cerezyme] </td>
                                    <td>3000 units IV Infusion every 2 weeks</td>
                                    <td>Start: 08-01-2018</td>
                                    <td>Active</td>
                                    <td>Nancy Nurse, RN</td>
                                    <td>Harold Hippocrates, MD</td>
                                </tr>
                            </tbody>
                        </table>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Intervention For: </content>
                                            <content>Social Isolation </content>
                                        </content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Related to: </content>
                                            <content>Gaucher's disease, type III </content>
                                        </content>
                                    </td>
                                </tr>
                                <tr ID="_5e5ca204-df1a-44d6-8bd5-30c5558919f8">
                                    <td>
                                        <content ID="_Intervention1" styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content>Refer patient and mother to adult gaucher's disease support group</content>
                                        </content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Start: </content>
                                        <content styleCode="xSecondary">1-Aug-2018</content>
                                        <br/>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel">Intervention Type: </content>
                                        <content ID="_d62e5f68-3d12-406c-aaaf-cf18b261ee82">Referral</content>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <!--An Intervention Act is wrapper to identify activities as interventions.
                        Interventions are actions taken to increase the likelihood of achieving the patient's or providers' goals. 
                        An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention.
                        -->
                        <act classCode="ACT" moodCode="EVN">
                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.131"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.131"/>
                            <id root="45a8d282-2409-450f-b26f-cc0eb6204296"/>
                            <code code="362956003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Procedure / intervention (navigational concept)"/>
                            <statusCode code="completed"/>
                            <!-- This intervention is a medication to treat Gaucher's disease that should help decrease digestive issues -->
                            <entryRelationship typeCode="REFR">
                                <substanceAdministration classCode="SBADM" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.16"/>
                                    <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.16"/>
                                    <id extension="1234" root="00000000-5CF3-EC63-0513-4A4838595787"/>
                                    <text>
                                        <reference value="#medications1"/>
                                    </text>
                                    <statusCode code="active"/>
                                    <effectiveTime xsi:type="IVL_TS">
                                        <low value="201808011400-0500"/>
                                        <high nullFlavor="NI"/>
                                    </effectiveTime>
                                    <effectiveTime institutionSpecified="true" operator="A" xsi:type="PIVL_TS">
                                        <period unit="wk" value="2"/>
                                    </effectiveTime>
                                    <doseQuantity unit="[IU]" value="3000"/>
                                    <consumable>
                                        <manufacturedProduct classCode="MANU">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
                                            <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.23"/>
                                            <manufacturedMaterial>
                                                <code code="1726267" codeSystem="2.16.840.1.113883.6.88" displayName="imiglucerase 400 UNT [Cerezyme]">
                                                </code>
                                            </manufacturedMaterial>
                                        </manufacturedProduct>
                                    </consumable>
                                    <!-- This performer represents the person who actually adminstered the medication -->
                                    <performer>
                                        <assignedEntity>
                                            <id extension="2981824" root="2.16.840.1.113883.19.5.9999.456"/>
                                            <addr>
                                                <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                                                <city>Beaverton</city>
                                                <state>MD</state>
                                                <postalCode>21014</postalCode>
                                                <country>US</country>
                                            </addr>
                                            <telecom use="WP" value="tel: +1(555)555-1030"/>
                                            <assignedPerson>
                                                <name>
                                                    <given>Nancy</given>
                                                    <family>Nurse</family>
                                                </name>
                                            </assignedPerson>
                                            <representedOrganization>
                                                <id root="2.16.840.1.113883.19.5.9999.1394"/>
                                                <name>Good Health Clinic</name>
                                                <telecom use="WP" value="tel: +1(555)555-1030"/>
                                                <addr>
                                                    <streetAddressLine>1001 Healthcare Drive</streetAddressLine>
                                                    <city>Beaverton</city>
                                                    <state>MD</state>
                                                    <postalCode>21014</postalCode>
                                                    <country>US</country>
                                                </addr>
                                            </representedOrganization>
                                        </assignedEntity>
                                    </performer>
                                    <!-- This is the author of the medication, or the person who wrote the prescription. Here the ID and name are fully represented rather than referenced to the ID of the document author -->
                                    <author>
                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                        <time value="201607061445-0500"/>
                                        <assignedAuthor>
                                            <id extension="181301190" root="1.3.6.1.4.1.22812.11.2016.163"/>
                                            <code nullFlavor="NI"/>
                                            <addr>
                                                <streetAddressLine>123 ABC St</streetAddressLine>
                                                <city>Raleigh</city>
                                                <state>North Carolina</state>
                                                <postalCode>27615-0000</postalCode>
                                                <country>US</country>
                                            </addr>
                                            <telecom use="WP" value="tel:+1(555)555-1234"/>
                                            <assignedPerson>
                                                <name>
                                                    <given>Harold Hippocrates</given>
                                                    <family>Primary</family>
                                                </name>
                                            </assignedPerson>
                                        </assignedAuthor>
                                    </author>
                                </substanceAdministration>
                            </entryRelationship>
                            <entryRelationship typeCode="REFR">
                                <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                     In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                <!-- An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention. -->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This ID equals the ID of the GOAL: Decrease Nausea and Vomiting  -->
                                    <id extension="1074100" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                                    <!-- The code is nulled to "NP" Not Present" -->
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_InterventionRef-2"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                        </act>
                    </entry>
                    <entry>
                        <!--An Intervention Act is wrapper to identify activities as interventions.
                        Interventions are actions taken to increase the likelihood of achieving the patient's or providers' goals. 
                        An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention.
                        -->
                        <act classCode="ACT" moodCode="EVN">
                            <templateId extension="2015-08-01" root="2.16.840.1.113883.10.20.22.4.131"/>
                            <templateId root="2.16.840.1.113883.10.20.22.4.131"/>
                            <id root="45a8d282-2409-450f-b26f-cc0eb6204296"/>
                            <code code="362956003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Procedure / intervention (navigational concept)"/>
                            <statusCode code="completed"/>
                            <!-- This intervention is a referal to a support group for the patient's isolation -->
                            <entryRelationship typeCode="REFR">
                                <!-- This is a Procedure Activity Act template which should be used for care of the patient that cannot be classified as a procedure or observation (e.g. wound dressing change, counseling) -->
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.12"/>
                                    <templateId extension="2014-06-09" root="2.16.840.1.113883.10.20.22.4.12"/>
                                    <id root="9c0f070c-2e9e-4be1-a5b5-ff6d0f68123c"/>
                                    <code code="711281004" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED-CT" displayName="Referral to support group (procedure)">
                                        <originalText>
                                            <reference value="#Intervention2"/>
                                        </originalText>
                                    </code>
                                    <statusCode code="completed"/>
                                    <effectiveTime value="20140329104513-0500"/>
                                    <author>
                                        <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                        <time value="20180801095235-0400"/>
                                        <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                        <assignedAuthor>
                                            <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                            <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                            <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                        </assignedAuthor>
                                    </author>
                                    <entryRelationship typeCode="REFR">
                                        <!-- This is the "Entry Reference" Template that enables referencing another entry in the same CDA document instance. 
                                     In a Care Plan it is particularly useful because it is necessary to repeatedly relate Health Concerns, Goals, Interventions and Outcomes.-->
                                        <!-- An Intervention Act should contain a reference to a Goal Observation representing the reason for the intervention. -->
                                        <act classCode="ACT" moodCode="EVN">
                                            <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                            <!-- This ID equals the ID of the GOAL: Decrease Social Isolation  -->
                                            <id extension="1074100" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                                            <!-- The code is nulled to "NP" Not Present" -->
                                            <code nullFlavor="NP"/>
                                            <text>
                                                <reference value="#_InterventionRef-2"/>
                                            </text>
                                            <statusCode code="completed"/>
                                        </act>
                                    </entryRelationship>
                                </act>
                            </entryRelationship>
                        </act>
                    </entry>
                </section>
            </component>
            <!-- ******************** HEALTH STATUS EVALUATION AND OUTCOMES SECTION ************************ -->
            <!-- This section contains observations regarding the outcome of care from the interventions used to treat the patient. -->
            <component>
                <section>
                    <templateId root="2.16.840.1.113883.10.20.22.2.61"/>
                    <code code="11383-7" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Patient problem outcome"/>
                    <title>Health Status Evaluations and Outcomes</title>
                    <text>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Outcome Evaluation: </content>
                                            <content ID="_Outcome1">Patient verbalizes decreased nausea and vomiting </content>
                                        </content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Progress Towards Goal: </content>
                                            <content ID="_OutcomeAch1">Goal achieved</content>
                                        </content>
                                    </td>
                                </tr>
                                <tr ID="_5e5ca204-df1a-44d6-8bd5-30c5558919f0">
                                    <td>
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Related to Goal: </content>
                                            <content ID="_RelGoal_1">Patient will experience decreased nausea and vomiting within 2 weeks of the increased imiglucerase (Cerezyme)</content>
                                        </content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Achieved: </content>
                                        <content styleCode="xSecondary">14-Aug-2018</content>
                                        <br/>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                        <table>
                            <colgroup>
                                <col width="40%"/>
                                <col width="20%"/>
                                <col width="40%"/>
                            </colgroup>
                            <tbody styleCode="xRowGroup">
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Outcome Evaluation: </content>
                                            <content ID="_Outcome2">Patient attended adult gaucher's disease support group and reports some beginning friendships</content>
                                        </content>
                                    </td>
                                </tr>
                                <tr>
                                    <td colspan="3">
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Progress Towards Goal: </content>
                                            <content ID="_OutcomeAch2">Goal achieved</content>
                                        </content>
                                    </td>
                                </tr>
                                <tr ID="_5e5ca204-df1a-44d6-8bd5-30c5558919f1">
                                    <td>
                                        <content styleCode="xIndent"> •</content>
                                        <content styleCode="xContentWrapping">
                                            <content styleCode="xLabel">Related to Goal: </content>
                                            <content ID="_RelGoal_2">Patient will experience decreased social isolation within one month</content>
                                        </content>
                                    </td>
                                    <td>
                                        <content styleCode="xLabel xSecondary">Achieved: </content>
                                        <content styleCode="xSecondary">1-Sept-2018</content>
                                        <br/>
                                    </td>
                                </tr>
                            </tbody>
                        </table>
                    </text>
                    <entry>
                        <!-- This observation represents an observation about an outcome of care resulting from the interventions used to treat the patient. -->
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.144"/>
                            <id extension="OUTCOME_100" root="1.3.6.1.4.1.22812.4.222.334.4.24"/>
                            <!-- The standard advises that observation/code SHOULD be from LOINC. This particularly true when the Outcome Observation is a measurement (PQ), such as a PulseOx (observation/code) 
                                where the actual goal is a certain %, such as (95%) which would be held in observation/value. Here the observation/code example is from the Problem Type value set
                            -->
                            <code code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical Finding">
                            </code>
                            <text>
                                <reference value="#__Outcome1"/>
                            </text>
                            <statusCode code="completed"/>
                            <effectiveTime value="20180814"/>
                            <value code="33841007" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Decreased nausea and vomiting (disorder)" xsi:type="CD"/>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <!-- The following entryRelationship represents the relationship between an Outcome Observation and a Goal Observation. 
                                Because the Goal Observation is already described in the CDA document instance's Goals section, 
                                rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. -->
                            <entryRelationship typeCode="GEVL">
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This is the ID of the Decreased Nausea and Vomiting Goal -->
                                    <id extension="1074100" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_RelGoal_1"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                            <!-- The following entryRelationship represents a patient's progress toward a goal. 
                                It describes whether a goal has been achieved or not and can also describe movement a patient is making toward the achievement of a goal -->
                            <entryRelationship inversionInd="true" typeCode="SPRT">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.110"/>
                                    <id extension="PROGRESS_100" root="1.3.6.1.4.1.22812.4.222.334.4.42"/>
                                    <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
                                    <statusCode code="completed"/>
                                    <value code="390802008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Goal achieved (finding)" xsi:type="CD">
                                        <originalText>
                                            <reference value="#_OutcomeAch1"/>
                                        </originalText>
                                    </value>
                                </observation>
                            </entryRelationship>
                        </observation>
                    </entry>
                    <entry>
                        <!-- This observation represents an observation about an outcome of care resulting from the interventions used to treat the patient. -->
                        <observation classCode="OBS" moodCode="EVN">
                            <templateId root="2.16.840.1.113883.10.20.22.4.144"/>
                            <id extension="OUTCOME_100" root="1.3.6.1.4.1.22812.4.222.334.4.24"/>
                            <!-- The standard advises that observation/code SHOULD be from LOINC. This particularly true when the Outcome Observation is a measurement (PQ), such as a PulseOx (observation/code) 
                                where the actual goal is a certain %, such as (95%) which would be held in observation/value. Here the observation/code example is from the Problem Type value set
                            -->
                            <code code="75321-0" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Clinical Finding">
                            </code>
                            <text>
                                <reference value="#__Outcome2"/>
                            </text>
                            <statusCode code="completed"/>
                            <effectiveTime value="20180901"/>
                            <value code="276049006" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Self-help group support (finding)" xsi:type="CD"/>
                            <author>
                                <templateId root="2.16.840.1.113883.10.20.22.4.119"/>
                                <time value="20180801095235-0400"/>
                                <!-- The author is Harold Hippocrates, the same author as the document author. The IDs equal ClinicalDocument/Author/ID
                                        The author could be another member of the healthcare team - such as a nurse-->
                                <assignedAuthor>
                                    <id extension="68" root="1.3.6.1.4.1.22812.4.222.334"/>
                                    <id extension="7892456337" root="2.16.840.1.113883.4.6"/>
                                    <code code="260000000X" codeSystem="2.16.840.1.113883.6.101"/>
                                </assignedAuthor>
                            </author>
                            <!-- The following entryRelationship represents the relationship between an Outcome Observation and a Goal Observation. 
                                Because the Goal Observation is already described in the CDA document instance's Goals section, 
                                rather than repeating the full content of the Goal Observation, the Entry Reference template can be used to reference this entry. -->
                            <entryRelationship typeCode="GEVL">
                                <act classCode="ACT" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.122"/>
                                    <!-- This is the ID of the Decreased Social Isolation Goal -->
                                    <id extension="abcd" root="1.3.6.1.4.1.22812.4.222.334.4.34"/>
                                    <code nullFlavor="NP"/>
                                    <text>
                                        <reference value="#_RelGoal_2"/>
                                    </text>
                                    <statusCode code="completed"/>
                                </act>
                            </entryRelationship>
                            <!-- The following entryRelationship represents a patient's progress toward a goal. 
                                It describes whether a goal has been achieved or not and can also describe movement a patient is making toward the achievement of a goal -->
                            <entryRelationship inversionInd="true" typeCode="SPRT">
                                <observation classCode="OBS" moodCode="EVN">
                                    <templateId root="2.16.840.1.113883.10.20.22.4.110"/>
                                    <id extension="PROGRESS_100" root="1.3.6.1.4.1.22812.4.222.334.4.42"/>
                                    <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
                                    <statusCode code="completed"/>
                                    <value code="390802008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Goal achieved (finding)" xsi:type="CD">
                                        <originalText>
                                            <reference value="#_OutcomeAch1"/>
                                        </originalText>
                                    </value>
                                </observation>
                            </entryRelationship>
                        </observation>
                    </entry>
                </section>
            </component>
        </structuredBody>
    </component>
</ClinicalDocument>
