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<!-- This is meant to represent multiple implants during the same procedure -->
<!-- This is not necessarily an ideal modeling and other changes to transition away from procedure act may be in future -->
<!-- That said, this is designed for compliance with current C-CDA 1.1 & 2.1 (and MU rules) -->
<section>
<templateId root="2.16.840.1.113883.10.20.22.2.23"/>
<templateId root="2.16.840.1.113883.10.20.22.2.23" extension="2014-06-09"/>
<code code="46264-8" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Medical Equipment"/>
<title>Implants</title>
<text>
<table>
<thead>
<tr>
<th>Implant</th>
<th>Area</th>
<th>Manufacturer</th>
<th>Device Identifier</th>
<th>Model</th>
<th>Serial Number</th>
<th>Lot</th>
<th>Date and Provider</th>
</tr>
</thead>
<tbody>
<tr>
<td ID="implantOne">Drug Eluting Coronary Stent (LIBERTE TAXUS 3.00 mm)</td>
<td>Left Anterior Descending Coronary Artery</td>
<td>Boston Scientific</td>
<td>(01)00848486001048(11)160330(10)ABC124</td>
<td>Z-0068-2010</td>
<td>0111-066-31456</td>
<td>ABC124</td>
<td>Implanted 04/13/2016 by Fleming, Barry</td>
</tr>
<tr>
<td ID="implantTwo">Drug Eluting Coronary Stent (LIBERTE TAXUS 2.75 mm)</td>
<td>Left Anterior Descending Coronary Artery</td>
<td>Boston Scientific</td>
<td>(01)00848486001048(11)160542(10)ABC125</td>
<td>Z-0068-2010</td>
<td>0111-066-31456</td>
<td>ABC125</td>
<td>Implanted 04/13/2016 by Fleming, Barry</td>
</tr>
</tbody>
</table>
</text>
<entry>
<procedure classCode="PROC" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.14"/>
<templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
<id extension="27456789" root="1.2.840.114350.1.13.5552.1.7.2.737780"/>
<code code="609153008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Percutaneous insertion of drug eluting stent into coronary artery using fluoroscopic guidance"/>
<!-- Procedure is completed, even though the implant is still active -->
<statusCode code="completed"/>
<effectiveTime>
<!-- Placed Date -->
<low value="20160413"/>
</effectiveTime>
<targetSiteCode code="59438005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Structure of anterior descending branch of left coronary artery" />
<performer typeCode="PRF">
<assignedEntity>
<id extension="2222222222" root="2.16.840.1.113883.4.6" />
<addr>
<streetAddressLine>#456, Lincon Street</streetAddressLine>
<streetAddressLine>Wilson Garden</streetAddressLine>
<city>Colorado</city>
<postalCode>80203</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1-(859)085-0945" />
<assignedPerson>
<name>
<family>Barry</family>
<given>Fleming</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="DEV">
<participantRole classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.37"/>
<id assigningAuthorityName="FDA" extension="(01)00848486001048(11)160330(10)ABC124" root="2.16.840.1.113883.3.3719"/>
<playingDevice>
<code nullFlavor="UNK">
<originalText>
<reference value="#implantOne"/>
</originalText>
</code>
</playingDevice>
<!-- From Product Instance template:
The scopingEntity/id should correspond to FDA or the appropriate issuing agency. -->
<scopingEntity>
<id root="2.16.840.1.113883.3.3719"/>
</scopingEntity>
</participantRole>
</participant>
</procedure>
</entry>
<entry>
<procedure classCode="PROC" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.22.4.14"/>
<templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
<!-- Note that since this is the same procedure, the id is the same as prior entry -->
<id extension="27456789" root="1.2.840.114350.1.13.5552.1.7.2.737780"/>
<code code="609153008" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED" displayName="Percutaneous insertion of drug eluting stent into coronary artery using fluoroscopic guidance"/>
<!-- Procedure is completed, even though the implant is still active -->
<statusCode code="completed"/>
<effectiveTime>
<!-- Placed Date -->
<low value="20160413"/>
</effectiveTime>
<targetSiteCode code="59438005" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Structure of anterior descending branch of left coronary artery" />
<performer typeCode="PRF">
<assignedEntity>
<id extension="2222222222" root="2.16.840.1.113883.4.6" />
<addr>
<streetAddressLine>#456, Lincon Street</streetAddressLine>
<streetAddressLine>Wilson Garden</streetAddressLine>
<city>Colorado</city>
<postalCode>80203</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1-(859)085-0945" />
<assignedPerson>
<name>
<family>Barry</family>
<given>Fleming</given>
</name>
</assignedPerson>
</assignedEntity>
</performer>
<participant typeCode="DEV">
<participantRole classCode="MANU">
<templateId root="2.16.840.1.113883.10.20.22.4.37"/>
<id assigningAuthorityName="FDA" extension="(01)00848486001048(11)160542(10)ABC125" root="2.16.840.1.113883.3.3719"/>
<playingDevice>
<code nullFlavor="UNK">
<originalText>
<reference value="#implantTwo"/>
</originalText>
</code>
</playingDevice>
<!-- From Product Instance template:
The scopingEntity/id should correspond to FDA or the appropriate issuing agency. -->
<scopingEntity>
<id root="2.16.840.1.113883.3.3719"/>
</scopingEntity>
</participantRole>
</participant>
</procedure>
</entry>
</section>