The initial load of this repository in January 2021 includes all examples (figures) from the June 2019 Errata published PDF of C-CDA 2.1 and 2019 release of C-CDA Companion Guide.
These examples were reviewed through the HL7 ballot process. They have not been formally reviewed/approved by the examples task force.
US Realm Header (V3)
2.16.840.1.113883.10.20.22.1.1
Example: Supporting Person participant Example.xml download example view on GitHub
<ClinicalDocument>
<!-- ... -->
<participant typeCode="IND">
<!-- typeCode "IND" represents an individual -->
<associatedEntity classCode="NOK">
<!-- classCode "NOK" represents the patient's next of kin-->
<addr use="HP">
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-2008" use="MC" />
<associatedPerson>
<name>
<given>Boris</given>
<given qualifier="CL">Bo</given>
<family>Betterhalf</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
<!-- Entities playing multiple roles are recorded in multiple participants -->
<participant typeCode="IND">
<associatedEntity classCode="ECON">
<!-- classCode "ECON" represents an emergency contact -->
<addr use="HP">
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-2008" use="MC" />
<associatedPerson>
<name>
<given>Boris</given>
<given qualifier="CL">Bo</given>
<family>Betterhalf</family>
</name>
</associatedPerson>
</associatedEntity>
</participant>
</ClinicalDocument>
Example: Assigned Health Care Provider informant Example.xml download example view on GitHub
<informant>
<assignedEntity>
<id extension="888888888" root="1.1.1.1.1.1.1.3" />
<addr>
<streetAddressLine>1007 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1003" />
<assignedPerson>
<name>
<given>Harold</given>
<family>Hippocrates</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
<representedOrganization>
<name>The DoctorsApart Physician Group</name>
</representedOrganization>
</assignedEntity>
</informant>
Example: inFulfillmentOf Example.xml download example view on GitHub
<inFulfillmentOf typeCode="FLFS">
<order classCode="ACT" moodCode="RQO">
<id root="2.16.840.1.113883.6.96" extension="1298989898" />
<code code="388975008" displayName="Weight reduction consultation" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" />
</order>
</inFulfillmentOf>
Example: authenticator Example.xml download example view on GitHub
<authenticator>
<time value="201209151030-0800" />
<signatureCode code="S" />
<assignedEntity>
<id extension="5555555555" root="2.16.840.1.113883.4.6" />
<code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy" />
<addr>
<streetAddressLine>1004 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1004" />
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedEntity>
</authenticator>
Example: US Realm Header (V3) Example.xml download example view on GitHub
<ClinicalDocument>
<realmCode code="US" />
<typeId extension="POCD_HD000040" root="2.16.840.1.113883.1.3" />
<!-- CCD template -->
<templateId root="2.16.840.1.113883.10.20.22.1.1" extension="2015-08-01" />
<!-- Globally unique identifier for the document -->
<id extension="TT988" root="2.16.840.1.113883.19.5.99999.1" />
<code code="34133-9" displayName="Summary of episode note" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" />
<!-- Title of the document -->
<title>Patient Chart Summary</title>
<effectiveTime value="201209151030-0800" />
<confidentialityCode code="N" displayName="normal" codeSystem="2.16.840.1.113883.5.25" codeSystemName="Confidentiality" />
<languageCode code="en-US" />
<setId extension="sTT988" root="2.16.840.1.113883.19.5.99999.19" />
<!-- Version of the document -->
<versionNumber value="1" />
. . .
</ClinicalDocument>
Example: recordTarget Example.xml download example view on GitHub
<recordTarget>
<patientRole>
<id extension="444-22-2222" root="2.16.840.1.113883.4.1" />
<!-- Example Social Security Number using the actual SSN OID. -->
<addr use="HP">
<!-- HP is "primary home" from codeSystem 2.16.840.1.113883.5.1119 -->
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
<!-- US is "United States" from ISO 3166-1 Country Codes: 1.0.3166.1 -->
</addr>
<telecom value="tel:+1(555)555-2003" use="HP" />
<!-- HP is "primary home" from HL7 AddressUse 2.16.840.1.113883.5.1119 -->
<patient>
<!-- The first name element represents what the patient is known as -->
<name use="L">
<given>Eve</given>
<!-- The "SP" is "Spouse" from
HL7 Code System EntityNamePartQualifier 2.16.840.1.113883.5.43 -->
<family qualifier="SP">Betterhalf</family>
</name>
<!-- The second name element represents another name
associated with the patient -->
<name>
<given>Eve</given>
<!-- The "BR" is "Birth" from
HL7 Code System EntityNamePartQualifier 2.16.840.1.113883.5.43 -->
<family qualifier="BR">Everywoman</family>
</name>
<administrativeGenderCode code="F" displayName="Female" codeSystem="2.16.840.1.113883.5.1" codeSystemName="AdministrativeGender" />
<!-- Date of birth need only be precise to the day -->
<birthTime value="19750501" />
<maritalStatusCode code="M" displayName="Married" codeSystem="2.16.840.1.113883.5.2" codeSystemName="MaritalStatusCode" />
<religiousAffiliationCode code="1013" displayName="Christian (non-Catholic, non-specific)" codeSystem="2.16.840.1.113883.5.1076" codeSystemName="HL7 Religious Affiliation" />
<!-- CDC Race and Ethnicity code set contains the five minimum
race and ethnicity categories defined by OMB Standards -->
<raceCode code="2106-3" displayName="White" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC" />
<!-- The raceCode extension is only used if raceCode is valued -->
<sdtc:raceCode code="2076-8" displayName="Native Hawaiian or Other Pacific Islander" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC" />
<ethnicGroupCode code="2186-5" displayName="Not Hispanic or Latino" codeSystem="2.16.840.1.113883.6.238" codeSystemName="Race & Ethnicity - CDC" />
<guardian>
<code code="POWATT" displayName="Power of Attorney" codeSystem="2.16.840.1.113883.1.11.19830" codeSystemName="ResponsibleParty" />
<addr use="HP">
<streetAddressLine>2222 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
<telecom value="tel:+1(555)555-2008" use="MC" />
<guardianPerson>
<name>
<given>Boris</given>
<given qualifier="CL">Bo</given>
<family>Betterhalf</family>
</name>
</guardianPerson>
</guardian>
<birthplace>
<place>
<addr>
<streetAddressLine>4444 Home Street</streetAddressLine>
<city>Beaverton</city>
<state>OR</state>
<postalCode>97867</postalCode>
<country>US</country>
</addr>
</place>
</birthplace>
<languageCommunication>
<languageCode code="eng" />
<!-- "eng" is ISO 639-2 alpha-3 code for "English" -->
<modeCode code="ESP" displayName="Expressed spoken" codeSystem="2.16.840.1.113883.5.60" codeSystemName="LanguageAbilityMode" />
<proficiencyLevelCode code="G" displayName="Good" codeSystem="2.16.840.1.113883.5.61" codeSystemName="LanguageAbilityProficiency" />
<!-- Patient's preferred language -->
<preferenceInd value="true" />
</languageCommunication>
</patient>
<providerOrganization>
<id extension="219BX" root="1.1.1.1.1.1.1.1.2" />
<name>The DoctorsTogether Physician Group</name>
<telecom use="WP" value="tel: +(555)-555-5000" />
<addr>
<streetAddressLine>1007 Health Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</providerOrganization>
</patientRole>
</recordTarget>
Example: authorization Example.xml download example view on GitHub
<authorization typeCode="AUTH">
<consent classCode="CONS" moodCode="EVN">
<id root="629deb70-5306-11df-9879-0800200c9a66" />
<code codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" code="64293-4" displayName="Procedure consent" />
<statusCode code="completed" />
</consent>
</authorization>
Example: legalAuthenticator Example.xml download example view on GitHub
<legalAuthenticator>
<time value="20120915223615-0800" />
<signatureCode code="S" />
<assignedEntity>
<id extension="5555555555" root="2.16.840.1.113883.4.6" />
<code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy" />
<addr>
<streetAddressLine>1004 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1004" />
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedEntity>
</legalAuthenticator>
Example: performer Example.xml download example view on GitHub
<performer typeCode="PRF">
<functionCode code="PCP"
displayName="primary care physician"
codeSystem="2.16.840.1.113883.5.88"
codeSystemName="ParticipationFunction">
<originalText>Primary Care Provider</originalText>
</functionCode>
<assignedEntity>
<id extension="5555555555" root="2.16.840.1.113883.4.6" />
<code code="207QA0505X" displayName="Adult Medicine" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy" />
<addr>
<streetAddressLine>1004 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1004" />
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
<representedOrganization>
<id extension="219BX" root="1.1.1.1.1.1.1.1.2" />
<name>The DoctorsTogether Physician Group</name>
<telecom use="WP" value="tel: +(555)-555-5000" />
<addr>
<streetAddressLine>1004 Health Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedEntity>
</performer>
Example: informationRecipient Example.xml download example view on GitHub
<informationRecipient>
<intendedRecipient>
<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>
Example: documentationOf Example.xml download example view on GitHub
<documentationOf>
<serviceEvent classCode="PCPR">
<!-- The effectiveTime reflects the provision of care summarized in the document.
In this scenario, the provision of care summarized is the lifetime for the patient -->
<effectiveTime>
<low value="19750501" />
<!-- The low value represents when the summarized provision of care began.
In this scenario, the patient's date of birth -->
<high value="20120915" />
<!-- The high value represents when the summarized provision of care being ended.
In this scenario, when chart summary was created -->
</effectiveTime>
<performer typeCode="PRF">
<functionCode code="PCP"
displayName="primary care physician"
codeSystem="2.16.840.1.113883.5.88"
codeSystemName="ParticipationFunction">
<originalText>Primary Care Provider</originalText>
</functionCode>
<assignedEntity>
<id extension="5555555555" root="2.16.840.1.113883.4.6" />
<code code="207QA0505X" displayName="Adult Medicine"
codeSystem="2.16.840.1.113883.5.53"
codeSystemName="Health Care Provider Taxonomy" />
<addr>
<streetAddressLine>1004 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1004" />
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
<representedOrganization>
<id extension="219BX" root="1.1.1.1.1.1.1.1.2" />
<name>The DoctorsTogether Physician Group</name>
<telecom use="WP" value="tel: +(555)-555-5000" />
<addr>
<streetAddressLine>1004 Health Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</representedOrganization>
</assignedEntity>
</performer>
</serviceEvent>
</documentationOf>
Example: custodian Example.xml download example view on GitHub
<custodian>
<assignedCustodian>
<representedCustodianOrganization>
<id extension="321CX" root="1.1.1.1.1.1.1.1.3" />
<name>Good Health HIE</name>
<telecom use="WP" value="tel:+1(555)555-1009" />
<addr use="WP">
<streetAddressLine>1009 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
</representedCustodianOrganization>
</assignedCustodian>
</custodian>
Example: Personal Relation informant Example.xml download example view on GitHub
<informant>
<relatedEntity classCode="PRS">
<!-- classCode "PRS" represents a person with personal relationship with the patient -->
<code code="SPS" displayName="SPOUSE" codeSystem="2.16.840.1.113883.1.11.19563" codeSystemName="Personal Relationship Role Type Value Set" />
<relatedPerson>
<name>
<given>Boris</given>
<given qualifier="CL">Bo</given>
<family>Betterhalf</family>
</name>
</relatedPerson>
</relatedEntity>
</informant>
Example: Digital signature Example.xml download example view on GitHub
<sdtc:signatureText mediaType="text/xml" representation="B64">omSJUEdmde9j44zmMiromSJUEdmde9j44zmMirdMDSsWdIJdksIJR3373jeu83
6edjzMMIjdMDSsWdIJdksIJR3373jeu83MNYD83jmMdomSJUEdmde9j44zmMir
... MNYD83jmMdomSJUEdmde9j44zmMir6edjzMMIjdMDSsWdIJdksIJR3373jeu83
4zmMir6edjzMMIjdMDSsWdIJdksIJR3373jeu83==</sdtc:signatureText>
Example: author Example.xml download example view on GitHub
<author>
<time value="201209151030-0800" />
<assignedAuthor>
<id extension="5555555555" root="2.16.840.1.113883.4.6" />
<code code="163W00000X" displayName="Registered nurse" codeSystem="2.16.840.1.113883.5.53" codeSystemName="Health Care Provider Taxonomy" />
<addr>
<streetAddressLine>1004 Healthcare Drive </streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1004" />
<assignedPerson>
<name>
<given>Patricia</given>
<given qualifier="CL">Patty</given>
<family>Primary</family>
<suffix qualifier="AC">M.D.</suffix>
</name>
</assignedPerson>
</assignedAuthor>
</author>
Example: dateEnterer Example.xml download example view on GitHub
<dataEnterer>
<assignedEntity>
<id extension="333777777" root="2.16.840.1.113883.4.6" />
<addr>
<streetAddressLine>1007 Healthcare Drive</streetAddressLine>
<city>Portland</city>
<state>OR</state>
<postalCode>99123</postalCode>
<country>US</country>
</addr>
<telecom use="WP" value="tel:+1(555)555-1050" />
<assignedPerson>
<name>
<given>Ellen</given>
<family>Enter</family>
</name>
</assignedPerson>
</assignedEntity>
</dataEnterer>
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