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                  {
                    "reference": "urn:uuid:52264896-8a96-488f-9edd-2c10ab323748"
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                  {
                    "reference": "urn:uuid:970a39fc-2e21-42ff-aff3-24945ce5df19"
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                  {
                    "reference": "urn:uuid:d3d51445-da99-4d5f-8b9d-88c06bec5717"
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                  {
                    "reference": "urn:uuid:9caf51e0-d1e7-46c9-872a-96308602ec74"
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                  {
                    "reference": "urn:uuid:a59df998-f8c5-4011-877f-b955374962e2"
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                  {
                    "reference": "urn:uuid:7e9a58b2-ff49-4af4-b5c2-44e036d9900b"
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                "text": {
                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Chemistry</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>15-SEP-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>68.8</td><td>65 - 99</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>18.0</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>1.7 H</strong></td><td>0.5 - 1.1</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>8.9</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>140.0</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.5</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>107.6</td><td>98 - 110</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>27.4</td><td>22 - 32</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = trace</td><td></td><td></td></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>4.5</td><td>4.0 - 5.6</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td><strong>68.8 L</strong></td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>18.0</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td>0.9</td><td>0.5 - 1.1</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>8.9</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>140.0</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.5</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td><strong>107.6 H</strong></td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>27.4</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
              },
              {
                "code": {
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                      "code": "18729-4",
                      "system": "http://loinc.org",
                      "display": "Urinalysis studies (set)"
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                  "text": "Urinalysis"
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                "entry": [
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                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>15-SEP-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td><strong>1.2 H</strong></td><td>0 - 0</td><td>mg/dL</td></tr><tr><td>Glucose [Presence] in Urine by Test strip</td><td>Urine glucose test = ++</td><td></td><td></td></tr><tr><td>Bilirubin.total [Mass/volume] in Urine by Test strip</td><td>0.9</td><td>0 - 4</td><td>mg/dL</td></tr><tr><td>Bilirubin.total [Presence] in Urine by Test strip</td><td>Finding of bilirubin in urine</td><td></td><td></td></tr><tr><td>Ketones [Mass/volume] in Urine by Test strip</td><td><strong>18.7 H</strong></td><td>0 - 4</td><td>mg/dL</td></tr><tr><td>Specific gravity of Urine by Test strip</td><td><strong>1.0 L</strong></td><td>1.005 - 1.030</td><td>{nominal}</td></tr><tr><td>pH of Urine by Test strip</td><td>6.9</td><td>4.5 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>102.1 H</strong></td><td>0 - 20</td><td>mg/dL</td></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = +</td><td></td><td></td></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td><td></td><td></td></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td><td></td><td></td></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td><td>Urine leukocyte test negative</td><td></td><td></td></tr></tbody></table></div>"
                },
                "title": "Urinalysis"
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              {
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                  "status": "generated",
                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Specimen information</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>15-SEP-2024</th><th>Specimen</th><th></th></tr></thead><tbody><tr><td>Appearance of Urine</td><td>Cloudy urine</td><td>Urine</td><td></td></tr><tr><td>Odor of Urine</td><td>Urine smell ammoniacal</td><td>Urine</td><td></td></tr><tr><td>Clarity of Urine</td><td>Translucent</td><td>Urine</td><td></td></tr><tr><td>Color of Urine</td><td>Brown color</td><td>Urine</td><td></td></tr></tbody></table></div>"
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              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Annotation</h3><table class=\"hl7__eu__lab__report\"><tr><th>Conclusion and Recommendations based on this report and previous findings known to us</th></tr><tr><td>The patient shows elevated serum creatinine, proteinuria, glycosuria, ketonuria, and low urine specific gravity, suggesting possible renal dysfunction and impaired glucose handling. Urine is cloudy, brown, and ammoniacal, but no evidence of infection (negative nitrites/leukocytes). Blood glucose and HbA1c are within or below normal, making diabetes less likely. Recommend further renal evaluation and correlation with clinical findings.</td></tr></table></div>"
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          "display": "Lara Baum"
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        "date": "2024-09-15T06:04:55Z",
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        "address": [
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            "use": "home",
            "type": "physical",
            "postalCode": "85354",
            "city": "Freising",
            "country": "Germany"
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        ],
        "telecom": [
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            "system": "phone",
            "value": "+49(0)0013 16572"
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        ],
        "extension": [
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                      "code": "DE",
                      "system": "urn:iso:std:iso:3166"
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__ips\"><tr><td>Lara Baum</td><td>female</td><td>10-Dec-1969</td></tr></table></div>"
        },
        "gender": "female",
        "birthDate": "1969-12-10"
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    },
    {
      "fullUrl": "urn:uuid:ee153816-5229-472d-abb7-dc10b7849a60",
      "resource": {
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        "id": "ee153816-5229-472d-abb7-dc10b7849a60",
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          "profile": [
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        },
        "identifier": [
          {
            "system": "http://example.org",
            "value": "0b2dbda3-c883-4475-94c6-77706ae63ce6"
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        ],
        "specimen": [
          {
            "reference": "urn:uuid:e2866ad2-a3aa-438b-8e8b-7ab8c8617dc8"
          },
          {
            "reference": "urn:uuid:2965f922-1fb1-45e7-98f7-b347b9dc34ff"
          },
          {
            "reference": "urn:uuid:405f23b0-5edf-4644-8d32-ab091dd0dc2d"
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        ],
        "reasonCode": [
          {
            "coding": [
              {
                "code": "239873007",
                "system": "http://snomed.info/sct",
                "display": "Osteoarthritis of knee"
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            ]
          },
          {
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                "code": "127013003",
                "system": "http://snomed.info/sct",
                "display": "Disorder of kidney due to diabetes mellitus"
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            ]
          },
          {
            "coding": [
              {
                "code": "431855005",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 1"
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            ]
          },
          {
            "coding": [
              {
                "code": "237602007",
                "system": "http://snomed.info/sct",
                "display": "Metabolic syndrome X"
              }
            ]
          },
          {
            "coding": [
              {
                "code": "59621000",
                "system": "http://snomed.info/sct",
                "display": "Essential hypertension"
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            ]
          }
        ],
        "text": {
          "status": "empty",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
        },
        "status": "active",
        "intent": "order",
        "code": {
          "coding": [
            {
              "code": "108252007",
              "system": "http://snomed.info/sct",
              "display": "Laboratory procedure"
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          ]
        },
        "subject": {
          "reference": "urn:uuid:79801b0b-d545-4f5c-987f-7c276c6ba055",
          "display": "Lara Baum"
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        "requester": {
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      }
    },
    {
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        "resourceType": "PractitionerRole",
        "id": "464d2cf5-250b-4ba5-a058-74e958d032a4",
        "meta": {
          "profile": [
            "http://hl7.eu/fhir/base/StructureDefinition/practitionerRole-eu"
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        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Role Id: 464d2cf5-250b-4ba5-a058-74e958d032a4</div>"
        },
        "organization": {
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          {
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              "display": "HL7 Europe"
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          {
            "line": [
              "Alois-Steinecker-Straße 16"
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            "city": "Freising",
            "postalCode": "85354",
            "country": "Germany"
          }
        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: KfH-Nierenzentrum am Klinikum Freising</div>"
        },
        "name": "KfH-Nierenzentrum am Klinikum Freising"
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    {
      "fullUrl": "urn:uuid:e2866ad2-a3aa-438b-8e8b-7ab8c8617dc8",
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            "http://hl7.eu/fhir/laboratory/StructureDefinition/Specimen-eu-lab"
          ]
        },
        "collection": {
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          "status": "generated",
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        },
        "type": {
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              "code": "122592007",
              "system": "http://snomed.info/sct",
              "display": "Acellular blood (serum or plasma) specimen"
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    {
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            "http://hl7.eu/fhir/laboratory/StructureDefinition/Specimen-eu-lab"
          ]
        },
        "collection": {
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          "status": "generated",
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        },
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              "code": "122575003",
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    {
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          "status": "generated",
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        },
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            {
              "code": "258580003",
              "system": "http://snomed.info/sct",
              "display": "Whole blood specimen (specimen)"
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              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Serum or Plasma"
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              "value": 99,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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          }
        ],
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              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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          "text": "Urea nitrogen [Mass/volume] in Serum or Plasma"
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              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
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        },
        "status": "final",
        "subject": {
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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          "value": 1.7,
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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            ]
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        ],
        "text": {
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        },
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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    {
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        "code": {
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              "code": "17861-6",
              "system": "http://loinc.org",
              "display": "Calcium [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Calcium [Mass/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 8.9,
          "unit": "mg/dL",
          "code": "mg/dL"
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          }
        ],
        "text": {
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        },
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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    {
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              "system": "http://loinc.org",
              "display": "Sodium [Moles/volume] in Serum or Plasma"
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          ],
          "text": "Sodium [Moles/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 140,
          "unit": "mmol/L",
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              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
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        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "code": {
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              "code": "2823-3",
              "system": "http://loinc.org",
              "display": "Potassium [Moles/volume] in Serum or Plasma"
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          ],
          "text": "Potassium [Moles/volume] in Serum or Plasma"
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        "valueQuantity": {
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          "value": 4.5,
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              "system": "http://unitsofmeasure.org"
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          }
        ],
        "text": {
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        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
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        "code": {
          "coding": [
            {
              "code": "2514-8",
              "system": "http://loinc.org",
              "display": "Ketones [Presence] in Urine by Test strip"
            }
          ],
          "text": "Ketones [Presence] in Urine by Test strip"
        },
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              "display": "Urine ketone test = trace"
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        "code": {
          "coding": [
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              "code": "5811-5",
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              "display": "Specific gravity of Urine by Test strip"
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          ],
          "text": "Specific gravity of Urine by Test strip"
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        "valueQuantity": {
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          "value": 1,
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              "unit": "Specific Gravity"
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              "value": 1.03,
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              "system": "http://unitsofmeasure.org",
              "unit": "Specific Gravity"
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        ],
        "text": {
          "status": "generated",
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      "fullUrl": "urn:uuid:56cf4eab-fbae-4314-a22b-a99101c58638",
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        "code": {
          "coding": [
            {
              "code": "5803-2",
              "system": "http://loinc.org",
              "display": "pH of Urine by Test strip"
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          ],
          "text": "pH of Urine by Test strip"
        },
        "valueQuantity": {
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          "value": 6.9,
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            },
            "high": {
              "value": 8,
              "code": "pH",
              "system": "http://unitsofmeasure.org"
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          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>pH of Urine by Test strip</td><td>6.9</td><td>4.5 - 8.0</td><td></td><td>pH</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Lara Baum"
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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      }
    },
    {
      "fullUrl": "urn:uuid:7808530a-f17c-4c53-96be-87644b53ba50",
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        "resourceType": "Observation",
        "id": "7808530a-f17c-4c53-96be-87644b53ba50",
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        "category": [
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        ],
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        "code": {
          "coding": [
            {
              "code": "5804-0",
              "system": "http://loinc.org",
              "display": "Protein [Mass/volume] in Urine by Test strip"
            }
          ],
          "text": "Protein [Mass/volume] in Urine by Test strip"
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        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 102.1,
          "unit": "mg/dL",
          "code": "mg/dL"
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        "referenceRange": [
          {
            "low": {
              "value": 0,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 20,
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              "system": "http://unitsofmeasure.org"
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        ],
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                "code": "H",
                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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            ]
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>102.1</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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      "fullUrl": "urn:uuid:0396d535-08d9-4780-a55d-99479e97d667",
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        "category": [
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        ],
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        "code": {
          "coding": [
            {
              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
            }
          ],
          "text": "Protein [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Presence] in Urine by Test strip</td><td>Urine protein test = +</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "valueCodeableConcept": {
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              "display": "Urine protein test = +"
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        ],
        "code": {
          "coding": [
            {
              "code": "5802-4",
              "system": "http://loinc.org",
              "display": "Nitrite [Presence] in Urine by Test strip"
            }
          ],
          "text": "Nitrite [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Nitrite [Presence] in Urine by Test strip</td><td>Urine nitrite negative</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Lara Baum"
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "valueCodeableConcept": {
          "coding": [
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              "display": "Urine nitrite negative"
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      }
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    {
      "fullUrl": "urn:uuid:622bce25-e833-4713-9e97-33ec7f39f53d",
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5794-3",
              "system": "http://loinc.org",
              "display": "Hemoglobin [Presence] in Urine by Test strip"
            }
          ],
          "text": "Hemoglobin [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin [Presence] in Urine by Test strip</td><td>Urine blood test = negative</td></tr></table></div>"
        },
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          "display": "Lara Baum"
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "valueCodeableConcept": {
          "coding": [
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              "display": "Urine blood test = negative"
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          ]
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          }
        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "5799-2",
              "system": "http://loinc.org",
              "display": "Leukocyte esterase [Presence] in Urine by Test strip"
            }
          ],
          "text": "Leukocyte esterase [Presence] in Urine by Test strip"
        },
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Leukocyte esterase [Presence] in Urine by Test strip</td><td>Urine leukocyte test negative</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "valueCodeableConcept": {
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              "display": "Urine leukocyte test negative"
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    {
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        "category": [
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "4548-4",
              "system": "http://loinc.org",
              "display": "Hemoglobin A1c/Hemoglobin.total in Blood"
            }
          ],
          "text": "Hemoglobin A1c/Hemoglobin.total in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 4.5,
          "unit": "%",
          "code": "%"
        },
        "referenceRange": [
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            "low": {
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 5.6,
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              "system": "http://unitsofmeasure.org"
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          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>15-Sep-2024</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>4.5</td><td>4.0 - 5.6</td><td></td><td>%</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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    },
    {
      "fullUrl": "urn:uuid:f45f7c99-5b72-4b7c-b8da-7a81e654ea0c",
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        "id": "f45f7c99-5b72-4b7c-b8da-7a81e654ea0c",
        "meta": {
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        "category": [
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        ],
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        ],
        "code": {
          "coding": [
            {
              "code": "2339-0",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Blood"
            }
          ],
          "text": "Glucose [Mass/volume] in Blood"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 68.8,
          "unit": "mg/dL",
          "code": "mg/dL"
        },
        "referenceRange": [
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
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        "interpretation": [
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                "display": "Low"
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            ]
          }
        ],
        "text": {
          "status": "generated",
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        },
        "status": "final",
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        "effectiveDateTime": "2024-09-15T04:04:55Z",
        "specimen": {
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      }
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    {
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        "category": [
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        ],
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        ],
        "code": {
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            {
              "code": "6299-2",
              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Blood"
            }
          ],
          "text": "Urea nitrogen [Mass/volume] in Blood"
        },
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            "postalCode": "1000",
            "city": "Brussels",
            "country": "Belgium"
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        ],
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  "type": "document",
  "timestamp": "2024-09-15T06:04:55Z"
}