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                  {
                    "reference": "urn:uuid:b1bab782-3bbe-428b-b833-16444daa7b38"
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                  {
                    "reference": "urn:uuid:a07c34f2-192f-4c21-a4aa-043183c402a3"
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                  {
                    "reference": "urn:uuid:7e5ecf6b-2ff8-4026-a131-b8f491ba4345"
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                    "reference": "urn:uuid:fd01e42e-4a7a-4afb-9bdf-fd480c1ee5e6"
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                  "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>09-MAY-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Serum or Plasma</td><td>94.7</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Serum or Plasma</td><td>19.2</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Serum or Plasma</td><td><strong>2.0 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Serum or Plasma</td><td>9.8</td><td>8.6 - 10.3</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>143.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Serum or Plasma</td><td>4.3</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Serum or Plasma</td><td>103.1</td><td>98 - 107</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Serum or Plasma</td><td>27.7</td><td>22 - 29</td><td>mmol/L</td></tr><tr><td>Ketones [Presence] in Urine by Test strip</td><td>Urine ketone test = +</td><td></td><td></td></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td><strong>3.0 L</strong></td><td>4.8 - 5.9</td><td>%</td></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>94.7</td><td>70 - 100</td><td>mg/dL</td></tr><tr><td>Urea nitrogen [Mass/volume] in Blood</td><td>19.2</td><td>7 - 20</td><td>mg/dL</td></tr><tr><td>Creatinine [Mass/volume] in Blood</td><td><strong>1.5 H</strong></td><td>0.6 - 1.3</td><td>mg/dL</td></tr><tr><td>Calcium [Mass/volume] in Blood</td><td>9.8</td><td>8.5 - 10.5</td><td>mg/dL</td></tr><tr><td>Sodium [Moles/volume] in Blood</td><td>143.5</td><td>135 - 145</td><td>mmol/L</td></tr><tr><td>Potassium [Moles/volume] in Blood</td><td>4.3</td><td>3.5 - 5.1</td><td>mmol/L</td></tr><tr><td>Chloride [Moles/volume] in Blood</td><td>103.1</td><td>98 - 110</td><td>mmol/L</td></tr><tr><td>Carbon dioxide, total [Moles/volume] in Blood</td><td>27.7</td><td>22 - 29</td><td>mmol/L</td></tr></tbody></table></div>"
                },
                "title": "Chemistry"
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                  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h3>Urinalysis</h3><table class=\"hl7__eu__lab__report\"><thead><tr><th>Test</th><th>09-MAY-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr></thead><tbody><tr><td>Glucose [Mass/volume] in Urine by Test strip</td><td>2.3</td><td>0 - 20</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>0.5</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>4.8 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>5.4</td><td>5.0 - 8.0</td><td>pH</td></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td><strong>309.4 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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                  "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>09-MAY-2021</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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              "status": "generated",
              "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 creatinine, significant proteinuria, low urine specific gravity, and abnormal urine appearance, suggesting impaired renal function, possibly chronic kidney disease. Urine ketones are mildly elevated. Blood glucose is normal, but HbA1c is unexpectedly low—this may warrant repeat testing or evaluation for anemia or hemoglobinopathies. No evidence of urinary tract infection. Recommend nephrology evaluation and further assessment of renal function and possible underlying causes.</td></tr></table></div>"
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        "date": "2021-05-09T01:37:39Z",
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            "use": "home",
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            "city": "Kronach",
            "country": "Germany"
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        ],
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                    {
                      "code": "DE",
                      "system": "urn:iso:std:iso:3166"
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                  ]
                }
              }
            ],
            "url": "http://hl7.org/fhir/StructureDefinition/patient-nationality"
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        ],
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          "status": "generated",
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        "gender": "male",
        "birthDate": "1948-10-02"
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      "fullUrl": "urn:uuid:dacdef0c-4353-4f03-804b-fa701bf557ed",
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          {
            "reference": "urn:uuid:235613ba-f2fc-401b-9198-ea64de3095c1"
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        ],
        "reasonCode": [
          {
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            ]
          },
          {
            "coding": [
              {
                "code": "431856006",
                "system": "http://snomed.info/sct",
                "display": "Chronic kidney disease stage 2"
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            ]
          },
          {
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                "code": "90781000119102",
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                "display": "Microalbuminuria due to type 2 diabetes mellitus"
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            ]
          },
          {
            "coding": [
              {
                "code": "55822004",
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                "display": "Hyperlipidemia"
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            ]
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          {
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                "display": "Chronic sinusitis"
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            ]
          },
          {
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          {
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                "code": "59621000",
                "system": "http://snomed.info/sct",
                "display": "Essential hypertension"
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            ]
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          {
            "coding": [
              {
                "code": "271737000",
                "system": "http://snomed.info/sct",
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            ]
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          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">intentionally left empty / not meaningful</div>"
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        "status": "active",
        "intent": "order",
        "code": {
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              "display": "Laboratory procedure"
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Role Id: 753e32be-3dfe-4053-a458-338eff5f33e6</div>"
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              "display": "HL7 Europe"
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          {
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              "Friesener Straße 41"
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            "city": "Kronach",
            "postalCode": "96317",
            "country": "Germany"
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        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Provider Organization: Medizinisches Versorgungszentrum Kronach</div>"
        },
        "name": "Medizinisches Versorgungszentrum Kronach"
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      "fullUrl": "urn:uuid:271785f9-5cbd-4268-8d73-64da1712a308",
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            "http://hl7.eu/fhir/laboratory/StructureDefinition/Specimen-eu-lab"
          ]
        },
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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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          ]
        },
        "collection": {
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        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Specimen</th><th>Collection Date</th></tr><tr><td>Urine specimen</td><td><span class=\"nb\">08-May-2021</span></td></tr></table></div>"
        },
        "type": {
          "coding": [
            {
              "code": "122575003",
              "system": "http://snomed.info/sct",
              "display": "Urine specimen"
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        },
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        },
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          "coding": [
            {
              "code": "258580003",
              "system": "http://snomed.info/sct",
              "display": "Whole blood specimen (specimen)"
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          ]
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    {
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            {
              "code": "2345-7",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Serum or Plasma"
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          ],
          "text": "Glucose [Mass/volume] in Serum or Plasma"
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          "system": "http://unitsofmeasure.org",
          "value": 94.7,
          "unit": "mg/dL",
          "code": "mg/dL"
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            "high": {
              "value": 100,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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          }
        ],
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        "status": "final",
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          "reference": "urn:uuid:d5e8fb70-e33b-4095-b982-ff10c17f0f16",
          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
        "specimen": {
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            {
              "code": "3094-0",
              "system": "http://loinc.org",
              "display": "Urea nitrogen [Mass/volume] in Serum or Plasma"
            }
          ],
          "text": "Urea nitrogen [Mass/volume] in Serum or Plasma"
        },
        "valueQuantity": {
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          "value": 19.2,
          "unit": "mg/dL",
          "code": "mg/dL"
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              "value": 20,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
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        },
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
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      "fullUrl": "urn:uuid:30f8600e-7c3b-495c-8b25-66635de433ac",
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              "display": "Creatinine [Mass/volume] in Serum or Plasma"
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          "value": 2,
          "unit": "mg/dL",
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              "code": "mg/dL",
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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            ]
          }
        ],
        "text": {
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        "status": "final",
        "subject": {
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      "fullUrl": "urn:uuid:0f5aee6b-f57d-4f0f-882e-65590a95ef06",
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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": {
          "system": "http://unitsofmeasure.org",
          "value": 9.8,
          "unit": "mg/dL",
          "code": "mg/dL"
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              "value": 10.3,
              "code": "mg/dL",
              "system": "http://unitsofmeasure.org"
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        ],
        "text": {
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        "status": "final",
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
        "specimen": {
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              "code": "2951-2",
              "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": {
          "system": "http://unitsofmeasure.org",
          "value": 143.5,
          "unit": "mmol/L",
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              "code": "mmol/L",
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            },
            "high": {
              "value": 145,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>09-May-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Sodium [Moles/volume] in Serum or Plasma</td><td>143.5</td><td>135 - 145</td><td></td><td>mmol/L</td></tr></table></div>"
        },
        "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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          "system": "http://unitsofmeasure.org",
          "value": 4.3,
          "unit": "mmol/L",
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              "value": 5.1,
              "code": "mmol/L",
              "system": "http://unitsofmeasure.org"
            }
          }
        ],
        "text": {
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        },
        "status": "final",
        "subject": {
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    },
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            {
              "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 = +"
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          "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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          "coding": [
            {
              "code": "5803-2",
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              "display": "pH of Urine by Test strip"
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          ],
          "text": "pH of Urine by Test strip"
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        "valueQuantity": {
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              "value": 8,
              "code": "pH",
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        ],
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        },
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        "specimen": {
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    {
      "fullUrl": "urn:uuid:0c60e6ee-28a9-43f9-afe4-e5e4cebe0512",
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        "id": "0c60e6ee-28a9-43f9-afe4-e5e4cebe0512",
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        "category": [
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        "code": {
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            {
              "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"
        },
        "valueQuantity": {
          "system": "http://unitsofmeasure.org",
          "value": 309.4,
          "unit": "mg/dL",
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        "referenceRange": [
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              "value": 0,
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              "system": "http://unitsofmeasure.org"
            },
            "high": {
              "value": 20,
              "code": "mg/dL",
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                "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
                "display": "High"
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          }
        ],
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          "status": "generated",
          "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table class=\"hl7__eu__lab__report\"><tr><th>Test</th><th>09-May-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Protein [Mass/volume] in Urine by Test strip</td><td>309.4</td><td>0 - 20</td><td>H</td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
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      "fullUrl": "urn:uuid:f139996c-6b1c-41a6-8c3b-8fd84abf4b01",
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              "code": "20454-5",
              "system": "http://loinc.org",
              "display": "Protein [Presence] in Urine by Test strip"
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          ],
          "text": "Protein [Presence] in Urine by Test strip"
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        ],
        "code": {
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            {
              "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>09-May-2021</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": "Ahmed Wirth"
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        "valueCodeableConcept": {
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              "display": "Urine nitrite negative"
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              "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>09-May-2021</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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            {
              "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>09-May-2021</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>"
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          "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": 3,
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              "value": 5.9,
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                "display": "Low"
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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>09-May-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Hemoglobin A1c/Hemoglobin.total in Blood</td><td>3.0</td><td>4.8 - 5.9</td><td>L</td><td>%</td></tr></table></div>"
        },
        "status": "final",
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
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            ]
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        ],
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        ],
        "code": {
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              "code": "2339-0",
              "system": "http://loinc.org",
              "display": "Glucose [Mass/volume] in Blood"
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          ],
          "text": "Glucose [Mass/volume] in Blood"
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        "valueQuantity": {
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          "value": 94.7,
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          "code": "mg/dL"
        },
        "referenceRange": [
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            },
            "high": {
              "value": 100,
              "code": "mg/dL",
              "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>09-May-2021</th><th>Reference&#xA0;Range</th><th>Unit</th></tr><tr><td>Glucose [Mass/volume] in Blood</td><td>94.7</td><td>70 - 100</td><td></td><td>mg/dL</td></tr></table></div>"
        },
        "status": "final",
        "subject": {
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          "display": "Ahmed Wirth"
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        "effectiveDateTime": "2021-05-08T23:37:39Z",
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    },
    {
      "fullUrl": "urn:uuid:d1137a21-edbb-4936-b789-361077151837",
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            "postalCode": "1000",
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}