# Patient Test Record: VirtualEncWithin14DaysAfterEpisode NUMER1PassStrat1

Patient
VirtualEncWithin14DaysAfterEpisode NUMER1PassStrat1
Sex
248152002
Date of birth
2009-01-02T08:00:00+00:00
Date of expiration
None
Race
1002-5
Ethnicity
2135-2
Insurance Providers
1
Patient IDs
2
Address
Telecom
(HP) 555-555-2003

### QDM::EncounterPerformed

Description
Codes
Time
Fields/Results
Encounter, Performed: Telephone Visits
Codes:
CPT: 98966
Time Elements:
Relevant Period Start: 2027-11-14T08:00:00.000+00:00
Relevant Period End: 2027-11-14T08:15:00.000+00:00
Other Fields:
Encounter, Performed: Virtual Encounter
Codes:
CPT: 98970
Time Elements:
Relevant Period Start: 2027-11-17T08:00:00.000+00:00
Relevant Period End: 2027-11-17T08:15:00.000+00:00
Other Fields:

### QDM::Diagnosis

Description
Codes
Time
Fields/Results
Diagnosis: Alcohol and Drug Dependence
Codes:
SNOMEDCT: 10327003
Time Elements:
Prevalence Period Start: 2027-11-14T08:01:00.000+00:00
Prevalence Period End: 2027-11-17T08:15:00.000+00:00
Other Fields:

### QDM::ProcedurePerformed

Description
Codes
Time
Fields/Results
Procedure, Performed: Substance Use Disorder Short Acting Medication Administration
Codes:
SNOMEDCT: 310653000
Time Elements:
Relevant Period Start: 2027-11-17T08:00:00.000+00:00
Relevant Period End: 2027-11-17T08:15:00.000+00:00
Author Date/Time: 2027-11-17T08:00:00.000+00:00
Other Fields:

### QDM::PatientCharacteristicSex

Description
Codes
Time
Fields/Results
Patient Characteristic Sex: FederalAdministrativeSex
Codes:
SNOMEDCT: 248152002
Time Elements:
Other Fields:

### QDM::PatientCharacteristicBirthdate

Description
Codes
Time
Fields/Results
Codes:
Time Elements:
Birth Date/Time: 2009-01-02T08:00:00.000+00:00
Other Fields:

### QDM::PatientCharacteristicRace

Description
Codes
Time
Fields/Results
Patient Characteristic Race: Race
Codes:
CDCREC: 1002-5
Time Elements:
Other Fields:

### QDM::PatientCharacteristicEthnicity

Description
Codes
Time
Fields/Results
Patient Characteristic Ethnicity: Ethnicity
Codes:
CDCREC: 2135-2
Time Elements:
Other Fields:

### QDM::PatientCharacteristicPayer

Description
Codes
Time
Fields/Results
Codes:
Source of Payment Typology: 1
Time Elements:
Relevant Period Start: 2009-01-02T08:00:00.000+00:00
Other Fields: