# Patient Test Record: SUDTx61DaysB4Episode DENOMPassStrat2

Patient
SUDTx61DaysB4Episode DENOMPassStrat2
Sex
248153007
Date of birth
1965-03-05T23:59:00+00:00
Date of expiration
None
Race
2131-1
Ethnicity
2186-5
Insurance Providers
1
Patient IDs
29
Address
Telecom
(HP) 555-555-2003

### QDM::Diagnosis

Description
Codes
Time
Fields/Results
Diagnosis: Alcohol And Drug Dependence
Codes:
SNOMEDCT: 125851000119106
Time Elements:
Prevalence Period Start: 2027-01-20T17:05:00.000+00:00
Prevalence Period End: 2027-07-07T17:00:00.000+00:00
Other Fields:

### QDM::InterventionPerformed

Description
Codes
Time
Fields/Results
Intervention, Performed: Substance Use Disorder Treatment
Codes:
SNOMEDCT: 171047005
Time Elements:
Relevant Period Start:
Relevant Date/Time: 2026-11-20T23:59:00.000+00:00
Other Fields:

### QDM::EncounterPerformed

Description
Codes
Time
Fields/Results
Encounter, Performed: Initial Hospital Inpatient Visit
Codes:
CPT: 99221
Time Elements:
Relevant Period Start: 2027-01-20T17:00:00.000+00:00
Relevant Period End: 2027-01-20T17:10:00.000+00:00
Other Fields:

### QDM::PatientCharacteristicSex

Description
Codes
Time
Fields/Results
Patient Characteristic Sex: FederalAdministrativeSex
Codes:
SNOMEDCT: 248153007
Time Elements:
Other Fields:

### QDM::PatientCharacteristicBirthdate

Description
Codes
Time
Fields/Results
Codes:
Time Elements:
Birth Date/Time: 1965-03-05T23:59:00.000+00:00
Other Fields:

### QDM::PatientCharacteristicRace

Description
Codes
Time
Fields/Results
Patient Characteristic Race: Race
Codes:
CDCREC: 2131-1
Time Elements:
Other Fields:

### QDM::PatientCharacteristicEthnicity

Description
Codes
Time
Fields/Results
Patient Characteristic Ethnicity: Ethnicity
Codes:
CDCREC: 2186-5
Time Elements:
Other Fields:

### QDM::PatientCharacteristicPayer

Description
Codes
Time
Fields/Results
Codes:
Source of Payment Typology: 1
Time Elements:
Relevant Period Start: 1965-03-05T23:59:00.000+00:00
Other Fields: