{
  "birthDatetime": "1970-01-01T03:00:00.000-05:00",
  "bundleId": "59638a8b942c6d2e17000435",
  "dataElements": [
    {
      "authorDatetime": "2012-08-23T04:00:00.000-04:00",
      "category": "laboratory_test",
      "components": [

      ],
      "dataElementCodes": [
        {
          "code": "12773-8",
          "system": "2.16.840.1.113883.6.1"
        }
      ],
      "description": "Laboratory Test, Performed: LDL Test",
      "hqmfOid": "2.16.840.1.113883.3.560.1.5",
      "method": null,
      "negationRationale": null,
      "qdmStatus": "performed",
      "qdmVersion": "5.3",
      "reason": null,
      "referenceRange": null,
      "relevantPeriod": {
        "low": "2012-08-23T08:00:00.000+00:00",
        "high": "2012-08-23T08:15:00.000+00:00",
        "lowClosed": true,
        "highClosed": true
      },
      "result": null,
      "resultDatetime": null,
      "status": null,
      "_type": "QDM::LaboratoryTestPerformed"
    },
    {
      "birthDatetime": "1970-01-01T03:00:00.000-05:00",
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "21112-8",
          "display": null,
          "system": "2.16.840.1.113883.6.1",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.54",
      "qdmStatus": "birthdate",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicBirthdate"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "2186-5",
          "display": "Not Hispanic or Latino",
          "system": "2.16.840.1.113883.6.238",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.56",
      "qdmStatus": "ethnicity",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicEthnicity"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "1002-5",
          "display": "American Indian or Alaska Native",
          "system": "2.16.840.1.113883.6.238",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.59",
      "qdmStatus": "race",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicRace"
    },
    {
      "category": "patient_characteristic",
      "dataElementCodes": [
        {
          "code": "M",
          "display": "M",
          "system": "2.16.840.1.113883.5.1",
          "version": null,
          "_type": "QDM::Code"
        }
      ],
      "description": null,
      "hqmfOid": "2.16.840.1.113883.10.20.28.3.55",
      "qdmStatus": "gender",
      "qdmVersion": "5.3",
      "_type": "QDM::PatientCharacteristicSex"
    }
  ],
  "extendedData": {
    "type": null,
    "measure_ids": [
      "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
      null
    ],
    "source_data_criteria": [
      {
        "negation": false,
        "definition": "laboratory_test",
        "status": "performed",
        "title": "LDL Test",
        "description": "Laboratory Test, Performed: LDL Test",
        "code_list_id": "2.16.840.1.113883.3.464.1003.198.11.1029",
        "type": "laboratory_tests",
        "id": "LDLTest_LaboratoryTestPerformed_dfc0eb1c_63c5_4b29_ac69_d74cc67a97fc_source",
        "start_date": 1345708800000,
        "end_date": 1345709700000,
        "value": [

        ],
        "references": null,
        "field_values": {
        },
        "hqmf_set_id": "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
        "cms_id": "CMS735v0",
        "criteria_id": "15e10e21b84iy",
        "codes": {
          "LOINC": [
            "12773-8"
          ]
        },
        "negation_code_list_id": "",
        "coded_entry_id": "599dec1ad7c8ac5456000004",
        "code_source": "DEFAULT"
      },
      {
        "id": "MeasurePeriod",
        "start_date": 0,
        "end_date": 0,
        "references": null
      }
    ],
    "expected_values": [
      {
        "measure_id": "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
        "population_index": 0,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0,
        "DENEXCEP": 0
      },
      {
        "measure_id": "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
        "population_index": 1,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0,
        "DENEXCEP": 0
      },
      {
        "measure_id": "E075A7F3-D272-4B6C-A677-84C4BC780D4E",
        "population_index": 2,
        "IPP": 0,
        "DENOM": 0,
        "DENEX": 0,
        "NUMER": 0,
        "DENEXCEP": 0
      }
    ],
    "notes": "",
    "is_shared": null,
    "origin_data": [

    ],
    "test_id": null,
    "medical_record_number": "304b80402aae7cf71a37fc82556a7358",
    "medical_record_assigner": "Bonnie",
    "description": null,
    "description_category": null,
    "insurance_providers": "[{\"codes\":{\"SOP\":[\"349\"]},\"description\":null,\"end_time\":null,\"financial_responsibility_type\":{\"code\":\"SELF\",\"codeSystem\":\"HL7 Relationship Code\"},\"health_record_field\":null,\"member_id\":\"1234567890\",\"mood_code\":\"EVN\",\"name\":\"Other\",\"negationInd\":null,\"negationReason\":null,\"oid\":null,\"payer\":{\"name\":\"Other\"},\"reason\":null,\"relationship\":null,\"specifics\":null,\"start_time\":1199163600,\"status_code\":null,\"time\":null,\"type\":\"OT\"}]"
  },
  "familyName": "last",
  "givenNames": [
    "first"
  ],
  "qdmVersion": "5.3"
}
