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=Addenda voor inhoudelijke gegevens=
 
===Patiënt I. XXX_Jangi===
 
<section begin=XXX_Jangi />
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="4" | Patiënt
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="3" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Naamgegevens
 
|style="background-color: white;"|I. XXX_Jangi
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Knolweg 1002 9999ZZ Stitswerd
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="4"|Telefoonnummers
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Telefoonnummer
 
|style="background-color: white;"|+31612345678
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Nummer soort
 
|style="background-color: white;"|Mobiel telefoonnummer (code = 'MC' in codeSystem '2.16.840.1.113883.5.1119')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Identificatienummer
 
|style="background-color: white;"|999911727 [BSN]
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Identificatienummer
 
|style="background-color: white;"|10009 met root OID '2.16.840.1.113883.2.4.3.11.999.77.19829.1'
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Geboortedatum
 
|style="background-color: white;"|2 aug 1964 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Geslacht
 
|style="background-color: white;"|Man (code = 'M' in codeSystem '2.16.840.1.113883.5.1')
 
|}<section end=XXX_Jangi /><section begin=DG_XXX_Jangi />
 
====Documentgegevens XXX_Jangi ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Documentgegevens
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Document datum
 
|style="background-color: white;"|16 aug 2018
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Auteur - zorgaanbieder [voorbeeldgegevens - mag gevuld met eigen testgegevens]
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="11"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Apotheek de Gulle Gaper
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|1 Tegenover 1 Postadres
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="4"|Telefoonnummers
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Telefoonnummer
 
|style="background-color: white;"|+31703655424
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Nummer soort
 
|style="background-color: white;"|Zakelijk telefoonnummer (code = 'WP' in codeSystem '2.16.840.1.113883.5.1119')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="4"|Email adressen
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Email adres
 
|style="background-color: white;"|info@apotheekgullegaper.com
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="2"|Email soort
 
|style="background-color: white;"|Zakelijk e-mailadres (code = 'WP' in codeSystem '2.16.840.1.113883.5.1119')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Verificatie patient
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Verificatie zorgverlener
 
|style="background-color: white;"|Nee
 
|}<section end=DG_XXX_Jangi /><section begin=MBHS_XXX_Jangi /><section begin=MBH_MBH_MO_123_1 />
 
====Medicamenteuze behandeling MBH_MO_123_1 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Medicatie gebruik
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_1_MGB_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.6.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Registratiedatum
 
|style="background-color: white;"|T, om 10:57
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruik indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 3 dagen, gedurende 3 dagen
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Geneesmiddel - Product specificatie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="2"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Product naam
 
|style="background-color: white;"|Ibuprofen
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 3 dagen, gedurende 3 dagen, 4 maal per dag 1 tablet, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Doseerinstructie
 
|style="background-color: white;"|4 maal per dag 1 stuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Auteur
 
|style="background-color: white;"|Patiënt
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toelichting
 
|style="background-color: white;"|Pijn
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_1
 
|}<section end=MBH_MBH_MO_123_1 /><section begin=MBH_MBH_MO_123_2 />
 
====Medicamenteuze behandeling MBH_MO_123_2 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_2_TA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 6 dagen, om 11:55
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 6 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|01236578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Apotheek De Gulle Gaper
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|Emovate zalf 0,5 mg/g (code = '400629' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|CLOBETASON ZALF 0,5MG/G (code = '65617' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|CLOBETASON ZALF 0,5MG/G (code = '115606' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="6"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 6 dagen, tot nader order, eerst 2 maal per dag zalf gedurende 7 dagen, daarna 1 maal per dag zalf gedurende 7 dagen, daarna 3 maal per week zalf gedurende 7 dagen, cutaan
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|cutaan (code = '53' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie 1
 
|style="background-color: white;"|eerst gedurende 7 dagen 2 maal per dag
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie 2
 
|style="background-color: white;"|dan gedurende 7 dagen 1 maal per dag
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie 3
 
|style="background-color: white;"|dan gedurende 7 dagen 3 maal per week
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toelichting
 
|style="background-color: white;"|Eczeem oogleden
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_2
 
|}<section end=MBH_MBH_MO_123_2 /><section begin=MBH_MBH_MO_123_3 />
 
====Medicamenteuze behandeling MBH_MO_123_3 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="7" | Medicatieafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="6" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_3_MA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Afspraakdatum
 
|style="background-color: white;"|T- 15 dagen, om 09:13
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 15 dagen, gedurende 4 weken
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Voorschrijver - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="10"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Zorgverlener
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="8"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Naamgegevens
 
|style="background-color: white;"|John de  Vries
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Specialisme
 
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatienummer
 
|style="background-color: white;"|00001111 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Dorpsstraat 1 1234AA Ons Dorp
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - primaire code
 
|style="background-color: white;"|GLIMEPIRIDE TABLET 3MG (code = '44458' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|GLIMEPIRIDE TABLET 3MG (code = '98345' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 15 dagen, gedurende 4 weken, 1 maal per dag 2 tabletten, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 2 stuks
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Toelichting
 
|style="background-color: white;"|Exact 4 weken
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_3
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_3_TA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 14 dagen, om 15:55
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 14 dagen, tot en met T+ 13 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|01236578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Apotheek De Gulle Gaper
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|Glimepiride activis tablet 3mg (code = '1753029' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|GLIMEPIRIDE TABLET 3MG (code = '44458' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|GLIMEPIRIDE TABLET 3MG (code = '98345' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 14 dagen, tot en met T+ 13 dagen, om 23:59, 1 maal per dag 2 tabletten, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 2 stuks
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Relatie naar medicatieafspraak
 
|style="background-color: white;"|MBH_MO_123_3_MA_1
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_3
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Medicatie gebruik
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_3_MGB_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.6.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Registratiedatum
 
|style="background-color: white;"|T, om 12:58
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruik indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 10 dagen, tot en met T+ 1 dag, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Geneesmiddel - Product specificatie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="2"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Product naam
 
|style="background-color: white;"|Glimepiride
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 10 dagen, tot en met T+ 1 dag, om 23:59, 1 maal per dag 1 tablet
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Auteur
 
|style="background-color: white;"|Patiënt
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_3
 
|}<section end=MBH_MBH_MO_123_3 /><section begin=MBH_MBH_MO_123_4 />
 
====Medicamenteuze behandeling MBH_MO_123_4 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="7" | Medicatieafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="6" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_4_MA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Afspraakdatum
 
|style="background-color: white;"|T- 60 dagen, om 09:13
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 60 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Voorschrijver - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="10"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Zorgverlener
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="8"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Naamgegevens
 
|style="background-color: white;"|I. Ternist
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Specialisme
 
|style="background-color: white;"|Medisch specialisten, inwendige geneeskunde (code = '0313' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatienummer
 
|style="background-color: white;"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Dorpsstraat 1 1234AA Ons Dorp
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - primaire code
 
|style="background-color: white;"|INSULINE GLARGINE INJVLST 100E/ML (code = '121312' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|INSULINE GLARGINE INJVLST 100E/ML (code = '128651' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 60 dagen, tot nader order, 1 maal per dag 10IE, SUBCUTAAN
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toedieningsweg
 
|style="background-color: white;"|subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 10 internationale eenheid
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_4
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_4_TA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 60 dagen, om 15:55
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 604 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|13336578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Poliapotheek Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|LANTUS SOLOSTAR INJ 100E/ML PEN 3ML (code = '1859226' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|INSULINE GLARGINE INJVLST 100E/ML (code = '121312' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|INSULINE GLARGINE INJVLST 100E/ML (code = '128651' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 604 dagen, tot nader order, Elke dag om 9 uur 10IE, subcutaan
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|elke dag om 10 internationale eenheid
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Relatie naar medicatieafspraak
 
|style="background-color: white;"|MBH_MO_123_4_MA_1
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_4
 
|}<section end=MBH_MBH_MO_123_4 /><section begin=MBH_MBH_MO_123_5 />
 
====Medicamenteuze behandeling MBH_MO_123_5 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_5_TA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 36 dagen, om 15:55
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 36 dagen, gedurende 90 dagen
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|13336578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Poliapotheek Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|PERINDOPRIL TERT-BUTYLAMINE GLENMARK TABLET 8MG (code = '2105594' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 8MG (ERBUMINE) (code = '69523' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 8MG (ERBUMINE) (code = '117722' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 36 dagen, gedurende 90 dagen, 1 maal per dag 1 tablet, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_5
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Medicatie gebruik
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_5_MGB_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.6.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Registratiedatum
 
|style="background-color: white;"|T- 33 dagen, om 13:58
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruik indicator
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Volgens afspraak indicator
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 36 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Stoptype
 
|style="background-color: white;"|Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - primaire code
 
|style="background-color: white;"|PERINDOPRIL TERT-BUTYLAMINE GLENMARK TABLET 8MG (code = '2105594' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 8MG (ERBUMINE) (code = '69523' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 8MG (ERBUMINE) (code = '117722' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="2"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 36 dagen, tot nader order, 1 maal per dag 1 tablet, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gerelateerde afspraak : TA
 
|style="background-color: white;"|MBH_MO_123_5_TA_1
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Auteur
 
|style="background-color: white;"|Patiënt
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Reden wijzigen of stoppen gebruik
 
|style="background-color: white;"|Te sterk effect (code = '6' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.2')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toelichting
 
|style="background-color: white;"|Gestopt vanwege bijwerkingen
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_5
 
|}<section end=MBH_MBH_MO_123_5 /><section begin=MBH_MBH_MO_123_6 />
 
====Medicamenteuze behandeling MBH_MO_123_6 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="7" | Medicatieafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="6" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_6_MA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Afspraakdatum
 
|style="background-color: white;"|T- 728 dagen, om 09:13
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 728 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Voorschrijver - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="10"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Zorgverlener
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="8"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Naamgegevens
 
|style="background-color: white;"|John de  Vries
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Specialisme
 
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatienummer
 
|style="background-color: white;"|00001111 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Dorpsstraat 1 1234AA Ons Dorp
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - primaire code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '67814' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '116580' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 728 dagen, tot nader order, 1 maal per dag 1 tablet ‘s avonds, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk 's avonds
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_6
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_6_TA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 323 dagen, om 15:55
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 323 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|13336578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Poliapotheek Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|SIMVASTATINE APOTEX TABLET FILMOMHULD 10MG (code = '1537792' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '67814' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '116580' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 323 dagen, tot nader order, 1 maal per dag 2 tabletten ‘s avonds, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 2 stuks 's avonds
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Relatie naar medicatieafspraak
 
|style="background-color: white;"|MBH_MO_123_6_MA_1
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_6
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Medicatie gebruik
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_6_MGB_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.6.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Registratiedatum
 
|style="background-color: white;"|T- 248 dagen, om 09:00
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruik indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Volgens afspraak indicator
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 248 dagen, tot nader order
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - primaire code
 
|style="background-color: white;"|SIMVASTATINE APOTEX TABLET FILMOMHULD 10MG (code = '1537792' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '67814' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '116580' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 248 dagen, tot nader order, 1 maal per dag 12 tablet ‘s avonds, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk 's avonds
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Auteur
 
|style="background-color: white;"|Zorgverlener [voorbeeldgegevens, mag gevuld met eigen gegevens]:  I. Ternist  - Medisch specialisten, inwendige geneeskunde.  Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Kopie indicator
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toelichting
 
|style="background-color: white;"|Patiënt gebruikt niet volgens voorschrift
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_6
 
|}
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="5" | Medicatie gebruik
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="4" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_6_MGB_2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.6.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Registratiedatum
 
|style="background-color: white;"|T- 172 dagen, om 15:37
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruik indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Volgens afspraak indicator
 
|style="background-color: white;"|Nee
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 248 dagen, tot en met T- 173 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - primaire code
 
|style="background-color: white;"|SIMVASTATINE APOTEX TABLET FILMOMHULD 10MG (code = '1537792' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '67814' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Simvastine tablet fo 20 mg (code = '116580' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 248 dagen, tot en met T- 173 dagen, om 23:59, 1 maal per dag 1 tablet ‘s avonds, oraal, gestopt
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk 's avonds
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Gerelateerde afspraak : MA
 
|style="background-color: white;"|MBH_MO_123_6_MA_1
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Auteur
 
|style="background-color: white;"|Patiënt
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toelichting
 
|style="background-color: white;"|Veel last van jeuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_6
 
|}<section end=MBH_MBH_MO_123_6 /><section begin=MBH_MBH_MO_123_7 />
 
====Medicamenteuze behandeling MBH_MO_123_7 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="7" | Medicatieafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="6" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_7_MA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Afspraakdatum
 
|style="background-color: white;"|T+ 3 dagen, om 09:27
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T+ 3 dagen, tot en met T+ 17 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Voorschrijver - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="10"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Zorgverlener
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="8"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Naamgegevens
 
|style="background-color: white;"|John de  Vries
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Specialisme
 
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatienummer
 
|style="background-color: white;"|00001111 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Dorpsstraat 1 1234AA Ons Dorp
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - primaire code
 
|style="background-color: white;"|Flucloxacilline capsule 500mg (code = '5274' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|Flucloxacilline capsule 500mg (code = '15466' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Omschrijving
 
|style="background-color: white;"|Vanaf T+ 3 dagen, tot en met T+ 17 dagen, om 23:59, Elke 8 uur 1 capsule, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_7
 
|}<section end=MBH_MBH_MO_123_7 /><section begin=MBH_MBH_MO_123_8 />
 
====Medicamenteuze behandeling MBH_MO_123_8 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_8_TA_2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 28 dagen, om 11:50
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 45 dagen, tot en met T- 29 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Stoptype
 
|style="background-color: white;"|Onderbreking (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|13336578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Poliapotheek Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Reden afspraak
 
|style="background-color: white;"|Beleidswijziging
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|Atorvastatine ranbaxy tablet filmomhuld 40 mg (code = '2230879' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|ATORVASTATINE TABLET 40MG (ALS CA-ZOUT-3-WATER) (code = '98620' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|ATORVASTATINE TABLET 40MG (ALS CA-ZOUT-3-WATER) (code = '137219' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 45 dagen, tot en met T- 29 dagen, om 23:59, 1 maal per dag 2 tabletten ‘s avonds, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 2 stuks 's avonds
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Relatie naar medicatieafspraak
 
|style="background-color: white;"|MBH_MO_123_8_MA_3
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_8
 
|}<section end=MBH_MBH_MO_123_8 /><section begin=MBH_MBH_MO_123_9 />
 
====Medicamenteuze behandeling MBH_MO_123_9 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="7" | Medicatieafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="6" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_9_MA_1 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Afspraakdatum
 
|style="background-color: white;"|T- 45 dagen, om 11:50
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 45 dagen, tot en met T- 31 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Voorschrijver - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="10"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Zorgverlener
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="8"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Naamgegevens
 
|style="background-color: white;"|John de  Vries
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Specialisme
 
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatienummer
 
|style="background-color: white;"|00001111 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Adresgegevens
 
|style="background-color: white;"|Dorpsstraat 1 1234AA Ons Dorp
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - primaire code
 
|style="background-color: white;"|FLUCLOXACILLINE CAPSULE 500MG (code = '5274' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|FLUCLOXACILLINE CAPSULE 500MG (code = '15466' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="7"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 45 dagen, tot en met T- 31 dagen, om 23:59, 1 keer per exact 8 uur 1 stuk, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Doseerinstructie
 
|style="background-color: white;"|exact iedere 8 uur 1 stuk
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="6"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_9
 
|}<section end=MBH_MBH_MO_123_9 /><section begin=MBH_MBH_MO_123_10 />
 
====Medicamenteuze behandeling MBH_MO_123_10 ====
 
 
{| class="wikitable" width="85%"
 
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;"  colspan="6" | Toedieningsafspraak
 
|-style="background-color: #1F497D;; color: white; text-align:left;"
 
|colspan="5" width="25%"| Gegevenselement
 
|| Waarde
 
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Identificatie
 
|style="background-color: white;"|MBH_MO_123_10_TA_2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.422037009.1)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Afspraakdatum
 
|style="background-color: white;"|T- 36 dagen, om 15:50
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Gebruiksperiode
 
|style="background-color: white;"|Vanaf T- 56 dagen, tot en met T- 37 dagen, om 23:59
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Stoptype
 
|style="background-color: white;"|Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Verstrekker - onderstaand zijn voorbeeldgegevens, mag voor kwalificatie gevuld worden met eigen testgegevens
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="5"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="5"|Zorgaanbieder
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="3"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Zorgaanbieder identificatie nummer
 
|style="background-color: white;"|13336578 (in identificerend systeem: 2.16.528.1.1007.3.3)
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="3"|Organisatie naam
 
|style="background-color: white;"|Poliapotheek Antonius
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Reden afspraak
 
|style="background-color: white;"|Geen of onvoldoende effect
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - primaire code
 
|style="background-color: white;"|PERINDOPRIL TERT-BUTYLAMINE GLENMARK TABLET 4MG (code = '2105586' in codeSystem 'G-Standaard HPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 4MG (ERBUMINE) (code = '29076' in codeSystem 'G-Standaard PRK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Geneesmiddel - generiekere code
 
|style="background-color: white;"|PERINDOPRIL TABLET 4MG (ERBUMINE) (code = '75434' in codeSystem 'G-Standaard GPK')
 
|-style="vertical-align:top; background-color: #E3E3E3;;" 
 
|colspan="6"|Gebruiksinstructie
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|rowspan="4"|
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Omschrijving
 
|style="background-color: white;"|Vanaf T- 56 dagen, tot en met T- 37 dagen, om 23:59, 1 maal per dag 1 tablet ‘s morgens, oraal
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Toedieningsweg
 
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)')
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="4"|Doseerinstructie
 
|style="background-color: white;"|1 maal per dag 1 stuk 's ochtends
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|Kopie indicator
 
|style="background-color: white;"|Ja
 
|-style="vertical-align:top; background-color: #E3E3E3;;"
 
|colspan="5"|MBH identificatie
 
|style="background-color: white;"|MBH_MO_123_10
 
|}<section end=MBH_MBH_MO_123_10 /><section end=MBHS_XXX_Jangi />
 
 
[[Categorie:Kwalificatie]]
 

Huidige versie van 30 jan 2019 om 09:25