MedMij:V1.0 Sandbox5: verschil tussen versies
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{{DISPLAYTITLE:Sturen medicatievoorschrift 9.0.7: addendum inhoudelijke gegevens kwalificatie}} | |||
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=Addenda voor inhoudelijke gegevens= | =Addenda voor inhoudelijke gegevens= | ||
== | == Medicatievoorschriften Basis 1 (verplicht)== | ||
<section begin= | <section begin=1-basis-1 /> | ||
=== MBH_VO_start_eind=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Identificatie | |||
|style="background-color: white;"|MBH_VO_start_eind_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:25 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 25 jun 2019, om 00:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Naamgegevens | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"| | |colspan="3"|Specialisme | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="3"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Metoclopramide zetpil 20mg (code = '6939' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|METOCLOPRAMIDE 20MG ZETPIL (code = '63630' 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 20 jun 2019, tot en met 25 jun 2019, om 00:00, Vanaf <T> t/m <T+5>, 1 maal per dag 1 stuk, rectaal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Rectaal (code = '12' 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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_start_eind (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_start_eind_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:25 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"| | |colspan="2"|Te verstrekken hoeveelheid | ||
|style="background-color: white;"| | |style="background-color: white;"|5 stuks | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"| | |colspan="2"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|Metoclopramide zetpil 20mg (code = '6939' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|METOCLOPRAMIDE 20MG ZETPIL (code = '63630' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek De Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_start_eind_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_start_eind (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== | === MBH_VO_start_duur=== | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_start_duur_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:30 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, gedurende 3 weken | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="11"| | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"| | |rowspan="9"| | ||
|style="background-color: white;"| | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"| | |colspan="3"|Specialisme | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '71587' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |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 20 jun 2019, gedurende 3 weken, Vanaf <T>, gedurende 3 weken, 1 maal per dag 1 stuk, 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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_start_duur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_start_duur_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:30 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|21 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="2"|Geneesmiddel - primaire code | ||
|style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"| | |colspan="2"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '71587' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"| | |colspan="2"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek De Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_start_duur_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_start_duur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== | === MBH_VO_chronisch=== | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_chronisch_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:32 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Specialisme | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"|APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf T | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal per dag 1 stuk, 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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_chronisch (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_chronisch_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:32 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Te verstrekken hoeveelheid | ||
|style="background-color: white;"| | |style="background-color: white;"|21 stuks | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek De Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_chronisch_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_chronisch (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|}<section end= | |}<section end=1-basis-1 /> | ||
=== | == Medicatievoorschriften Basis 2 (verplicht)== | ||
<section begin=1-basis-2 /> | |||
=== MBH_VO_aanvullendeinstructie=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 152: | Regel 331: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_aanvullendeinstructie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 08:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"| | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Gebruiksinstructie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="5"| | |rowspan="5"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|Bij het eten innemen overig (code = 'OTH' in codeSystem 'HL7 NullFlavor') | |||
|-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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|90 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_toelichting=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_toelichting_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' 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 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-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"|Toelichting | |||
|style="background-color: white;"|In overleg met specialist | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_toelichting_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Toelichting | |||
|style="background-color: white;"|Extra verstrekkingsverzoek omdat patient medicatie is kwijtgeraakt | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_toelichting_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_redenvanvoorschrijven=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_redenvanvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 08:03 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 13:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 13:00, Vanaf <T>, gedurende 28 dagen, 1 maal per week 5 stuks, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|1 maal per week 5 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_redenvanvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:03 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|20 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek De Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== | === MBH_VO_aanvullendeinformatiewensen=== | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_aanvullendeinformatiewensen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 08:04 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Bertine van Doorn | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Specialisme | ||
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf T | |style="background-color: white;"|Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59, Vanaf <T>, gedurende 10 dagen, 3 maal per dag 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|3 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"| | |colspan="5"|Lichaamslengte | ||
|style="background-color: white;"| | |style="background-color: white;"|155 cm. Gemeten: 23 nov 2018, om 08:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Lichaamsgewicht | ||
|style="background-color: white;"| | |style="background-color: white;"|54 kg. Gemeten: 23 nov 2018, om 08:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Aanvullende informatie | ||
|style="background-color: white;"| | |style="background-color: white;"|Bewust hoge dosering (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.14.2050') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_aanvullendeinformatiewensen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinformatiewensen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:04 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|40 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Aanvullende wensen | |||
|style="background-color: white;"|Bezorgen (code = '3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.14.2051') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_aanvullendeinformatiewensen_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinformatiewensen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|}<section end=1-basis-2 /> | |||
== Medicatievoorschriften Basis 3 Staken Wijzigen (verplicht)== | |||
<section begin=1-basis-3 /> | |||
=== MBH_VO_aanvullendeinstructie=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 289: | Regel 770: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_aanvullendeinstructie_MA_staken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|4 jul 2019, om 10:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 4 jul 2019, om 10:00 | ||
|-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="5"|Relatie naar afspraak of gebruik: MA | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="9"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Reden wijzigen of staken | ||
|style="background-color: white;"| | |style="background-color: white;"|Overgevoeligheid (code = '16' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.2') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Gebruiksinstructie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="5"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 4 jul 2019, om 10:00, Vanaf <T> t/m <T>, 1 maal per dag 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|Bij het eten innemen overig (code = 'OTH' in codeSystem 'HL7 NullFlavor') | |||
|-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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_toelichting=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_toelichting_MA_wijzigingmetVV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|4 jul 2019, om 10:01 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 4 jul 2019, om 10:01, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Relatie naar afspraak of gebruik: MA | |||
|style="background-color: white;"|MBH_VO_toelichting_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Reden wijzigen of staken | |||
|style="background-color: white;"|Geen of onvoldoende effect (code = '5' 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="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 325: | Regel 907: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 4 jul 2019, om 10:01, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 2 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 2 stuks | |style="background-color: white;"|1 maal per dag 2 stuks | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|MBH identificatie | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_toelichting_MA_techstaken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|4 jul 2019, om 10:01 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 08:03, tot en met 4 jul 2019, om 10:01 | |||
|-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="5"|Relatie naar afspraak of gebruik: MA | |||
|style="background-color: white;"|MBH_VO_toelichting_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="10"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="8"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Bertine van Doorn | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf 20 jun 2019, om 08:03, tot en met 4 jul 2019, om 10:01, Vanaf <T->, tot <T>, 1 maal daags 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 1 stuk | |style="background-color: white;"|1 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Auteur | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_toelichting_VV_extra (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|4 jul 2019, om 10:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_toelichting_MA_wijzigingmetVV | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
==== | === MBH_VO_redenvanvoorschrijven=== | ||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_redenvanvoorschrijven_MA_wijzigingzonderVV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|4 jul 2019, om 10:03 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 4 jul 2019, om 10:03, tot en met 18 jul 2019, om 13:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Reden wijzigen of staken | |||
|style="background-color: white;"|Beleidswijziging (code = '10' 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="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '42609' 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 4 jul 2019, om 10:03, tot en met 18 jul 2019, om 13:00, Vanaf <T>, gedurende 14 dagen, 1 maal per week 4 stuks, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|1 maal per week 4 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven_MA_techstaken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|4 jul 2019, om 10:03 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 12:00, tot en met 4 jul 2019, om 10:03 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Stoptype | ||
|style="background-color: white;"| | |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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Relatie naar afspraak of gebruik: MA | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="10"| | |rowspan="10"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="8"| | |rowspan="8"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Bertine van Doorn | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|) | |style="background-color: white;"|00001111 (in identificerend systeem: UZI Personen) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf T | |style="background-color: white;"|Vanaf 20 jun 2019, om 12:00, tot en met 4 jul 2019, om 10:03, Vanaf <T>, t/m <T>, 1 maal per week 5 stuks, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per | |style="background-color: white;"|1 maal per week 5 stuks | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"| | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|}<section end=1-basis-3 /> | |||
== Medicatievoorschriften Aanvullend 1 (Doseerschemas)== | |||
<section begin=2-aanvullend-1 /> | |||
=== MBH_VO_variabelefrequentie=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_variabelefrequentie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:59 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 19 aug 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|MIZOLASTINE TABLET MGA 10MG (code = '48291' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|MIZOLASTINE TABLET MGA 10MG (code = '102164' 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 20 jun 2019, tot en met 19 aug 2019, om 12:00, Vanaf <T>, gedurende 60 dagen, 1 à 2 maal per dag 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|1 à 2 maal per dag 1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelefrequentie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_variabelefrequentie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:59 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|90 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|MIZOLASTINE TABLET MGA 10MG (code = '48291' in codeSystem 'G-standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|MIZOLASTINE TABLET MGA 10MG (code = '102164' in codeSystem 'G-standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_variabelefrequentie_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_variabelefrequentie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== MBH_VO_interval=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 462: | Regel 1.283: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_interval_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 11:58 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"|INSULINE | |style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '111325' 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 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, exact iedere 12 uur 16 IE, subcutaan | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|exact iedere 12 uur 16 internationale eenheid | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_interval (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_interval_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:58 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_interval_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_interval (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_variabelehoeveelheid=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_variabelehoeveelheid_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:57 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|PARACETAMOL 500MG TABLET (code = '67903' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|PARACETAMOL 500MG TABLET (code = '2194' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 498: | Regel 1.436: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf T- | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 4 weken, 3 maal per dag 1 à 2 stuks, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|3 maal per dag 1 à 2 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:57 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|40 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|PARACETAMOL 500MG TABLET (code = '67903' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|PARACETAMOL 500MG TABLET (code = '2194' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_zonderkeerdosis=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_zonderkeerdosis_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:56 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Cetomacrogolcreme met vaseline 10% (code = '92789' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Cetomacrogolcreme met vaseline 10% (code = '133329' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Gebruiksinstructie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="5"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 30 dagen, 3 maal per dag aanbrengen, cutaan | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|aanbrengen (code = '1018' in codeSystem 'NHG tabel 25 aanvullende tekst') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|3 maal per dag | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"| | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_zonderkeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_zonderkeerdosis_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:56 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Cetomacrogolcreme met vaseline 10% (code = '92789' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Cetomacrogolcreme met vaseline 10% (code = '133329' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_zonderkeerdosis_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_zonderkeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_bijzonderekeerdosis=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_bijzonderekeerdosis_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:55 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|NAPROXEN 500MG TABLET (code = '20850' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|NAPROXEN 500MG TABLET (code = '51233' 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 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 30 dagen, 2 maal per dag 1/2 tablet | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|2 maal per dag 0.5 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|MBH identificatie | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_bijzonderekeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
==== | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_bijzonderekeerdosis_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:55 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|NAPROXEN 500MG TABLET (code = '20850' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|NAPROXEN 500MG TABLET (code = '51233' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_bijzonderekeerdosis_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_bijzonderekeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_variabelehoeveelheid2=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 525: | Regel 1.702: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_variabelehoeveelheid2_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 11:54 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"| | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|Waterstofperoxide 30MG/ML (code = '67016' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Waterstofperoxide 30MG/ML (code = '116041' 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 20 jun 2019, tot en met 4 jul 2019, om 12:00, Vanaf <T>, gedurende 14 dagen, 2x per dag 10 tot 15 ml, Eerst oplossen in water, mond spoelen, daarna uitspugen | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|niet van toepassing (code = '1' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|Eerst oplossen in water (code = '27' in codeSystem 'NHG tabel 25 aanvullende tekst') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|mond spoelen, daarna uitspugen (code = '69' in codeSystem 'NHG tabel 25 aanvullende tekst') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|2 maal per dag 10 à 15 ml | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid2_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:54 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|450 ml | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Waterstofperoxide 30MG/ML (code = '67016' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Waterstofperoxide 30MG/ML (code = '116041' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid2_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelehoeveelheid2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_tijdstippen=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_tijdstippen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:53 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 561: | Regel 1.861: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf T | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00, Vanaf <T>, gedurende 14 dagen, elke dag om 08:00, 14:00 en 20:00 uur 16IE | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 | |style="background-color: white;"|elke dag om 08:00, 14:00 en 20:00 16 internationale eenheid | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_tijdstippen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_tijdstippen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:53 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_tijdstippen_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_tijdstippen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== MBH_VO_weekdagen=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_weekdagen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:52 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 29 aug 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Specialisme | ||
|style="background-color: white;"| | |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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|IMIQUIMOD 50MG/G CREME (code = '55050' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|IMIQUIMOD 50MG/G CREME (code = '109398' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |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 20 jun 2019, tot en met 29 aug 2019, om 12:00, Vanaf <T>, gedurende 10 weken, op maandag, woensdag en vrijdag, voor de nacht aanbrengen | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|voor de nacht (code = '1128' in codeSystem 'NHG tabel 25 aanvullende tekst') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|aanbrengen (code = '1018' in codeSystem 'NHG tabel 25 aanvullende tekst') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|op maandag, woensdag en vrijdag | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_weekdagen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_weekdagen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:52 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Auteur | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Te verstrekken hoeveelheid | ||
|style="background-color: white;"| | |style="background-color: white;"|70 sachet | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|IMIQUIMOD 50MG/G CREME (code = '55050' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|IMIQUIMOD 50MG/G CREME (code = '109398' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek de Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_weekdagen_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_weekdagen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== | === MBH_VO_dagdeel=== | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_dagdeel_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 11:51 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="9"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Specialisme | ||
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|EZETIMIB/SIMVASTATINE 10/20 (code = '77038' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|EZETIMIB/SIMVASTATINE 10/20 (code = '123129' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order, Vanaf <T>, 1 maal daags 1 stuk ’s avonds innemen, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G- | |style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 1 stuk 's avonds | |style="background-color: white;"|1 maal per dag 1 stuk 's avonds | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_dagdeel (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_dagdeel_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:51 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|60 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|EZETIMIB/SIMVASTATINE 10/20 (code = '77038' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|EZETIMIB/SIMVASTATINE 10/20 (code = '123129' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_dagdeel_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_dagdeel (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== MBH_VO_cyclischschema=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 712: | Regel 2.130: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_cyclischschema_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 11:50 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"| | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '16292' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '39578' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Gebruiksinstructie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="5"| | |rowspan="5"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, cyclus van 28 dagen: steeds 21 dagen 1 x per dag 1 tablet, dan 7 dagen niet | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|gedurende 21 dagen 1 maal per dag 1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Herhaalperiode cyclisch schema | |||
|style="background-color: white;"|28 dagen | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_cyclischschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_cyclischschema_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:50 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|6 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '16292' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '39578' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_cyclischschema_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_cyclischschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_afbouwschema=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_afbouwschema_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:49 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 31 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Fusidinezuur creme 20mg/g (code = '16705' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Fusidinezuur creme 20mg/g (code = '73466' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Gebruiksinstructie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="7"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 31 jul 2019, om 12:00, Vanaf <T>, gedurende 41 dagen, eerst 2 weken 3gr per dag, dan 3 weken 2gr per dag, dan 6 dagen 1gr per dag, dun aanbrengen, cutaan | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Aanvullende instructie | |||
|style="background-color: white;"|dun aanbrengen (code = '1033' in codeSystem 'NHG tabel 25 aanvullende teksten') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie 1 | |||
|style="background-color: white;"|eerst gedurende 2 weken 1 maal per dag 3 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie 2 | |||
|style="background-color: white;"|dan gedurende 3 weken 1 maal per dag 2 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie 3 | |||
|style="background-color: white;"|dan gedurende 6 dagen 1 maal per dag 1 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_afbouwschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_afbouwschema_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:49 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Fusidinezuur creme 20mg/g (code = '16705' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Fusidinezuur creme 20mg/g (code = '73466' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_afbouwschema_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_afbouwschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_variabelefrequentieenmaximum=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_variabelefrequentieenmaximum_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:48 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 11 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|CODEINE TABLET 10MG (FOSFAAT) (code = '42773' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|CODEINE TABLET 10MG (FOSFAAT) (code = '23086' 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 20 jun 2019, tot en met 11 jul 2019, om 12:00, Vanaf <T>, gedurende 3 weken, iedere 3 à 4 uur 1 stuk bij hoest, maximaal 6 stuks per dag, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|bij hoest 3 à 4 maal per uur 1 stuk , maximaal 6 stuks per dag | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelefrequentieenmaximum (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_variabelefrequentieenmaximum_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:48 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|120 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|CODEINE TABLET 10MG (FOSFAAT) (code = '42773' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|CODEINE TABLET 10MG (FOSFAAT) (code = '23086' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_variabelefrequentieenmaximum_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_variabelefrequentieenmaximum (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_toedieningssnelheid=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_toedieningssnelheid_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:47 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 28 jun 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|MORFINE INFVLST 5MG/ML CAS 100ML (code = '94692' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|MORFINE INFVLST 5MG/ML CAS 100ML (code = '134538' 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 20 jun 2019, tot en met 28 jun 2019, om 12:00, Vanaf <T>, gedurende 8 dagen, 0.2 tot 0.5 ml per uur parenteraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|parenteraal (code = '10' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Doseerinstructie | |||
|style="background-color: white;"|0.2 à 0.5 ml per uur | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningssnelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningssnelheid_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:47 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|100 ml | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|MORFINE INFVLST 5MG/ML CAS 100ML (code = '94692' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|MORFINE INFVLST 5MG/ML CAS 100ML (code = '134538' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_toedieningssnelheid_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningssnelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_toedieningsduur=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_toedieningsduur_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:46 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 16:00, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '44520' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '98477' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 748: | Regel 2.607: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, om 16:00, tot nader order, tot nader order, eenmaal daags 1 pleister aanbrengen gedurende 16 uur (daarna 8 uur geen pleister), transdermaal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|transdermaal (code = '58' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 2 stuks ' | |style="background-color: white;"|1 maal per dag 1 stuk gedurende 16 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningsduur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningsduur_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:46 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '44520' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '98477' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_toedieningsduur_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_toedieningsduur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_zonodig=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_zonodig_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 11:42 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 11:42, gedurende 4 weken | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="10"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="8"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"| | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|ACETYLSALICYLZUUR 100MG TAB (code = '3956' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|ACETYLSALICYLZUUR TABLET 100MG (code = '12548' 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 20 jun 2019, om 11:42, gedurende 4 weken, Vanaf <T> gedurende 4 weken, 1x per dag 1 stuk zo nodig, 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;"|zo nodig 1 maal per dag 1 stuk | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_zonodig (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_zonodig_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 11:42 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|14 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|ACETYLSALICYLZUUR 100MG TAB (code = '3956' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|ACETYLSALICYLZUUR TABLET 100MG (code = '12548' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek de Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_zonodig_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_zonodig (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|}<section end=2-aanvullend-1 /> | |||
== Medicatievoorschriften Aanvullend 2 (Magistraal)== | |||
<section begin=2-aanvullend-2 /> | |||
=== MBH_VO_magistraalalleingredienten=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_magistraalalleingredienten_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 12:05 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 21 jun 2019, om 12:00, tot en met 21 jul 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Product naam | |||
|style="background-color: white;"|Ureum 10% in eucerine cum aqua 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="3"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Ingredient code | |||
|style="background-color: white;"|UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Sterkte | |||
|style="background-color: white;"|10 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="3"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Ingredient code | |||
|style="background-color: white;"|EUCERINE MET WATER FAGRON (code = '14740877' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Sterkte | |||
|style="background-color: white;"|90 gram per 100 gram | |||
|-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 21 jun 2019, om 12:00, tot en met 21 jul 2019, om 12:00, Vanaf <T>, zo nodig, aanbrengen, cutaan | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|geen informatie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|MBH identificatie | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraalalleingredienten (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Verstrekkingsverzoek | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="4" width="25%"| Gegevenselement | |colspan="4" width="25%"| Gegevenselement | ||
| Regel 773: | Regel 2.857: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Identificatie | |colspan="4"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraalalleingredienten_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 12:05 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|100 ml | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Product naam | |||
|style="background-color: white;"|Ureum 10% in eucerine cum aqua 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Omschrijving | |||
|style="background-color: white;"|Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="3"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Ingredient code | |||
|style="background-color: white;"|UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Sterkte | |||
|style="background-color: white;"|10 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="3"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Ingredient code | |||
|style="background-color: white;"|EUCERINE MET WATER FAGRON (code = '14740877' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Sterkte | |||
|style="background-color: white;"|90 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_magistraalalleingredienten_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_magistraalalleingredienten (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_magistraalactieveingredient=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_magistraalactieveingredient_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 12:10 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 21 jun 2019, om 12:00, tot en met 30 aug 2019, om 12:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="10"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="8"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="7"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Product naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Vaseline 20% in cetomacrogolcrème FNA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Omschrijving | ||
|style="background-color: white;"| | |style="background-color: white;"|Titel: Vaseline 20% in cetomacrogolcrème FNA Regel 1: cetomacrogolcreme 80 gr | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="3"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Ingredient code | ||
|style="background-color: white;"| | |style="background-color: white;"|CETOMACROGOLCREME FNA (code = '457590' in codeSystem 'G-Standaard HPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Sterkte | |||
|style="background-color: white;"|80 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Omschrijving | |||
|style="background-color: white;"|Vanaf 21 jun 2019, om 12:00, tot en met 30 aug 2019, om 12:00, Vanaf <T> t/m <T+39>, 1x daags, cutaan | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|7 (code = 'cutaan' 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 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_magistraalactieveingredient (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Verstrekkingsverzoek | |||
|-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_VO_magistraalactieveingredient_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 12:10 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="7"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Product naam | |||
|style="background-color: white;"|Vaseline 20% in cetomacrogolcrème FNA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Omschrijving | |colspan="3"|Omschrijving | ||
|style="background-color: white;"| | |style="background-color: white;"|Titel: Vaseline 20% in cetomacrogolcrème FNA Regel 1: cetomacrogolcreme 80 gr | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="3"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Ingredient code | ||
|style="background-color: white;"| | |style="background-color: white;"|CETOMACROGOLCREME FNA (code = '457590' in codeSystem 'G-Standaard HPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Sterkte | ||
|style="background-color: white;"| | |style="background-color: white;"|80 gram per 100 gram | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Beoogd verstrekker | ||
|style="background-color: white;"| | |style="background-color: white;"|Apotheek De Gulle Gaper | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Relatie naar medicatieafspraak | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraalactieveingredient_MA | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|MBH identificatie | |colspan="4"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraalactieveingredient (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
=== MBH_VO_magistraal90miljoennr=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraal90miljoennr_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 12:15 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 12:15, tot en met 20 jul 2019, om 12:15 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="10"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="8"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="7"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Product naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Ureum 10% in eucerine cum aqua 100gr | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Omschrijving | ||
|style="background-color: white;"| | |style="background-color: white;"|Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |rowspan="3"| | ||
|style="background-color: white;"| | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Ingredient code | |||
|style="background-color: white;"|UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Sterkte | |||
|style="background-color: white;"|10 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, om 12:15, tot en met 20 jul 2019, om 12:15, Vanaf <T> t/m <T+30>, 1x per dag, cutaan | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|cutaan (code = '7' 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 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraal90miljoennr (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="4" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Identificatie | ||
|style="background-color: white;"|1 | |style="background-color: white;"|MBH_VO_magistraal90miljoennr_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |colspan="4"|Datum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 12:15 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Auteur | |colspan="4"|Auteur | ||
|style="background-color: white;"| | |style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - Product specificatie | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="6"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Product naam | |||
|style="background-color: white;"|Ureum 10% in eucerine cum aqua 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Omschrijving | |||
|style="background-color: white;"|Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Ingredient | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"| | |rowspan="2"| | ||
|style="background-color: white;"| | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Sterkte | |||
|style="background-color: white;"|10 gram per 100 gram | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_magistraal90miljoennr_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|MBH identificatie | |colspan="4"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_magistraal90miljoennr (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|}<section end= | |}<section end=2-aanvullend-2 /> | ||
=== | == Medicatievoorschriften Aanvullend 3 (andermans MA)== | ||
<section begin=2-aanvullend-3 /> | |||
=== MBH_VO_VVandermansMA=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_VVandermansMA_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|5 aug 2019, om 11:25 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 5 aug 2019, tot en met 26 aug 2019, om 00:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"|000001118 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Marcha van Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Specialisme | ||
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|DICLOFENAC NATRIUM TABLET MGA 100MG (code = '8052' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|DICLOFENAC NATRIUM TABLET MGA 100MG (code = '22268' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 5 aug 2019, tot en met 26 aug 2019, om 00:00, Vanaf <T> t/m <T+21>, 1 maal per dag 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"|oraal (code = '9' in codeSystem 'G- | |style="background-color: white;"|oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 1 stuk | |style="background-color: white;"|1 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Kopie indicator | ||
|style="background-color: white;"|Ja | |style="background-color: white;"|Ja | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_VVandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|}< | |} | ||
==== | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_VVandermansMA_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|19 aug 2019, om 03:25 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|DICLOFENAC NATRIUM TABLET MGA 100MG (code = '8052' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|DICLOFENAC NATRIUM TABLET MGA 100MG (code = '22268' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_VVandermansMA_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_VVandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_stakenandermansMA=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_stakenandermansMA_MA2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|19 aug 2019, om 03:27 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 14 aug 2019, tot en met 19 aug 2019, om 03:27 | |||
|-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="5"|Relatie naar afspraak of gebruik: MA | |||
|style="background-color: white;"|MBH_VO_stakenandermansMA_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|LISINOPRIL 10MG TABLET (code = '71587' 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 14 aug 2019, tot en met 19 aug 2019, om 03:27, Vanaf <T-5> tot <T>, 1 maal per dag 1 stuk, 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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_stakenandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_onderbrekenandermansMA=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 957: | Regel 3.357: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_onderbrekenandermansMA_MA2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|19 aug 2019, om 03:30 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 19 aug 2019, om 03:30 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Stoptype | |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="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="5"|Relatie naar afspraak of gebruik: MA | |||
|style="background-color: white;"|MBH_VO_onderbrekenandermansMA_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001111 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Peter van Pulver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' 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 20 jun 2019, tot en met 19 aug 2019, om 03:30, Vanaf <T-60> tot <T>, 1 maal per dag 1 stuk, 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"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_onderbrekenandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|}<section end=2-aanvullend-3 /> | |||
== Medicatievoorschriften Aanvullend 4 (diversen VV)== | |||
<section begin=2-aanvullend-4 /> | |||
=== MBH_VO_logistiekeverbruiksperiode=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_logistiekeverbruiksperiode_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 999: | Regel 3.484: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag | |style="background-color: white;"|1 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"| | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_logistiekeverbruiksperiode (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_logistiekeverbruiksperiode_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Verbruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, om 08:00, tot en met 31 dec 2019, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_logistiekeverbruiksperiode_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_logistiekeverbruiksperiode (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_herhalingen=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_herhalingen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' 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 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|1 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|MBH identificatie | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_herhalingen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
==== | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_herhalingen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|30 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Aantal herhalingen | |||
|style="background-color: white;"|5 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_herhalingen_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_herhalingen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_afleverlocatie=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="5" width="25%"| Gegevenselement | ||
|| Waarde | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_afleverlocatie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 08:04 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Voorschrijver | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="9"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Zorgverlener identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="3"|Naamgegevens | ||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Specialisme | |||
|style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="6"|Gebruiksinstructie | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan="4"| | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59, Vanaf <T>, gedurende 10 dagen, 3 maal per dag 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"| | |style="background-color: white;"|3 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Lichaamslengte | ||
|style="background-color: white;"| | |style="background-color: white;"|155 cm. Gemeten: 23 nov 2018, om 08:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Lichaamsgewicht | |||
|style="background-color: white;"|54 kg. Gemeten: 23 nov 2018, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_afleverlocatie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_afleverlocatie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:04 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|40 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Afleverlocatie | |||
|style="background-color: white;"|Dorpsrand 200,1256ZZ Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_afleverlocatie_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_afleverlocatie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|}<section end= | |}<section end=2-aanvullend-4 /> | ||
=== | == Medicatievoorschriften Aanvullend 5 (HPK,ZInr)== | ||
<section begin=2-aanvullend-5 /> | |||
=== MBH_VO_HPKvoorschrijven=== | |||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="5" width="25%"| Gegevenselement | |colspan="5" width="25%"| Gegevenselement | ||
| Regel 1.096: | Regel 3.761: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Identificatie | |colspan="5"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_HPKvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Afspraakdatum | |colspan="5"|Afspraakdatum | ||
|style="background-color: white;"| | |style="background-color: white;"|20 jun 2019, om 08:00 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Gebruiksperiode | |colspan="5"|Gebruiksperiode | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
| | |rowspan="11"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="5"|Zorgverlener | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="9"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Zorgaanbieder | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|rowspan=" | |rowspan="4"| | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Zorgaanbieder identificatienummer | ||
|style="background-color: white;"| | |style="background-color: white;"|00001111 (in identificerend systeem: URA) | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Organisatie naam | ||
|style="background-color: white;"| | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="2"|Adresgegevens | ||
|style="background-color: white;"| | |style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - primaire code | |colspan="5"|Geneesmiddel - primaire code | ||
|style="background-color: white;"| | |style="background-color: white;"|XARELTO TABLET FILMOMHULD 20MG (code = '2214350' in codeSystem 'G-Standaard HPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|RIVAROXABAN TABLET 20MG (code = '100153' in codeSystem 'G-Standaard PRK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Geneesmiddel - generiekere code | |colspan="5"|Geneesmiddel - generiekere code | ||
|style="background-color: white;"| | |style="background-color: white;"|RIVAROXABAN TABLET 20MG (code = '138363' in codeSystem 'G-Standaard GPK') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|Gebruiksinstructie | |colspan="6"|Gebruiksinstructie | ||
| Regel 1.138: | Regel 3.813: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Omschrijving | |colspan="4"|Omschrijving | ||
|style="background-color: white;"|Vanaf | |style="background-color: white;"|Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Toedieningsweg | |colspan="4"|Toedieningsweg | ||
|style="background-color: white;"| | |style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Doseerinstructie | |colspan="4"|Doseerinstructie | ||
|style="background-color: white;"|1 maal per dag 1 stuk ' | |style="background-color: white;"|1 maal per dag 1 stuk | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_HPKvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | |||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |||
|colspan="2" width="25%"| Gegevenselement | |||
|| Waarde | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Identificatie | |||
|style="background-color: white;"|MBH_VO_HPKvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Datum | |||
|style="background-color: white;"|20 jun 2019, om 08:00 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|90 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|XARELTO TABLET FILMOMHULD 20MG (code = '2214350' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|RIVAROXABAN TABLET 20MG (code = '100153' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|RIVAROXABAN TABLET 20MG (code = '138363' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_HPKvoorschrijven_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_HPKvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|} | |||
=== MBH_VO_ZINRvoorschrijven=== | |||
{| class="wikitable" width="85%" | |||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Medicatieafspraak | |||
|-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_VO_ZINRvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Afspraakdatum | |||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Gebruiksperiode | |||
|style="background-color: white;"|Vanaf 20 jun 2019, tot nader order | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="6"|Voorschrijver | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="11"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Zorgverlener | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="9"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Zorgverlener identificatienummer | |||
|style="background-color: white;"|000001112 (in identificerend systeem: UZI Personen) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|Naamgegevens | |||
|style="background-color: white;"|Bertine van Doorn | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="3"|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="4"|Zorgaanbieder | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|rowspan="4"| | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Zorgaanbieder identificatienummer | |||
|style="background-color: white;"|00001111 (in identificerend systeem: URA) | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Organisatie naam | |||
|style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Adresgegevens | |||
|style="background-color: white;"|Werkadres: Dorpsstraat 1 1234AA Ons Dorp | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|INDAPAMIDE SANDOZ TABLET 2,5MG (code = '14896087' in codeSystem 'G-Standaard ZI-nr') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE SANDOZ TABLET 2,5MG (code = '685410' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE 2,5MG TABLET (code = '2941' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="5"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE 2,5MG TABLET (code = '83593' 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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan=" | |colspan="4"|Omschrijving | ||
|style="background-color: white;"| | |style="background-color: white;"|Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="4"|Toedieningsweg | |||
|style="background-color: white;"|Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | |||
|-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;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|MBH identificatie | |colspan="5"|MBH identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_ZINRvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||
|} | |} | ||
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
|style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan=" | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="3" | Verstrekkingsverzoek | ||
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan=" | |colspan="2" width="25%"| Gegevenselement | ||
|| | || Waarde | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="1"| | |colspan="2"|Identificatie | ||
|style="background-color: white;"| | |style="background-color: white;"|MBH_VO_ZINRvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | ||
|} | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
<section end= | |colspan="2"|Datum | ||
|style="background-color: white;"|20 jun 2019, om 08:02 | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Auteur | |||
|style="background-color: white;"|Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Te verstrekken hoeveelheid | |||
|style="background-color: white;"|90 stuks | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - primaire code | |||
|style="background-color: white;"|INDAPAMIDE SANDOZ TABLET 2,5MG (code = '14896087' in codeSystem 'G-Standaard ZI-nr') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE SANDOZ TABLET 2,5MG (code = '685410' in codeSystem 'G-Standaard HPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE 2,5MG TABLET (code = '2941' in codeSystem 'G-Standaard PRK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Geneesmiddel - generiekere code | |||
|style="background-color: white;"|INDAPAMIDE 2,5MG TABLET (code = '83593' in codeSystem 'G-Standaard GPK') | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Beoogd verstrekker | |||
|style="background-color: white;"|Apotheek De Gulle Gaper | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|Relatie naar medicatieafspraak | |||
|style="background-color: white;"|MBH_VO_ZINRvoorschrijven_MA | |||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |||
|colspan="2"|MBH identificatie | |||
|style="background-color: white;"|MBH_VO_ZINRvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
|}<section end=2-aanvullend-5 /> | |||
[[Categorie:Kwalificatie]] | [[Categorie:Kwalificatie]] | ||
Huidige versie van 20 jul 2020 om 01:12
__NUMBEREDHEADINGS__

Addenda voor inhoudelijke gegevens
Medicatievoorschriften Basis 1 (verplicht)
MBH_VO_start_eind
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_start_eind_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:25 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 25 jun 2019, om 00:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Metoclopramide zetpil 20mg (code = '6939' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | METOCLOPRAMIDE 20MG ZETPIL (code = '63630' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 25 jun 2019, om 00:00, Vanaf <T> t/m <T+5>, 1 maal per dag 1 stuk, rectaal | ||||
| Toedieningsweg | Rectaal (code = '12' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_start_eind (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_start_eind_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:25 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 5 stuks | |
| Geneesmiddel - primaire code | Metoclopramide zetpil 20mg (code = '6939' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | METOCLOPRAMIDE 20MG ZETPIL (code = '63630' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_start_eind_MA | |
| MBH identificatie | MBH_VO_start_eind (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_start_duur
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_start_duur_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:30 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, gedurende 3 weken | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | LISINOPRIL 10MG TABLET (code = '71587' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, gedurende 3 weken, Vanaf <T>, gedurende 3 weken, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_start_duur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_start_duur_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:30 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 21 stuks | |
| Geneesmiddel - primaire code | LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | LISINOPRIL 10MG TABLET (code = '71587' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_start_duur_MA | |
| MBH identificatie | MBH_VO_start_duur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_chronisch
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_chronisch_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:32 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_chronisch (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_chronisch_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:32 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 21 stuks | |
| Geneesmiddel - primaire code | APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_chronisch_MA | |
| MBH identificatie | MBH_VO_chronisch (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
Medicatievoorschriften Basis 2 (verplicht)
MBH_VO_aanvullendeinstructie
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_aanvullendeinstructie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:00 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | Bij het eten innemen overig (code = 'OTH' in codeSystem 'HL7 NullFlavor') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_aanvullendeinstructie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:00 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 90 stuks | |
| Geneesmiddel - primaire code | Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_aanvullendeinstructie_MA | |
| MBH identificatie | MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_toelichting
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_toelichting_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:02 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| Toelichting | In overleg met specialist | ||||
| MBH identificatie | MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_toelichting_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:02 | |
| Auteur | Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Toelichting | Extra verstrekkingsverzoek omdat patient medicatie is kwijtgeraakt | |
| Relatie naar medicatieafspraak | MBH_VO_toelichting_MA | |
| MBH identificatie | MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_redenvanvoorschrijven
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_redenvanvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:03 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 13:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 13:00, Vanaf <T>, gedurende 28 dagen, 1 maal per week 5 stuks, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per week 5 stuks | ||||
| MBH identificatie | MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_redenvanvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:03 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 20 stuks | |
| Geneesmiddel - primaire code | Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_redenvanvoorschrijven_MA | |
| MBH identificatie | MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_aanvullendeinformatiewensen
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_aanvullendeinformatiewensen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:04 | ||||
| Gebruiksperiode | Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59, Vanaf <T>, gedurende 10 dagen, 3 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 3 maal per dag 1 stuk | ||||
| Lichaamslengte | 155 cm. Gemeten: 23 nov 2018, om 08:00 | ||||
| Lichaamsgewicht | 54 kg. Gemeten: 23 nov 2018, om 08:00 | ||||
| Aanvullende informatie | Bewust hoge dosering (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.14.2050') | ||||
| MBH identificatie | MBH_VO_aanvullendeinformatiewensen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_aanvullendeinformatiewensen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:04 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 40 stuks | |
| Geneesmiddel - primaire code | FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Aanvullende wensen | Bezorgen (code = '3' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.14.2051') | |
| Relatie naar medicatieafspraak | MBH_VO_aanvullendeinformatiewensen_MA | |
| MBH identificatie | MBH_VO_aanvullendeinformatiewensen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
Medicatievoorschriften Basis 3 Staken Wijzigen (verplicht)
MBH_VO_aanvullendeinstructie
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_aanvullendeinstructie_MA_staken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 4 jul 2019, om 10:00 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 10:00 | ||||
| Stoptype | Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1') | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_aanvullendeinstructie_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Reden wijzigen of staken | Overgevoeligheid (code = '16' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.2') | ||||
| Geneesmiddel - primaire code | Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 10:00, Vanaf <T> t/m <T>, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | Bij het eten innemen overig (code = 'OTH' in codeSystem 'HL7 NullFlavor') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_aanvullendeinstructie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
MBH_VO_toelichting
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_toelichting_MA_wijzigingmetVV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 4 jul 2019, om 10:01 | ||||
| Gebruiksperiode | Vanaf 4 jul 2019, om 10:01, tot nader order | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_toelichting_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Reden wijzigen of staken | Geen of onvoldoende effect (code = '5' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.2') | ||||
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 4 jul 2019, om 10:01, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 2 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 2 stuks | ||||
| MBH identificatie | MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_toelichting_MA_techstaken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 4 jul 2019, om 10:01 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, om 08:03, tot en met 4 jul 2019, om 10:01 | ||||
| Stoptype | Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1') | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_toelichting_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, om 08:03, tot en met 4 jul 2019, om 10:01, Vanaf <T->, tot <T>, 1 maal daags 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_toelichting_VV_extra (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 4 jul 2019, om 10:00 | |
| Auteur | Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_toelichting_MA_wijzigingmetVV | |
| MBH identificatie | MBH_VO_toelichting (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_redenvanvoorschrijven
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_redenvanvoorschrijven_MA_wijzigingzonderVV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 4 jul 2019, om 10:03 | ||||
| Gebruiksperiode | Vanaf 4 jul 2019, om 10:03, tot en met 18 jul 2019, om 13:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Reden wijzigen of staken | Beleidswijziging (code = '10' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.2') | ||||
| Geneesmiddel - primaire code | Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 4 jul 2019, om 10:03, tot en met 18 jul 2019, om 13:00, Vanaf <T>, gedurende 14 dagen, 1 maal per week 4 stuks, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per week 4 stuks | ||||
| MBH identificatie | MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_redenvanvoorschrijven_MA_techstaken (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 4 jul 2019, om 10:03 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, om 12:00, tot en met 4 jul 2019, om 10:03 | ||||
| Stoptype | Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1') | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_redenvanvoorschrijven_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: UZI Personen) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Methotrexaat tablet 2,5mg (code = '6009' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Methotrexaat tablet 2,5mg (code = '42609' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, om 12:00, tot en met 4 jul 2019, om 10:03, Vanaf <T>, t/m <T>, 1 maal per week 5 stuks, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per week 5 stuks | ||||
| MBH identificatie | MBH_VO_redenvanvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
Medicatievoorschriften Aanvullend 1 (Doseerschemas)
MBH_VO_variabelefrequentie
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_variabelefrequentie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:59 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 19 aug 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | MIZOLASTINE TABLET MGA 10MG (code = '48291' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | MIZOLASTINE TABLET MGA 10MG (code = '102164' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 19 aug 2019, om 12:00, Vanaf <T>, gedurende 60 dagen, 1 à 2 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 à 2 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_variabelefrequentie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_variabelefrequentie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:59 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 90 stuks | |
| Geneesmiddel - primaire code | MIZOLASTINE TABLET MGA 10MG (code = '48291' in codeSystem 'G-standaard PRK') | |
| Geneesmiddel - generiekere code | MIZOLASTINE TABLET MGA 10MG (code = '102164' in codeSystem 'G-standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_variabelefrequentie_MA | |
| MBH identificatie | MBH_VO_variabelefrequentie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_interval
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_interval_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:58 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, exact iedere 12 uur 16 IE, subcutaan | ||||
| Toedieningsweg | subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | exact iedere 12 uur 16 internationale eenheid | ||||
| MBH identificatie | MBH_VO_interval (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_interval_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:58 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 1 stuk | |
| Geneesmiddel - primaire code | INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_interval_MA | |
| MBH identificatie | MBH_VO_interval (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_variabelehoeveelheid
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_variabelehoeveelheid_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:57 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | PARACETAMOL 500MG TABLET (code = '67903' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | PARACETAMOL 500MG TABLET (code = '2194' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 4 weken, 3 maal per dag 1 à 2 stuks, oraal | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 3 maal per dag 1 à 2 stuks | ||||
| MBH identificatie | MBH_VO_variabelehoeveelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_variabelehoeveelheid_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:57 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 40 stuks | |
| Geneesmiddel - primaire code | PARACETAMOL 500MG TABLET (code = '67903' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | PARACETAMOL 500MG TABLET (code = '2194' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_variabelehoeveelheid_MA | |
| MBH identificatie | MBH_VO_variabelehoeveelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_zonderkeerdosis
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_zonderkeerdosis_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:56 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Cetomacrogolcreme met vaseline 10% (code = '92789' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Cetomacrogolcreme met vaseline 10% (code = '133329' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 30 dagen, 3 maal per dag aanbrengen, cutaan | ||||
| Toedieningsweg | cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | aanbrengen (code = '1018' in codeSystem 'NHG tabel 25 aanvullende tekst') | ||||
| Doseerinstructie | 3 maal per dag | ||||
| MBH identificatie | MBH_VO_zonderkeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_zonderkeerdosis_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:56 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 1 stuk | |
| Geneesmiddel - primaire code | Cetomacrogolcreme met vaseline 10% (code = '92789' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Cetomacrogolcreme met vaseline 10% (code = '133329' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_zonderkeerdosis_MA | |
| MBH identificatie | MBH_VO_zonderkeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_bijzonderekeerdosis
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_bijzonderekeerdosis_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:55 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | NAPROXEN 500MG TABLET (code = '20850' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | NAPROXEN 500MG TABLET (code = '51233' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 18 jul 2019, om 12:00, Vanaf <T>, gedurende 30 dagen, 2 maal per dag 1/2 tablet | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 2 maal per dag 0.5 stuk | ||||
| MBH identificatie | MBH_VO_bijzonderekeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_bijzonderekeerdosis_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:55 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Geneesmiddel - primaire code | NAPROXEN 500MG TABLET (code = '20850' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | NAPROXEN 500MG TABLET (code = '51233' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_bijzonderekeerdosis_MA | |
| MBH identificatie | MBH_VO_bijzonderekeerdosis (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_variabelehoeveelheid2
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_variabelehoeveelheid2_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:54 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Waterstofperoxide 30MG/ML (code = '67016' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Waterstofperoxide 30MG/ML (code = '116041' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00, Vanaf <T>, gedurende 14 dagen, 2x per dag 10 tot 15 ml, Eerst oplossen in water, mond spoelen, daarna uitspugen | ||||
| Toedieningsweg | niet van toepassing (code = '1' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | Eerst oplossen in water (code = '27' in codeSystem 'NHG tabel 25 aanvullende tekst') | ||||
| Aanvullende instructie | mond spoelen, daarna uitspugen (code = '69' in codeSystem 'NHG tabel 25 aanvullende tekst') | ||||
| Doseerinstructie | 2 maal per dag 10 à 15 ml | ||||
| MBH identificatie | MBH_VO_variabelehoeveelheid2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_variabelehoeveelheid2_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:54 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 450 ml | |
| Geneesmiddel - primaire code | Waterstofperoxide 30MG/ML (code = '67016' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Waterstofperoxide 30MG/ML (code = '116041' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_variabelehoeveelheid2_MA | |
| MBH identificatie | MBH_VO_variabelehoeveelheid2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_tijdstippen
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_tijdstippen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:53 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 4 jul 2019, om 12:00, Vanaf <T>, gedurende 14 dagen, elke dag om 08:00, 14:00 en 20:00 uur 16IE | ||||
| Toedieningsweg | subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | elke dag om 08:00, 14:00 en 20:00 16 internationale eenheid | ||||
| MBH identificatie | MBH_VO_tijdstippen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_tijdstippen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:53 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 1 stuk | |
| Geneesmiddel - primaire code | INSULINE ISOFAAN 100IE/ML (code = '34851' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | INSULINE ISOFAAN 100IE/ML (code = '111325' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_tijdstippen_MA | |
| MBH identificatie | MBH_VO_tijdstippen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_weekdagen
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_weekdagen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:52 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 29 aug 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | IMIQUIMOD 50MG/G CREME (code = '55050' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | IMIQUIMOD 50MG/G CREME (code = '109398' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 29 aug 2019, om 12:00, Vanaf <T>, gedurende 10 weken, op maandag, woensdag en vrijdag, voor de nacht aanbrengen | ||||
| Toedieningsweg | subcutaan (code = '21' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | voor de nacht (code = '1128' in codeSystem 'NHG tabel 25 aanvullende tekst') | ||||
| Aanvullende instructie | aanbrengen (code = '1018' in codeSystem 'NHG tabel 25 aanvullende tekst') | ||||
| Doseerinstructie | op maandag, woensdag en vrijdag | ||||
| MBH identificatie | MBH_VO_weekdagen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_weekdagen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:52 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 70 sachet | |
| Geneesmiddel - primaire code | IMIQUIMOD 50MG/G CREME (code = '55050' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | IMIQUIMOD 50MG/G CREME (code = '109398' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_weekdagen_MA | |
| MBH identificatie | MBH_VO_weekdagen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_dagdeel
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_dagdeel_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:51 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | EZETIMIB/SIMVASTATINE 10/20 (code = '77038' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | EZETIMIB/SIMVASTATINE 10/20 (code = '123129' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, 1 maal daags 1 stuk ’s avonds innemen, oraal | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk 's avonds | ||||
| MBH identificatie | MBH_VO_dagdeel (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_dagdeel_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:51 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 60 stuks | |
| Geneesmiddel - primaire code | EZETIMIB/SIMVASTATINE 10/20 (code = '77038' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | EZETIMIB/SIMVASTATINE 10/20 (code = '123129' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_dagdeel_MA | |
| MBH identificatie | MBH_VO_dagdeel (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_cyclischschema
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_cyclischschema_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:50 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '16292' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '39578' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, cyclus van 28 dagen: steeds 21 dagen 1 x per dag 1 tablet, dan 7 dagen niet | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | gedurende 21 dagen 1 maal per dag 1 stuk | ||||
| Herhaalperiode cyclisch schema | 28 dagen | ||||
| MBH identificatie | MBH_VO_cyclischschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_cyclischschema_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:50 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 6 stuks | |
| Geneesmiddel - primaire code | ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '16292' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | ETHINYLESTRADIOL/DESOGESTREL TABLET 30/150UG (code = '39578' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_cyclischschema_MA | |
| MBH identificatie | MBH_VO_cyclischschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_afbouwschema
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_afbouwschema_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:49 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 31 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Fusidinezuur creme 20mg/g (code = '16705' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Fusidinezuur creme 20mg/g (code = '73466' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 31 jul 2019, om 12:00, Vanaf <T>, gedurende 41 dagen, eerst 2 weken 3gr per dag, dan 3 weken 2gr per dag, dan 6 dagen 1gr per dag, dun aanbrengen, cutaan | ||||
| Toedieningsweg | cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Aanvullende instructie | dun aanbrengen (code = '1033' in codeSystem 'NHG tabel 25 aanvullende teksten') | ||||
| Doseerinstructie 1 | eerst gedurende 2 weken 1 maal per dag 3 gram | ||||
| Doseerinstructie 2 | dan gedurende 3 weken 1 maal per dag 2 gram | ||||
| Doseerinstructie 3 | dan gedurende 6 dagen 1 maal per dag 1 gram | ||||
| MBH identificatie | MBH_VO_afbouwschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_afbouwschema_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:49 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 30 gram | |
| Geneesmiddel - primaire code | Fusidinezuur creme 20mg/g (code = '16705' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Fusidinezuur creme 20mg/g (code = '73466' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_afbouwschema_MA | |
| MBH identificatie | MBH_VO_afbouwschema (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_variabelefrequentieenmaximum
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_variabelefrequentieenmaximum_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:48 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 11 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | CODEINE TABLET 10MG (FOSFAAT) (code = '42773' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | CODEINE TABLET 10MG (FOSFAAT) (code = '23086' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 11 jul 2019, om 12:00, Vanaf <T>, gedurende 3 weken, iedere 3 à 4 uur 1 stuk bij hoest, maximaal 6 stuks per dag, oraal | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | bij hoest 3 à 4 maal per uur 1 stuk , maximaal 6 stuks per dag | ||||
| MBH identificatie | MBH_VO_variabelefrequentieenmaximum (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_variabelefrequentieenmaximum_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:48 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 120 stuks | |
| Geneesmiddel - primaire code | CODEINE TABLET 10MG (FOSFAAT) (code = '42773' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | CODEINE TABLET 10MG (FOSFAAT) (code = '23086' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_variabelefrequentieenmaximum_MA | |
| MBH identificatie | MBH_VO_variabelefrequentieenmaximum (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_toedieningssnelheid
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_toedieningssnelheid_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:47 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 28 jun 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | MORFINE INFVLST 5MG/ML CAS 100ML (code = '94692' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | MORFINE INFVLST 5MG/ML CAS 100ML (code = '134538' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 28 jun 2019, om 12:00, Vanaf <T>, gedurende 8 dagen, 0.2 tot 0.5 ml per uur parenteraal | ||||
| Toedieningsweg | parenteraal (code = '10' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 0.2 à 0.5 ml per uur | ||||
| MBH identificatie | MBH_VO_toedieningssnelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_toedieningssnelheid_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:47 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 100 ml | |
| Geneesmiddel - primaire code | MORFINE INFVLST 5MG/ML CAS 100ML (code = '94692' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | MORFINE INFVLST 5MG/ML CAS 100ML (code = '134538' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_toedieningssnelheid_MA | |
| MBH identificatie | MBH_VO_toedieningssnelheid (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_toedieningsduur
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_toedieningsduur_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:46 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, om 16:00, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '44520' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '98477' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, om 16:00, tot nader order, tot nader order, eenmaal daags 1 pleister aanbrengen gedurende 16 uur (daarna 8 uur geen pleister), transdermaal | ||||
| Toedieningsweg | transdermaal (code = '58' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk gedurende 16 uur | ||||
| MBH identificatie | MBH_VO_toedieningsduur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_toedieningsduur_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:46 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Geneesmiddel - primaire code | NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '44520' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | NITROGLYCERINE PLEISTER 5MG/24UUR (DEPONIT T) (code = '98477' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_toedieningsduur_MA | |
| MBH identificatie | MBH_VO_toedieningsduur (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_zonodig
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_zonodig_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 11:42 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, om 11:42, gedurende 4 weken | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | ACETYLSALICYLZUUR 100MG TAB (code = '3956' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | ACETYLSALICYLZUUR TABLET 100MG (code = '12548' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, om 11:42, gedurende 4 weken, Vanaf <T> gedurende 4 weken, 1x per dag 1 stuk zo nodig, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | zo nodig 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_zonodig (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_zonodig_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 11:42 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 14 stuks | |
| Geneesmiddel - primaire code | ACETYLSALICYLZUUR 100MG TAB (code = '3956' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | ACETYLSALICYLZUUR TABLET 100MG (code = '12548' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek de Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_zonodig_MA | |
| MBH identificatie | MBH_VO_zonodig (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
Medicatievoorschriften Aanvullend 2 (Magistraal)
MBH_VO_magistraalalleingredienten
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_magistraalalleingredienten_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 12:05 | ||||
| Gebruiksperiode | Vanaf 21 jun 2019, om 12:00, tot en met 21 jul 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - Product specificatie | |||||
| Product naam | Ureum 10% in eucerine cum aqua 100gr | ||||
| Omschrijving | Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | ||||
| Ingredient | |||||
| Ingredient code | UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | ||||
| Sterkte | 10 gram per 100 gram | ||||
| Ingredient | |||||
| Ingredient code | EUCERINE MET WATER FAGRON (code = '14740877' in codeSystem 'G-Standaard HPK') | ||||
| Sterkte | 90 gram per 100 gram | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 21 jun 2019, om 12:00, tot en met 21 jul 2019, om 12:00, Vanaf <T>, zo nodig, aanbrengen, cutaan | ||||
| Toedieningsweg | cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | geen informatie | ||||
| MBH identificatie | MBH_VO_magistraalalleingredienten (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||||
| Gegevenselement | Waarde | |||
| Identificatie | MBH_VO_magistraalalleingredienten_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
| Datum | 20 jun 2019, om 12:05 | |||
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
| Te verstrekken hoeveelheid | 100 ml | |||
| Geneesmiddel - Product specificatie | ||||
| Product naam | Ureum 10% in eucerine cum aqua 100gr | |||
| Omschrijving | Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | |||
| Ingredient | ||||
| Ingredient code | UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | |||
| Sterkte | 10 gram per 100 gram | |||
| Ingredient | ||||
| Ingredient code | EUCERINE MET WATER FAGRON (code = '14740877' in codeSystem 'G-Standaard HPK') | |||
| Sterkte | 90 gram per 100 gram | |||
| Beoogd verstrekker | Apotheek De Gulle Gaper | |||
| Relatie naar medicatieafspraak | MBH_VO_magistraalalleingredienten_MA | |||
| MBH identificatie | MBH_VO_magistraalalleingredienten (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
MBH_VO_magistraalactieveingredient
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_magistraalactieveingredient_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 12:10 | ||||
| Gebruiksperiode | Vanaf 21 jun 2019, om 12:00, tot en met 30 aug 2019, om 12:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - Product specificatie | |||||
| Product naam | Vaseline 20% in cetomacrogolcrème FNA | ||||
| Omschrijving | Titel: Vaseline 20% in cetomacrogolcrème FNA Regel 1: cetomacrogolcreme 80 gr | ||||
| Ingredient | |||||
| Ingredient code | CETOMACROGOLCREME FNA (code = '457590' in codeSystem 'G-Standaard HPK') | ||||
| Sterkte | 80 gram per 100 gram | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 21 jun 2019, om 12:00, tot en met 30 aug 2019, om 12:00, Vanaf <T> t/m <T+39>, 1x daags, cutaan | ||||
| Toedieningsweg | 7 (code = 'cutaan' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag | ||||
| MBH identificatie | MBH_VO_magistraalactieveingredient (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||||
| Gegevenselement | Waarde | |||
| Identificatie | MBH_VO_magistraalactieveingredient_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
| Datum | 20 jun 2019, om 12:10 | |||
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
| Te verstrekken hoeveelheid | 100 gram | |||
| Geneesmiddel - Product specificatie | ||||
| Product naam | Vaseline 20% in cetomacrogolcrème FNA | |||
| Omschrijving | Titel: Vaseline 20% in cetomacrogolcrème FNA Regel 1: cetomacrogolcreme 80 gr | |||
| Ingredient | ||||
| Ingredient code | CETOMACROGOLCREME FNA (code = '457590' in codeSystem 'G-Standaard HPK') | |||
| Sterkte | 80 gram per 100 gram | |||
| Beoogd verstrekker | Apotheek De Gulle Gaper | |||
| Relatie naar medicatieafspraak | MBH_VO_magistraalactieveingredient_MA | |||
| MBH identificatie | MBH_VO_magistraalactieveingredient (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
MBH_VO_magistraal90miljoennr
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_magistraal90miljoennr_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 12:15 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, om 12:15, tot en met 20 jul 2019, om 12:15 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - Product specificatie | |||||
| Product naam | Ureum 10% in eucerine cum aqua 100gr | ||||
| Omschrijving | Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | ||||
| Ingredient | |||||
| Ingredient code | UREUM (code = '15219127' in codeSystem 'G-Standaard HPK') | ||||
| Sterkte | 10 gram per 100 gram | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, om 12:15, tot en met 20 jul 2019, om 12:15, Vanaf <T> t/m <T+30>, 1x per dag, cutaan | ||||
| Toedieningsweg | cutaan (code = '7' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag | ||||
| MBH identificatie | MBH_VO_magistraal90miljoennr (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||||
| Gegevenselement | Waarde | |||
| Identificatie | MBH_VO_magistraal90miljoennr_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |||
| Datum | 20 jun 2019, om 12:15 | |||
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |||
| Te verstrekken hoeveelheid | 100 gram | |||
| Geneesmiddel - Product specificatie | ||||
| Product naam | Ureum 10% in eucerine cum aqua 100gr | |||
| Omschrijving | Titel: Ureum 10% in eucerine cum aqua 100gr Regel: UREUM 10gr Regel: EUCERINE MET WATER FAGRON ad 100gr | |||
| Ingredient | ||||
| Sterkte | 10 gram per 100 gram | |||
| Beoogd verstrekker | Apotheek De Gulle Gaper | |||
| Relatie naar medicatieafspraak | MBH_VO_magistraal90miljoennr_MA | |||
| MBH identificatie | MBH_VO_magistraal90miljoennr (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |||
Medicatievoorschriften Aanvullend 3 (andermans MA)
MBH_VO_VVandermansMA
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_VVandermansMA_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 5 aug 2019, om 11:25 | ||||
| Gebruiksperiode | Vanaf 5 aug 2019, tot en met 26 aug 2019, om 00:00 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001118 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Marcha van Partners | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | DICLOFENAC NATRIUM TABLET MGA 100MG (code = '8052' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | DICLOFENAC NATRIUM TABLET MGA 100MG (code = '22268' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 5 aug 2019, tot en met 26 aug 2019, om 00:00, Vanaf <T> t/m <T+21>, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| Kopie indicator | Ja | ||||
| MBH identificatie | MBH_VO_VVandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_VVandermansMA_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 19 aug 2019, om 03:25 | |
| Auteur | Peter van Pulver - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Geneesmiddel - primaire code | DICLOFENAC NATRIUM TABLET MGA 100MG (code = '8052' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | DICLOFENAC NATRIUM TABLET MGA 100MG (code = '22268' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_VVandermansMA_MA | |
| MBH identificatie | MBH_VO_VVandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_stakenandermansMA
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_stakenandermansMA_MA2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 19 aug 2019, om 03:27 | ||||
| Gebruiksperiode | Vanaf 14 aug 2019, tot en met 19 aug 2019, om 03:27 | ||||
| Stoptype | Staking (code = '2' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1') | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_stakenandermansMA_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | LISINOPRIL 10MG TABLET (code = '26638' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | LISINOPRIL 10MG TABLET (code = '71587' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 14 aug 2019, tot en met 19 aug 2019, om 03:27, Vanaf <T-5> tot <T>, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_stakenandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
MBH_VO_onderbrekenandermansMA
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_onderbrekenandermansMA_MA2 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 19 aug 2019, om 03:30 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 19 aug 2019, om 03:30 | ||||
| Stoptype | Onderbreking (code = '1' in codeSystem '2.16.840.1.113883.2.4.3.11.60.20.77.5.2.1') | ||||
| Relatie naar afspraak of gebruik: MA | MBH_VO_onderbrekenandermansMA_MA | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001111 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Peter van Pulver | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | APACOF 250/250/50MG TABLET (code = '3891' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | ACETYLSALICYLZUUR/PARACETAMOL/COF TAB 250/250/50MG (code = '61433' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 19 aug 2019, om 03:30, Vanaf <T-60> tot <T>, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_onderbrekenandermansMA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
Medicatievoorschriften Aanvullend 4 (diversen VV)
MBH_VO_logistiekeverbruiksperiode
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_logistiekeverbruiksperiode_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:00 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_logistiekeverbruiksperiode (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_logistiekeverbruiksperiode_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:00 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Geneesmiddel - primaire code | Acetylsalicylzuur tabletmsr 100mg (code = '49484' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | Acetylsalicylzuur tabletmsr 100mg (code = '103039' in codeSystem 'G-Standaard GPK') | |
| Verbruiksperiode | Vanaf 20 jun 2019, om 08:00, tot en met 31 dec 2019, om 08:00 | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_logistiekeverbruiksperiode_MA | |
| MBH identificatie | MBH_VO_logistiekeverbruiksperiode (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_herhalingen
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_herhalingen_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:02 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_herhalingen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_herhalingen_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:02 | |
| Auteur | Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |
| Te verstrekken hoeveelheid | 30 stuks | |
| Aantal herhalingen | 5 | |
| Geneesmiddel - primaire code | FUROSEMIDE 40MG TABLET (code = '5967' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | FUROSEMIDE 40MG TABLET (code = '16810' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_herhalingen_MA | |
| MBH identificatie | MBH_VO_herhalingen (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_afleverlocatie
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_afleverlocatie_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:04 | ||||
| Gebruiksperiode | Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 21 jun 2019, tot en met 30 jun 2019, om 23:59, Vanaf <T>, gedurende 10 dagen, 3 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 3 maal per dag 1 stuk | ||||
| Lichaamslengte | 155 cm. Gemeten: 23 nov 2018, om 08:00 | ||||
| Lichaamsgewicht | 54 kg. Gemeten: 23 nov 2018, om 08:00 | ||||
| MBH identificatie | MBH_VO_afleverlocatie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_afleverlocatie_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:04 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 40 stuks | |
| Geneesmiddel - primaire code | FENETICILLINE CAPSULE 500MG (code = '17205' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | FENETICILLINE 500MG CAPSULE (code = '41092' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Afleverlocatie | Dorpsrand 200,1256ZZ Ons Dorp | |
| Relatie naar medicatieafspraak | MBH_VO_afleverlocatie_MA | |
| MBH identificatie | MBH_VO_afleverlocatie (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
Medicatievoorschriften Aanvullend 5 (HPK,ZInr)
MBH_VO_HPKvoorschrijven
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_HPKvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:00 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59 | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | XARELTO TABLET FILMOMHULD 20MG (code = '2214350' in codeSystem 'G-Standaard HPK') | ||||
| Geneesmiddel - generiekere code | RIVAROXABAN TABLET 20MG (code = '100153' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | RIVAROXABAN TABLET 20MG (code = '138363' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot en met 20 jun 2020, om 11:59, Vanaf <T>, gedurende 1 jaar, 1 maal per dag 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_HPKvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_HPKvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:00 | |
| Auteur | Bertine van Doorn - Huisartsen, niet nader gespecificeerd. Huisartsenpraktijk Pulver & Partners | |
| Te verstrekken hoeveelheid | 90 stuks | |
| Geneesmiddel - primaire code | XARELTO TABLET FILMOMHULD 20MG (code = '2214350' in codeSystem 'G-Standaard HPK') | |
| Geneesmiddel - generiekere code | RIVAROXABAN TABLET 20MG (code = '100153' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | RIVAROXABAN TABLET 20MG (code = '138363' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_HPKvoorschrijven_MA | |
| MBH identificatie | MBH_VO_HPKvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |
MBH_VO_ZINRvoorschrijven
| Medicatieafspraak | |||||
| Gegevenselement | Waarde | ||||
| Identificatie | MBH_VO_ZINRvoorschrijven_MA (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.16076005.1) | ||||
| Afspraakdatum | 20 jun 2019, om 08:02 | ||||
| Gebruiksperiode | Vanaf 20 jun 2019, tot nader order | ||||
| Voorschrijver | |||||
| Zorgverlener | |||||
| Zorgverlener identificatienummer | 000001112 (in identificerend systeem: UZI Personen) | ||||
| Naamgegevens | Bertine van Doorn | ||||
| Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT (Vektis Zorgverlenersspecificatie (subberoepsgroep))') | ||||
| Zorgaanbieder | |||||
| Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: URA) | ||||
| Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
| Adresgegevens | Werkadres: Dorpsstraat 1 1234AA Ons Dorp | ||||
| Geneesmiddel - primaire code | INDAPAMIDE SANDOZ TABLET 2,5MG (code = '14896087' in codeSystem 'G-Standaard ZI-nr') | ||||
| Geneesmiddel - generiekere code | INDAPAMIDE SANDOZ TABLET 2,5MG (code = '685410' in codeSystem 'G-Standaard HPK') | ||||
| Geneesmiddel - generiekere code | INDAPAMIDE 2,5MG TABLET (code = '2941' in codeSystem 'G-Standaard PRK') | ||||
| Geneesmiddel - generiekere code | INDAPAMIDE 2,5MG TABLET (code = '83593' in codeSystem 'G-Standaard GPK') | ||||
| Gebruiksinstructie | |||||
| Omschrijving | Vanaf 20 jun 2019, tot nader order, Vanaf <T>, tot nader order, 1 maal daags 1 stuk, oraal | ||||
| Toedieningsweg | Oraal (code = '9' in codeSystem 'G-Standaard Toedieningswegen') | ||||
| Doseerinstructie | 1 maal per dag 1 stuk | ||||
| MBH identificatie | MBH_VO_ZINRvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | ||||
| Verstrekkingsverzoek | ||
| Gegevenselement | Waarde | |
| Identificatie | MBH_VO_ZINRvoorschrijven_VV (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.52711000146108.1) | |
| Datum | 20 jun 2019, om 08:02 | |
| Auteur | Hans van Doorn - Huisartsen, niet nader gespecificeerd. Ziekenhuis Stitswerd | |
| Te verstrekken hoeveelheid | 90 stuks | |
| Geneesmiddel - primaire code | INDAPAMIDE SANDOZ TABLET 2,5MG (code = '14896087' in codeSystem 'G-Standaard ZI-nr') | |
| Geneesmiddel - generiekere code | INDAPAMIDE SANDOZ TABLET 2,5MG (code = '685410' in codeSystem 'G-Standaard HPK') | |
| Geneesmiddel - generiekere code | INDAPAMIDE 2,5MG TABLET (code = '2941' in codeSystem 'G-Standaard PRK') | |
| Geneesmiddel - generiekere code | INDAPAMIDE 2,5MG TABLET (code = '83593' in codeSystem 'G-Standaard GPK') | |
| Beoogd verstrekker | Apotheek De Gulle Gaper | |
| Relatie naar medicatieafspraak | MBH_VO_ZINRvoorschrijven_MA | |
| MBH identificatie | MBH_VO_ZINRvoorschrijven (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.77.1.1) | |