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  <identifier>
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  <type value="message"/>
  <timestamp value="2026-07-02T08:44:38.631Z"/>
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    <fullUrl value="urn:uuid:3bed1f74-173f-4841-b3c0-c112b8d53e12"/>
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        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_null"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader </b></p><p><b>event</b>: <a href="http://terminology.hl7.org/7.2.0/CodeSystem-v2-0003.html#v2-0003-O21">event: O21</a> (OML - Laboratory order)</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style="display: none">*</td><td><a href="https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=http://fhir.org/packages/fhir.r4.ukcore.stu3.currentbuild/https//fhir.mft.nhs.uk/Endpoint/RIE">https//fhir.mft.nhs.uk/Endpoint/RIE</a></td><td>Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0</td></tr></table><p><b>sender</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0</p><h3>Sources</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Name</b></td><td><b>Software</b></td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td>IGENE</td><td>NW GLH</td><td><a href="https://simplifier.net/resolve?scope=fhir.r4.ukcore.stu3.currentbuild@0.29.0-pre-release&amp;canonical=https://fhir.nwgenomics.nhs.uk/Endpoint/IGENE">https://fhir.nwgenomics.nhs.uk/Endpoint/IGENE</a></td></tr></table><p><b>focus</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-afae0544-f0d1-4cb1-afb9-572ee5dad285">ServiceRequest ctDNA_M4</a></p></div>
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          <code value="O21"/>
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          <receiver>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
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        <sender>
          <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
            <value value="699X0"/>
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        </sender>
        <source>
          <name value="IGENE"/>
          <software value="NW GLH"/>
          <endpoint value="https://fhir.nwgenomics.nhs.uk/Endpoint/IGENE"/>
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  <entry>
    <fullUrl value="urn:uuid:17d826c4-911c-4b49-8910-fa079f50705f"/>
    <resource>
      <Patient>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_null"> </a><p class="res-header-id"><b>Generated Narrative: Patient </b></p><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Alicent DURHAM  Female, DoB: 1993-12-27 ( National Health Plan Identifier)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Ids (see the one above)">Other Ids:</td><td colspan="3"><ul><li>Patient internal identifier/336389</li><li>Medical record number/336577</li></ul></td></tr></table></div>
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              <coding>
                <system value="https://fhir.hl7.org.uk/CodeSystem/UKCore-NHSNumberVerificationStatusEngland"/>
                <code value="05"/>
                <display value="Trace needs to be resolved - (NHS number or patient detail conflict)"/>
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            </valueCodeableConcept>
          </extension>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="NH"/>
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          <system value="https://fhir.nhs.uk/Id/nhs-number"/>
          <value value="9737873998"/>
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        <identifier>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PI"/>
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          <system value="https://fhir.nwgenomics.nhs.uk/Identifier/IGENE-PatientIdentifier"/>
          <value value="336389"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
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        <identifier>
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              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="MR"/>
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          <value value="336577"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="RAE"/>
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        </identifier>
        <name>
          <family value="DURHAM"/>
          <given value="Alicent"/>
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        <gender value="female"/>
        <birthDate value="1993-12-27"/>
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        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="Specimen_null"> </a><p class="res-header-id"><b>Generated Narrative: Specimen </b></p><p><b>identifier</b>: Filler Identifier/S26-1K74</p><p><b>status</b>: Available</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 119297000}">Blood specimen</span></p><p><b>subject</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-17d826c4-911c-4b49-8910-fa079f50705f">Alicent DURHAM  Female, DoB: 1993-12-27 ( National Health Plan Identifier)</a></p><h3>Collections</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Collected[x]</b></td></tr><tr><td style="display: none">*</td><td>2026-06-26</td></tr></table></div>
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          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="FILL"/>
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          <system value="https://fhir.nwgenomics.nhs.uk/Identifier/IGENE-SpecimenIdentifier"/>
          <value value="S26-1K74"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
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        <status value="available"/>
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          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="119297000"/>
            <display value="Blood specimen"/>
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        <subject>
          <reference value="urn:uuid:17d826c4-911c-4b49-8910-fa079f50705f"/>
          <identifier>
            <type>
              <coding>
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                <code value="NH"/>
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            <system value="https://fhir.nhs.uk/Id/nhs-number"/>
            <value value="9737873998"/>
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        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_null"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest </b></p><p><b>identifier</b>: Filler Identifier/R26-15F8</p><p><b>status</b>: Active</p><p><b>intent</b>: Original Order</p><p><b>category</b>: <span title="Codes:{http://snomed.info/sct 116148004}">Molecular genetics procedure</span></p><p><b>code</b>: <span title="Codes:{https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory M4.14}">PACKAGE: M4.14 - Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel - small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon </span></p><p><b>subject</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-17d826c4-911c-4b49-8910-fa079f50705f">Alicent DURHAM  Female, DoB: 1993-12-27 ( National Health Plan Identifier)</a></p><p><b>requester</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/RAE</p><p><b>specimen</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-b3cc579c-66b5-4fb1-91d4-dcc07d0f548c">Specimen: identifier = Filler Identifier; status = available; type = Blood specimen</a></p></div>
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              <code value="FILL"/>
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          <system value="https://fhir.nwgenomics.nhs.uk/Identifier/IGENE-ReferralIdentifier"/>
          <value value="R26-15F8"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
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        </identifier>
        <status value="active"/>
        <intent value="original-order"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="116148004"/>
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        <code>
          <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory"/>
            <code value="M4.14"/>
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          <text value="PACKAGE: M4.14 - Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel - small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon "/>
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              <coding>
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                <code value="NH"/>
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            <system value="https://fhir.nhs.uk/Id/nhs-number"/>
            <value value="9737873998"/>
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        <requester>
          <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
            <value value="RAE"/>
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        </requester>
        <specimen>
          <reference value="urn:uuid:b3cc579c-66b5-4fb1-91d4-dcc07d0f548c"/>
          <type value="Specimen"/>
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  <entry>
    <fullUrl value="urn:uuid:afae0544-f0d1-4cb1-afb9-572ee5dad285"/>
    <resource>
      <ServiceRequest>
        <language value="en"/>
        <text>
          <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_null"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest </b></p><p><b>identifier</b>: Placer Identifier/T26-5AMV</p><p><b>basedOn</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-ae7d645c-f0e0-468b-a34f-a40aa2246874">ServiceRequest Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel, small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon</a></p><p><b>requisition</b>: Placer Group Number/R26-15F8</p><p><b>status</b>: Active</p><p><b>intent</b>: Filler Order</p><p><b>category</b>: <span title="Codes:{http://snomed.info/sct 116148004}">Molecular genetics procedure</span></p><p><b>code</b>: <span title="Codes:{https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory ctDNA_M4}">PACKAGE: M4.14 - Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel - small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon </span></p><p><b>subject</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-17d826c4-911c-4b49-8910-fa079f50705f">Alicent DURHAM  Female, DoB: 1993-12-27 ( National Health Plan Identifier)</a></p><p><b>authoredOn</b>: 2026-06-30</p><p><b>requester</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0</p><p><b>performer</b>: Identifier: <a href="NamingSystem-ods-organization-code-namingsystem.html" title="The identifier system for an Organisation registered with the Organisation Data Service (ODS).">ODS Organisation Code</a>/699X0</p><p><b>specimen</b>: <a href="Bundle-Bundle-Message-FillerOrder.html#urn-uuid-b3cc579c-66b5-4fb1-91d4-dcc07d0f548c">Specimen: identifier = Filler Identifier; status = available; type = Blood specimen</a></p></div>
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              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PLAC"/>
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          <system value="https://fhir.nwgenomics.nhs.uk/Identifier/IGENE-TestIdentifier"/>
          <value value="T26-5AMV"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
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        <basedOn>
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        <requisition>
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              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PGN"/>
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          <system value="https://fhir.nwgenomics.nhs.uk/Identifier/IGENE-ReferralIdentifier"/>
          <value value="R26-15F8"/>
          <assigner>
            <identifier>
              <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
              <value value="699X0"/>
            </identifier>
          </assigner>
        </requisition>
        <status value="active"/>
        <intent value="filler-order"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="116148004"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="https://fhir.nhs.uk/CodeSystem/England-GenomicTestDirectory"/>
            <code value="ctDNA_M4"/>
          </coding>
          <text value="PACKAGE: M4.14 - Non-Small Cell Lung Cancer, Multi-target ctDNA combined Multi-target NGS panel - small variant (EGFR, ALK, BRAF, KRAS, MET exon 14 skipping and copy number variations) and structural variant (ROS1, RET, ALK, NTRK1, NTRK2, NTRK3, MET exon "/>
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          <reference value="urn:uuid:17d826c4-911c-4b49-8910-fa079f50705f"/>
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                <code value="NH"/>
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            </type>
            <system value="https://fhir.nhs.uk/Id/nhs-number"/>
            <value value="9737873998"/>
          </identifier>
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        <authoredOn value="2026-06-30"/>
        <requester>
          <identifier>
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            <value value="699X0"/>
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        <performer>
          <identifier>
            <system value="https://fhir.nhs.uk/Id/ods-organization-code"/>
            <value value="699X0"/>
          </identifier>
        </performer>
        <specimen>
          <reference value="urn:uuid:b3cc579c-66b5-4fb1-91d4-dcc07d0f548c"/>
          <type value="Specimen"/>
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