Moonlitic — FHIR Clinical Detail

Comprehensive Lipid Panel

Quest Diagnostics · Ordered by Dr. Michael Chen, MD FACC · January 8, 2026

Total Cholesterol

218 mg/dL

Borderline high · Target: <200

LDL (Bad) Cholesterol

142 mg/dL

High · Target: <100 optimal, <130 near-optimal

HDL (Good) Cholesterol

52 mg/dL

Normal · Target: >40 (men), >50 (women)

Triglycerides

150 mg/dL

Borderline · Target: <150

VLDL Cholesterol

30 mg/dL

Normal · Range: 2–30

TC/HDL Ratio

4.19

Borderline · Target: <4.0

Clinical Interpretation

Lipid panel shows improvement from prior results (TC 232 → 218, LDL 155 → 142) since Atorvastatin dose was increased from 20mg to 40mg in March 2025. However, LDL remains above optimal target (<100 mg/dL). HDL is adequate. Triglycerides are at the upper boundary of normal.

Recommendation: Continue Atorvastatin 40mg. Reinforce dietary modifications (reduced saturated fat, increased fiber). Consider adding Ezetimibe if LDL does not reach target by next check. Recheck lipids in 12 weeks.

Interpreting physician: Dr. Michael Chen, MD FACC · Baylor Scott & White Cardiology

Analyte	Result	Reference Range	Flag	Units
Total Cholesterol	218	Desirable: <200 · Borderline: 200-239 · High: ≥240	BORDERLINE HIGH	mg/dL
LDL Cholesterol	142	Optimal: <100 · Near-Optimal: 100-129 · Borderline: 130-159	BORDERLINE HIGH	mg/dL
HDL Cholesterol	52	Low: <40 · Normal: 40-59 · High/Protective: ≥60	NORMAL	mg/dL
Triglycerides	150	Normal: <150 · Borderline: 150-199 · High: 200-499	BORDERLINE	mg/dL
VLDL Cholesterol	30	Normal: 2–30	NORMAL	mg/dL
Non-HDL Cholesterol	166	Desirable: <130 · Above Desirable: 130-159 · Borderline: 160-189	BORDERLINE HIGH	mg/dL

R4 Raw FHIR Resource

{
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  "id": "lipid-panel-2026-01-08",
  "meta": {
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    "lastUpdated": "2026-01-08T14:32:00.000Z",
    "source": "#moonlitic-vault-ingestion",
    "profile": [
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    ],
    "security": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
        "code": "R",
        "display": "Restricted"
      }
    ]
  },
  "status": "final",
  "category": [{
    "coding": [{
      "system": "http://terminology.hl7.org/CodeSystem/v2-0074",
      "code": "LAB",
      "display": "Laboratory"
    }]
  }],
  "code": {
    "coding": [{
      "system": "http://loinc.org",
      "code": "57698-3",
      "display": "Lipid panel with direct LDL"
    }],
    "text": "Comprehensive Lipid Panel"
  },
  "subject": {
    "reference": "Patient/maria-santos-a7b3c9",
    "display": "Maria Santos"
  },
  "effectiveDateTime": "2026-01-08T07:15:00-06:00",
  "issued": "2026-01-08T14:32:00-06:00",
  "performer": [{
    "reference": "Organization/quest-diagnostics",
    "display": "Quest Diagnostics"
  }],
  "result": [
    { "reference": "Observation/total-cholesterol-218", "display": "Total Cholesterol 218 mg/dL" },
    { "reference": "Observation/ldl-cholesterol-142", "display": "LDL Cholesterol 142 mg/dL" },
    { "reference": "Observation/hdl-cholesterol-52", "display": "HDL Cholesterol 52 mg/dL" },
    { "reference": "Observation/triglycerides-150", "display": "Triglycerides 150 mg/dL" }
  ],
  "conclusion": "Lipid panel shows borderline high total cholesterol and LDL. Improvement noted since Atorvastatin dose increase. Continue current regimen.",
  "_moonlitic": {
    "vaultId": "mvlt-a7b3c9-20260108-lip01",
    "consentGate": "TIER_1_CLINICAL",
    "encryption": "AES-256-GCM",
    "ledgerHash": "0x7f3a...b92e",
    "ingestionSource": "FHIR_R4_BULK_EXPORT",
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Data Provenance & Chain of Custody

Source System

Quest Diagnostics LIS → FHIR R4 Bulk Export

Ordering Provider

Dr. Michael Chen, MD FACC · NPI: 1234567890

Specimen Collected

Jan 8, 2026 · 7:15 AM CT · Fasting specimen

Report Issued

Jan 8, 2026 · 2:32 PM CT

Moonlitic Vault Ingestion

Jan 8, 2026 · 3:01 PM CT · Auto-ingested via FHIR subscription

Consent Gate

Tier 1 — Clinical (patient-controlled, provider-visible)

Zero-Trust Security Audit Trail

Encryption: AES-256-GCM at rest & in transit

Ledger: Azure Confidential Ledger — immutable hash recorded

Access Log: 3 views (patient: 2, provider: 1) — all consented

Identity: CLEAR IAL2 biometric verified

Retention: Lifetime vault — beyond federal 5-6yr mandate

Fail Mode: Fail-closed — data inaccessible without valid consent + identity

Diagnostic Report — Lipid Panel