Patient Summary Record Test Data – Set #3 

Patient 
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone 
Lorraine|04/16/1957|Female|967385998|Medical Record Number|1020 Stuart Street 
Blevins|20:15:35|Morton, 

“Source” for all data for this patient: Louis Randolph, MD 

Problem List 
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed 
Diagnosis|715.35|Right hip osteoarthritis|Resolved|02/12/2010 
Finding|414.01|Coronary Artery Disease (CAD)|Chronic|05/05/2002 

Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed 
Disorder|239872002|Right hip osteoarthritis|Resolved|02/12/2010 
Disorder|53741008|Coronary Arteriosclerosis|Chronic|05/05/2002 

Medication List 
RxNorm 
|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status 
Code 
855320|Medication|warfarin|Coumadin|3 mg|1 Tablet|PO|QD|02/15/2010|Active 
209613|Medication|bisacodyl|Dulcolax|5 mg|1 Tablet|PO|QD|02/15/2010|Active 
309362|Medication|clopidogrel|Plavix|75 mg|1 Tablet|PO|QD|05/15/2002|Active 
197361|Medication|amlodipine|Norvasc|5 mg|1 Tablet|PO|QD|07/15/2009|Active 

Medication Allergy List 
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded 
Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|06/06/1998 
Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|04/25/1994 

Diagnostic Test Results 
Type|LOINC Code|Test (Normal Range)|Result|Date Performed 
Subchondral sclerosis, 
37721-8 
Imaging|X-ray, 2 views, Right Hip|increased density in|02/12/2010 
subchondral bone 
No disease is seen in the lung 
Imaging|24648-8|Chest X-ray, PA|06/05/2009 
fields or pleura 
Hemoglobin (male: 14-18 g/dl 
Hematology|718-7|11.2 g/dl|06/05/2009 
female: 12-16 g/dl) 
Hematocrit (male: 40-54% 
Hematology|4544-3|34%|06/05/2009 
female: 36-48%) 
 Type|LOINC Code|Test (Normal Range)|Result|Date Performed 
Prothrombin Time/ International Normalized Ratio (PT/INR) 
Coagulation|34714-6|3.1|06/05/2009 
(2.5 – 3.5) 

Procedure List 
Type|ICD-9 Code|Procedure|Status|Date Performed 
Surgical|81.51|Total Hip Replacement, Right|Completed|02/14/2010 
Cardiac|37.21|Cardiac catheterization|Completed|05/05/2002 

Type|CPT Code*|Procedure|Status|Date Performed 
Surgical|27130|Total Hip Replacement, Right|Completed|02/14/2010 
Cardiac|93501|Cardiac catheterization|Completed|05/05/2002