| [1030] | 1 | Patient Summary Record Test Data Set #3
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| 2 |
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| 3 | Patient
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| 4 | Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
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| 5 | Jane Andrews|05/12/1955 09:30:15|Female|9639275266|Medical Record Number|355 1st Street<br>Fargo,<br>North Dakota 54102<br>701-366-8364
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| 6 |
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| 7 | Source for all data for this patient: Robert James, MD
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| 8 |
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| 9 | Problem List
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| 10 | Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
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| 11 | Diagnosis|486|Pneumonia|Resolved|01/22/2010
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| 12 | Diagnosis|496.0|Chronic Obstructive Pulmonary Disease|Chronic|10/10/1999
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| 13 | Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
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| 14 | Disorder|233604007|Pneumonia|Resolved|01/22/2010
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| 15 | Disorder|13645005|Chronic Obstructive Lung Disease|Chronic|10/10/1999
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| 16 |
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| 17 | Medication List
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| 18 | RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
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| 19 | 308460|Medication|azithromycin|Azithromycin|250 mg|1 Tablet|PO|QD|01/22/2010|No Longer Active
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| 20 | 836370|Medication|ipratropium bromide monhydrate|Atrovent Inhaler|18 mcg/puff|2 Puffs|Inhaled|QID|10/10/1999|Active
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| 21 | 630208|Medication|albuterol sulfate|Albuterol Inhaler|2.5 mg/3ml|2 Puffs|Inhaled|Q 4 PRN|10/10/1999|Active
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| 22 |
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| 23 | Medication Allergy List
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| 24 | Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
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| 25 | Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|06/10/2009
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| 26 | Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1988
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| 27 |
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| 28 | Diagnostic Test Results
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| 29 | Type|LOINC Code|Test (Normal Range)|Result|Date Performed
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| 30 | 42272-5|Imaging|Chest X-ray, PA & Lateral|Hyperinflated lungs with<br>flattened diaphragm and<br>central pulmonary artery<br>enlargement|02/15/2010
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| 31 | Hematology|718-7|Hemoglobin (male: 14-18 g/dl<br>female: 12-16 g/dl)|16 g/dl|12/22/2009
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| 32 | Hematology|4544-3|Hematocrit (male: 40-54%<br>female: 36-48%)| 45%|12/22/2009
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| 33 | Cardiology|34534-8|Electrocardiogram|Normal Sinus Rhythm|12/22/2009
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