1 | Patient Summary Record Test Data Set #4
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2 |
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3 | {| border="1"|
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4 | !colspan="6"|Patient
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5 | |----
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6 | !scope="col"|Name
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7 | !scope="col"|Date/Time of Birth
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8 | !scope="col"|Gender
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9 | !scope="col"|Identification Number
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10 | !scope="col"|Identification Number Type
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11 | !scope="col"|Address/Phone
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12 | |----
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13 | |Sally Eckerd
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14 | |08/08/1962 18:25:59
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15 | |Female
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16 | |998877799
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17 | |Medical Record Number
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18 | |754 Samuel Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-2981
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19 | |----
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20 | |}
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21 |
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22 | Source for all data for this patient: Mark Payne, MD
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23 |
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24 | {| border="1"|
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25 | !colspan="6"|Problem List
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26 | |----
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27 | !scope="col"|Type
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28 | !scope="col"|ICD-9 Code
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29 | !scope="col"|Patient Problem
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30 | !scope="col"|Status
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31 | !scope="col"|Date Diagnosed
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32 | |----
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33 | |Condition
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34 | |272.4
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35 | |Hyperlipidemia
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36 | |Active
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37 | |07/05/2006
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38 | |----
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39 | |Symptom
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40 | |401.9
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41 | |Hypertension, Essential
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42 | |Active
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43 | |07/05/2006
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44 | |----
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45 | |----
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46 | !scope="col"|Type
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47 | !scope="col"|SNOMED Code*
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48 | !scope="col"|Patient Problem
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49 | !scope="col"|Status
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50 | !scope="col"|Date Diagnosed
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51 | |----
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52 | |Disorder
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53 | |55822004
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54 | |Hyperlipidemia
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55 | |Active
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56 | |07/05/2006
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57 | |----
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58 | |Disorder
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59 | |59621000
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60 | |Essential Hypertension
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61 | |Active
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62 | |07/05/2006
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63 | |----
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64 | |}
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65 |
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66 | {| border="1"|
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67 | !colspan="10"|Medication List
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68 | |----
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69 | !scope="col"|RxNorm Code
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70 | !scope="col"|Product
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71 | !scope="col"|Generic Name
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72 | !scope="col"|Brand Name
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73 | !scope="col"|Strength
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74 | !scope="col"|Dose
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75 | !scope="col"|Route
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76 | !scope="col"|Frequency
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77 | !scope="col"|Date Started
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78 | !scope="col"|Status
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79 | |----
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80 | |617314
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81 | |Medication
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82 | |atorvastatin calcium
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83 | |Lipitor
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84 | |10 mg
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85 | |1 Tablet
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86 | |PO
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87 | |Q Day
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88 | |07/05/2006
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89 | |Active
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90 | |----
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91 | |200801
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92 | |Medication
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93 | |furosemide
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94 | |Lasix
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95 | |20 mg
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96 | |1 Tablet
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97 | |PO
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98 | |BID
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99 | |07/05/2006
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100 | |Active
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101 | |----
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102 | |628958
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103 | |Medication
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104 | |potassium chloride
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105 | |Klor-Con
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106 | |10 mEq
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107 | |1 Tablet
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108 | |PO
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109 | |BID
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110 | |07/05/2006
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111 | |Active
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112 | |----
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113 | |}
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114 |
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115 | {| border="1"|
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116 | !colspan="5"|Medication Allergy List
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117 | |----
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118 | !scope="col"|Type
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119 | !scope="col"|SNOMED Code
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120 | !scope="col"|Medication/Agent
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121 | !scope="col"|Reaction
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122 | !scope="col"|Date Recorded
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123 | |----
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124 | |Drug Allergy
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125 | |91936005
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126 | |Penicillin
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127 | |Rash and anaphylaxis
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128 | |05/22/1998
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129 | |----
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130 | |Drug Allergy
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131 | |293597001
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132 | |Codeine
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133 | |Hives
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134 | |02/17/1992
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135 | |----
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136 | |}
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137 |
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138 | {| border="1"|
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139 | !colspan="5"|Diagnostic Test Results
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140 | |----
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141 | !scope="col"|Type
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142 | !scope="col"|LOINC Code
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143 | !scope="col"|Test (Normal Range)
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144 | !scope="col"|Result
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145 | !scope="col"|Date Performed
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146 | |----
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147 | |Chemistry
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148 | |2823-3
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149 | |Potassium (3.55.3 mg/dl)
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150 | |4.5 mg/dl
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151 | |07/15/2009
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152 | |----
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153 | |Chemistry
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154 | |14647-2
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155 | |Total cholesterol (<200 mg/dl)
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156 | |180 mg/dl
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157 | |07/15/2009
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158 | |----
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159 | |Chemistry
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160 | |14646-4
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161 | |HDL cholesterol (?40 mg/dl)
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162 | |38 mg/dl
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163 | |07/15/2009
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164 | |----
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165 | |Chemistry
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166 | |2089-1
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167 | |LDL cholesterol (<100 mg/dl)
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168 | |120 mg/dl
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169 | |07/15/2009
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170 | |----
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171 | |Chemistry
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172 | |14927-8
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173 | |Triglycerides (<150 mg/dl)
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174 | |187 mg/dl
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175 | |07/15/2009
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176 | |----
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177 | |Imaging
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178 | |42272-5
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179 | |Chest X-ray, PA & Lateral
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180 | |The heart outline is normal<br>and the hilar and<br>mediastinal vessels are of<br>normal appearance
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181 | |07/15/2009
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182 | |----
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183 | |}
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184 |
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185 |
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