[1030] | 1 | Patient Summary Record Test Data Set #5
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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 | |Matthew Brown
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| 14 | |09/22/1965 16:48:25
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| 15 | |Male
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| 16 | |988730987
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| 17 | |Medical Record Number
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| 18 | |754 Sharp Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
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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: Pamela Jones, 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 | |Diagnosis
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| 34 | |250.02
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| 35 | |Diabetes Mellitus, Type 2
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| 36 | |Active
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| 37 | |07/17/2009
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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 | |06/05/2008
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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 | |44054006
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| 54 | |Diabetes Mellitus, Type 2
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| 55 | |Active
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| 56 | |07/17/2009
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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 | |06/05/2008
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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 | |----
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| 71 | |
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| 72 | |Product
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| 73 | |Generic Name
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| 74 | |Brand Name
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| 75 | |Strength
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| 76 | |Dose
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| 77 | |Route
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| 78 | |Frequency
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| 79 | |Date Started
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| 80 | |Status
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| 81 | |----
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| 82 | |205875
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| 83 | |Medication
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| 84 | |glyburide
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| 85 | |Diabeta
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| 86 | |2.5 mg
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| 87 | |1 Tablet
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| 88 | |PO
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| 89 | |Q AM
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| 90 | |07/17/2009
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| 91 | |Active
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| 92 | |----
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| 93 | |200801
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| 94 | |Medication
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| 95 | |furosemide
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| 96 | |Lasix
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| 97 | |20 mg
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| 98 | |1 Tablet
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| 99 | |PO
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| 100 | |BID
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| 101 | |06/05/2008
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| 102 | |Active
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| 103 | |----
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| 104 | |628958
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| 105 | |Medication
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| 106 | |potassium chloride
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| 107 | |Klor-Con
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| 108 | |10 mEq
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| 109 | |1 Tablet
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| 110 | |PO
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| 111 | |BID
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| 112 | |06/05/2008
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| 113 | |Active
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| 114 | |----
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| 115 | |}
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| 116 |
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| 117 | {| border="1"|
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| 118 | !colspan="5"|Medication Allergy List
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| 119 | |----
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| 120 | !scope="col"|Type
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| 121 | !scope="col"|SNOMED Code
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| 122 | !scope="col"|Medication/Agent
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| 123 | !scope="col"|Reaction
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| 124 | !scope="col"|Date Recorded
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| 125 | |----
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| 126 | |Drug Allergy
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| 127 | |294506009
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| 128 | |Ampicillin
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| 129 | |Diarrhea, nausea, vomiting
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| 130 | |03/25/1997
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| 131 | |----
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| 132 | |Drug Allergy
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| 133 | |91939003
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| 134 | |Sulfonamides
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| 135 | |Hives, photosensitivity
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| 136 | |04/25/1989
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| 137 | |----
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| 138 | |}
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| 139 |
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| 140 | {| border="1"|
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| 141 | !colspan="5"|Diagnostic Test Results
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| 142 | |----
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| 143 | !scope="col"|Type
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| 144 | !scope="col"|LOINC Code
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| 145 | !scope="col"|Test (Normal Range)
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| 146 | !scope="col"|Result
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| 147 | !scope="col"|Date Performed
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| 148 | |----
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| 149 | |Chemistry
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| 150 | |14771-0
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| 151 | |Fasting Blood Glucose (70100 mg/dl)
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| 152 | |145 mg/dl
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| 153 | |07/17/2009
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| 154 | |----
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| 155 | |Hemistry
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| 156 | |2823-3
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| 157 | |Potassium (3.55.3 mg/dl)
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| 158 | |4.5 mg/dl
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| 159 | |07/17/2009
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| 160 | |----
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| 161 | |Chemistry
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| 162 | |14927-8
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| 163 | |Triglycerides (<150 mg/dl)
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| 164 | |187 mg/dl
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| 165 | |07/17/2009
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| 166 | |----
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| 167 | |42272-5
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| 168 | |Imaging
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| 169 | |Chest X-ray, PA & Lateral
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| 170 | |The heart outline is normal<br>and the hilar and<br>mediastinal vessels are of<br>normal appearance
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| 171 | |07/17/2009
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| 172 | |----
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