[1030] | 1 | Patient Summary Record Test Data Set #5
|
---|
| 2 |
|
---|
| 3 | Patient
|
---|
| 4 | Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
|
---|
| 5 | Matthew Brown|09/22/1965 16:48:25|Male|988730987|Medical Record Number|754 Sharp Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
|
---|
| 6 |
|
---|
| 7 | Source for all data for this patient: Pamela Jones, MD
|
---|
| 8 |
|
---|
| 9 | Problem List
|
---|
| 10 | Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
|
---|
| 11 | Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|07/17/2009
|
---|
| 12 | Symptom|401.9|Hypertension, Essential|Active|06/05/2008
|
---|
| 13 | Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
|
---|
| 14 | Disorder|44054006|Diabetes Mellitus, Type 2|Active|07/17/2009
|
---|
| 15 | Disorder|59621000|Essential Hypertension|Active|06/05/2008
|
---|
| 16 |
|
---|
| 17 | Medication List
|
---|
| 18 | RxNorm Code
|
---|
| 19 | |Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
|
---|
| 20 | 205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|07/17/2009|Active
|
---|
| 21 | 200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|06/05/2008|Active
|
---|
| 22 | 628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|06/05/2008|Active
|
---|
| 23 |
|
---|
| 24 | Medication Allergy List
|
---|
| 25 | Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
|
---|
| 26 | Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/25/1997
|
---|
| 27 | Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1989
|
---|
| 28 |
|
---|
| 29 | Diagnostic Test Results
|
---|
| 30 | Type|LOINC Code|Test (Normal Range)|Result|Date Performed
|
---|
| 31 | Chemistry|14771-0|Fasting Blood Glucose (70100 mg/dl)|145 mg/dl|07/17/2009
|
---|
| 32 | Hemistry|2823-3|Potassium (3.55.3 mg/dl)|4.5 mg/dl|07/17/2009
|
---|
| 33 | Chemistry|14927-8|Triglycerides (<150 mg/dl)|187 mg/dl|07/17/2009
|
---|
| 34 | 42272-5|Imaging|Chest X-ray, PA & Lateral|The heart outline is normal<br>and the hilar and<br>mediastinal vessels are of<br>normal appearance|07/17/2009
|
---|