Patient Summary Record Test Data – Set #5 

Patient 
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone 
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 

“Source” for all data for this patient: Pamela Jones, MD 

Problem List 
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed 
Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|07/17/2009 
Symptom|401.9|Hypertension, Essential|Active|06/05/2008 
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed 
Disorder|44054006|Diabetes Mellitus, Type 2|Active|07/17/2009 
Disorder|59621000|Essential Hypertension|Active|06/05/2008 

Medication List 
RxNorm Code
|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status 
205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|07/17/2009|Active 
200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|06/05/2008|Active 
628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|06/05/2008|Active 

Medication Allergy List 
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded 
Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/25/1997 
Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1989 

Diagnostic Test Results 
Type|LOINC Code|Test (Normal Range)|Result|Date Performed 
Chemistry|14771-0|Fasting Blood Glucose (70–100 mg/dl)|145 mg/dl|07/17/2009 
Hemistry|2823-3|Potassium (3.5–5.3 mg/dl)|4.5 mg/dl|07/17/2009 
Chemistry|14927-8|Triglycerides (<150 mg/dl)|187 mg/dl|07/17/2009 
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