| 1 | Patient Summary Record Test Data Set #5
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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 | 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
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| 6 |
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| 7 | Source for all data for this patient: Pamela Jones, 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|250.02|Diabetes Mellitus, Type 2|Active|07/17/2009
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| 12 | Symptom|401.9|Hypertension, Essential|Active|06/05/2008
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| 13 | Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
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| 14 | Disorder|44054006|Diabetes Mellitus, Type 2|Active|07/17/2009
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| 15 | Disorder|59621000|Essential Hypertension|Active|06/05/2008
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| 16 |
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| 17 | Medication List
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| 18 | RxNorm Code
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| 19 | |Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
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| 20 | 205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|07/17/2009|Active
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| 21 | 200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|06/05/2008|Active
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| 22 | 628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|06/05/2008|Active
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| 23 |
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| 24 | Medication Allergy List
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| 25 | Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
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| 26 | Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/25/1997
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| 27 | Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1989
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| 28 |
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| 29 | Diagnostic Test Results
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| 30 | Type|LOINC Code|Test (Normal Range)|Result|Date Performed
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| 31 | Chemistry|14771-0|Fasting Blood Glucose (70100 mg/dl)|145 mg/dl|07/17/2009
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| 32 | Hemistry|2823-3|Potassium (3.55.3 mg/dl)|4.5 mg/dl|07/17/2009
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| 33 | Chemistry|14927-8|Triglycerides (<150 mg/dl)|187 mg/dl|07/17/2009
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| 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
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