Patient Summary Record Test Data – Set #5 

Patient 
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone 
Christine Taylor|09/22/1965 16:48:25|Female|9787478034|Medical Record Number|754 Angel Street Marshalltown Iowa 50158 641-544-9988 

“Source” for all data for this patient: Kathryn Thomson, MD 

Problem List 
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed 
Diagnosis|540.0|Acute Appendicitis|Resolved|01/09/2010 
Diagnosis|434.91|Cerebrovascular Accident (Stroke)|Resolved|07/09/2009 
Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|03/30/2009 
Symptom|401.9|Hypertension, Essential|Chronic|02/25/2008 
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed 
Disorder|74400008|Appendicitis|Resolved|01/09/2010 
Disorder|230690007|Cerebrovascular Accident (Stroke)|Resolved|07/09/2009 
Disorder|44054006|Diabetes Mellitus, Type 2|Active|03/30/2009 
Disorder|59621000|Essential Hypertension|Chronic|02/25/2008 

Medication List 
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status 
309362|Medication|clopidogrel|Plavix|75 mg|1 Tablet|PO|QD|07/15/2009|Active 
205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|03/30/2009|Active 
209834|Medication|docusate|Colace|100 mg|1 Capsule|PO|BID|03/30/2009|Active 
200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|02/25/2008|Active 
628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|02/25/2008|Active 
884175|Medication|clonidine hydrochloride|Catapres|0.1 mg|1 Tablet|PO|BID|02/25/2008|Active 

Medication Allergy List 
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded 
Drug Allergy|293620004|Indomethacin|Rash, dizziness, headache|06/05/2008 
Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|05/25/1997 
Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|08/25/1989 

Diagnostic Test Results 
Type|LOINC Code|Test (Normal Range)|Result|Date Performed 
Chemistry|14771-0|Fasting Blood Glucose (70–100 mg/dl)|126 mg/dl|07/15/2010 
Chemistry|2823-3|Potassium (3.5–5.3 mg/dl)|4.3 mg/dl|07/15/2010 
Chemistry|14927-8|Triglycerides (<150 mg/dl)|178 mg/dl|07/15/2010 
Imaging|42272-5|Chest X-ray, PA & Lateral|The heart outline is normal<br> and the hilar and mediastinal<br> vessels are of normal appearance|02/25/2008 

Procedure List 
Type|ICD-9 Code|Procedure|Status|Date Performed 
Surgical|47.09|Emergency Appendectomy|Completed|01/09/2010 
Type|CPT Code*|Procedure|Status|Date Performed 
Surgical|44950|Emergency Appendectomy|Completed|01/09/2010