| [1019] | 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 Male 988730987 Medical Record Number 754 Sharp Street
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| 6 | 16:48:25 Aurora,
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| 7 | Colorado 80011
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| 8 | 303-544-9988
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| 9 |
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| 10 | Source for all data for this patient: Pamela Jones, MD
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| 11 |
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| 12 | Problem List
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| 13 | Type ICD-9 Code Patient Problem Status Date Diagnosed
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| 14 | Diagnosis 250.02 Diabetes Mellitus, Type 2 Active 07/17/2009
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| 15 | Symptom 401.9 Hypertension, Essential Active 06/05/2008
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| 16 |
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| 17 | Type SNOMED Code* Patient Problem Status Date Diagnosed
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| 18 | Disorder 44054006 Diabetes Mellitus, Type 2 Active 07/17/2009
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| 19 | Disorder 59621000 Essential Hypertension Active 06/05/2008
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| 20 |
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| 21 | Medication List
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| 22 | RxNorm
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| 23 | Product Generic Name Brand Name Strength Dose Route Frequency Date Started Status
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| 24 | Code
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| 25 | 205875 Medication glyburide Diabeta 2.5 mg 1 Tablet PO Q AM 07/17/2009 Active
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| 26 | 200801 Medication furosemide Lasix 20 mg 1 Tablet PO BID 06/05/2008 Active
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| 27 | potassium
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| 28 | 628958 Medication Klor-Con 10 mEq 1 Tablet PO BID 06/05/2008 Active
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| 29 | chloride
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| 30 | Medication Allergy List
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| 31 | Type SNOMED Code Medication/Agent Reaction Date Recorded
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| 32 | Drug Allergy 294506009 Ampicillin Diarrhea, nausea, vomiting 03/25/1997
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| 33 | Drug Allergy 91939003 Sulfonamides Hives, photosensitivity 04/25/1989
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| 34 |
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| 35 | Diagnostic Test Results
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| 36 | Type LOINC Code Test (Normal Range) Result Date Performed
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| 37 | Chemistry 14771-0 Fasting Blood Glucose (70100 mg/dl) 145 mg/dl 07/17/2009
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| 38 |
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| 39 | Hemistry 2823-3 Potassium (3.55.3 mg/dl) 4.5 mg/dl 07/17/2009
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| 40 | Chemistry 14927-8 Triglycerides (<150 mg/dl) 187 mg/dl 07/17/2009
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| 41 |
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| 42 | The heart outline is normal
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| 43 | 42272-5 and the hilar and
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| 44 | Imaging Chest X-ray, PA & Lateral mediastinal vessels are of 07/17/2009
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| 45 |
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| 46 | normal appearance
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