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 Female 9787478034 Medical Record Number 754 Angel Street 16:48:25 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 Product Generic Name Brand Name Strength Dose Route Frequency Date Started Status Code 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 potassium 628958 Medication Klor-Con 10 mEq 1 Tablet PO BID 02/25/2008 Active chloride RxNorm Product Generic Name Brand Name Strength Dose Route Frequency Date Started Status Code clonidine 884175 Medication Catapres 0.1 mg 1 Tablet PO BID 02/25/2008 Active hydrochloride 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 The heart outline is normal 42272-5 and the hilar and Imaging Chest X-ray, PA & Lateral mediastinal vessels are of 02/25/2008 normal appearance 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