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 Male 988730987 Medical Record Number 754 Sharp Street 16:48:25 Aurora, Colorado 80011 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 Product Generic Name Brand Name Strength Dose Route Frequency Date Started Status Code 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 potassium 628958 Medication Klor-Con 10 mEq 1 Tablet PO BID 06/05/2008 Active chloride 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 The heart outline is normal 42272-5 and the hilar and Imaging Chest X-ray, PA & Lateral mediastinal vessels are of 07/17/2009 normal appearance