* indicates alternative standard code per certification criteria

Patient Summary Record Test Data – Set #1

{| border="1"|
!colspan="6"|Patient
|----
!scope="col"|Name
!scope="col"|Date/Time of Birth
!scope="col"|Gender
!scope="col"|Identification Number
!scope="col"|Identification Number Type
!scope="col"|Address/Phone
|----
|John D. Smith
|07/04/1960 10:15:02
|Male
|999999999
|Medical Record Number
|355 Maple Street <br>Williamsport, <br>Pennsylvania 17701 <br>570-837-8364
|----
|}

“Source” for all data for this patient: John Fitzgerald, MD

{| border="1"|
!colspan="6"|Problem List
|----
!scope="col"|Type
!scope="col"|ICD-9 Code
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Diagnosis
|250.02
|Diabetes Mellitus, Type 2
|Active
|09/16/2009
|----
|Condition
|272.4
|Hyperlipidemia
|Active
|05/05/2002
|----
|Finding
|414.01
|Coronary Artery Disease (CAD)
|Chronic
|05/05/2002
|----
|Symptom
|401.9
|Hypertension, Essential
|Active
|05/05/2002
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|44054006
|Diabetes Mellitus, Type 2
|Active
|09/16/2009
|----
|Disorder
|55822004
|Hyperlipidemia
|Active
|05/05/2002
|----
|Disorder
|53741008
|Coronary Arteriosclerosis
|Chronic
|05/05/2002
|----
|Disorder
|59621000
|Essential Hypertension
|Active
|05/05/2002
|----
|}

{| border="1"|
!colspan="10"|Medication List
|----
!scope="col"|RxNorm Code
!scope="col"|Product
!scope="col"|Generic Name
!scope="col"|Brand Name
!scope="col"|Strength
!scope="col"|Dose
!scope="col"|Route
!scope="col"|Frequency
!scope="col"|Date Started
!scope="col"|Status
|----
|205875
|Medication
|glyburide
|Diabeta
|2.5 mg
|1 Tablet
|PO
|Q AM
|09/16/2009
|Active
|----
|617314
|Medication
|atorvastatin calcium
|Lipitor
|10 mg
|1 Tablet
|PO
|Q Day
|05/05/2002
|Active
|----
|200801
|Medication
|furosemide
|Lasix
|20 mg
|1 Tablet
|PO
|BID
|05/05/2002
|Active
|----
|628958
|Medication
|potassium chloride
|Klor-Con
|10 mEq
|1 Tablet
|PO
|BID
|05/05/2002
|Active
|----
|}

{| border="1"|
!colspan="5"|Medication Allergy List
|----
!scope="col"|Type
!scope="col"|SNOMED Code
!scope="col"|Medication/Agent
!scope="col"|Reaction
!scope="col"|Date Recorded
|----
|Drug Allergy
|293597001
|Codeine
|Hives
|06/27/1996
|----
|Drug Allergy
|294506009
|Ampicillin
|Diarrhea, nausea, vomiting
|03/15/1994
|----
|}

{| border="1"|
!colspan="5"|Diagnostic Test Results
|----
!scope="col"|Type
!scope="col"|LOINC Code
!scope="col"|Test (Normal Range)
!scope="col"|Result
!scope="col"|Date Performed
|----
|Chemistry
|14771-0
|Fasting Blood Glucose (70–100 mg/dl)
|178 mg/dl
|09/16/2009
|----
|Chemistry
|14682-9
|Creatinine (0.5–1.4 mg/dl)
|1.0 mg/dl
|09/16/2009
|----
|Chemistry
|14937-7
|BUN (7–30 mg/dl)
|18 mg/dl
|09/16/2009
|----
|Chemistry
|2951-2
|Sodium (135–146 mg/dl)
|141 mg/dl
|09/16/2009
|----
|Chemistry
|2823-3
|Potassium (3.5–5.3 mg/dl)
|4.3 mg/dl
|09/16/2009
|----
|Chemistry
|14647-2
|Total cholesterol (<200 mg/dl)
|162 mg/dl
|09/16/2009
|----
|Chemistry
|14646-4
|HDL cholesterol (?40 mg/dl)
|43 mg/dl
|09/16/2009
|----
|Chemistry
|2089-1
|LDL cholesterol (<100 mg/dl)
|84 mg/dl
|09/16/2009
|----
|Chemistry
|14927-8
|Triglycerides (<150 mg/dl)
|177 mg/dl
|09/16/2009
|----
|Imaging
|24648-8
|Chest X-ray, PA
|No disease is seen in the<br>lung fields or pleura 
|09/16/2009
|----
|}