NIST-EP-Patient-5-Visit-1

Test Procedure for §170.304.h Clinical Summaries  APPROVED (Pending) Version 1.0  July 21, 2010  

TD170.304.h.: Clinical summaries

• indicates alternative standard code per certification criteria

Clinical Summaries Test Data – Set #5|Office Visit #1 for Johnathan Stone

Patient
Name	Date/Time of Birth	Gender	Identification Number	Identification Number Type	Address/Phone
Johnathan Stone	11/12/1966 08:18:08	Male	988772587	Medical Record Number	937 Sutter Street Aurora, Colorado 80011 303-544-9988

“Source” for all data for this patient: Samuel Johnston, MD

Problem List
Type	ICD-9 Code	Patient Problem	Status	Date Diagnosed
Diagnosis	250.02	Diabetes Mellitus, Type 2	Active	07/17/2010
Type	SNOMED Code*	Patient Problem	Status	Date Diagnosed
Disorder	44054006	Diabetes Mellitus, Type 2	Active	07/17/2010

Medication List
RxNorm Code	Product	Generic Name	Brand Name	Strength	Dose	Route	Frequency	Date Started	Status
205875	Medication	glyburide	Diabeta	2.5 mg	1 Tablet	PO	Q AM	07/17/2010	Active

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	LOINC	Fasting Blood Glucose (70–100 mg/dl)	120 mg/dl	07/17/2010

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