NIST Ambulatory Test Patient 5

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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 16:48:25 Male 988730987 Medical Record Number 754 Sharp Street
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 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 07/17/2009 Active
200801 Medication furosemide Lasix 20 mg 1 Tablet PO BID 06/05/2008 Active
628958 Medication potassium chloride Klor-Con 10 mEq 1 Tablet PO BID 06/05/2008 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 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
42272-5 Imaging Chest X-ray, PA & Lateral The heart outline is normal
and the hilar and
mediastinal vessels are of
normal appearance 		07/17/2009

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