41 lines
1.4 KiB
Plaintext
41 lines
1.4 KiB
Plaintext
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Test<EFBFBD>Procedure<EFBFBD>for<EFBFBD><EFBFBD>170.304.h<>Clinical<61>Summaries<65>
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APPROVED<EFBFBD>(Pending)<29>Version<6F>1.0<EFBFBD><EFBFBD>July<EFBFBD>21,<2C>2010<31><30>
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TD170.304.h.: Clinical summaries
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* indicates alternative standard code per certification criteria
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Clinical Summaries Test Data <20> Set #1|Office Visit #1 for Jonas Barnaby
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Patient
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Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
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Jonas Barnaby|07/14/1961|Male|969988999|Medical Record Number|478 Charles Street,
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12:30:24|Williamsport,
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Pennsylvania|17701
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570-857-8593
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<EFBFBD>Source<EFBFBD> for all data for this patient: Marcus Welby, MD
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Problem List
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Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
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Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|07/20/2010
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Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
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Disorder|44054006|Diabetes Mellitus, Type 2|Active|07/20/2010
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Medication List
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RxNorm
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|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
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Code
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205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|07/20/2010|Active
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Medication Allergy List
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Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
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Drug Allergy|293597001|Codeine|Hives|06/27/1996
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Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/15/1994
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Diagnostic Test Results
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Type|LOINC Code|Test (Normal Range)|Result|Date Performed
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Chemistry|14771-0|Fasting Blood Glucose (70<37>100 mg/dl)|178 mg/dl|07/20/2010
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