Correct all of the office visit csv files and rename per the new naming scheme.

Generate wiki text file output for all office visit files
This commit is contained in:
mish 2010-11-25 23:17:56 +00:00
parent 0b30c0d292
commit a2fa042af5
19 changed files with 1680 additions and 118 deletions

View File

@ -1,118 +1,125 @@
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 #1|Office Visit #1 for Jonas Barnaby
{| 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
|----
|Jonas Barnaby
|07/14/1961 12:30:24
|Male
|969988999
|Medical Record Number
|478 Charles Street,<br>Williamsport,<br>Pennsylvania 17701<br>570-857-8593
|----
|}
“Source” for all data for this patient: Marcus Welby, 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
|07/20/2010
|----
|----
!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
|07/20/2010
|----
|}
{| border="1"|
!colspan="10"|Medication List
|----
!scope="col"|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|07/20/2010|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 (70100 mg/dl)
|178 mg/dl
|07/20/2010
|----
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 #1|Office Visit #1 for Jonas Barnaby
{| 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
|----
|Jonas Barnaby
|07/14/1961 12:30:24
|Male
|969988999
|Medical Record Number
|478 Charles Street,<br>Williamsport,<br>Pennsylvania 17701<br>570-857-8593
|----
|}
“Source” for all data for this patient: Marcus Welby, 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
|07/20/2010
|----
|----
!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
|07/20/2010
|----
|}
{| 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
|07/20/2010
|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 (70100 mg/dl)
|178 mg/dl
|07/20/2010
|----

View File

@ -0,0 +1,143 @@
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 #1|Office Visit #2 for Jonas Barnaby
{| 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
|----
|Jonas Barnaby
|07/14/1961 12:30:24
|Male
|969988999
|Medical Record Number
|478 Charles Street,<br>Williamsport,<br>Pennsylvania 17701<br>570-857-8593
|----
|}
“Source” for all data for this patient: Marcus Welby, 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
|----
|Condition
|272.4
|Hyperlipidemia
|Active
|02/20/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|55822004
|Hyperlipidemia
|Active
|02/20/2010
|----
|}
{| 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
|----
|617314
|Medication
|atorvastatin calcium
|Lipitor
|10 mg
|1 Tablet
|PO
|Q Day
|02/20/2010
|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
|14647-2
|Total cholesterol (<200 mg/dl)
|262 mg/dl
|02/20/2010
|----
|Chemistry
|14646-4
|HDL cholesterol (?40 mg/dl)
|78 mg/dl
|02/20/2010
|----
|Chemistry
|2089-1
|LDL cholesterol (<100 mg/dl)
|184 mg/dl
|02/20/2010
|----
|Chemistry
|14927-8
|Triglycerides (<150 mg/dl)
|177 mg/dl
|02/20/2010
|----

View File

@ -0,0 +1,36 @@
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 #1|Office Visit #2 for Jonas Barnaby
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Jonas Barnaby|07/14/1961 12:30:24|Male|969988999|Medical Record Number|478 Charles Street,<br>Williamsport,<br>Pennsylvania 17701<br>570-857-8593
“Source” for all data for this patient: Marcus Welby, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Condition|272.4|Hyperlipidemia|Active|02/20/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|55822004|Hyperlipidemia|Active|02/20/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
617314|Medication|atorvastatin calcium|Lipitor|10 mg|1 Tablet|PO|Q Day|02/20/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|293597001|Codeine|Hives|06/27/1996
Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/15/1994
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Chemistry|14647-2|Total cholesterol (<200 mg/dl)|262 mg/dl|02/20/2010
Chemistry|14646-4|HDL cholesterol (?40 mg/dl)|78 mg/dl|02/20/2010
Chemistry|2089-1|LDL cholesterol (<100 mg/dl)|184 mg/dl|02/20/2010
Chemistry|14927-8|Triglycerides (<150 mg/dl)|177 mg/dl|02/20/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #1|Office Visit #2 for Jonas Barnaby
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Jonas Barnaby|07/14/1961 12:30:24|Male|969988999|Medical Record Number|478 Charles Street,<br>Williamsport,<br>Pennsylvania 17701<br>570-857-8593
9 “Source” for all data for this patient: Marcus Welby, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Condition|272.4|Hyperlipidemia|Active|02/20/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|55822004|Hyperlipidemia|Active|02/20/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 617314|Medication|atorvastatin calcium|Lipitor|10 mg|1 Tablet|PO|Q Day|02/20/2010|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|293597001|Codeine|Hives|06/27/1996
21 Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/15/1994
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Chemistry|14647-2|Total cholesterol (<200 mg/dl)|262 mg/dl|02/20/2010
25 Chemistry|14646-4|HDL cholesterol (?40 mg/dl)|78 mg/dl|02/20/2010
26 Chemistry|2089-1|LDL cholesterol (<100 mg/dl)|184 mg/dl|02/20/2010
27 Chemistry|14927-8|Triglycerides (<150 mg/dl)|177 mg/dl|02/20/2010

View File

@ -0,0 +1,125 @@
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 #2|Office Visit #1 for Robert Flint
{| 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
|----
|Robert Flint
|04/18/1983 20:18:04
|Male
|9813624798
|Medical Record Number
|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
|----
|}
“Source” for all data for this patient: Carl Roberts, 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
|493.00
|Asthma, unspecified
|Active
|07/19/2009
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|195967001
|Asthma
|Active
|07/19/2009
|----
|}
{| 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
|----
|206833
|Medication
|metaproterenol sulfate
|Alupent Inhalation Aerosol
|15 mg/ml
|2 Puffs
|Inhaled
|Q4h
|07/19/2009
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|08/10/2008
|----
|Drug Allergy
|293620004
|Indomethacin
|Nausea, vomiting, rash, dizziness, headache
|03/25/2003
|----
|}
{| 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
|----
|Imaging
|24648-8
|Chest X-ray, PA
|Increased bronchial wall markings, patchy infiltrates
|07/19/2009
|----

View File

@ -0,0 +1,33 @@
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 #2|Office Visit #1 for Robert Flint
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Robert Flint|04/18/1983 20:18:04|Male|9813624798|Medical Record Number|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
“Source” for all data for this patient: Carl Roberts, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Diagnosis|493.00|Asthma, unspecified|Active|07/19/2009
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|195967001|Asthma|Active|07/19/2009
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
206833|Medication|metaproterenol sulfate|Alupent Inhalation Aerosol|15 mg/ml|2 Puffs|Inhaled|Q4h|07/19/2009|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|08/10/2008
Drug Allergy|293620004|Indomethacin|Nausea, vomiting, rash, dizziness, headache|03/25/2003
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Imaging|24648-8|Chest X-ray, PA|Increased bronchial wall markings, patchy infiltrates|07/19/2009
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #2|Office Visit #1 for Robert Flint
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Robert Flint|04/18/1983 20:18:04|Male|9813624798|Medical Record Number|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
9 “Source” for all data for this patient: Carl Roberts, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Diagnosis|493.00|Asthma, unspecified|Active|07/19/2009
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|195967001|Asthma|Active|07/19/2009
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 206833|Medication|metaproterenol sulfate|Alupent Inhalation Aerosol|15 mg/ml|2 Puffs|Inhaled|Q4h|07/19/2009|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|08/10/2008
21 Drug Allergy|293620004|Indomethacin|Nausea, vomiting, rash, dizziness, headache|03/25/2003
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Imaging|24648-8|Chest X-ray, PA|Increased bronchial wall markings, patchy infiltrates|07/19/2009

View File

@ -0,0 +1,133 @@
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 #2|Office Visit #2 for Robert Flint
{| 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
|----
|Robert Flint
|04/18/1983 20:18:04
|Male
|9813624798
|Medical Record Number
|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
|----
|}
“Source” for all data for this patient: Carl Roberts, 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
|03/10/2010
|----
|----
!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
|03/10/2010
|----
|}
{| 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
|03/10/2010
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|08/10/2008
|----
|Drug Allergy
|293620004
|Indomethacin
|Nausea, vomiting, rash, dizziness, headache
|03/25/2003
|----
|}
{| 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 (70100 mg/dl)
|150 mg/dl
|03/10/2010
|----
|Imaging
|24648-8
|Chest X-ray, PA
|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance
|03/10/2010
|----
|}

View File

@ -0,0 +1,35 @@
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 #2|Office Visit #2 for Robert Flint
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Robert Flint|04/18/1983 20:18:04|Male|9813624798|Medical Record Number|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
“Source” for all data for this patient: Carl Roberts, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|03/10/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|44054006|Diabetes Mellitus, Type 2|Active|03/10/2010
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|03/10/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|08/10/2008
Drug Allergy|293620004|Indomethacin|Nausea, vomiting, rash, dizziness, headache|03/25/2003
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Chemistry|14771-0|Fasting Blood Glucose (70100 mg/dl)|150 mg/dl|03/10/2010
Imaging|24648-8|Chest X-ray, PA|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance|03/10/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #2|Office Visit #2 for Robert Flint
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Robert Flint|04/18/1983 20:18:04|Male|9813624798|Medical Record Number|747 Market Street,<br>Morton,<br>Illinois 61550<br>309-365-8298
9 “Source” for all data for this patient: Carl Roberts, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|03/10/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|44054006|Diabetes Mellitus, Type 2|Active|03/10/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|03/10/2010|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|08/10/2008
21 Drug Allergy|293620004|Indomethacin|Nausea, vomiting, rash, dizziness, headache|03/25/2003
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Chemistry|14771-0|Fasting Blood Glucose (70–100 mg/dl)|150 mg/dl|03/10/2010
25 Imaging|24648-8|Chest X-ray, PA|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance|03/10/2010

View File

@ -0,0 +1,131 @@
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 #3|Office Visit #1 for Barbara Simpson
{| 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
|----
|Barbara Simpson
|10/12/1956 19:47:01
|Female
|9688675266
|Medical Record Number
|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
|----
|}
“Source” for all data for this patient: Robert James, 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
|486
|Pneumonia
|Active
|07/02/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|233604007
|Pneumonia
|Active
|07/02/2010
|----
|}
{| 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
|----
|308460
|Medication
|azithromycin
|Azithromycin
|250 mg
|1 Tablet
|PO
|QD
|07/02/2010
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|06/10/2009
|----
|Drug Allergy
|91939003
|Sulfonamides
|Hives, photosensitivity
|04/25/1988
|----
|}
{| 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
|----
|Imaging
|42272-5
|Chest X-ray, PA & Lateral
|Bilateral Pneumonia
|07/02/2010
|----
|Cardiology
|34534-8
|Electrocardiogram
|Sinus Tachycardia
|07/02/2010
|----

View File

@ -0,0 +1,34 @@
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 #3|Office Visit #1 for Barbara Simpson
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Barbara Simpson|10/12/1956 19:47:01|Female|9688675266|Medical Record Number|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
“Source” for all data for this patient: Robert James, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Diagnosis|486|Pneumonia|Active|07/02/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|233604007|Pneumonia|Active|07/02/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
308460|Medication|azithromycin|Azithromycin|250 mg|1 Tablet|PO|QD|07/02/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|06/10/2009
Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1988
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Imaging|42272-5|Chest X-ray, PA & Lateral|Bilateral Pneumonia|07/02/2010
Cardiology|34534-8|Electrocardiogram|Sinus Tachycardia|07/02/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #3|Office Visit #1 for Barbara Simpson
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Barbara Simpson|10/12/1956 19:47:01|Female|9688675266|Medical Record Number|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
9 “Source” for all data for this patient: Robert James, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Diagnosis|486|Pneumonia|Active|07/02/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|233604007|Pneumonia|Active|07/02/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 308460|Medication|azithromycin|Azithromycin|250 mg|1 Tablet|PO|QD|07/02/2010|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|06/10/2009
21 Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1988
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Imaging|42272-5|Chest X-ray, PA & Lateral|Bilateral Pneumonia|07/02/2010
25 Cardiology|34534-8|Electrocardiogram|Sinus Tachycardia|07/02/2010

View File

@ -0,0 +1,148 @@
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 #3|Office Visit #2 for Barbara Simpson
{| 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
|----
|Barbara Simpson
|10/12/1956 19:47:01
|Female
|9688675266
|Medical Record Number
|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
|----
|}
“Source” for all data for this patient: Robert James, 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
|496.0
|Chronic Obstructive Pulmonary Disease
|Chronic
|02/10/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|13645005
|Chronic Obstructive Lung Disease
|Chronic
|02/10/2010
|----
|}
{| 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
|----
|836370
|Medication
|ipratropium bromide monohydrate
|Atrovent Inhaler
|18 mcg/puff
|2 Puffs
|Inhaled
|QID
|02/10/2010
|Active
|----
|630208
|Medication
|albuterol sulfate
|Albuterol Inhaler
|2.5 mg/3ml
|2 Puffs
|Inhaled
|Q 4 hours as needed
|02/10/2010
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|06/10/2009
|----
|Drug Allergy
|91939003
|Sulfonamides
|Hives, photosensitivity
|04/25/1988
|----
|}
{| 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
|----
|Imaging
|42272-5
|Chest X-ray, PA & Lateral
|Hyperinflated lungs with flattened diaphragm and central pulmonary artery enlargement
|02/10/2010
|----
|Hematology
|718-7
|Hemoglobin (male: 14-18 g/dl female: 12-16 g/dl)
|16 g/dl
|02/10/2010
|----
|Hematology
|4544-3
|Hematocrit (male: 40-54% female: 36-48%)
|45%
|02/10/2010
|----

View File

@ -0,0 +1,36 @@
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 #3|Office Visit #2 for Barbara Simpson
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Barbara Simpson|10/12/1956 19:47:01|Female|9688675266|Medical Record Number|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
“Source” for all data for this patient: Robert James, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Diagnosis|496.0|Chronic Obstructive Pulmonary Disease|Chronic|02/10/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|13645005|Chronic Obstructive Lung Disease|Chronic|02/10/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
836370|Medication|ipratropium bromide monohydrate|Atrovent Inhaler|18 mcg/puff|2 Puffs|Inhaled|QID|02/10/2010|Active
630208|Medication|albuterol sulfate|Albuterol Inhaler|2.5 mg/3ml|2 Puffs|Inhaled|Q 4 hours as needed|02/10/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|06/10/2009
Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1988
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Imaging|42272-5|Chest X-ray, PA & Lateral|Hyperinflated lungs with flattened diaphragm and central pulmonary artery enlargement|02/10/2010
Hematology|718-7|Hemoglobin (male: 14-18 g/dl female: 12-16 g/dl)|16 g/dl|02/10/2010
Hematology|4544-3|Hematocrit (male: 40-54% female: 36-48%)|45%|02/10/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #3|Office Visit #2 for Barbara Simpson
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Barbara Simpson|10/12/1956 19:47:01|Female|9688675266|Medical Record Number|996 Dalton Street,<br>Fargo,<br>North Dakota 54102<br>701-366-5534
9 “Source” for all data for this patient: Robert James, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Diagnosis|496.0|Chronic Obstructive Pulmonary Disease|Chronic|02/10/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|13645005|Chronic Obstructive Lung Disease|Chronic|02/10/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 836370|Medication|ipratropium bromide monohydrate|Atrovent Inhaler|18 mcg/puff|2 Puffs|Inhaled|QID|02/10/2010|Active
18 630208|Medication|albuterol sulfate|Albuterol Inhaler|2.5 mg/3ml|2 Puffs|Inhaled|Q 4 hours as needed|02/10/2010|Active
19 Medication Allergy List
20 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
21 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|06/10/2009
22 Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1988
23 Diagnostic Test Results
24 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
25 Imaging|42272-5|Chest X-ray, PA & Lateral|Hyperinflated lungs with flattened diaphragm and central pulmonary artery enlargement|02/10/2010
26 Hematology|718-7|Hemoglobin (male: 14-18 g/dl female: 12-16 g/dl)|16 g/dl|02/10/2010
27 Hematology|4544-3|Hematocrit (male: 40-54% female: 36-48%)|45%|02/10/2010

View File

@ -0,0 +1,144 @@
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 #4|Office Visit #1 for Susan Ellerby
{| 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
|----
|Susan Ellerby
|12/08/1963 21:54:24
|Female
|925377799
|Medical Record Number
|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
|----
|}
“Source” for all data for this patient: Dorcas Wayne, 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
|----
|Condition
|272.4
|Hyperlipidemia
|Active
|07/06/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|55822004
|Hyperlipidemia
|Active
|07/06/2010
|----
|}
{| 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
|----
|617314
|Medication
|atorvastatin calcium
|Lipitor
|10 mg
|1 Tablet
|PO
|Q Day
|07/06/2010
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|05/22/1998
|----
|Drug Allergy
|293597001
|Codeine
|Hives
|02/17/1992
|----
|}
{| 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
|14647-2
|Total cholesterol (<200 mg/dl)
|279 mg/dl
|07/06/2010
|----
|Chemistry
|14646-4
|HDL cholesterol (?40 mg/dl)
|89 mg/dl
|07/06/2010
|----
|Chemistry
|2089-1
|LDL cholesterol (<100 mg/dl)
|190 mg/dl
|07/06/2010
|----
|Chemistry
|14927-8
|Triglycerides (<150 mg/dl)
|187 mg/dl
|07/06/2010
|----

View File

@ -0,0 +1,37 @@
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 #4|Office Visit #1 for Susan Ellerby
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Susan Ellerby|12/08/1963 21:54:24|Female|925377799|Medical Record Number|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
“Source” for all data for this patient: Dorcas Wayne, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Condition|272.4|Hyperlipidemia|Active|07/06/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|55822004|Hyperlipidemia|Active|07/06/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
617314|Medication|atorvastatin calcium|Lipitor|10 mg|1 Tablet|PO|Q Day|07/06/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|05/22/1998
Drug Allergy|293597001|Codeine|Hives|02/17/1992
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Chemistry|14647-2|Total cholesterol (<200 mg/dl)|279 mg/dl|07/06/2010
Chemistry|14646-4|HDL cholesterol (?40 mg/dl)|89 mg/dl|07/06/2010
Chemistry|2089-1|LDL cholesterol (<100 mg/dl)|190 mg/dl|07/06/2010
Chemistry|14927-8|Triglycerides (<150 mg/dl)|187 mg/dl|07/06/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #4|Office Visit #1 for Susan Ellerby
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Susan Ellerby|12/08/1963 21:54:24|Female|925377799|Medical Record Number|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
9 “Source” for all data for this patient: Dorcas Wayne, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Condition|272.4|Hyperlipidemia|Active|07/06/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|55822004|Hyperlipidemia|Active|07/06/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 617314|Medication|atorvastatin calcium|Lipitor|10 mg|1 Tablet|PO|Q Day|07/06/2010|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|05/22/1998
21 Drug Allergy|293597001|Codeine|Hives|02/17/1992
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Chemistry|14647-2|Total cholesterol (<200 mg/dl)|279 mg/dl|07/06/2010
25 Chemistry|14646-4|HDL cholesterol (?40 mg/dl)|89 mg/dl|07/06/2010
26 Chemistry|2089-1|LDL cholesterol (<100 mg/dl)|190 mg/dl|07/06/2010
27 Chemistry|14927-8|Triglycerides (<150 mg/dl)|187 mg/dl|07/06/2010

View File

@ -0,0 +1,142 @@
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 #4|Office Visit #2 for Susan Ellerby
{| 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
|----
|Susan Ellerby
|12/08/1963 21:54:24
|Female
|925377799
|Medical Record Number
|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
|----
|}
“Source” for all data for this patient: Dorcas Wayne, 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
|----
|Symptom
|401.9
|Hypertension, Essential
|Active
|02/05/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|59621000
|Essential Hypertension
|Active
|02/05/2010
|----
|}
{| 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
|----
|200801
|Medication
|furosemide
|Lasix
|20 mg
|1 Tablet
|PO
|BID
|02/05/2010
|Active
|----
|628958
|Medication
|potassium chloride
|Klor-Con
|10 mEq
|1 Tablet
|PO
|BID
|02/05/2010
|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
|91936005
|Penicillin
|Rash and anaphylaxis
|05/22/1998
|----
|Drug Allergy
|293597001
|Codeine
|Hives
|02/17/1992
|----
|}
{| 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
|2823-3
|Potassium (3.55.3 mg/dl)
|4.5 mg/dl
|02/05/2010
|----
|Imaging
|42272-5
|Chest X-ray, PA & Lateral
|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance
|02/05/2010
|----

View File

@ -0,0 +1,35 @@
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 #4|Office Visit #2 for Susan Ellerby
Patient
Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
Susan Ellerby|12/08/1963 21:54:24|Female|925377799|Medical Record Number|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
“Source” for all data for this patient: Dorcas Wayne, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Symptom|401.9|Hypertension, Essential|Active|02/05/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|59621000|Essential Hypertension|Active|02/05/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|02/05/2010|Active
628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|02/05/2010|Active
Medication Allergy List
Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|05/22/1998
Drug Allergy|293597001|Codeine|Hives|02/17/1992
Diagnostic Test Results
Type|LOINC Code|Test (Normal Range)|Result|Date Performed
Chemistry|2823-3|Potassium (3.55.3 mg/dl)|4.5 mg/dl|02/05/2010
Imaging|42272-5|Chest X-ray, PA & Lateral|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance|02/05/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #4|Office Visit #2 for Susan Ellerby
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Susan Ellerby|12/08/1963 21:54:24|Female|925377799|Medical Record Number|483 Powell Street,<br>Shawville,<br>Pennsylvania 16873<br>814-645-9475
9 “Source” for all data for this patient: Dorcas Wayne, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Symptom|401.9|Hypertension, Essential|Active|02/05/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|59621000|Essential Hypertension|Active|02/05/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|02/05/2010|Active
18 628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|02/05/2010|Active
19 Medication Allergy List
20 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
21 Drug Allergy|91936005|Penicillin|Rash and anaphylaxis|05/22/1998
22 Drug Allergy|293597001|Codeine|Hives|02/17/1992
23 Diagnostic Test Results
24 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
25 Chemistry|2823-3|Potassium (3.5–5.3 mg/dl)|4.5 mg/dl|02/05/2010
26 Imaging|42272-5|Chest X-ray, PA & Lateral|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance|02/05/2010

View File

@ -0,0 +1,126 @@
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
{| 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
|----
|Johnathan Stone
|11/12/1966 08:18:08
|Male
|988772587
|Medical Record Number
|937 Sutter Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
|----
|}
“Source” for all data for this patient: Samuel Johnston, 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
|07/17/2010
|----
|----
!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
|07/17/2010
|----
|}
{| 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
|07/17/2010
|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
|294506009
|Ampicillin
|Diarrhea, nausea, vomiting
|03/25/1997
|----
|Drug Allergy
|91939003
|Sulfonamides
|Hives, photosensitivity
|04/25/1989
|----
|}
{| 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
|LOINC
|Fasting Blood Glucose (70100 mg/dl)
|120 mg/dl
|07/17/2010
|----

View File

@ -0,0 +1,33 @@
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<br>Aurora,<br>Colorado 80011<br>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 (70100 mg/dl)|120 mg/dl|07/17/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #5|Office Visit #1 for Johnathan Stone
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Johnathan Stone|11/12/1966 08:18:08|Male|988772587|Medical Record Number|937 Sutter Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
9 “Source” for all data for this patient: Samuel Johnston, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Diagnosis|250.02|Diabetes Mellitus, Type 2|Active|07/17/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|44054006|Diabetes Mellitus, Type 2|Active|07/17/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 205875|Medication|glyburide|Diabeta|2.5 mg|1 Tablet|PO|Q AM|07/17/2010|Active
18 Medication Allergy List
19 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
20 Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/25/1997
21 Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1989
22 Diagnostic Test Results
23 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
24 Chemistry|14771-0|LOINC|Fasting Blood Glucose (70–100 mg/dl)|120 mg/dl|07/17/2010

View File

@ -0,0 +1,146 @@
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 #2 for Johnathan Stone
{| 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
|----
|Johnathan Stone
|11/12/1966 08:18:08
|Male
|988772587
|Medical Record Number
|937 Sutter Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
|----
|}
“Source” for all data for this patient: Samuel Johnston, 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
|----
|Symptom
|401.9
|Hypertension, Essential
|Active
|01/15/2010
|----
|----
!scope="col"|Type
!scope="col"|SNOMED Code*
!scope="col"|Patient Problem
!scope="col"|Status
!scope="col"|Date Diagnosed
|----
|Disorder
|59621000
|Essential Hypertension
|Active
|01/15/2010
|----
|}
{| 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
|----
|200801
|Medication
|furosemide
|Lasix
|20 mg
|1 Tablet
|PO
|BID
|01/15/2010
|Active
|----
|628958
|Medication
|potassium chloride
|Klor-Con
|10 mEq
|1 Tablet
|PO
|BID
|01/15/2010
|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
|294506009
|Ampicillin
|Diarrhea, nausea, vomiting
|03/25/1997
|----
|Drug Allergy
|91939003
|Sulfonamides
|Hives, photosensitivity
|04/25/1989
|----
|}
{| 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
|2823-3
|Potassium (3.55.3 mg/dl)
|4.5 mg/dl
|01/15/2010
|----
|Imaging
|42272-5
|Chest X-ray, PA & Lateral
|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance
|01/15/2010
|----
|}

View File

@ -0,0 +1,38 @@
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 #2 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<br>Aurora,<br>Colorado 80011<br>303-544-9988
“Source” for all data for this patient: Samuel Johnston, MD
Problem List
Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
Symptom|401.9|Hypertension, Essential|Active|01/15/2010
Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
Disorder|59621000|Essential Hypertension|Active|01/15/2010
Medication List
RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|01/15/2010|Active
628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|01/15/2010|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|2823-3|Potassium (3.55.3 mg/dl)|4.5 mg/dl|01/15/2010
Imaging|42272-5|Chest X-ray, PA & Lateral|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance |01/15/2010
1 Test Procedure for §170.304.h Clinical Summaries 
2 APPROVED (Pending) Version 1.0  July 21, 2010  
3 TD170.304.h.: Clinical summaries
4 * indicates alternative standard code per certification criteria
5 Clinical Summaries Test Data – Set #5|Office Visit #2 for Johnathan Stone
6 Patient
7 Name|Date/Time of Birth|Gender|Identification Number|Identification Number Type|Address/Phone
8 Johnathan Stone|11/12/1966 08:18:08|Male|988772587|Medical Record Number|937 Sutter Street<br>Aurora,<br>Colorado 80011<br>303-544-9988
9 “Source” for all data for this patient: Samuel Johnston, MD
10 Problem List
11 Type|ICD-9 Code|Patient Problem|Status|Date Diagnosed
12 Symptom|401.9|Hypertension, Essential|Active|01/15/2010
13 Type|SNOMED Code*|Patient Problem|Status|Date Diagnosed
14 Disorder|59621000|Essential Hypertension|Active|01/15/2010
15 Medication List
16 RxNorm Code|Product|Generic Name|Brand Name|Strength|Dose|Route|Frequency|Date Started|Status
17 200801|Medication|furosemide|Lasix|20 mg|1 Tablet|PO|BID|01/15/2010|Active
18 628958|Medication|potassium chloride|Klor-Con|10 mEq|1 Tablet|PO|BID|01/15/2010|Active
19 Medication Allergy List
20 Type|SNOMED Code|Medication/Agent|Reaction|Date Recorded
21 Drug Allergy|294506009|Ampicillin|Diarrhea, nausea, vomiting|03/25/1997
22 Drug Allergy|91939003|Sulfonamides|Hives, photosensitivity|04/25/1989
23 Diagnostic Test Results
24 Type|LOINC Code|Test (Normal Range)|Result|Date Performed
25 Chemistry|2823-3|Potassium (3.5–5.3 mg/dl)|4.5 mg/dl|01/15/2010
26 Imaging|42272-5|Chest X-ray, PA & Lateral|The heart outline is normal and the hilar and mediastinal vessels are of normal appearance |01/15/2010