1.4 KiB
1.4 KiB
1 | Test Procedure for §170.304.h Clinical Summaries |
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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 |