Cypress Certification Patient Test Record: Jack Carpenter

Patient Jack Carpenter Sex Male
Date of birth January 3rd, 1945 17:31 Date of expiration
Race American Indian or Alaska Native Ethnicity Not Hispanic or Latino
Insurance Providers Other Patient IDs 527aa97177fabcc9980000e8 Cypress
Contact info
Document Id 527aa97177fabcc9980000e8 2.16.840.1.113883.3.72
Document Created: November 8th, 2013 09:56
Author Auto Generated
Contact info Tel: +1-781-271-3000
Document maintained by Cypress
Contact info 202 Burlington Rd.
Bedford, MA 01730
Tel: +1-781-271-3000

View By Encounter

Diagnoses

Description Codes Time Status Results Fields
Diagnosis, Active: Heart Failure (Code List: 2.16.840.1.113883.3.526.3.376) SNOMED-CT: 10091002
ICD-9-CM: 428.0
ICD-10-CM: I50.1
February 1st, 2012 13:31 - present active

Encounters

Description Codes Time Status Results Fields
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
August 1st, 2011 13:31 - August 1st, 2011 14:31 performed
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
October 1st, 2011 13:31 - October 1st, 2011 14:31 performed
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
February 1st, 2012 13:31 - February 1st, 2012 14:31 performed
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
June 1st, 2012 13:31 - June 1st, 2012 14:31 performed

Medications

Description Codes Time Status Results Fields
Medication, Order: High Risk Medications for the Elderly (Code List: 2.16.840.1.113883.3.464.1003.196.12.1253) RxNorm: 1000351
June 1st, 2012 14:31 - June 1st, 2012 14:31 ordered

Functional Status Results

Description Codes Time Status Results Fields
Functional Status, Result: Functional Status Assessment for Knee Replacement (Code List: 2.16.840.1.113883.3.464.1003.118.12.1030) LOINC: 71955-9
August 1st, 2011 13:31 - August 1st, 2011 14:31
Functional Status, Result: Functional Status Assessment for Hip Replacement (Code List: 2.16.840.1.113883.3.464.1003.118.12.1029) LOINC: 71955-9
August 1st, 2011 13:31 - August 1st, 2011 14:31
Functional Status, Result: Functional Status Assessment for Heart Failure (Code List: 2.16.840.1.113883.3.464.1003.118.12.1031) LOINC: 71938-5
February 1st, 2012 13:31 - February 1st, 2012 13:31
Functional Status, Result: Functional Status Assessment for Hip Replacement (Code List: 2.16.840.1.113883.3.464.1003.118.12.1029) LOINC: 71955-9
February 1st, 2012 13:31 - February 1st, 2012 13:46
Functional Status, Result: Functional Status Assessment for Knee Replacement (Code List: 2.16.840.1.113883.3.464.1003.118.12.1030) LOINC: 71955-9
February 1st, 2012 13:46 - February 1st, 2012 14:01
Functional Status, Result: Functional Status Assessment for Heart Failure (Code List: 2.16.840.1.113883.3.464.1003.118.12.1031) LOINC: 71938-5
June 1st, 2012 13:31 - June 1st, 2012 13:31