Summary: Ofc Visit: Testing

Patient Name:Holly A Yytest

SSN:123456789; DOB:10/6/1970
Sex:F
MRN:OLD1234

Summary: Clinical Visit Summary

Family Medicine Associates of Texas, PA Clinical Summary

Patient Holly Yytest
Date of Octob Sex Female
birth er 6,
1970
Race White Ethnici Not Hispanic or Latino
ty
Contact Primar Patient 1721564140008770
info y IDs 1.2.840.113619.21.1.4781333460697213193.
Home: 2.1.1.1
13459 OLD1234
Lime 1.2.840.113619.21.1.4781333460697213193.
Ridge 2.1.1.2
Drive
Frisco
, TX 7
5033,
US
Tel:
+1-
469-
323-
2188
Preferre Englis
d h
Langua
ge

Document 513fc45a-f32b-41bf-887e-e63403ecae40
Id 1.2.840.113619.21.1.4781333460697213193.5.2
Document October 29, 2018, 15:21:38, EST
Created

Performer Holly Adams (SFH)

Author CDA Document Generator

Contact Work Place:
info 4333 N Josey Lane Suite 302
Carrollton, TX 75010-4632, US
Tel: +1-972-394-8844

Encounter 1852203843054230 2.16.840.1.113883.19

Id
Encounter From September 10, 2018, 13:03:49, EST to September
Date 10, 2018, 13:03:49, EST
Encounter id: 1712946890056150 2.16.540.1.113883.19.2
Location

Legal Holly Adams (SFH) of Family Medicine Associates of

authenticator Texas, PA signed at September 10, 2018, 13:08:10,
EST
Contact info Work Place:
4333 N Josey Lane Suite 302
Carrollton, TX 75010-4632, US

Document Family Medicine Associates of Texas, PA

maintained
by
Contact Work Place:
info 4333 N Josey Lane Suite 302
Carrollton, TX 75010-4632, US
Tel: +1-972-394-8844

Encounter Holly Adams (SFH)

Participant
Contact Work Place:
info 4333 N Josey Lane Suite 302
Carrollton, TX 75010-4632, US

Table of Contents
 Reason for Visit
 Chief Complaint
 Instructions
 Plan of Care
 Medications
 Conditions or Problems
 Allergies, Adverse Reactions, Alerts
 Social History
 Vital Signs
 Results
 Procedures
 Medications Administered
 Immunizations
 Advance Directives
 Assessments
 Review of Systems
 Family History
 History of Past Illness
 History of Present Illness
Reason for Visit

No information available.

Chief Complaint

No information available.

Instructions

No information available.

Plan of Care

Type Date Detail

Pending order 2018/09/10 CBC w/ differential

Medications

Medication Instructions Start Date Stop Generic Name NDC Provider

Date
METFORMIN Take 1 2014/07/23 METFORMIN 00093726701 Richard
HCL ER 500 tablet/capsule HCL A
MG XR24H- by mouth Honaker
TAB daily MD
GLIPIZIDE 5 Take 1 2014/07/23 GLIPIZIDE 00378110501 Richard
MG TABS tablet/capsule A
by mouth Honaker
daily MD

Conditions or Problems

Problem Problem Onset Status Entry Date Provider Comme Standard Annota
Name Code Date nt Description te
Dyslipidem 3709920 2014/07/ Activ 2014/07/ Richar Dyslipide
ia 07 31 e 31 dA mia
(SNOME Honak
D CT) er MD
Depressio 3548900 2014/07/ Activ 2014/07/ Richar Depressiv
n 7 31 e 31 dA e disorder
(SNOME Honak
D CT) er MD
Wart, viral 5701900 2014/07/ Activ 2014/07/ Richar Verruca
3 31 e 31 dA vulgaris
(SNOME Honak
D CT) er MD
Fatigue 8422900 2014/07/ Activ 2014/07/ Richar Fatigue
1 31 e 31 dA
(SNOME Honak
D CT) er MD
Nevus, 1953810 2014/07/ Activ 2014/07/ Richar Non-
non- 05 31 e 31 dA neoplastic
neoplastic (SNOME Honak nevus
D CT) er MD
Nevus, 2548180 2014/07/ Activ 2014/07/ Richar Dysplastic
atypical 00 31 e 31 dA nevus of
(SNOME Honak skin
D CT) er MD
Mole 4000960 2014/07/ Activ 2014/07/ Richar Melanocyti
01 31 e 31 dA c nevus
(SNOME Honak
D CT) er MD
Urinary 6856600 2014/07/ Activ 2014/07/ Richar Urinary
tract 5 31 e 31 dA tract
infection (SNOME Honak infectious
D CT) er MD disease
Skin lesion 9532400 2014/07/ Activ 2014/07/ Susie Skin lesion
1 24 e 24 Serrats
(SNOME ,
D CT) NRCM
A
FH Z83.3 2014/07/ Activ 2014/07/ Richar Family
Diabetes (ICD-10- 23 e 23 dA history of
CM) Honak diabetes
er MD mellitus
FH Z81.8 2014/07/ Activ 2014/07/ Richar Family
Depressio (ICD-10- 23 e 23 dA history of
n CM) Honak other
er MD mental
and
behavioral
disorders
Diabetes 4405400 2014/07/ Activ 2014/07/ Richar Type 2
mellitus, 6 21 e 21 dA diabetes
type II (SNOME Honak mellitus
D CT) er MD
Hypertensi 3834100 2014/07/ Activ 2014/07/ Richar Hypertensi
on 3 21 e 21 dA ve
(SNOME Honak disorder
D CT) er MD
Routine Z00.00 2014/07/ Activ 2014/07/ Richar Encounter
general (ICD-10- 21 e 21 dA for general
medical CM) Honak adult
examinatio er MD medical
n at a examinatio
health n without
care abnormal
facility findings
Anxiety 1974800 2014/07/ Activ 2014/07/ Jennife Anxiety
Disorder 06 21 e 21 r disorder
(SNOME McClu
D CT) ng
(SFH)
Asthma 1959670 2014/07/ Activ 2014/07/ Jennife Asthma
01 21 e 21 r
(SNOME McClu
D CT) ng
(SFH)

Allergies, Adverse Reactions, Alerts

No information available.

Social History

No information available.

Vital Signs

No information available.

Results

No information available.

Procedures

No information available.

Medications Administered

No information available.

Immunizations

No information available.

Advance Directives

There may be information available, but it has not been provided by the sender.

Assessments

There may be information available, but it has not been provided by the sender.

Review of Systems

There may be information available, but it has not been provided by the sender.

Family History

There may be information available, but it has not been provided by the sender.
History of Past Illness

There may be information available, but it has not been provided by the sender.

History of Present Illness

There may be information available, but it has not been provided by the sender.

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