Transition of Care Document

Patient Miriam J Bair Preferred Language Unspecified
Date of birth September 3, 1979 Sex Female
Race White

Ethnicity Unspecified
Contact info Home:

11818 Kinney Cir

Riverton, UT 84065, US

Tel (Mobile): +1(801)-647-1925

Tel (Primary Home): +1(801)-999-8189

Tel (Work Place): +1(385)-645-5386

Mail: miriam.bair@gmail.com

Mail: miriam@thebairs.net

Patient IDs 3587588 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101

MM0000001264 2.16.840.1.113883.3.3710.3

MODMED 2.16.840.1.113883.3.3710.200.501

115636PAT000001274 2.16.840.1.113883.3.3710.200.500

Document Id test-id-108579273 2.16.840.1.113883.3.3710.0
Document Created: April 5, 2024, 23:16:04 +0000
Performer Karen Herbst
Author Diana Tagaban, Total Lipedema Care - Arizona
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Encounter Id 4398520 2.16.840.1.113883.3.3710.999.44.88800115636.7770000111
Encounter Date  From January 3, 2024
Encounter Participant Karen Herbst
Contact info Work Place:

6365 E Tanque Verde Road, Suite 200

Tucson, AZ 857153830, US

Tel (Work Place): 3108825454

Legal authenticator Diana Tagaban signed at April 5, 2024, 23:16:04 +0000
Contact info Work Place:

240 S La Cienega Blvd Ste 200

Beverly Hills, CA 902113324, US

Tel (Work Place): 3108825454

Document maintained by Total Lipedema Care - Arizona
Contact info Work Place:

6365 E Tanque Verde Road, Suite 200

Tucson, AZ 857153830, US

Tel (Work Place): 3108825454

Table of Contents

Social History

Code Activity Start Date End Date
266919005 (SNOMED) Never smoker
Birth Sex female
Sexual orientation Unspecified
Gender identity Unspecified

Problems

Problem Code Type Status Date of Diagnosis Date of Resolution
Hypermobile Ehlers-Danlos syndrome (disorder) 30652003(SNOMED) Diagnosis active 01/03/2024
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 01/03/2024
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 01/03/2024
Lymphedema (disorder) 234097001(SNOMED) Diagnosis active 01/03/2024
Peripheral venous insufficiency (disorder) 20696009(SNOMED) Diagnosis active 01/03/2024
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 01/03/2024
Hypermobile Ehlers-Danlos syndrome (disorder) 30652003(SNOMED) Diagnosis active 01/03/2024
Lymphedema (disorder) 234097001(SNOMED) Diagnosis active 01/03/2024
Mast cell disorder (disorder) 397007003(SNOMED) Diagnosis active 01/03/2024
Varicose veins of lower extremity (disorder) 72866009(SNOMED) Diagnosis active 01/03/2024
Peripheral venous insufficiency (disorder) 20696009(SNOMED) Diagnosis active 01/03/2024
Eczema (disorder) 43116000(SNOMED) Problem active
History of hay fever (situation) 161524000(SNOMED) Problem active

Allergies

Substance RxNorm Reaction(s) Severity Status Start Date
Sulfa (Sulfonamide Antibiotics) Hives moderate active

Medications

No data

Instructions

No Data

Results

No data

History of Procedures

Code Site Date Diagnosed Status
Plastic surgery self-referral (procedure)
Documentation of past medical history (procedure)

Vital Signs

No data

Plan of Treatment

Future visit for 01/03/2025 - Follow up in 1 year

History of Past Illness

Problem Code Type Status Date of Diagnosis Date of Resolution
History of hay fever (situation) 161524000 FINDING
Eczema (disorder) 43116000 FINDING
History of clinical finding in subject (situation) - none 417662000 FINDING

General Status

No data

Assessments

1.Hypermobile Ehlers-Danlos Syndrome 2.Lipedema

Immunizations

No data

Functional Status

No data

Mental Status

No data

Reason for Referral

No data

Encounters

Service provided at Total Lipedema Care - Arizona, 6365 E Tanque Verde Road, Suite 200, Tucson, AZ 857153830. Office phone number is 3108825454. Office fax number is 3107475908.

Encounter Diagnosis Location Date / Time Type
Hypermobile Ehlers-Danlos Syndrome (Q79.62) Lipedema (E65) Total Lipedema Care - Arizona 01/03/2024 18:01:20 UTC

Review Of Systems

No Data

Goals

No data

Medical Equipment

No data

Health Concerns

No data

History of Present Illness

No Data

Family History

No data

Consultation Notes

No data

Laboratory Narrative

No data

Pathology Narrative

No data

Imaging Narrative

No data

Procedure Notes

No data

Progress Notes

No data

Care Team

Care Team Member Name Role Identifier location Telecom
Karen Herbst Doctor 1114977840 6365 E Tanque Verde Road, Suite 200 Tucson, AZ 857153830, US 3108825454

History And Physical Notes

No data