Transition of Care Document

Patient	Anna Behrman	Preferred Language	Unspecified
Date of birth	October 13, 1965	Sex	Female
Race	Unspecified	Ethnicity	Unspecified
Contact info	Home: 1730 N Clark St. Apt. 1507 Chicago, IL 60614, US Tel (Mobile): +1(312)-925-0020 Tel (Primary Home): +1(312)-925-0020 Mail: anna.behrman@comcast.net	Patient IDs	3040820 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101 MM0000001109 2.16.840.1.113883.3.3710.3 MODMED 2.16.840.1.113883.3.3710.200.501 115636PAT000001119 2.16.840.1.113883.3.3710.200.500

Document Id	test-id-254516232 2.16.840.1.113883.3.3710.0
Document Created:	April 6, 2024, 08:44:03 +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	3901753 2.16.840.1.113883.3.3710.999.44.88800115636.7770000111
Encounter Date	From November 30, 2023
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 6, 2024, 08:44:03 +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

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
Lymphedema (disorder)	234097001(SNOMED)	Diagnosis	active	11/30/2023
Localized obesity (disorder)	270486005(SNOMED)	Diagnosis	active	11/30/2023
Lymphedema (disorder)	234097001(SNOMED)	Diagnosis	active	11/30/2023
Peripheral venous insufficiency (disorder)	20696009(SNOMED)	Diagnosis	active	11/30/2023
Anxiety (finding)	48694002(SNOMED)	Problem	active
Arthritis (disorder)	3723001(SNOMED)	Problem	active
Circulatory care for venous insufficiency (regime/therapy)	386238003(SNOMED)	Problem	active
History of orthopedic surgery (situation)	53371000119101(SNOMED)	Problem	active
Lipedema (disorder)	234102003(SNOMED)	Problem	active
Sleep apnea (disorder)	73430006(SNOMED)	Problem	active

Allergies

Substance	RxNorm	Reaction(s)	Severity	Status	Start Date
Penicillins		Anaphylaxis	unspecified	active
Nickel, Some Silicones	N/A	N/A	N/A	N/A	N/A

Medications

No data

Instructions

No Data

Results

No data

History of Procedures

Code	Site	Date Diagnosed	Status
No Procedure Data	N/A	N/A	N/A

Vital Signs

No data

Plan of Treatment

Future visit PRN - Follow up PRN

History of Past Illness

Problem	Code	Type
Lipedema (disorder)	234102003	FINDING
Arthritis (disorder)	3723001	FINDING
Circulatory care for venous insufficiency (regime/therapy)	386238003	FINDING
Anxiety (finding)	48694002	FINDING
History of orthopedic surgery (situation)	53371000119101	FINDING
Sleep apnea (disorder)	73430006	FINDING

General Status

No data

Assessments

1.Lymphedema Physical Therapy Services

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.