Transition of Care Document

Patient Stephanie Brakefield Preferred Language en
Date of birth July 17, 1963 Sex Female
Race White

Ethnicity Not Hispanic or Latino
Contact info Home:

901 Cantrell ave.

Nashville, TN 37215, US

Tel (Mobile): +1(615)-485-3415

Mail: thebrakefields@gmail.com

Patient IDs 3056689 2.16.840.1.113883.3.3710.999.44.88800115636.7770000101

MM0000001136 2.16.840.1.113883.3.3710.3

MODMED 2.16.840.1.113883.3.3710.200.501

115636PAT000001146 2.16.840.1.113883.3.3710.200.500

Document Id test-id-1535068153 2.16.840.1.113883.3.3710.0
Document Created: April 6, 2024, 00:05:41 +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 3980090 2.16.840.1.113883.3.3710.999.44.88800115636.7770000111
Encounter Date  From December 21, 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, 00:05:41 +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 Straight (Heterosexual)
Gender identity Identifies as Female

Problems

Problem Code Type Status Date of Diagnosis Date of Resolution
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 12/21/2023
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 12/21/2023
Hypermobile Ehlers-Danlos syndrome (disorder) 30652003(SNOMED) Diagnosis active 12/21/2023
Lymphedema (disorder) 234097001(SNOMED) Diagnosis active 12/21/2023
Varicose veins of lower extremity (disorder) 72866009(SNOMED) Diagnosis active 12/21/2023
Peripheral venous insufficiency (disorder) 20696009(SNOMED) Diagnosis active 12/21/2023
Localized obesity (disorder) 270486005(SNOMED) Diagnosis active 11/03/2023
Autoimmune disease (disorder) 85828009(SNOMED) Problem active
Circulatory care for venous insufficiency (regime/therapy) 386238003(SNOMED) Problem active
Easy bruising (finding) 424131007(SNOMED) Problem active
Ehlers-Danlos syndrome (disorder) 398114001(SNOMED) Problem active
History of pregnancy (situation) 271903000(SNOMED) Problem active
Hypothyroidism (disorder) 40930008(SNOMED) Problem active
Lipedema (disorder) 234102003(SNOMED) Problem active
History of clinical finding in subject (situation) 417662000(SNOMED) Problem active
Arthritis (disorder) 3723001(SNOMED) Problem active

Allergies

Substance RxNorm Reaction(s) Severity Status Start Date
No Known Allergies 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
Documentation of past medical history (procedure) completed
Documentation of past medical history (procedure) completed
Documentation of past medical history (procedure) completed
Plastic surgery self-referral (procedure)
Documentation of past medical history (procedure)

Vital Signs

No data

Plan of Treatment

Future visit PRN - Follow up PRN

History of Past Illness

Problem Code Type Status Date of Diagnosis Date of Resolution
History of skin disorder (situation) - none 161560005 FINDING
Lipedema (disorder) 234102003 FINDING
History of pregnancy (situation) 271903000 FINDING
Arthritis (disorder) 3723001 FINDING
Circulatory care for venous insufficiency (regime/therapy) 386238003 FINDING
Ehlers-Danlos syndrome (disorder) 398114001 FINDING
Hypothyroidism (disorder) 40930008 FINDING
History of clinical finding in subject (situation) 417662000 FINDING
Easy bruising (finding) 424131007 FINDING
Autoimmune disease (disorder) 85828009 FINDING

General Status

No data

Assessments

1.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
Lipedema (E65) Total Lipedema Care - Arizona 12/21/2023 16:29:44 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