Encounter Type (SBD51):  Duplex IVC/Iliac Veins-Complete

Clinical Template ID: 112, Name: Presentation of Abdominal Duplex Narrative (VarID=3846)(Recent Data=0) Brachial Blood Pressure Right Systolic (mm hg) (VarID=101)(Recent Data=0) Diastolic (mm hg) (VarID=104)(Recent Data=0) Left Systolic (mm hg) (VarID=102)(Recent Data=0) Diastolic (mm hg) (VarID=105)(Recent Data=0) Abdominal Bruit (VarID=527)(Recent Data=0) Abdominal Pain (VarID=548)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Enlarged liver (VarID=549)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Enlarged Spleen (VarID=550)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes Plusating mass (Aneurysm) (VarID=551)(Recent Data=0) Lookup ID=208 Lookup Name=True False No Yes RiskFactorStatement (VarID=2000034)(Recent Data=0)

Conclusion Template ID: 137, Name: Lab Next Followup Next Followup (VarID=730)(Recent Data=0) Lookup ID=657 Lookup Name=Lab Study Next Followup No follow-up is needed One Week Two Weeks Three Weeks One Month Two Months Three Months Six Months One Year Two Years Critical Findings: Reported to: (VarID=2000001)(Recent Data=0) Reported by: (VarID=2000002)(Recent Data=0) Found time/date: (VarID=2000003)(Recent Data=0) Report time/date: (VarID=2000004)(Recent Data=0) Critical Result (VarID=2000010)(Recent Data=0) Read Back Performed (VarID=2000008)(Recent Data=0)

Risk Factors Template ID: 27, Name: Risk Factors DVT History of DVT (VarID=40)(Recent Data=0) Lookup ID=66 Lookup Name=DVTHistory Yes Multiple None Proven Suspected Immobilization (VarID=38)(Recent Data=0) Post Operative State (VarID=41)(Recent Data=0) History of Malignancy (VarID=35)(Recent Data=0) Lookup ID=134 Lookup Name=Malignancy Yes local or nonrecurrence Metastatic tumor None Regional tumor Adenocarcinoma (VarID=36)(Recent Data=0) Lookup ID=8 Lookup Name=Adenocarcinoma Adenocarcinoma Not adenocarcinoma Cardiac Status (NYHA) (VarID=259)(Recent Data=0) Limb Trauma (VarID=39)(Recent Data=0) Pregnancy (VarID=34)(Recent Data=0) Lookup ID=161 Lookup Name=Pregnancy [DVT RF] Postpartum Absent Present Obesity (VarID=42)(Recent Data=0) Hormonal Treatment (VarID=298)(Recent Data=0) Hypercoagulable State (VarID=12)(Recent Data=0) Lookup ID=112 Lookup Name=Hypercoagulation None Proven, treated Proven, untreated Suspected Yes Hemodialysis Access Location (VarID=78)(Recent Data=0) Lookup ID=260 Lookup Name=Access Location and Conduit Material [AV ACCESS] Placement of lower extremity autogenous AV access Placement of lower extremity non-autogenous AV access Placement of upper extremity autogenous AV access Placement of upper extremity non-autogenous AV access