Encounter Type (SBE192):  Laser Ablation 1st Vein

Clinical Template ID: 56, Name: Presentation Lower Limb Venous Study Narrative (VarID=3846)(Recent Data=0) Right Lower Limb Pain (VarID=350)(Recent Data=0) Edema (VarID=351)(Recent Data=0) Tenderness (VarID=352)(Recent Data=0) Inflammation (VarID=353)(Recent Data=0) Venous Ulcer (VarID=354)(Recent Data=0) Induration (VarID=355)(Recent Data=0) Pigmentation (VarID=327)(Recent Data=0) Varicose Veins (VarID=328)(Recent Data=0) Cyanosis (VarID=329)(Recent Data=0) Circumference Thigh Circumference (cm) (VarID=340)(Recent Data=0) Calf Circumference (cm) (VarID=341)(Recent Data=0) Ankle Circumference (cm) (VarID=342)(Recent Data=0) Left Lower Limb Pain (VarID=330)(Recent Data=0) Edema (VarID=331)(Recent Data=0) Tenderness (VarID=332)(Recent Data=0) Inflammation (VarID=333)(Recent Data=0) Venous Ulcer (VarID=334)(Recent Data=0) Induration (VarID=336)(Recent Data=0) Pigmentation (VarID=337)(Recent Data=0) Varicose Veins (VarID=338)(Recent Data=0) Cyanosis (VarID=339)(Recent Data=0) Circumference Thigh Circumference (cm) (VarID=343)(Recent Data=0) Calf Circumference (cm) (VarID=344)(Recent Data=0) Ankle Circumference (cm) (VarID=345)(Recent Data=0) 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