Encounter Type (SBA121):  Cerebrovascular Duplex, Right

Clinical Template ID: 2000005, Name: Presentation of Cerebovascular Study - vcu Neck Bruit Right Supraclavicular Bruit (VarID=250)(Recent Data=0) Proximal Neck Bruit (VarID=2000010)(Recent Data=0) Distal Neck Bruit (VarID=2000012)(Recent Data=0) Left Supraclavicular Bruit (VarID=252)(Recent Data=0) Proximal Neck Bruit (VarID=2000011)(Recent Data=0) Distal Neck Bruit (VarID=2000013)(Recent Data=0) Pulse Examination Right Superficial Temporal (VarID=89)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent Carotid (VarID=91)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent Radial (VarID=81)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent Left Superficial Temporal (VarID=90)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent Carotid (VarID=92)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent Radial (VarID=85)(Recent Data=0) Lookup ID=263 Lookup Name=Clinical Pulse Grade Diminished Healthy Absent 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)

Conclusion Template ID: 2000042, Name: Cerebrovascular Conclusion - vcu 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

Risk Factors Template ID: 26, Name: Risk Factors Arteriosclerosis Age (VarID=258)(Recent Data=0) Age Group (VarID=37)(Recent Data=0) Lookup ID=9 Lookup Name=Age >= 80 < 55 55 - 69 70 - 79 Carotid Artery Disease (VarID=13)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Cardiac Status (SVS) (VarID=2)(Recent Data=0) Lookup ID=23 Lookup Name=ASHD Mild Moderate None Severe Yes Diabetes (VarID=4)(Recent Data=0) Lookup ID=61 Lookup Name=Diabetes IDDM adult IDDM juvenile NIDDM No Yes Embolization (VarID=297)(Recent Data=0) Lookup ID=403 Lookup Name=Arterial Emolization Multiple Incidents No Single Incident Yes Fibrinogen Level (mg/dl) (VarID=296)(Recent Data=0) Hyperlipidemia (VarID=9)(Recent Data=0) Lookup ID=113 Lookup Name=Hyperlipidemia None Mild Moderate Severe Yes Cholesterol (mg/dl) (VarID=28)(Recent Data=0) LDL (mg/dl) (VarID=26)(Recent Data=0) Triglycerides (mg/dl) (VarID=29)(Recent Data=0) HDL ((mg/dl) (VarID=27)(Recent Data=0) VLDL (%) (VarID=257)(Recent Data=0) History of Irradiation (VarID=3982)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes HIV (VarID=72)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypertension (VarID=3)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Hypercoagulable State (VarID=12)(Recent Data=0) Lookup ID=112 Lookup Name=Hypercoagulation No Proven, treated Proven, untreated Suspected Yes Peripheral Arterial Disease (VarID=516)(Recent Data=0) Lookup ID=502 Lookup Name=PAD Amputation Claudication No Rest Pain/Tissue loss Yes Pulmonary Status (VarID=11)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Renal Disease (VarID=10)(Recent Data=0) Lookup ID=2000002 Lookup Name=Carotid Artery Disease VCU no yes Smoking (VarID=5)(Recent Data=0) Lookup ID=189 Lookup Name=Smoking Yes No Active Former PPD yrs Weight (Kg) (VarID=33)(Recent Data=0)