"MedcinForm-V1.0"
"General --ENT--NAV--RLE--19 September 2006~51","Navy Forms","System"
0,0,0,830,535,0,1048576,"","",""
4,5,377,295,295,0,32," |||||||0|0||0|0|||0|||0|0|0|0|0||||","V=1:DF=0:PS=1:TP=0:MR=F:BS=0:TWS=0:PB=0:NB=1:ROS=0:PL=0:FB=0:EM=0:CB=2",":-2147483633:HPI|PMH|ROS|PE / Tests"
1,10,340,400,400,195091,4202753," |||||||19|80|YCN|0|0|X||0|||0|0|0|0|0||||","|B=T|T=T|L=","Discussion~Specific risks attendant to the procedure(s) to be performed were discussed and include the following: "
1,10,160,400,330,253812,4203265," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Informed Consent Obtained~--SURGICAL CONSENT NOTE--~I have reviewed the risks, benefits, and alternatives of the procedure with the patient and/or family members/caregivers at NHOki.  Risks include, but are not limited to: bleeding, scarring, infection, the need for further surgery, the risks of anesthesia, and the risk of death.  The particular risks of the procedure were also discussed.  For ambulatory or conscious sedation cases the risks, benefits, and alternatives of perioperative sedation with narcotics, benzodiazepines, antihistamines, analgesics, hypnotics, antiemetics, and local and topical anesthetics were discussed.  The patient and/or representatives are alert, appear to understand the discussion, and agree that the patient should undergo the procedure as planned."
1,10,410,400,430,120010,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Illness Since Last Visit"
1,10,430,400,450,115268,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Symptoms Unchanged Since Last Visit"
1,10,450,400,470,115277,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Feeling Tired (fatigue)"
1,10,470,400,490,10,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Headache"
1,10,490,400,510,90,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Sinus Pain"
1,430,75,820,95,281330,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Concerns About Cosmetic Appearance"
1,430,95,820,115,281339,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Concerns About Nose Appearance"
1,430,115,820,135,141,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Hearing Loss"
1,430,135,820,155,2962,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Ears Feel Pressured"
1,430,155,820,175,148,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Discharge From the Ears"
1,430,175,820,195,153,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Ringing in the Ears (tinnitus)"
1,430,195,820,215,162,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Nasal Discharge"
1,430,215,820,235,230,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Drip or Drainage Down Throat From Above"
1,430,235,820,255,168,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Nosebleeds (epistaxis)"
1,430,255,820,275,170,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Nasal Passage Blockage (stuffiness)"
1,430,275,820,295,1731,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Snoring"
1,430,295,820,315,217,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Hoarseness"
1,430,315,820,335,219,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Sore Throat"
1,430,335,820,355,215,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Lump in the Mouth"
1,430,355,820,375,231,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Neck Pain"
1,430,375,820,395,244,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Lump or Swelling in the Neck"
1,430,395,820,415,247,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Cough"
1,430,415,820,435,399,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Difficulty Swallowing (dysphagia)"
1,430,435,820,455,407,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Pain on Swallowing (odynophagia)"
1,430,455,820,475,655,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Spinning Dizziness (vertigo)"
1,430,475,820,495,743,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Difficulty Keeping Balanced"
1,10,520,820,540,0,32768," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=128|B=T|T=T","NAVY GENERAL ENT Form DRAFT September 2006"
1,430,495,820,515,1158,268444417," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Excessive Sleepiness During The Day (daytime Somnolence)"
2,10,195,390,215,120233,33563393," |||||||19|260|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Recent Events"
2,10,135,390,155,122300,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Past Medical/Surgical History"
2,10,215,390,235,4200,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Taking Blood Thinners"
3,10,40,390,60,1878,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Systemic Symptoms"
2,440,275,820,295,5104,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Pediatric History (N=Normal)"
2,440,305,820,325,5098,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Family History"
2,440,225,820,245,120045,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Caffeine Use"
2,440,205,820,225,120047,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Tobacco use"
2,440,245,820,265,120046,8961," ||||||drinks/day|19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Alcohol Use"
2,440,135,820,155,120089,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Military History"
2,10,345,390,365,31226,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Otitis Media"
2,10,365,390,385,30778,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Motion Sickness"
2,10,385,390,405,35988,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Coronary Artery Disease"
2,10,405,390,425,33288,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Hypertension"
2,10,425,390,445,90715,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Thyroid Disorder"
2,10,445,390,465,30479,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Diabetes Mellitus"
2,10,465,390,485,90006,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Headache Syndromes"
2,10,485,390,505,74364,8961,"H|||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","History of Ear Surgery"
3,10,60,390,80,112217,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Recent Change in Weight"
3,10,100,390,120,1879,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Head-related Symptoms"
3,10,140,390,160,2901,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Eye Symptoms"
3,10,180,390,200,2902,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Otolaryngeal Symptoms"
3,10,220,390,240,2903,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Neck Symptoms"
3,10,260,390,280,1881,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Cardiovascular Symptoms"
3,10,300,390,320,1880,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Pulmonary Symptoms"
3,10,340,390,360,1882,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Gastrointestinal Symptoms"
3,415,50,415,405,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
3,440,40,820,60,1883,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Genitourinary Symptoms"
3,440,80,820,100,1887,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Endocrine Symptoms"
3,440,120,820,140,1888,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Skin Symptoms"
3,440,160,820,180,1889,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Hematologic Symptoms"
3,440,180,820,200,1129,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Easy Bleeding"
3,440,220,820,240,1886,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Musculoskeletal Symptoms"
3,440,260,820,280,1885,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Neurological Symptoms"
3,440,300,820,320,1891,268449537," |||||||19|80|YCBHN|0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Psychological Symptoms"
3,10,10,390,30,2952,4097," |||||||19|80|CB|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|P=Detailed ROS = 2+ Systems|L=","REVIEW OF SYSTEMS"
4,10,40,270,60,195992,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Current Vital Signs Reviewed"
4,10,70,270,90,9307,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","General Appearance (N=Normal)"
4,10,90,270,110,10008,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Oriented to Time, Place, and Person"
4,10,240,270,260,6527,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Extraocular Movements were Abnormal"
4,10,260,270,280,6595,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Visual Fields Checked (N=Normal)"
4,10,290,270,310,6675,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Ears (N=Normal)"
4,10,310,270,330,266410,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","External Auditory Canal Abnormalities"
4,10,520,820,540,0,32768," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=128|B=T|T=T","NAVY GENERAL ENT Form DRAFT September 2006"
4,10,350,270,370,6680,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Weber's Test was Abnormal"
4,10,370,270,390,6685,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Rinne's Test was Abnormal"
4,10,400,270,420,6721,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Nose (N=Normal)"
4,10,420,270,440,6722,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","External Nasal Deformity"
4,10,440,270,460,64942,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Nasal Cavity Abnormalities"
4,10,460,270,480,64968,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Nasal Turbinate Abnormalities"
4,10,480,270,500,6744,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Sinus Tenderness"
4,285,40,545,60,6751,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Oral Cavity (N=Normal)"
4,285,60,545,80,6758,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Lips Showed Abnormalities"
4,285,80,545,100,265082,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Buccal Mucosal Abnormalities"
4,285,100,545,120,6893,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Salivary Glands Showed Abnormalities"
4,285,130,545,150,64866,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Nasopharynx was Abnormal"
4,285,160,545,180,62448,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Oropharynx was Abnormal"
4,285,180,545,200,65305,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Soft Palate Elongation"
4,285,200,545,220,6840,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Tonsils Showed Abnormalities"
4,285,220,545,240,11009,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Anterior Tonsillar Pillar was Abnormal"
4,285,240,545,260,64876,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Posterior Tonsillar Pillar was Abnormal"
4,285,260,545,280,65282,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Posterior Pharyngeal Wall was Abnormal"
4,285,290,545,310,64867,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Hypopharynx was Abnormal"
4,285,320,545,340,6870,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Larynx (N=Normal)"
4,285,370,545,390,262078,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Neck was Asymmetrical"
4,285,390,545,410,262079,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Neck Palpation Revealed Abnormalities"
4,560,90,820,110,6963,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Lymph Nodes (N=Normal)"
4,560,120,820,140,7649,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Musculoskeletal System"
4,560,170,820,190,292870,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Change in Voice"
4,560,190,820,210,62532,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Speech not Appropriate for Age"
4,560,210,820,230,8494,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Cranial Nerves were Abnormal"
4,560,230,820,250,8615,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Sensory Exam Abnormalities"
4,560,250,820,270,8913,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Motor Exam Dysfunction"
4,560,270,820,290,9035,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Gait and Stance were Abnormal"
4,285,350,545,370,6908,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Neck (N=Normal)"
4,285,460,545,480,7027,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Chest Percussion Revealed Abnormalities"
4,285,480,545,500,7041,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Auscultation Revealed Abnormalities"
4,10,140,270,160,6404,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Scalp Tenderness"
4,285,410,545,430,6920,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Thyroid Showed Abnormalities"
4,560,40,820,60,206245,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Heart Rate and Rhythm was Abnormal"
4,560,60,820,80,7293,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Arterial Pulses were Abnormal"
4,10,190,270,210,155097,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Motor Strength of Face was Reduced"
0,420,5,825,530,0,4,"","I=FS=FB=T",""
1,20,15,810,45,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=200|B=T|T=T","DOCUMENATION RECOMMENDATIONS:  Under HPI document the reason for the visit with attention to the elements of duration onset and alleviating/exacerbating factors using free text if structured items can not be found easily."
1,20,50,810,70,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=200|B=T|T=T","REMINDER:  Include pertinent positives and negatives as related to HPI/Purpose of visit here."
1,10,10,820,70,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","|T=T|S=T",""
1,205,75,395,95,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T|P=Detailed ROS = 2+ Systems","(Detailed HPI = 4 Acute or 3+ Chronic Items)"
1,10,75,400,95,2952,4097," |||||||19|80||0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","HISTORY OF PRESENT ILLNESS"
1,10,100,400,120,1718,33562881," |||||||19|275|YCN|0|0|X||0|||0|0|0|0|0||||","|B=T|T=T|L=","Chief Complaint:"
1,10,130,400,150,112176,33562881," |||||||19|275|YCN|0|0|X||0|||0|0|0|0|0||||","|B=T|T=T|L=","Visit For:~PREOPERATIVE WORKUP"
2,440,365,820,425,122300,4202753," |||||||19|80|YCN|0|0|X||0|||0|0|0|0|0||||","|B=T|T=T|L=","Other Past Medical/Surgical History"
2,440,435,820,465,0,32768," |||||||0|150||0|0|T|F|0|||0|0|0|0|0||||","C=200|T=T","TIP: If you enter past medical and surgical info in the patient 'Problems List' the items will be autocited into future visits and available in Dx pick-lists."
1,415,90,415,495,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
2,10,520,820,540,0,32768," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=128|B=T|T=T","NAVY GENERAL ENT Form DRAFT September 2006"
2,20,15,120,35,0,32769," |||||||0|80||0|0|Y|N|0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|B=T|T=T","DETAILED HISTORY"
2,20,30,150,50,0,32769," |||||||0|80||0|0|Y|N|0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|B=T|T=T","COMPREHENSIVE HISTORY"
2,120,15,320,35,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T|P=Detailed ROS = 2+ Systems","Detailed Past / Family / Social History = 1 Item"
2,10,10,820,125,0,32769," |||||||0|80||0|0|Y|N|0|||0|0|0|0|0||||","|T=T|S=T",""
2,20,75,810,95,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T","At least one specific item from each of the three history areas must be documented for a complete PFSH for the following categories of E/M services:"
2,40,60,810,80,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T","Office or other outpatient services - Established patient; Emergency Department; Domiciliary care - Established patient; Home care -  Established patient"
2,40,90,810,120,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T","Office or other outpatient services - New patient; Hospital observation services; Hospital inpatient services - Initial care; Consultations; Comprehensive nursing facility assessments; Domiciliary care -  New patient; Home care - New patient"
2,20,45,810,65,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T","At least one specific item from two of the three history areas must be documented for a complete PFSH for the following categories of E/M services:"
3,155,10,347,30,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T|P=Detailed ROS = 2+ Systems","(Detailed ROS = 2+ Systems)"
2,10,175,390,195,282540,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Surgical History Reviewed"
2,10,155,390,175,112381,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Past Medical History Reviewed"
2,440,165,820,185,5097,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Social History"
2,440,185,820,205,122667,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Social History Reviewed"
2,440,325,820,345,122669,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Family History Reviewed"
2,10,325,390,345,39448,4097," |||||||19|80||0|0|||0|||0|0|0|0|0||||","|B=T|T=T|L=","Previous Diagnoses"
3,10,520,820,540,0,32768," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=128|B=T|T=T","NAVY GENERAL ENT Form DRAFT September 2006"
3,440,340,820,430,112344,4202752," |||||||19|80||0|0|X||4|||0|0|0|0|0||||","|B=T|T=T|L=","Additional Review of Systems"
2,50,275,390,295,40933,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Coumadin"
2,50,235,390,255,40457,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","NSAIDS"
2,50,255,390,275,40170,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Aspirin"
2,50,295,390,315,132257,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Plavix"
2,415,140,415,495,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
3,10,400,390,420,393,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Decrease In Appetite"
3,10,360,390,380,1412,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Appetite Normal"
3,10,380,390,400,393,268445441," |||||||19|80|YCHN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Decrease In Appetite"
4,130,10,370,30,0,32769," |||||||0|0||0|0|||0|||0|0|0|0|0||||","C=10485760|F=Arial Narrow|T=T|P=Detailed ROS = 2+ Systems","(Detailed PE = 2 in each of 6 areas or 12+ in 2+ areas)"
4,10,10,390,30,6000,4096," |||||7||19|80||0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","PHYSICAL EXAM"
4,10,120,270,140,6369,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Head (N=Normal)"
4,10,170,270,190,266315,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Face Exam was Performed"
4,10,220,270,240,6425,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Eyes (N=Normal)"
4,560,150,820,170,8202,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Neurological System (N=Normal)"
4,560,380,820,400,81209,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","CBC (N=Normal)"
4,560,400,820,420,12131,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Coagulation Studies (N=Normal)"
4,560,420,820,440,105547,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Electrolyte Panel (N=Normal)"
4,560,440,820,460,19149,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Audiometry Performed~performed"
4,560,460,820,480,13658,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Chest X-Ray (N=Normal)"
4,560,300,820,350,208847,4202753," |||||||19|80|YCN|0|0|X||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Other Physical Findings"
4,285,440,545,460,7010,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Lungs (N=Normal)"
4,560,20,820,40,7105,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","CV System (N=Normal)"
4,560,360,820,380,102905,13057," |||||||19|80|YCBN|0|0|||0|||0|0|0|0|0||||","|B=T|U=T|T=T|L=","Tests (N=Normal)"
4,560,480,820,500,220255,33562881," |||||||19|205|YCN|0|0|X||0|||0|0|0|0|0||||","|T=T|L=","Other:"
4,10,330,270,350,6710,8961," |||||||19|80|YCN|0|0|||0|||0|0|0|0|0||||","|T=T|L=","Tympanic Membranes Abnormal"
4,277,50,277,490,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"
4,553,50,553,490,0,1," |||||||0|0||0|0|||0|||0|0|0|0|0||||","","0:0:1:1:"