Abdominal pain McMullen office visit 3/23/2022 actually was for 3 separate issues.
- Abdominal pain
- Change in mole
- Body mass index 45.0-49.9, adult
So this appointment McMullen acknowledges: Chronic LUQ pain. She also is made aware of a large mole on my center mid back. The mole runs in my family and causes issues with getting hair tangled on it in the shower. McMullen also mentions my weight as being as issue.
Patient Active Problem List includes:
- Chronic gastroesophageal reflux disease / Diagnosed 2/8/2022
My Office Nurse Check
- Blood Pressure: 128/72
- Temperature: 97.1
- BMI: 49.42
- Pulse: 87
- Weight: 297
- Respiration: 18
- Height: 5′ 5″”
- Oxygen Saturation: 98%
McMullen Ordered Labs For This Clinic Visit
- CBC with Auto Differential
- Comprehensive Metabolic Panel
McMullen Ordered The Following Images
- CT Abdomen With Contrast
- McMullen sent a dermatology referral for the large mole on my center back.
- This mole on my back was removed April 27, 2022 by Dr. Le at Epiphany Dermatology in Mequite, Texas.
Body mass index (BMI) of 45.0-49.9 in adult (HCC) = she noted that I should continue with diet and exorcise. McMullen never offered any kind of diet or exorcise plan during our office visits.
No medications were prescribed with this visit.
Continued Medications
- pantoprazole (PROTONIX) 40 mg EC tablet, Take 1 tablet (40 mg total) by mouth 1 (one) time each day.
Surgery History Includes:
- Cesarean Section (The date is not in my medical records)
Extra Attention With These Medical Records
On 2/8/2022 McMullen noted that I showed no signs of neurological issues. Negative for dizziness, tremors, seizures, weakness, light-headedness, numbness and headaches. On 3/8/2022 The notes for neurological only say “she is alert”. There is no mention of the other neurological stuff previously mentioned. 3/23/2022 McMullen noted negative for dizziness, weakness, light-headedness and numbness.
On 2/8/2022 McMullen noted “she is obese. She is not ill-appearing, toxic-appearing or diaphoretic.” I believe the term “Obese” that McMullen was incorrect. I believe the correct term for me would be “Class III obesity” because my BMI at the time was over 40. On 3/8/2022 McMullen noted “she is obese”. Again, I do not agree we the label of “Obese” I believe the correct term to label me should be Class lll obesity since my BMI is over 40. 3/23/2022 McMullen labeled me as “Obese” again.
On 3/8/2022 Dr. McMullen did not comment on gastrointestinal issues or left CVA” tenderness as previously mention on the 2/8/2022 records. 3/23/2022 McMullen noted abdominal pain, left CVA tenderness in the area for gastrointestinal symptoms.
3/23/2022 Clinic Lab Results
- Urinalysis With Reflex To Microscopic = In the results section of MyChart it says that this test came back as “ABNORMAL”. Everything comes up as normal except “Blood, UA” Its marked as Abnormal with “TRACE” listed.
- Comprehensive Metabolic Panel = Everything in this test came back as “NORMAL”
- CBC W/ Auto Differential = Is marked as “ABNORMAL” , Basophils = 1.3 HIGH, Lymphocytes, Absolute = 3.3 HIGH, RBC = 4.26 LOW, Eosinophils = 3 HIGH, All other areas of this test come up as normal
In response to these lab test, Dr. McMullen commented that my chemistry, urine and blood count were all ok.
CT Abdomen With Contrast Ordered By Dr McMullen
Well this CT didn’t actually happen. Instead of the CT I was scheduled for a sonogram of my abdomen. The sonogram was ordered on 3/23/2022 but done Apr 20, 2022. The sonogram appointment was made for the UT Health East Texas Cedar Creek Lake location.
The sonogram was interpreted by Daniel C Bennett, MD. His noted findings include the following:
- Fatty liver without focal mass
- 1.3 CM Cholelith without sonographic evidence for acute cholecystitis
The same “leaflet” distributed by Ardent Health was also attached to my visit summary on 3/23/2022. McMullen never pointed out having this leaflet attached to my after visit summaries. Im only seeing them now because I’m dissecting my medical records page by page.
Attorney Documents For This Clinic Visit
- Document #3-22-7 = “After Visit Summary”
- Document #3-22-8 = “Notes From Care Team”
- Document #3-22-9 = “Visit Details” For Labs ordered
- Document #3-22-10 = Lab results CBC W/ Auto Differential
- Document #3-22-11 = Lab results Comprehensive Metabolic Panel
- Document #3-22-12 = Lab results Urinalysis With Reflex To Microscopic
- Document #22-6 = McMullen office visit bill
- Document #22-2 = billing for 3/23/22 lab test
- Document #22-3 = Sonogram Bill
Clinic Visits Billing
- $238.00 = McMullen Office / Outpatient Established Mod Mdm 30 min
- $29.54 = Insertion of needle into vein for collection of blood sample #36415
- $301.84 = Complete blood cell count (red cells, white blood cell, platelets), automated #85025
- $123.31 = Manual urinalysis test with examination using microscope, automated #81001
- $421.50 = Blood test, comprehensive group of blood chemicals #80053
Actual Medical Bill = $1,114.19
This office visit has already timed off of my insurance history, so I don’t have access to the EOB for this claim. The UT Health East Texas / Ardent Health bill says that my Ambetter health insurance paid 100% of these medical services.
Billing For the Sonogram of My Abdomen:
I do not have a bill for Daniel C Bennett, MD sonogram interpretation. I only have the bill of the imaging services and not the doctor services.
- $1,700.00 = Complete ultrasound scan of abdomen #76700
The bill says that my Ambetter health insurance policy covered $1,667.54 leaving me paying a $32.46 for the coinsurance.
Time Taking Pantoprazole
This day marks 1 month 15 days / or 6 weeks 1 day / or 43 days, of taking the Proton Pump Inhibitor Pantoprazole
This day is still within the Food And Drug Administration FDA Protonix label recommended 8 week treatment cycle for the medication.