My initial new patient appointment with Dr. McMullen was on February 8, 2022. As most new patient appointments go, I basically just let her know about all of my health concerns and get my vitals taken.
I specifically mentioned that I gained about 50 pounds during the Covid lock downs. All of that additional weight gain on top of my already original weight was what I believed to be an important medical issue.
Whats Noted In My Medical History
- Abdominal pain
- Abnormal weight gain
- Family history of diabetes mellitus
- Menopause syndrome
- Chronic GERD
- Screening mammogram for breast cancer
- Chronic fatigue
- Urinary frequency
My Office Nurse Check
- Blood Pressure 138/76
- Temp 98.2
- BMI 48.97
- Pulse 91
- Weight 294lbs 4oz
- Respiration 18
- Height 5’5″
- Oxygen Saturation 97%
Of this office visit McMullen told me to stop taking Nexium and to start taking pantoprazole 40 mg EC tablet.
A “leaflet” distributed by Ardent Health was also attached to my visit summary titled “Basics Of Diet And Health”. This leaflet affiliated with Ardent Health is similar to what a patient may see hanging in a doctors office with general information about diet. No services or instructions were on the leaflet.
Extra Attention With These 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. I agree with this note.
- On 2/8/2022 McMullen noted gastrointestinal issues as “positive for abdominal distention and abdominal pain. Negative for constipation, diarrhea, nausea and vomiting.” I agree with this note.
- 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 2/8/2022 McMullen noted that I had abdominal “left CVA” tenderness. I agree with this note.
- 2/8/22 McMullen specifically notes “Does have GERD, but that is fairly well controlled with medications, diet.“
New Diagnosis
New Medication
- Pantoprazole (PROTONIX) 40 mg EC tablet, Take 1 tablet (40 mg total) by mouth 1 (one) time each day.
Lab Test Ordered My McMullen With Results
These lab samples were taken by medical staff at the UT Health East Texas Cedar Creek Lake location.
- FSH (Follicle Stimulating Hormone) = 6.3 These test results put me in 2 groups MID-CYCLE PEAK & LUTEAL PHASE
- Microalbumin, Ur = 0.2 Falling within normal range
- UA MICROSCOPIC WITH REFLEX TO CULTURE = All was normal except Clarity, UA = Turbid ABNORMAL, Bacteria, UA = TRACE ABNORMAL
- CBC W/ AUTO DIFFERENTIAL All was normal except Eosinophils, Absolute = 0.7 HIGH normal range is 0.0 – 0.5, RBC = 4.44 LOW Normal range is 4.50 – 5.50, Eosinophils 8.2 HIGH normal range is .09 – 2.9
- LIPID PANEL Cholesterol = 130 LOW Normal range is 142 – 199, HDL Cholesterol = 26 LOW normal range is 32 – 96, Triglycerides = 207 HIGH normal range is <150
- HEMOGLOBIN A1C A1C% = 5.3 normal, Mean Glucose = 102
- THYROID STIMULATING HORMONE = 1.49 normal
- COMPREHENSIVE METABOLIC PANEL Sodium = 139 normal, Potassium = 3.9 normal, Chloride = 100 normal, CO2 = 28 normal, Calcium = 9.5 normal, Glucose = 90 normal, Creatinine = 1.02 normal, BUN = 12 normal, Albumin = 3.8 normal, Total Protein = 7.0 normal, Alkaline Phosphatase = 58 normal, ALT = 26 normal, AST = 26 normal, Bilirubin, Total = 0.5 normal, Anion Gap = 11.0 normal, Estimated GFR = >60
Mammogram ordered
2D Bilateral Screening Mammogram on 3/14/22 shows no suspicious findings. “Breasts are almost entirely fatty replaced.” This mammogram was interpreted by Michael Klouda, MD on 3/18/22.
Attorney Documents For This Clinic Visit:
- Document #2-22-2 = “After Visit Sumary”
- Document #2-22-3 = “Notes From Care Team”
- Document #2-22-4 = “Visit Details” for the ordered labs
- Document #2-22-5 = Lab results Follicle Stimulating Hormone
- Document #2-22-6 = Lab test results Microalbumin, Urine Random
- Document #2-22-7 = Lab test results UA Microscopic With Reflex To Cilture
- Document #2-22-8 = Lab test results CBC w/ Auto Differential
- Document #2-22-9 = Lab test results Lipid Panel
- Document #2-22-10 = Lab test results Hemoglobin A1C
- Document #2-22-11 = Lab test results Thyroid Stimulating Hormone
- Document #2-22-12 = Lab test results Comprehensive Metabolic Panel
- Document #22-1 = Lab Test Bill
- Document #22-2 = Mammo testing bill
- Document #22-5 = McMullen Office visit bill
- Document #22-6 = Mammo Klouda bill
Billing For Dr. McMullen’s Office Visit
- $365.00 = McMullen New Patient 45 min office visit
- $29.54 = Insertion of needle into vein for collection of blood
- $123.31 = Manual urinalysis test with examination using microscope, automated #81001
- $301.84 = Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count #85025
- $567.58 = Gonadotropin, follicle stimulating (reproductive hormone) level #83001
- $296.14 = Hemoglobin A1C level #83036
- $169.91 = Urine microalbumin (protein) level #82043
- $421.50 = Blood test, comprehensive group of blood chemicals #80053
- $534.00 = Blood test, lipids (cholesterol and triglycerides) #80061
- $512.98 = Blood test, thyroid stimulating hormone (TSH) #84443
Correct Bill Amount = $3,321.80
Of course, I also found an extra charge for test that wasn’t done. I think this kind of billing is insurance fraud, but apparently Texas Department of Insurance disagrees.
This time the added charge is:
- $291.16 = LDL cholesterol level #83721
Actual Bill Amount With Extra Charges = $3,612.96
Separate Billing For The Mammogram
- $110.00 = Screening Mammography Bi 2-View Breast Inc Cad / Provider = Dr. Klouda
- $773.53 = HC Screening Mammo Bilat W/Cad if Performed #77067
Making the total cost of ordered mammogram $883.53
Unfortunately the insurance claims for this visit are too far back to get the claim records. I cant see my Ambetter health insurance claims that were submitted before 11/30/23. If I find billing records for this visit, I will add as much detail as possible.
On the documents I have from UT Health East Texas / Ardent Health, it shows that my Ambetter health insurance paid 100% of medical bills on this day.
Time Taking Pantoprazole
This day marks day 1 of taking the Proton Pump Inhibitor Pantoprazole