Well Women’s Annual Exam With Dr. McMullen on 5/9/2022. The office visit took place at UT Health East Texas – Cedar Creek Lake location. This appointment is as mentioned, just regular annual exam. We went over how I get regular breakouts under my breast in right where my bra line usually sits. I have also been getting boils in my groin area. While the breakouts are not continuous – They tend to be regular.
Doctor McMullen performed the pap test and breast exam during this visit. Nothing out of the ordinary from any other annual exam. She did notice what she said was yeast in the scar of my cesarean. Im numb in my scar and cant see that area, so I had no idea there was an issue.
I’m seeing in the notes that “From last visit, pending GI eval 5/17/22”. I know that I was sent to a stomach doctor before and received an endoscopy. I did not see a referral or notes from my last visit saying this. Its possible the referral notes were not added to my medical records.
My Office Nurse Check
- Blood Pressure: 122/70
- Temperature: 98.1
- BMI: 48.47
- Pulse: 100
- Weight: 291 lbs 4oz
- Respiration: 18
- Height: 5′ 5″”
- Oxygen Saturation: 97%
Patient Active Problem List includes:
- Chronic gastroesophageal reflux disease / Diagnosed 2/8/2022
There is no mention of the “Fatty Liver” or “Gallstone” listed in active problem list. The radiologist Daniel Christopher Bennett, MD seen these issues and released the sonogram report on 4/20/2022. This fungus rash visit is 2 days after the sonogram was read. I wasn’t made aware of any kind of diagnostic errors in the sonogram report.
So was Dr. Bennett wrong in his reported findings or were these active health issues ignored by Dr. McMullen?
Diagnosis For 5/9/2022
- Candidal intertrigo – “Long term Weight Loss” was noted with this diagnosis
- Gynecologic exam normal – pending pap lab results, “Long term Weight Loss” was noted with my pelvic
- Recurrent boils
Labs Ordered For This Visit Include
- Pap lab samples
New Medications For 5/9/2022
- doxycycline (VIBRAMYCIN) 100 mg capsule; Take 1 capsule (100 mg total) by mouth 1 (one) time each day. SUN protection
Continued Medications
- pantoprazole (PROTONIX) 40 mg EC tablet, Take 1 tablet (40 mg total) by mouth 1 (one) time each day., Disp: 90 tablet, Rfl: 3
- clotrimazole (LOTRIMIN) 1 % cream; Apply topically 2 (two) times per day.
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. 4/22/2022 visit just notes “she is alert” for neurological. 5/9/2022 noted alert and no neurological symptoms.
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. 4/22/2022 again just noted as “obese” this is 2 days after the radiologist noted “fatty liver” on my sonogram. 5/9/2022 Noted that I appeared and “obese”
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. 4/22/2022 nothing noted about gastrointestinal symptoms. 5/9/2022 Noted that I was negative for pain, vomiting and diarrhea ect
The same useless “leaflet” distributed by Ardent Health was also attached to my visit summary on 3/23/2022.
Attorney Documents For This Clinic Visit:
- Document #5-22-2 = After Visit Summary
- Document #5-22-3 = Notes From Care Team
- Document #5-22-4 = Visit Details for Lab Test
- Document #5-22-11 = PAP 3, THINPREP, WITH HPV lab test results
- Document #22-7 = McMullen Clinic Visit Bill
- Document #22-4 = Bill PAP lab test
Billing For Dr. McMullen’s Office Visit
- $286.00 = Periodic Preventive Med Est Patient 40-64yrs = McMullen Office Visit
- $106.00 = Detection test by nucleic acid for human papillomavirus (HPV), high-risk types – #87624
- $61.00 = Pap test, manual screening #88142
Total Clinic Visit Charges For This Day = $453.00
Unfortunately the Ambetter Health insurance claims for this visit are too far back to get records. I cant see claims that were submitted before 11/30/23. So I cant tell exactly what items my health insurance paid for for this visit.
The UT Health East Texas / Ardent Health bill says that my health insurance paid 100% of the medical cost for this clinic visit.
*I am a bit confused as to why there were 2 different lab test charges, but only 1 lab test result. If there was only one lab test results provided – then there should only be 1 lab test on the medical bill. Google says that these 2 test are often done together – so why would the hospital charge separately for them. There are many lab test that actual test multiple items (like the CBC test) – so why not charge them as a single test? 1 test result = 1 charge. This could be something that needs to be looked at.
*There was also a separate “Visit Details” for UT Athens Cedar Creek Lake Hospital Lab. On this day, Dr. McMullen did the PAP sample in her clinic. McMullen’s clinic and the UT Athens Cedar Creek Lake Hospital Lab are supposed to be 2 separate “businesses” but located in the same building. I think its very strange to get 2 “Visit Detail” pages for 1 office visit. There may be a reasonable explanation for this, but it doesn’t make much sense.
On This Day My Time On Pantoprazole Is:
- 3 months 1 days
- or 12 weeks 6 days = 4 weeks and 6 days longer than the FDA recommended treatment cycle
- or 90 days
The recommended FDA treatment cycle for Pantoprazole is 8 weeks. So on this day I had already taken the Pantoprazole for 4 weeks and 6 days longer that the FDA recommendation. FDA recommends that doctors regular evaluations while using Pantoprazole.
I was there doing a well woman’s exam, so it would make sense to do some blood testing or medication modifications on this type of office visit. Dr. McMullen ordered no blood test on this day. She also did not mention the PPI Pantoprazole medication.