Unique Plan Description: Breast Ctr JE General Clinic
Plan Selection Display: Breast Ctr JE General Clinic
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2012-03-02 11:30:56
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2025-02-19 09:58:16
Available at all facilities: No

Breast Ctr JE General Clinic
Medications
	lidocaine-EPINEPHrine 2%-1:100000 (In Office)
		20 mL, Injection, IM-Intramuscular, Once, NOW
	lidocaine 1% (5 mL) (Xylocaine) (In Office)
		5 mL, Injection, SUBCUTANEOUS, Once, NOW
	sodium bicarbonate (In Office)
		50 mL, Injection, SUBCUTANEOUS, Once, NOW
			Comment: Mix with lidocaine as directed.
	amoxicillin-clavulanate  875 mg-125 mg oral tablet
		1 TAB BY MOUTH BID, X 10 Day(s), # 20 TAB, 0 Refill(s), Hard Stop
	Avelox 400 mg oral tablet
		1 TAB BY MOUTH DAILY, X 10 Day(s), # 10 TAB, 0 Refill(s), Hard Stop
	clindamycin 300 mg oral capsule
		1 CAP BY MOUTH QID, X 10 Day(s), # 40 CAP, 0 Refill(s), Hard Stop
	Evista 60 mg oral tablet
		1 TAB, BY MOUTH, DAILY, # 30 TAB, 3 Refill(s)
	metroNIDAZOLE 500 mg oral tablet
		1 TAB BY MOUTH TID, X 10 Day(s), # 30 TAB, 0 Refill(s), Hard Stop
	cephalexin 500 mg oral capsule
		1 CAP BY MOUTH TID, X 10 Day(s), # 30 CAP, 0 Refill(s), Hard Stop
	acetaminophen-hydrocodone 325 mg-5 mg oral tablet
		1 or 2 TAB, By Mouth, Q4-6H, PRN pain, # 20 TAB, 0 Refill(s), Hard Stop
	Percocet 5 mg-325 mg oral tablet
		1 or 2 TAB, BY MOUTH, Q4H, PRN pain, # 20 TAB, 0 Refill(s), Hard Stop
	Ultram 50 mg oral tablet
		1 or 2 TAB, BY MOUTH, Q6H, PRN pain, # 20 TAB, 0 Refill(s), Hard Stop
	tamoxifen 20 mg oral tablet
		1 TAB BY MOUTH DAILY, # 30 TAB, 3 Refill(s)
			Comment: Extremely Hazardous Drug | Antineoplastic |  PPE Requirements: Dispensed From Pharmacy In Rx Crush Bag, Double Gloves, Gown, Face Shield If Tube Admin Or Splashing Risk.
Consults/Follow-up
	Follow-up Appointment
		Follow Up Visit, 1 week
		Follow Up Visit, 2 weeks
		Follow Up Visit, 3 weeks
		Follow Up Visit, 1 month
		Follow Up Visit, 3 months
		Follow Up Visit, 6 months
		Follow Up Visit, 1 year
		Follow Up Visit, See Special Instructions
Charges/Supplies
	Multidisciplinary Conference
		
New Pt Visit
	zz99201 EVM-New Pt Visit Problem focused 10m
		T;N
	99202 EVM - OP VISIT NEW PATIENT, STRAIGHTFORWARD 15 MIN
		T;N
	99203 EVM - OP VISIT NEW PATIENT, LOW LEVEL 30 MIN
		T;N
	99204 EVM - OP VISIT NEW PATIENT, MODERATE LEVEL 45 MIN
		T;N
	99205 EVM - OP VISIT NEW PATIENT, HIGH LEVEL 60 MIN
		T;N
Est. Pt Visit
	99211 EVM - OP visit estab patient, minimal care < 10 min
		T;N
	99212 EVM - OP VISIT ESTAB PATIENT, STRAIGHTFORWARD 10 MIN
		T;N
	99213 EVM - OP VISIT ESTAB PATIENT, LOW LEVEL 20 MIN
		T;N
	99214 EVM - OP VISIT ESTAB PATIENT, MODERATE 30 MIN
		T;N
	99215 EVM - OP VISIT ESTAB PATIENT, HIGH LEVEL 40 MIN
		T;N
No Charge / Follow Up
	99211n EVM - No Charge Professional Service
		T;N
	99024 EVM - Post Op Visit
		T;N
Procedures in Office
	19100 Breast bx percu needle core
		
	zz11100 Biopsy of skin, subcu tissue; single
		
	10021 Fine Needle Asp
		
	10060 I&D abscess simple/single
		
	10140 I&D hematoma seroma
		
	19020 Mastotomy w/ Exploration Drain Abscess
		
	19000 Puncture asp breast cyst
		
	19001 Puncture asp breast cyst ea additional
		
	10160 Puncture aspirat abscess hematoma cyst
		
	11201 Removal of skin tags, each additional ten
		
	11200 Removal of skin tags, up to and inc 15

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase