CERMSGR|0|379924:21080220902;2096886:21080221101,1|HBSLD^0|1|| CERMSGR|0|379924:21080220902;2096886:21080221101,1|HBSLD^0|1|| CERMSGR|0|2108023043:21080230405;2108023042:21080230404,1|HBSLD^0|1||" CERMSGR|0|2108023043:21080230405;2108023042:21080230404,1|HBSLD^0|1|| : Assessment and Plan ASSESSNOHEADERBEGIN|1|||1||MR_COMSUM^``^#`BEGIN^``^#`Assessment^``^#`2^``^#`1370282.613798^``^#`0^``^#`3^``^#`MR_COMSUM^``^#`BEGIN^``^#`Assessment^``^#`2^``^#`1370282.613798^``^#`0^``^#`3^``^#` SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Assessment^``^#`2^``^#`1370282.613798^``^#`0^``^#`3^``^#`SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Assessment^``^#`2^``^#`1370282.613798^``^#`0^``^#`3^``^#` ASSESSNOHEADERBEGIN|1|||1||ASSESSPLAN1|1|||1||Annual physical exam Snoring - CBC with Differential - Comprehensive Metabolic Panel - Thyroid Stimulating Hormone - Ambulatory Referral to Sleep Medicine Grapevine (BSW- Grapevine Sleep Lab) - Lipid Panel Hyperlipidemia, unspecified hyperlipidemia type - Lipid Panel ASSESSPLAN1|1|||1||Followup: FOLLOWUP|1|||0|| No follow-ups on file. FOLLOWUP|1|||0||" HISTORYHEADERBEGIN|1|||0||MR_COMSUM^``^#`BEGIN^``^#`History^``^#`0^``^#`1370282.615704^``^#`0^``^#`1001^``^#`MR_COMSUM^``^#`BEGIN^``^#`History^``^#`0^``^#`1370282.615704^``^#`0^``^#`1001^``^#`History SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`History^``^#`0^``^#`1370282.615704^``^#`0^``^#`1001^``^#`SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`History^``^#`0^``^#`1370282.615704^``^#`0^``^#`1001^``^#` HISTORYHEADERBEGIN|1|||0||PREFNAME|0|||0||Devin SlickPREFNAME|0|||0||is a AGE|0|||0||37 y.o.AGE|0|||0||SEX|0|||0||maleSEX|0|||0||who is seen today for CCN|1|||1||Well Adult Exam (Pt is here for the annual exam and a fasting labs. ) CCN|1|||1||Here for annual exam feels daytime sleepy Wife states that he snores Denies chest pain but feels overall fatigued Doesn't go outside much but wears sunscreen when he does Wife worries about his snoring Drinks in moderation HISTORYEND|1|||0||MR_COMSUM^``^#`END^``^#`History^``^#`0^``^#`1370282.616661^``^#`0^``^#`1001^``^#`MR_COMSUM^``^#`END^``^#`History^``^#`0^``^#`1370282.616661^``^#`0^``^#`1001^``^#` HISTORYEND|1|||0||OBSERVHEADERBEGIN|1|||0||MR_COMSUM^``^#`BEGIN^``^#`Observations^``^#`0^``^#`1370282.617023^``^#`0^``^#`1002^``^#`MR_COMSUM^``^#`BEGIN^``^#`Observations^``^#`0^``^#`1370282.617023^``^#`0^``^#`1002^``^#`Observations SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Observations^``^#`0^``^#`1370282.617023^``^#`0^``^#`1002^``^#`SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Observations^``^#`0^``^#`1370282.617023^``^#`0^``^#`1002^``^#` OBSERVHEADERBEGIN|1|||0||CERMSGR|0|2099019:20831,1|HBSLD^0|1||CERMSGR|0|2099019:20831,1|HBSLD^0|1|| VS|1|||0||BP 120/80 (BP Location: Right Arm, Patient Position: Sitting, Cuff size: LAd) | Pulse 68 | Temp 98.3 F (36.8 C) (Temporal) | Resp 16 | Wt 98.9 kg (218 lb) | SpO2 98% | BMI 30.40 kg/m VS|1|||0||BLOCKBEGIN|HTPNPHYEXAMBYAGE|BLOCKBEGIN|HTPNPHYEXAMBYAGE|Physical Exam 1011192__1011193_BEGIN1011192__1011193_BEGIN Constitutional: He is well-developed and well-nourished. 1011192__1011193_END1011192__1011193_END1011192__1000446_BEGIN1011192__1000446_BEGIN HENT: Head: Normocephalic and atraumatic. Right Ear: Tympanic membrane normal. Left Ear: Tympanic membrane normal. 1011192__1000446_END1011192__1000446_END1011192__75105_BEGIN1011192__75105_BEGIN1011192__75105_END 1011192__75105_END1011192__1016336_BEGIN1011192__1016336_BEGIN Neck: Trachea normal, phonation normal, normal range of motion and neck supple. No JVD present. 1011192__1016336_END1011192__1016336_END1011192__1000604_BEGIN 1011192__1000604_BEGIN Cardiovascular: Normal rate, regular rhythm, S1 normal, S2 normal and normal heart sounds. Exam reveals no gallop and no friction rub. No murmur heard.1011192__1000604_END1011192__1000604_END1011192__1017310_BEGIN1011192__1017310_BEGIN Pulmonary/Chest: Effort normal and breath sounds normal. No accessory muscle usage or stridor. No apnea, no tachypnea and no bradypnea. No respiratory distress. He has no wheezes. He has no rales . He exhibits no tenderness. 1011192__1017310_END1011192__1017310_END1011192__1018171_BEGIN1011192__1018171_BEGIN1011192__1018171_END 1011192__1018171_END1011192__1000417_BEGIN1011192__1000417_BEGIN1011192__1000417_END1011192__1000417_END1011192__1011198_BEGIN1011192__1011198_BEGIN Musculoskeletal: Normal range of motion. No tenderness. 1011192__1011198_END1011192__1011198_END1011192__1000235_BEGIN1011192__1000235_BEGIN1011192__1000235_END1011192__1000235_END 1011192__75383_BEGIN1011192__75383_BEGIN Lymphadenopathy: He has no cervical adenopathy. 1011192__75383_END1011192__75383_END1011192__1018174_BEGIN1011192__1018174_BEGIN Neurological: He is alert. 1011192__1018174_END1011192__1018174_END1011192__1000420_BEGIN1011192__1000420_BEGIN Skin: Skin is warm and dry. 1011192__1000420_END1011192__1000420_END1011192__75442_BEGIN1011192__75442_BEGIN1011192__75442_END1011192__75442_END1011192__75063_BEGIN 1011192__75063_BEGIN1011192__75063_END1011192__75063_END BLOCKEND|HTPNPHYEXAMBYAGE|BLOCKEND|HTPNPHYEXAMBYAGE|OBSERVHEADEREND|1|||0||MR_COMSUM^``^#`END^``^#`Observations^``^#`0^``^#`1370282.61866^``^#`0^``^#`1002^``^#`MR_COMSUM^``^#`END^``^#`Observations^``^#`0^``^#`1370282.61866^``^#`0^``^#`1002^``^#` OBSERVHEADEREND|1|||0||CERMSGREFRESH|0|2108023041:HBSLD^0|1|| CERMSGREFRESH|0|2108023041:HBSLD^0|1||" CERMSGR|0|379924:21080220902;2096886:21080221101,1|HBSLD^0|1|| CERMSGR|0|379924:21080220902;2096886:21080221101,1|HBSLD^0|1|| CERMSGR|0|2108023043:21080230405;2108023042:21080230404,1|HBSLD^0|1||" CERMSGR|0|2108023043:21080230405;2108023042:21080230404,1|HBSLD^0|1||