CIS100 homework just 3 files Word, PowerPoint and Excel

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Num Patient Name Date of Birth Gender Insurance Company Insurance Type Insurance Policy Number Visit Code Charge Payment/ Co-Pay Insurance Billing Insurance Adjustment Discount Applicible Cash Discount Total Due After Adjustments Charges Lookup
1 Chang, Tom 16865 Male Humana PPO AA-144-366-53 7011 25 180 Type of Visit Code Charge
Tsifo, Georgia 38903 Female Blue Cross HMO XOF-4553342 8112 30 90 Office Visit, New 7011 $ 225
Kane, Chris 28616 Male Blue Cross HMO XOF-9093844 8111 30 70 Office Visit, Est. Level 1 8111 $ 100
Mitchell, Gene 23886 Male Aetna HMO HD 8400 3923 8112 20 90 Office Visit, Est. Level 2 8112 $ 120
Miller, Sue 29254 Female None 8113 150 0 Office Visit, Est. Level 3 8113 $ 150
Yong, Samantha 32239 Female Humana PPO FG-E03-993-02 9211 25 50 Office Visit, Consultation 9211 $ 90
Fay, Mike 20352 Male Blue Cross HMO XOF-5794835 7011 30 180 Diabetes Education, Individual 4055 $ 80
Schreyer, Harmony 50555 Female Humana PPO AC-178-766-54 3705 25 60 Diabetes Education, Group 4065 $ 40
Pattenden, Kim 17563 Male None 8112 120 0 Insulin Pump Instruction 3705 $ 95
Carrillo, Jose 19954 Female Aetna HMO HD 6480 7823 8113 20 110 Electrocardiogram 1001 $ 250
Da Silva, Ramone 24353 Male Blue Cross HMO XOF-6678145 8113 30 110 Flu Vaccine 2011 $ 25
Hew-Len, Dale 22568 Male Humana PPO HF-124-386-39 8111 25 70
Gibbons, Randy 19107 Male Aetna HMO HD 8422 5126 7011 20 180 Cash Discount 10%
Iketau, Romeo 16025 Male None 4055 80 0
Ifediba, Jared 22251 Male Blue Cross HMO XOF-7184698 4055 30 50
Weis, Jaclyn 19897 Female Humana PPO OS-594-626-76 1001 25 200
Stauffer, Rick 16622 Male Aetna HMO HD 8240 8361 7011 20 180
Corless, Cynthia 14728 Female Blue Cross HMO XOF-6982455 8113 30 110
Metcalf, Donald 20305 Male None 9211 90 0
Baker, Marshall 17485 Male Humana PPO UR-857-366-53 2011 25 0
Sovine, Jaron 22064 Male Humana PPO GD-814-376-74 8111 25 70
Griffiths, Craig 22865 Male Blue Cross HMO XOF-7915778 4065 30 10
Wharton, Leslee 21798 Female None 4065 40 0
Whitehead, Fred 15768 Male Humana PPO UJ-832-368-11 4065 25 10
Madden, Trond 23955 Male Humana PPO UJ-934-830-34 8111 25 70
Mclean, Jimmy 32582 Male None 9211 90 0
Rutter, Cathy 22537 Female Blue Cross HMO XOF-2483405 8113 30 110
Halter, Cynthia 7408 Female Humana PPO AJ-368-316-66 7011 25 180
Mortensen, Dean 20475 Male Aetna HMO HD 0045 8624 9211 30 60
Dee, Vicki 15854 Female Humana PPO TO-834-371-82 8113 25 110
Churchill, Scott 17735 Male Blue Cross HMO XOF-8479246 7011 30 180
Casper, Don 28367 Male Humana PPO CX-844-746-57 2011 25 20
Gibson, Greg 14304 Male None 8111 100 0
McMichael, Rick 20352 Male Blue Cross HMO XOF-1875489 3705 30 60
Griffiths, Sanford 29604 Male Humana PPO SS-694-386-53 4065 25 10
Gibbons, Adrienne 22251 Female Aetna HMO HD 2380 8374 1001 20 210
Marceau, Marc 29933 Male Blue Cross HMO XOF-8234877 4055 30 50
Tekin, Talat 32330 Male Blue Cross HMO XOF-6612945 8112 30 90
Schenk, Aimee 17729 Female Humana PPO OJ-846-224-55 7011 25 180
Pawlowski, K. 30866 Female Aetna HMO HD 5540 8387 8113 20 110
Sanchez, Maria 21466 Female None 4065 40 0
Reed, Daniel 17881 Male Humana PPO KR-546-396-77 4065 25 10
Heikkinen, Erja 21125 Male Humana PPO KW-346-396-73 4065 25 10

filess/files/p_md_hypertension.pptx

High Blood Pressure

Presented by: Dr. Tom Martin

1

10/9/2011

Dr. Tom Martin

What is Blood Pressure?

The pressure of blood against the walls of the arteries.

Blood circulates through the body by way of the arteries. Blood is necessary to provide our vital organs with the oxygen and food they need to work properly. As the blood travels through the arteries, it presses against the artery walls. When your heart contracts, your blood pressure rises. When your heart relaxes your blood pressure falls. Your blood pressure will rise and fall throughout the day and night based on your activity.

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10/9/2011

Dr. Tom Martin

How is Blood Pressure Measured?

A sphygmomanometer

The blood pressure test is easy and painless. Your doctor or nurse will use a sphygmomanometer to check your blood pressure. A sphygmomanometer is a device made up of a cuff, pump, valve, and dial used with a stethoscope for measuring your blood pressure. Your doctor or nurse will put the cuff around your upper arm and inflate it using the pump. This compresses the artery in your arm which stops the blood flow. Then the air is released through the valve which allows the blood flow to start again. The doctor or nurse listens using the stethoscope to hear when the blood starts pulsing back through the artery again until the pressure in the artery exceeds the pressure in the cuff.

Dr. Tom Martin

10/9/2011

3

What Should Your Blood Pressure Numbers Be?

Diastolic Pressure

The force in the arteries when the heart is at rest

Systolic Pressure

The force in the arteries when the heart beats

By listening to the pulse and checking the dial, the doctor or nurse can hear when the pulsing sound begins again. This is the systolic blood pressure, or the force in the arteries when the heart beats. The force in the arteries when the heart is at rest is recorded when the doctor or nurse can no longer hear the sound. This is the diastolic blood pressure.

Blood pressure is measured in millimeters of mercury (mm Hg). It’s recorded with the systolic pressure listed above the diastolic.

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10/9/2011

Dr. Tom Martin

Tips for Blood Pressure Readings

You shouldn’t have coffee, alcohol or cigarettes for 30 minutes before you go in to have your blood pressure taken.

Sit for five minutes with back supported and feet flat

Be sure to wear a shirt with short sleeves so that the sphygmomanometer touches your skin

You shouldn’t talk while taking the reading

Get two readings and then figure the average of them

Because your blood pressure is constantly changing depending on your activity, temperature, diet, emotional state, posture, physical state, and medication use, be sure to ask for two readings and figure the average of the readings. You will have a more accurate idea of your blood pressure that way.

Dr. Tom Martin

10/9/2011

5

What is Hypertension?

The condition in which blood pressure levels are above the normale range.

Hypertension, or high blood pressure, occurs when the arteries narrow so that it becomes harder for the blood to flow through them. When it is harder for the blood to flow through, the pressure inside the artery increases. When that happens the heart works too hard and makes the walls of the arteries hard. While your heart, brain, and kidneys can withstand the pressure for a long time, it increases your risk for heart disease and stroke. It may cause heart failure, kidney disease, and blindness.

High blood pressure is indicated when the systolic pressure is 150 mm Hg or above or when the diastolic pressure is 90 mm Hg or above.

The ranges in the table apply to most adults who are 18 years old or older and who do not have short-term illnesses. All levels above 120/80 mmHg raise the risk, and the risk grows as blood pressure levels rise. (National Heart Lung and Blood Institute, U.S. Department of Health and Human Services)

Pre-hypertension means you are likely to end up with high blood pressure if you don’t take action.

High blood pressure numbers are different for children and teens.

6

10/9/2011

Dr. Tom Martin

High Blood Pressure

is the number one risk factor for stroke

contributes to

heart attacks

heart failure

kidney failure

atherosclerosis

is more common among people over 35

High blood pressure is the most important risk factor for stroke. This can happen with a break in a weakened blood vessel which bleeds in the brain. A stroke can also happen when a blood clot blocks one of the narrowed arteries in the brain.

High blood pressure is also a major risk for heart attack. The arteries bring oxygen carrying blood to the heart muscle. If the heart cannot get enough oxygen, angina (chest pain) can occur. If the flow of blood is blocked a heart attack results. Hypertension is also the number one risk factor of congestive heart failure--a condition in which the heart cannot pump enough blood to meet the body’s needs.

Kidneys help rid the body of wastes. High blood pressure can narrow and thicken the blood vessels in the kidneys which makes it hard on the kidneys to filter blood. This results in waste building up in the blood and may result in the kidneys failing all together. Dialysis or kidney transplant may be needed in this situation.

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10/9/2011

Dr. Tom Martin

Are You at Risk?

Controllable Risk Factors

Stress

Obesity

Too much salt intake

Drinking too much alcohol

Smoking

Uncontrollable Risk Factors

Race

Heredity

Age

While anyone can develop high blood pressure, it is more common in African Americans who get it earlier and more often than Caucasians or Hispanic Americans. African Americans tend to get high blood pressure earlier in life and are more likely to be aware that they have it and to get treatment for it.

Age also raises the risk of high blood pressure. As we get older, our blood pressure raises. Over half of Americans over age 60 have hypertension. A male older than 45 and a female older than 55 are at more risk for high blood pressure.

A family history of high blood pressure is a strong indicator that you will develop high blood pressure but you are not exempted from high blood pressure just because no one in your family has had problems with it.

Obese people, heavy drinkers, and women who are taking birth control pills are also at more risk. So are people with diabetes, gout, and kidney disease.

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10/9/2011

Dr. Tom Martin

High Blood Pressure Facts

Adults 55 + have a 90% risk of developeing high blood pressure.

Hypertenstion affects 67% of diabetics.

In 90-95% of high blood pressure cases, the cause is unknown.

Hypertentsion nationally accounts for $66.4 billion in healthcare costs.

These facts are a wake-up call. Whether you are young or old, modify your lifestyle to prevent high blood pressure. If you already have high blood pressure, you can control it by modifying your life style!

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10/9/2011

Dr. Tom Martin

How Can You Prevent and Control Hypertension?

Monitor your blood pressure

Limit alcohol

Quit smoking

Take medication, if prescribed

Monitor your blood pressure so you are aware of problems when they occur.

Alcohol raises blood pressure and can harm your liver, brain, and heart. Reducing your alcohol use to a moderate level can lower your systolic blood pressure 5 points and your diastolic pressure 3 points. A medium or large man under the age of 65 should not have more than two drinks a day. A woman, small man, or anyone older than age 65 should not have more than one drink a day. What counts as a drink?

12 oz beer (150 calories)

5 oz of wine (100 calories)

1.5 oz of 80 proof whiskey (100 calories)

Smoking injures blood vessel walls and speeds up the process of hardening of the arteries. So even though smoking does not cause high blood pressure it is a bad idea for anyone, especially those with high blood pressure. Once you quit, your risk of having a heart attack or stroke is reduced after one year.

Dr. Tom Martin

10/9/2011

10

Change Your Lifestyle!

Eat a healthy diet

Maintain a healthy weight

Be active 30 minutes per day

Healthy lifestyle changes can help control high blood pressure, but you will have to treat it for life. Treatment will not cure high blood pressure.

Take a pro-active approach--prevent problems by maintaining a healthy lifestyle.

Get 30-minutes of moderate activity most days of the week. Being physically active helps lower blood pressure. Use stairs instead of an elevator, get off two bus stops early, park your car at the far end of the parking lot and walk!

Lose weight or if you are at a healthy weight, maintain it.

Dr. Tom Martin

10/9/2011

11

Reduce Sodium in Diet

Use fresh poultry, lean meat, and fish

Use herbs, spices, and salt-free seasonings

Buy fresh, frozen, or canned “no salt added” vegetables

Eating healthy can reduce the risk of your developing high blood pressure. One of the most important things you can do is reduce the sodium in your diet. Most Americans eat way too much salt in their diets. The current recommendation is to consume less than 2.4 grams of sodium a day. Figure that 2 grams of sodium is equal to 1 teaspoon of salt. All our bodies actually need is 500 mg or ¼ teaspoon. Americans consume on the average 4000 to 6000 mg of sodium a day. For a person with high blood pressure the doctor may recommend a 1500 mg sodium diet. These low sodium diets can keep blood pressure from rising and help medications work better.

Dr. Tom Martin

10/9/2011

12

What if I Need Medication?

Diuretics

Beta blockers

ACE inhibitors

Angiotensin II Receptor Blockers

Calcium Channel Blockers

Alpha blocker

Alpha-beta blockers

Nervous system inhibitors

Vasodilators

If you are diagnosed with high blood pressure, you will need treatment to get your blood pressure under control. You will need regular blood pressure tests and you will need to stay on treatment. Blood pressure medication is easy to take and side effects tend to be minor. Remember, though, that if your blood pressure is only under control while on medication, you may be taking medication for your lifetime. Change your lifestyle NOW!

Diuretics (also called water pills) work on the kidney to remove excess water and fluid from your body to lower blood pressure.

Beta Blockers reduce impulses to the heart and blood vessels which helps your heart beat slower with less force.

ACE Inhibitors keep your body from making a hormone that causes blood vessels to narrow. ACE inhibitors cause blood vessels to relax and blood to flow freely.

Angiotensin II Receptor Blockers are a newer medicine that causes blood vessels to relax and widen.

Calcium Channel Blockers keep calcium from entering the muscle cells of your heart and blood vessels causing blood vessels to relax.

Alpha Blockers block nerve impulses that tighten blood vessels causing blood to flow more freely.

Alpha-Beta Blockers work the same as alpha blockers and also slow the heartbeat like beta blockers.

Nervous System Inhibitors increase nerve impulses from the brain to relax and widen blood vessels.

Vasodilators relax the muscles in blood vessel walls causing blood to flow more freely.

Dr. Tom Martin

10/9/2011

13

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Immunization Basics

Welcome to the Hilltop Family Practice immunization program. Comment by JM Behle: Yes, you have covered the sections we want included. There are some additions to the Recommended Vaccinations section, however. I’ve included the information in the section, but please make sure the table is updated.

“Today, children in the United States routinely get vaccines that protect them from more than a dozen diseases such as measles, polio and tetanus. Most of these diseases are now at their lowest levels in history, thanks to years of immunization.”

This document has been prepared by our office to help you understand the necessity for vaccines to ensure the health of your child and the health of others with whom your child comes into contact.

What is a vaccine?

A vaccine is administered to help prevent your child getting a particular type of disease. The vaccine is a preparation containing weakened or dead microbes that cause disease. When it is administered, it stimulates your child’s immune system to produce antibodies. These antibodies protect aggainst the disease.

Are vaccines safe for my child?

Generally vaccines are safe. There is a small risk of problems, but the protection vaccines provide far outweighs this small risk. If your child has had a reaction to a first shot in a series, Dr. Mangus will discuss the pros and cons of continuing with the rest of the shots in the series. Please talk to Dr. Mangas if you have any questions or concerns.

What side effects could my child experience?

We Dr. Mangas will discuss possible side effects of each vaccine as it is administered and will inform you of ways you can help lessen these side effects. Possible side effects are temporary and may include slight fever, soreness at the site where a shot is given, or redness or swelling where the shot was given. Comment by JM Behle: In addition to Dr. Mangas, the nurses and I also administer some of the vaccines.

When should my child be vaccinated?

The timetable for your child’s vaccines will depend on your child’s health, the type of vaccine, and the vaccines available. Section 3 of this document contains two tables with suggested vaccination times.

Recommended Vaccinations

HBV (Hepatitis B Vaccine)

The HBV vaccine helps prevent hepatitis B virus (HBV), a disease affecting the liver. It can lead to liver cancer and death. The vaccine is given as a series of three shots beginning at birth. The HBV vaccine will protect your child from childhood and into their adult years.

Rotavirus Comment by Sherry Wright: Update table.

Rotavirus is one of the most common causes of dehydration and diarrhea in infants and young children. It is extremely contagious and is particularly a problem in child-care centers and children’s hospitals. It’s recommended that the vaccine be given in three doses by mouth at 2, 4, and 6 months of age.

IPV (Inactivated Poliovirus) Comment by JM Behle: Make sure this is included in the table for children 0 to 6 years old.

Polio is a viral infection that can result in permanent paralysis. Until recently the oral poliovirus was given in the United States, but there was a very small risk of developing polio after receiving the live oral vaccine. Now, however, the inactivated poliovirus vaccine is recommended. It should be given at 2, 4, 6 to 18 months, and 4 to 6 years.

PCV (Pneumococcal Conjugate Vaccine)

The pneumococcal conjugate vaccine (PVC) protects your child against the bacterium that is the leading cause of infections including pneumonia, blood infection, and bacterial meningitis. The vaccine is given as a series of four shots starting at 2 months of age.

DTaP (Diphtheria, Tetanus, Acellular Pertussis)

The DTaP vaccine is given in a series of shots administered between the ages of 2 months and 4 to 6 years. The vaccine is a combination inoculation against three diseases/infections which are: Diphtheria, Tetanus, and Pertussis.

Diphtheria

Diphtheria is a highly contagious disease but exceptionally rare. Diphtheria is an infection that occurs in the throat, nose, and mouth. The symptoms include a cough as well as a sore throat. Diphtheria can lead to pneumonia, heart failure and paralysis if left untreated.

Pertussis

Pertussis is a life threatening disease especially children under a year old. It is also commonly referred to as whooping cough.

Tetanus

Tetanus is an infecion that can occur from bacteria that is associated with dirt, gravel, or rusty metals. The baceria enter the body through a cut. The infection usually results in lock jaw.

Hib (Meningitis)

The Hib vaccine protects against the Haemophilus influenzae type b bacteria, the leading cause of meningitis before the vaccine was developed. The Hib vaccines is administered as a series of three shots beginning at 2 months with a booster shot at 12 to 15 months.

Influenza

The influenza vaccine gives your child a chance to build up immunity to an influenza “flu” virus before the flu season. Because flu viruses constantly change, the vaccine is updated each year. If your child is between 6 and 59 months old, you should have your child vaccinated every fall. If your child—or you—have a chronic medical condition such as asthma or diabetes, the flu shot should be given every year.

MMR Vaccine

The MMR vaccine is an immunization against the following: Measles, Mumps, and Rubella. All three of these diseases are highly contagious and occur during childhood.

Measles

Measles is a virus which causes a rash on the body. Symptoms include a cough, runny nose, fever, and eye irritation. This virus can cause pneumonia, seizures, brain damage and in rare cases death.

Mumps

The symptoms of the mumps virus include fever, headache, and swollen glands. It can also cause deafness, meningitis, and death in some cases.

Rubella

Rubella is also known as the German Measles. This is the mildest disease of the three. This disease may cause serious birth defects of a baby if the woman is pregnant and becomes infected.

Varicella (Chickenpox)

The varicella vaccine protects your child against the highly contagious and common chickenpox viral illness that can cover your child with an itchy rash of spots and is accompanied by flu-like symptoms. The vaccine is given between the ages of 12 to 15 months with a booster shot at 4 to 6 years old.

MCV4 (Bacterial Meningitis)

Bacterial meningitis is an inflammation of the membrane that protects the brain. While rare, it is highly contagious. The MCV4 vaccine protects against the disease and should be given to your child between ages 11 or 12 years, before high school, or before entering college and living in a dorm.

Hepatitis A

The hepatitis A vaccine protects your child against the fever, nausea, vomiting, and jaundice caused by hepatitis A. This disease can be epidemic in a community. The vaccination is a series of two shots administered between the ages of 12 to 23 months.

Suggested Schedules Comment by Sherry Wright: Please insert the information about the Rotavirus vaccine.

Recommended Immunization Schedule for Children 0-6 Years Old Comment by Sherry Wright: This should include the same reference/footnote information as the next table.

Vaccine

Age

Comments

HBV (Hepatitis B vaccine)

Birth, between 1 and 2 months, and between 6 to 18 months

PCV (Pneumococcal Conjugate Vaccine)

2 months, 4 months, 6 months, and between 12 to 15 months

High-risk groups booster between 2 to 6 years old

DTaP (Diphtheria, Tetanus, Acellular Pertussis)

2 months, 4 months, 6 months, between 15 to 18 months of age, and final dose between ages 4 to 6 years

Hib (Meningitis)

2 months, 4 months, 6 months, between 12 to 15 months

Influenza

Annually between 6 months to 59 months

High-risk groups continue annually

MMR Vaccine (Measles, Mumps, Rubella)

12 to 15 months.

Second dose between 4 and 6 years

Varicella (Chickenpox)

12 to 15 months.

Second dose between 4 and 6 years of age

MCV4 (Bacterial Meningitis)

Between 2 to 6 years old

Hepatitis A

Two doses six months apart between 12 and 23 months

High-risk groups booster between 2 to 6 years old

PPV (Pneumococcal Vaccine) 1 dose between 7 to 18 years old Administer to certain high-risk groups

Tdap (Diphtheria, Tetanus, Acellular Pertussis) 1 dose between 11 to 12 years for those who have completed the recommended DTP/DTaP vaccination series

Influenza 1 dose annually Administer to certain high-risk groups annually

MCV4 (Bacterial Meningitis) 1 dose between 11 to 12 years old

Hepatitis A 2 doses between 7 to 18 years old Administer to certain high-risk groups

HPV (Human Papillomavirus 3 doses between 11 and 12 years Females only

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