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The provided FHIR bundle appears truncated at the end; based on the visible data, Patricia Davis is a female patient born in 1971 whose general practitioner is Dr. Michael Thompson and whose managing organization is Valley Medical Center. Her documented medication allergy status is confirmed as no known drug allergies, with a note stating that the patient reports no known drug allergies. Her active confirmed conditions, all recorded on 2026-03-09, include newly diagnosed breast cancer, documented as malignant neoplasm of the breast (ICD-10-CM C50.919, malignant neoplasm of unspecified site of unspecified female breast), involving the breast, Stage IIA. A note states the tumor is ER-positive, PR-positive, and HER2-negative. She also has active confirmed hypertension and active confirmed hyperlipidemia.

Active medications ordered on 2026-03-09 by Dr. Michael Thompson include lisinopril 10 mg oral tablet, 10 mg by mouth once daily for hypertension, and atorvastatin 20 mg oral tablet, 20 mg by mouth once daily for hyperlipidemia. Current referral documentation dated 2026-03-09 includes recent breast biopsy results (PDF), recent mammogram images (DICOM), a pathology report (PDF), and insurance pre-authorization approval for oncology consultations (PDF). An urgent service request was placed on 2026-03-09 for an initial oncology consultation for treatment planning due to breast cancer. This referral is from Dr. Michael Thompson at Valley Medical Center to Dr. Jennifer Lee, with the consultation scheduled for 2026-03-16 at 14:00 at the Regional Cancer Center Oncology Clinic. The referral note states that the biopsy results, mammogram images, pathology report, and insurance pre-authorization approval were included. A second urgent service request was placed on 2026-03-09 for pre-consultation laboratory studies related to the breast cancer, to be performed by Valley Medical Center at Valley Medical Center Hospital Lab on 2026-03-13 at 09:00; the visible order detail includes a CBC (LOINC 57021-8, CBC panel - Blood). The bundle also contains directory entries for Dr. David Park, Regional Cancer Center, Imaging Center, and Imaging Center Main, although no specific visible active order links them to Patricia Davis in the shown portion of the record.

Clinical Narrative: Patricia Davis

Patricia Davis is a 55-year-old female (Patient ID: PAT-PD-20250001) with no known drug allergies. She carries an active, confirmed diagnosis of breast cancer, Stage IIA (ER+/PR+/HER2-), with an onset date of January 1, 2025, recorded by her primary physician, Dr. Michael Thompson, MD, at Valley Medical Center. The tumor has been characterized as estrogen receptor positive, progesterone receptor positive, and HER2 negative. Her comorbid conditions include active, confirmed essential hypertension and hyperlipidemia, both maintained on the problem list.

Current Medications:

• Lisinopril 10 mg oral tablet, taken once daily by mouth for hypertension, ordered by Dr. Michael Thompson.
• Atorvastatin 20 mg oral tablet, taken once daily by mouth for hyperlipidemia, ordered by Dr. Michael Thompson.

Referrals and Orders: On January 20, 2025, Dr. Michael Thompson placed several urgent orders in connection with the breast cancer diagnosis:

1. Referral to oncology — An urgent referral to Dr. Jennifer Lee, MD (Oncology), at the Regional Cancer Center for breast cancer treatment planning. Supporting documentation includes recent biopsy results, mammogram images, and a pathology report. Insurance pre-authorization has been obtained for oncology consultations.

2. Pre-consultation laboratory work — Urgent orders for a complete blood count (CBC), comprehensive metabolic panel (CMP), and tumor marker measurements.

3. Follow-up imaging — Urgent orders for a follow-up mammogram and breast MRI.

4. Referral to surgical oncology — An urgent referral to Dr. David Park, MD (Surgical Oncology), for a second opinion consultation regarding surgical planning. Insurance pre-authorization has been obtained.

Scheduled Appointments:

• January 24, 2025, 9:00–9:30 AM — Pre-consultation lab work (CBC, CMP, tumor markers) at Valley Medical Center Hospital Lab (30 minutes). Status: Booked.

• January 27, 2025, 2:00–3:00 PM — Initial oncology consultation with Dr. Jennifer Lee at the Regional Cancer Center for breast cancer treatment planning (60 minutes). Status: Booked.

• January 28, 2025, 10:30 AM–12:00 PM — Follow-up mammogram and breast MRI at the imaging center (90 minutes). Status: Booked.

• January 29, 2025, 3:00–4:00 PM — Second opinion surgical oncology consultation with Dr. David Park for surgical planning (60 minutes). Status: Booked.

Insurance Coverage: Ms. Davis has active insurance coverage, and pre-authorization has been obtained for the oncology consultations and second opinion surgical oncology evaluation.

Patricia Davis is a female patient born on June 15, 1968. She has no known drug allergies. Her active clinical conditions include a confirmed diagnosis of malignant neoplasm of the breast (specifically Stage IIA, ER+/PR+/HER2-), hypertension, and hyperlipidemia. Her current medications include lisinopril 10 mg oral tablets to be taken once daily and atorvastatin 20 mg oral tablets to be taken once daily.

For her ongoing oncology care, Dr. Michael Thompson has submitted several service requests, all of which have been successfully scheduled. She is booked for pre-consultation lab work (CBC, CMP, and tumor markers) on November 3, 2023, at 9:00 AM. On November 6, 2023, at 2:00 PM, she will have an initial Medical Oncology consultation with Dr. Jennifer Lee. The following day, November 7, 2023, at 10:30 AM, she is scheduled for a diagnostic follow-up mammogram and breast MRI. Finally, she will attend a Surgical Oncology second opinion appointment with Dr. David Park on November 8, 2023, at 3:00 PM.

Clinical Narrative for Patricia Davis

Patient Demographics: Patricia Davis is a 55-year-old female (DOB: 05/15/1968) with Social Security Number 123-45-6789. She is managed under Valley Medical Center and holds active insurance coverage through Premium Health Insurance (Premium Health Plan, PPO 500, Group #34567).

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Active Medical Conditions:

1. Invasive Ductal Carcinoma of the Breast (Stage IIA, ER+/PR+/HER2-)

   • Diagnosis Date: 05/10/2023
   • Pathology Findings (05/08/2023, City Hospital Laboratory):
     • Biopsy-confirmed invasive carcinoma (SNOMED: 254837009).
     • Receptor Status: Estrogen receptor (ER) 90% positive, progesterone receptor (PR) 80% positive, HER2 1+ (negative).
   • Supporting Evidence: Breast biopsy (LOINC: 26272-7) with pathology report available [PDF link].

2. Hypertension (ICD-10: I10)

   • Diagnosis Date: 05/10/2018
   • Recent Blood Pressure (05/10/2023): 138/86 mmHg.
   • Current Medication: Lisinopril 10mg orally daily (prescribed 01/15/2023).

3. Hyperlipidemia (ICD-10: E78.5)

   • Diagnosis Date: 11/15/2020
   • Recent Lipid Panel (05/10/2023):
     • Total Cholesterol: 220 mg/dL
     • LDL Cholesterol: 140 mg/dL
   • Current Medication: Atorvastatin 20mg orally at bedtime (prescribed 11/20/2022).

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Upcoming Appointments & Diagnostic Orders:

1. Pre-Consultation Laboratory Work (05/19/2023, 09:00–10:00)

   • Location: City Hospital Laboratory
   • Tests Ordered:
     • Complete Blood Count (CBC, LOINC: 58410-2)
     • Comprehensive Metabolic Panel (CMP, LOINC: 24323-8)
     • Tumor Markers: CA 15-3 (LOINC: 21698-7) and CA 27.29 (LOINC: 1994-6)

2. Initial Oncology Consultation (05/22/2023, 14:00–15:00)

   • Provider: Dr. Jennifer Lee (Medical Oncologist, Regional Cancer Center)
   • Purpose: Treatment planning for Stage IIA ER+/PR+/HER2- breast cancer.
   • Notes: Insurance pre-authorization approved (Auth#: XK987654, valid 05/15–08/15/2023).

3. Follow-Up Imaging (05/23/2023, 10:30–12:00)

   • Location: Metropolitan Imaging Center
   • Studies Ordered:
     • Mammogram (SNOMED: 16929005)
     • Breast MRI (SNOMED: 246236007)

4. Surgical Oncology Second Opinion (05/24/2023, 15:00–16:00)

   • Provider: Dr. David Park (Surgical Oncologist, Regional Cancer Center)
   • Purpose: Evaluation of surgical options.
   • Notes: Insurance pre-authorization confirmed (Auth#: XK987654).

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Referrals & Coordination of Care:

• Active Referral to Oncology (05/15/2023):
  • Referring Provider: Dr. Michael Thompson (Physician, Valley Medical Center)
  • Recipient: Dr. Jennifer Lee (Medical Oncologist)
  • Supporting Documents:
    • Breast biopsy pathology report
    • Diagnostic imaging (mammogram/MRI pending)
  • Linked Appointments:
    • Oncology consultation (05/22)
    • Surgical oncology second opinion (05/24)
    • Follow-up mammogram/MRI (05/23)
    • Pre-consultation labs (05/19)

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Summary:

Patricia Davis presents with newly diagnosed Stage IIA ER+/PR+/HER2- invasive breast cancer, confirmed by biopsy on 05/08/2023. She has controlled hypertension (on lisinopril) and hyperlipidemia (on atorvastatin), with recent BP 138/86 mmHg and LDL 140 mg/dL. A multidisciplinary oncology evaluation is underway, including:

• Medical oncology consultation (05/22) with Dr. Lee,
• Surgical oncology second opinion (05/24) with Dr. Park,
• Follow-up imaging (05/23) and pre-consultation labs (05/19).

Insurance pre-authorization (XK987654) is active for all scheduled services. Coordination between Valley Medical Center, Regional Cancer Center, and Metropolitan Imaging Center is documented.

Patricia Davis is an active female patient born in 1969. Her care involves Dr. Michael Thompson, MD; Dr. Jennifer Lee, MD, oncologist; and Dr. David Park, MD, surgical oncologist. Active healthcare organizations in her record include Valley Medical Center and Regional Cancer Center. She has an active, confirmed, newly diagnosed encounter diagnosis of malignant neoplasm of the breast, documented as breast cancer, Stage IIA, ER-positive, PR-positive, HER2-negative. The condition was recorded by Dr. Michael Thompson, with stage documented as Stage IIA, and notes state: “ER-positive, PR-positive, HER2-negative breast cancer. Newly diagnosed.” She also has active, confirmed hypertension and active, confirmed hyperlipidemia. Her allergy record indicates an active, confirmed medication allergy entry documenting no known drug allergies.

Active medication orders include lisinopril 10 mg oral tablet, 10 mg by mouth daily for hypertension, requested by Dr. Michael Thompson, and atorvastatin 20 mg oral tablet, 20 mg by mouth daily for hyperlipidemia, also requested by Dr. Michael Thompson. An active referral was placed by Dr. Michael Thompson to oncology for breast cancer treatment planning, with Dr. Jennifer Lee as the intended performer. Supporting information for this referral includes recent biopsy results, mammogram images, and a pathology report, and the note states that insurance pre-authorization was obtained for oncology consultations. Additional active service requests related to the breast cancer include pre-consultation laboratory work consisting of a complete blood count, comprehensive metabolic panel/serum biochemistry, and tumor marker measurement; imaging orders for a follow-up mammogram and breast MRI; and a referral for a second-opinion consultation with surgical oncologist Dr. David Park.

Booked appointments include pre-consultation lab work on 2025-01-24 from 09:00 to 09:30 UTC for CBC, comprehensive metabolic panel, and tumor markers at Valley Medical Center - Hospital Lab; an initial oncology consultation on 2025-01-27 from 14:00 to 15:00 UTC, a 60-minute specialist medical consultation with Dr. Jennifer Lee at Regional Cancer Center for breast cancer treatment planning; follow-up mammogram and breast MRI on 2025-01-28 from 10:30 to 12:30 UTC, lasting 120 minutes; and a second-opinion surgical oncology consultation with Dr. David Park on 2025-01-29 from 15:00 to 16:00 UTC, lasting 60 minutes. Comments on the oncology and surgical oncology consultations note that insurance pre-authorization was obtained, and the oncology appointment comment also states that the referral includes biopsy results, mammogram images, and the pathology report. Insurance coverage is active through Insurance Provider. A professional preauthorization claim response is active with outcome complete, and the disposition states that pre-authorization was approved for oncology consultations, including the initial oncology consultation and the surgical oncology second opinion. She also has an active care plan titled “Breast Cancer Coordinated Care Plan,” authored by Dr. Michael Thompson, describing coordinated care for newly diagnosed Stage IIA ER-positive/PR-positive/HER2-negative breast cancer, including oncology consultation, lab work, imaging, and surgical oncology second opinion.

Clinical Narrative for Patricia Davis

Patricia Davis is a 55-year-old female (DOB: June 15, 1968) with a diagnosis of Stage IIA, estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), and human epidermal growth factor receptor 2-negative (HER2-) invasive breast cancer. She also has active hypertension and hyperlipidemia, with no known drug allergies.

Her current medications include:

• Lisinopril 10mg orally once daily (for hypertension)
• Atorvastatin 20mg orally once daily (for hyperlipidemia)

A referral to medical oncology has been initiated by Dr. Michael Thompson for further management of her breast cancer.

Upcoming appointments are scheduled as follows:

• November 3, 2023, 09:00–09:30 – Pre-consultation lab work (CBC, CMP, tumor markers)
• November 6, 2023, 14:00–15:00 – Initial consultation with Dr. Jennifer Lee (oncologist)
• November 7, 2023, 10:30–11:30 – Follow-up mammogram and breast MRI
• November 8, 2023, 15:00–16:00 – Second opinion consultation with Dr. David Park (surgical oncologist)

This patient requires multidisciplinary coordination for her breast cancer treatment, hypertension, and hyperlipidemia management.

Clinical Narrative

Patricia Davis is a 55-year-old female (date of birth: May 15, 1968) managed by Valley Medical Center. Her primary care physician is Dr. Michael Thompson, a general physician.

Active Medical Conditions:

Ms. Davis has a confirmed diagnosis of invasive carcinoma of the breast, Stage IIA, with an onset date of May 10, 2023, asserted by Dr. Thompson. Pathologic examination supports the diagnosis. Immunohistochemistry testing performed on May 8, 2023, by City Hospital Laboratory revealed the tumor is estrogen receptor (ER) positive, progesterone receptor (PR) positive, and HER2 negative. She also carries active, confirmed diagnoses of hypertension (onset May 10, 2020) and hyperlipidemia (onset August 22, 2021).

Current Medications:

Ms. Davis is currently prescribed lisinopril 10 mg orally once daily and atorvastatin 20 mg orally once daily, both ordered by Dr. Thompson on November 15, 2022.

Pending Orders and Referrals:

On May 15, 2023, Dr. Thompson ordered the following diagnostic laboratory studies for breast cancer evaluation, all to be performed at City Hospital Laboratory: a complete blood count (CBC), a comprehensive metabolic panel (CMP), and tumor markers including CA 15-3, CA 27.29, and carcinoembryonic antigen (CEA). Additionally, a bilateral mammogram and a breast MRI with contrast were ordered for breast cancer follow-up, to be performed at Metropolitan Imaging Center.

Dr. Thompson also placed two oncology referrals: an initial oncology consultation with Dr. Jennifer Lee, a medical oncologist at Regional Cancer Center, for newly diagnosed breast cancer; and a second opinion consultation with Dr. David Park, a surgical oncologist also at Regional Cancer Center.

Scheduled Appointments:

1. May 19, 2023, 9:00–10:00 AM — Pre-consultation lab work (CBC, CMP, and tumor markers) at City Hospital Laboratory. The patient has been instructed to fast for 12 hours prior to this appointment.

2. May 22, 2023, 2:00–3:00 PM — Initial oncology consultation with Dr. Jennifer Lee at Regional Cancer Center. The patient has been advised to bring all medical records and a list of current medications.

3. May 23, 2023, 10:30 AM–12:30 PM — Follow-up mammogram and breast MRI at Metropolitan Imaging Center.

4. May 24, 2023, 3:00–4:00 PM — Second opinion consultation with surgical oncologist Dr. David Park at Regional Cancer Center. The patient has been advised to bring all medical records, imaging studies, and a list of current medications.

All appointments are booked and confirmed by both the patient and the respective providers.

Insurance Coverage:

Ms. Davis is the primary subscriber on an active HealthyLife Insurance Preferred Provider Organization (PPO500) plan under the Employee Group Plan (group ID: ABC123), with a coverage period from January 1, 2023, through December 31, 2023. The oncology referrals are linked to this coverage.