Received Sep 11, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 2 | 046A21A | IM / UN |
Hospitalization related to COVID 19 following completion of primary vaccine series
o Age-related macular degeneration, dry, both eyes (H35.3130) o Allergic rhinitis (J30.9) o Apnea (R06.81) o Back Pain o Chronic pain of both knees (M25.561,M25.562,G89.29) o Chronic recurrent major depressive disorder (F33.9) o Colon cancer screening (Z12.11) o Cough (R05) o Dermatochalasis (H02.839) o Dupuytren's contracture (M72.0) o Esophageal reflux (K21.9) o Furuncle of groin (L02.224) o Glaucoma (H40.9) o Herpes simplex (B00.9) o Hyperlipidemia (E78.5) o Hypertension (I10) o Nummular eczematous dermatitis (L30.0) o Osteoporosis (M81.0) o Pain of left hip joint (M25.552) o Pain of right hand (M79.641) o Primary open angle glaucoma of both eyes (H40.1130) o Primary osteoarthritis of both knees (M17.0) o Pseudoexfoliation of lens capsule, both eyes (H26.8) o Sleep disturbances (G47.9) o Tubular adenoma of colon (D12.6) o Type 2 diabetes mellitus (E11.9) o Urinary urgency (R39.15) o Visit for screening mammogram (Z12.31)
o Age-related macular degeneration, dry, both eyes (H35.3130) o Allergic rhinitis (J30.9) o Apnea (R06.81) o Back Pain o Chronic pain of both knees (M25.561,M25.562,G89.29) o Chronic recurrent major depressive disorder (F33.9) o Colon cancer screening (Z12.11) o Cough (R05) o Dermatochalasis (H02.839) o Dupuytren's contracture (M72.0) o Esophageal reflux (K21.9) o Furuncle of groin (L02.224) o Glaucoma (H40.9) o Herpes simplex (B00.9) o Hyperlipidemia (E78.5) o Hypertension (I10) o Nummular eczematous dermatitis (L30.0) o Osteoporosis (M81.0) o Pain of left hip joint (M25.552) o Pain of right hand (M79.641) o Primary open angle glaucoma of both eyes (H40.1130) o Primary osteoarthritis of both knees (M17.0) o Pseudoexfoliation of lens capsule, both eyes (H26.8) o Sleep disturbances (G47.9) o Tubular adenoma of colon (D12.6) o Type 2 diabetes mellitus (E11.9) o Urinary urgency (R39.15) o Visit for screening mammogram (Z12.31)
Acetaminophen 325 MG Oral TabletTAKE 1 TO 2 TABLETS EVERY 6 HOURS AS NEEDED.Aspirin 81 MG TABSTAKE 1 TABLET DAILY- Held for surgeryBayer Contour Next Monitor w/Device KitUSE TO TEST 2 TIMES PER DAY 2 TIMES PER WEEKBayer Microlet Lancets MIS
o Morphine Derivatives o Flagyl CAPS o Zithromax PACK o Sulfa Drugs o Other o Dust o Eggs o Grass o Latex o Mold o Trees
Covid positive test date: 088/14/2025