Schrader, Angelmarie Admin Sex: Female DOB: **/*/*962
Continuity of Care Document
Summarization of Episode Note 06/5/2025 to 06/5/2025 Source: Union Hospital Clinton
Created: 06/17/2025
Demographics
Contact Information:
655 E 750 N, BLOOMINGDALE, IN 478328063, US
655 E 750 N, BLOOMINGDALE, IN 478328063, US
Tel: 765-***-**** (Mobile)
Email: *************@*****.***
Previous Address(es):
--
Marital Status: Single
Religion: --
Race: White
Previous Name(s):
Schrader, Angelmarie
Schrader, ANGEL
Date of Death: //
Ethnic Group: Not Hispanic or Latino
Language: --
ID: 83041436
Care Team
Type Name
Represented
Organization
Address Phone
primary care
physician
Koch,
Amy E
-- (Work): UMG Primary Care Rockville111 West High Street, Rockville, IN 47872-, US
Tel: (765)569-
2057 (Work)
Relationships
No Data to Display
Document Details
Source Contact Info
801 South Main Street, Clinton, IN 47842-, US
Tel: 765-***-****
Author Contact Info
06/17/2025 1:03 PM
Union Hospital Clinton
Recipient Contact Info
--
Healthcare Professionals
No Data to Display
IDs & Code Type Data
Document Type ID: 2.16.840.1.113883.1.3 : POCD_HD000040 Document Template ID: 2.16.840.1.113883.10.20.22.1.1 : --, 2.16.840.1.113883.10.20.22.1.1 : 2015-08-01, 2.16.840.1.113883.10.20.22.1.2
: 2015-08-01
Document ID: 2.16.840.1.113883.3.9254.4.999362 : 154720247 Document Type Code: 2.16.840.1.113883.6.1, 34133-9 Document Language Code: en-US
Document Set ID: --
Document Version Number: --
Primary Encounter
Encounter Information
Registration Date: 06/5/2025
Discharge Date: 06/5/2025
Visit ID: --
Location Information
Radiology CL
(Work): Union Hospital Clinton801 S Main Street, Clinton, IN 47842-, US Providers
Type Name Address Phone
Admitting Koch,
Amy E
(Work): UMG Primary Care Rockville111 West High Street, Rockville, IN 47872-, US
Tel: (765)569-
2057 (Work)
Attending Koch,
Amy E
(Work): UMG Primary Care Rockville111 West High Street, Rockville, IN 47872-, US
Tel: (765)569-
2057 (Work)
Encounter
Union FIN 944874296 Date(s): 6/5/25 - 6/5/25
Union Hospital Clinton Union Hospital Clinton 801 S Main Street Clinton, IN 47842- US 765-***-**** Encounter Diagnosis
Unspecified injury of lower back, initial encounter (Discharge Diagnosis) - Discharge Disposition: Routine Discharge
Attending Physician: Koch, Amy E, NP
Admitting Physician: Koch, Amy E, NP
Encounter Type: Outpatient
Reason for Visit
tailbone pain
Allergies, Adverse Reactions, Alerts
No Known Medication Allergies
Author: Cooksey, Lisa, UMG Primary Care Rockville TH Last Modified: 09/11/2023 12:40 PM
Assessment and Plan
Future Scheduled Tests
Laboratory:
Covid 19 ID Now NAA 8/27/24
Author: Cooksey, Lisa, Union Health Provenance
Last Modified: 08/27/2024 2:16 PM
Radiology:
CT Abd/Pelvis W/O IV Contrast 6/4/25
Author: Cooksey, Lisa, Union Health Provenance
Last Modified: 06/4/2025 2:34 PM
MRI Shoulder W/O IV Contrast Right 6/2/25
Author: Grindle, Mikayla, Union Health Provenance
Last Modified: 06/2/2025 2:30 PM
Immunizations
Given and Recorded
Vaccine Date Status Refusal Reason
SARS-CoV-2 (COVID-19) mRNA BNT-162b2 vax
Author: Cooksey, Lisa, UMG Primary Care Rockville TH Last Modified: 07/30/2021 12:00 PM
7/30/21 Recorded
SARS-CoV-2 (COVID-19) mRNA BNT-162b2 vax
Author: Cooksey, Lisa, UMG Primary Care Rockville TH Last Modified: 07/9/2021 12:00 PM
7/9/21 Recorded
Medications
HYDROcodone-acetaminophen (HYDROcodone-acetaminophen 5 mg-325 mg oral tablet) Status: Ordered
Start Date: 6/13/25
1 tab(s) By mouth Every 8 hours as needed as needed for pain. Refills: 0. Ordering provider: Koch, Amy E, NP
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 06/13/2025 8:02 PM
CVS/pharmacy #6688
820 W Ohio St Rockville, IN 478721532
Problem List
Condition Confirmation Course
Effective
Dates
Status
Health
Status
Informant
Obesity (BMI 30-39.9)
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 12/30/2024 8:58 PM
Confirmed Resolved
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 12/30/2024 8:58 PM
CAD in native artery
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 1:54 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 1:54 PM
Cyst of right kidney
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 1:43 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 1:43 PM
Depression
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 05/8/2025 3:05 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 05/8/2025 3:05 PM
Rotator cuff insufficiency of right shoulder
Author: Grindle, Mikayla, UMG Orthopedics
BnJ TH
Last Modified: 06/2/2025 2:27 PM
Confirmed Active
Author: Grindle, Mikayla, UMG
Orthopedics BnJ TH
Last Modified: 06/2/2025 2:27 PM
Rash
Author: Ingebrigtsen, Janis C, UMG
Primary Care Rockville TH
Last Modified: 08/13/2024 7:48 PM
Confirmed Active
Author: Ingebrigtsen, Janis C, UMG
Primary Care Rockville TH
Last Modified: 08/13/2024 7:48 PM
History of kidney stones
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 1:42 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 1:42 PM
Kidney stones
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 1:57 PM
Confirmed Resolved
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 1:57 PM
Migraines
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 2:08 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 2:08 PM
Right knee pain
Author: Johansen, Kelbie, UMG
Orthopedics BnJ TH
Last Modified: 03/29/2024 12:44 PM
Confirmed Active
Author: Johansen, Kelbie, UMG
Orthopedics BnJ TH
Last Modified: 03/29/2024 12:44 PM
Right shoulder pain
Author: Grindle, Mikayla, UMG Orthopedics
BnJ TH
Last Modified: 06/2/2025 2:27 PM
Confirmed Active
Author: Grindle, Mikayla, UMG
Orthopedics BnJ TH
Last Modified: 06/2/2025 2:27 PM
Encounter for weight management
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 12/30/2024 6:11 AM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 12/30/2024 6:11 AM
Right rotator cuff tear
Author: Lembcke, Sydnee, UMG
Orthopedics BnJ TH
Last Modified: 06/17/2025 3:44 PM
Confirmed Active
Author: Lembcke, Sydnee, UMG
Orthopedics BnJ TH
Last Modified: 06/17/2025 3:44 PM
Right knee sprain
Author: Johansen, Kelbie, UMG
Orthopedics BnJ TH
Last Modified: 03/29/2024 12:44 PM
Confirmed Active
Author: Johansen, Kelbie, UMG
Orthopedics BnJ TH
Last Modified: 03/29/2024 12:44 PM
Hepatic steatosis
Author: Koch, Amy E, UMG Primary Care
Rockville TH
Last Modified: 09/11/2023 1:43 PM
Confirmed Active
Author: Koch, Amy E, UMG Primary
Care Rockville TH
Last Modified: 09/11/2023 1:43 PM
Biceps tendonitis on right
Author: Lembcke, Sydnee, UMG
Orthopedics BnJ TH
Last Modified: 06/17/2025 3:48 PM
Confirmed Active
Author: Lembcke, Sydnee, UMG
Orthopedics BnJ TH
Last Modified: 06/17/2025 3:48 PM
Condition Confirmation Course
Effective
Dates
Status
Health
Status
Informant
Procedures
Procedure Date Related Diagnosis Body Site Status
kidney stone removal
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:57 PM
12/21/22 Completed
Colonoscopy
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:56 PM
11/28/22 Completed
EGD (esophagogastroduodenoscopy) gastric outlet reduction Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:56 PM
11/28/22 Completed
Angioplasty 1
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:55 PM
2012 Completed
Tubal ligation
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:56 PM
Completed
1 Heart Center in Indianapolis
Author: Koch, Amy E, UMG Primary Care Rockville TH Last Modified: 09/11/2023 1:55 PM
Results
Radiology Reports
Exam Date Time Procedure Performing Provider Status 6/5/25 12:06 PM CT Pelvis W/O IV Contrast Vanderlijn, Pieter J, MD; Auth (Verified) Notes:
(CT Pelvis W/O IV Contrast) Reason For Exam: tailbone pain Report
CT PELVIS WITHOUT IV CONTRAST
HISTORY: Technologist Notes:Pt fell sev months ago, continued pain in tailbone; Technologist Initials:HMB1, JLG; PO Contrast Volume (mL):-999 tailbone pain; Unspecified injury of lower back, initial encounte
COMPARISON: None.
TECHNIQUE: Axial CT images of the pelvis were performed. Sagittal and coronal reconstruction images were generated from the acquired data set. Unless otherwise stated, incidental findings do not require dedicated follow-up imaging. DOSE OPTIMIZATION: This facility uses dose optimization techniques as appropriate to perform exams, including at least one of the following techniques: 1. Automated exposure control. 2. Adjustment of the mA and/or kV according to patient size (this includes techniques or standardized protocols for targeted exams where dose is matched to the indication/reason for exam, i.e. extremities or head). 3. Use of iterative reconstructive technique. FINDINGS:
VESSELS: Normal.
URINARY BLADDER:Normal.
VISUALIZED PORTIONS OF GASTROINTESTINAL TRACT AND MESENTERY: Normal. APPENDIX:Normal.
REPRODUCTIVE ORGANS:Normal.
PERITONEUM: Normal.
BONES AND SOFT TISSUES: No fracture of the sacrum and coccyx is identified. Posterior subcutaneous soft tissue calcifications.
IMPRESSION:
No fracture is visualized.
Electronically signed by: Pieter Vanderlijn MD 06/16/2025 09:24 AM EDT RP Workstation: RMCWRS94243
This examination and reported findings have been reviewed and confirmed by the undersigned. Read By: Vanderlijn, Pieter J, MD
I authorize my name to be Electronically affixed by using my unique signature access code. Author: Koch, Amy E, Union Hospital Clinton
Last Modified: 06/16/2025 4:57 PM
Vital Signs
No data available for this section
Social History
Social History Type Response
Smoking Status Former smoker, quit more than 30 days ago; Started at age: 15.0; Stopped at age: 28; 1 entered on: 9/11/23
Author: Cooksey, Lisa, UMG Primary Care Rockville TH Last Modified: 09/11/2023 12:44 PM
Birth Sex
Author: Union Health Provenance
Last Modified: 06/17/2025 2:47 PM
Female
Sex Representation
Author: Union Health Provenance
Last Modified: 06/17/2025 2:47 PM
Female (finding)
1 former smoker, not heavy (1-2 cigs daily) but will have one from time to time Author: Cooksey, Lisa, UMG Primary Care Rockville TH Last Modified: 09/11/2023 12:44 PM
Goals
No data available for this section
Hospital Discharge Instructions
No data available for this section
Reason for Referral
No data available for this section
Health Concerns
No data available for this section
Implantable Device List
No data available for this section
Clinical Note
No data available for this section
Patient Care team information
Care Team Personnel
Name: Koch, Amy E, NP
Position: OE: PC Provider Family Med
Member Role: Primary Care Physician
Address: UMG Primary Care Rockville
111 West High Street
Rockville, IN 47872- US
Telecom: 765-***-****
Author: Union Health Provenance
Last Modified: 09/11/2023 12:24 PM
Care Team Related Persons
Name: NONE, NONE
Author: Union Health Provenance
Last Modified: 09/11/2023 12:27 PM
Name: Schrader, Douglas S
Author: Union Health Provenance
Last Modified: 09/11/2023 12:27 PM
Family History
No data available for this section
Insurance Providers
Guarantor name: NI
Health Plan Information #: 1
Payer: UnitedHealthcare
Payer Identifier: CERN000033
Member Number: 964228710
Group Number: 730727
Subscriber Identifier: 59981123
Relationship to Subscriber: NA
Coverage Type: PPO
Coverage Verification Date: NA
Telecom: 999-***-****
Address: PO BOX 740800
ATLANTA, GA 30374- US