Qtr 1 Physician RBM 2017 (Oncology) case study # 7
AETTX-PPO SI Commercial
70553- MRI BRAIN (head); with and without contrast
Case initiated 01/27/2017
To MD review: Per: Jessie/mdo/req: 70553
LOV: 12/12/16
Reason: surveillance
ONC member hx Updated ___ Verified ___ Reviewed xxx. Hx of GBM L temporoparietal diagnosed 10/24/2014, WHO IV.
Resection 01/24/2014; chemoRT 11/17/14-12/30/14; temozolomide 1/23/15-08/2015; LITT 10/23/2015 , chemo 12/11/2015-7/12/2016
Prior Imaging: 12/10/16- MRI brain: no evidence of tumor progression. Stable imaging findings
PE: no abn findings on exam
Sx: none
NURSE COMMENT: ONC-2.3 early imaging request MRI brain indicated every 3 months for 3 years
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