Ana Sobrino

Packet ready

47 F · MRN TCPT-0047688 · Left breast IDC, pT2 N1a, post-mastectomy, regional nodes incl. IMN

Blue Cross and Blue Shield of Texas Blue Choice PPO (Commercial) — plan sponsor Walmart · ZGP 802211947

Ordered by R. Lee, MD · Sep 18, 2026 · CPT 77525 · C50.412 Malignant neoplasm of upper-outer quadrant of left female breast

Letter of medical necessity · Clinical Notes

Letter of medical necessity

Sep 17, 2026 · R. Lee, MD · 1 page

G2 › Sobrino, Ana › Clinical Notes › 2026-09-17 Letter of medical necessity

Proton therapy is medically necessary for this patient. Electronically signed by R. Lee, MD.^C-9