Patient Note — 267931

4/17/26, 4:57 AM Print Preview [PATIENT_NAME] DOB: [DOB] (80 yo M) Acc No. [ACCOUNT_ID] DOS: 04/16/2026 Progress Notes Patient: [PATIENT_NAME] Provider: Alok Desai, MD Account: [ACCOUNT_ID]: [ACCOUNT_ID] DOB: [DOB] Age: 80 Y Sex: Male Date: 04/16/2026 Phone: [PHONE] Address: [ADDRESS], FAIRFAX STATION, VA-[ZIP] Pcp: [PATIENT_NAME] Subjective: Chief Complaints: 1. Blood in urine. HPI: Hematuria: 80 year old male, new patient, presents for assessment of gross hematuria. He reports hematuria started on Sunday and denies any associated pain or other symptoms. No urinary complaints. He reports he has not been taking Xarelto and states his last dose was Sunday night. He reports his PSA has been within normal range for the past year. Pt was at Inova ED on 04/14/2026 with gross hematuria and was discharged on Keflex. His Xarelto was held for 2 days. Smoking Hx: None ++++++++++++ CT A/P: Nonobstructing left nephrolithiasis. Cholelithiasis. Colonic diverticulosis. [04/14/2026] UA/UCx: RBC too numerous to count, protienuria [04/14/2025]. PSA screening: PSA was 0.6 in May 2025. Medical History: High cholesterol, High blood pressure. Surgical History: bypass , stents in heart , rotator cuff , shoulder surgery , knee surgery . Hospitalization/Major Diagnostic Procedure: Denies Past Hospitalization. Family History: Father: deceased. Mother: deceased. Mom hx breast cancer. Screening: Social History: Smoking: no . Recreational drug use: no. Exercise: yes. Caffeine: no. Sexually active: yes. Medications: Taking Isosorbide Mononitrate 30 MG Tablet Extended Release 24 Hour 1 tablet in the morning Orally Once a day , Taking Crestor(Rosuvastatin Calcium) 20 MG Tablet 1 tablet Orally Once a day , Taking Atenolol 25 MG Tablet Oral , Taking Altace 5 MG Tablet as directed Orally , Taking Zetia(Ezetimibe) 10 MG Tablet 1 tablet Orally Once a day , Taking Xarelto(Rivaroxaban) 20 MG Tablet Oral , Taking Levothyroxine Sodium 25 MCG Capsule 1 capsule in the morning on an empty stomach Orally Once a day , Medication List reviewed and reconciled with the patient Allergies: Iodine. Objective: Vitals: Provider: Alok Desai, MD Date: 04/16/2026 1/2 4/17/26, 4:57 AM Print Preview [PATIENT_NAME] DOB: [DOB] (80 yo M) Acc No. [ACCOUNT_ID] DOS: 04/16/2026 Assessment: Assessment: 1. Gross hematuria - R31.0 (Primary) Plan: Treatment: 1. Gross hematuria Notes: Patient radiographic images are reviewed and interpreted. Given the patient's history of gross hematuria, according to the AUA guidelines, this places the patient in a high-risk category. Due to this classification, the patient warrants a full hematuria work-up, consisting of a urine culture (possibly urine PCR), urine analysis, urine cytology to check for abnormal or possibly malignant cells, a CT Urogram to evaluate the upper urinary tract (i.e., kidneys an ureters), and cystoscopy. He underwent CT urogram, which demonstrated a 4 mm left mid-pole stone with no evidence of ureteral calculi. No bladder clots were identified. Given the