2405 Shadelands Dr
Walnut Creek CA 94598
Medical School: Columbia University College Of Physicians And Surgeons - 1993
Accepts Medicare: Yes
Participates In eRX: No
Participates In PQRS: No
Participates In EHR: No
License #: G85060
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Awards & Recognitions
Dr. Donald Lewis is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:29827||Description:Arthroscop rotator cuff repr||Average Price:$2,600.05||Average Price Allowed
|HCPCS Code:29826||Description:Shoulder arthroscopy/surgery||Average Price:$1,500.00||Average Price Allowed
|HCPCS Code:73221||Description:Mri joint upr extrem w/o dye||Average Price:$1,343.00||Average Price Allowed
|HCPCS Code:64721||Description:Carpal tunnel surgery||Average Price:$937.00||Average Price Allowed
|HCPCS Code:29848||Description:Wrist endoscopy/surgery||Average Price:$1,060.00||Average Price Allowed
|HCPCS Code:26040||Description:Release palm contracture||Average Price:$725.90||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$229.00||Average Price Allowed
|HCPCS Code:29125||Description:Apply forearm splint||Average Price:$157.00||Average Price Allowed
|HCPCS Code:29075||Description:Application of forearm cast||Average Price:$199.00||Average Price Allowed
|HCPCS Code:20610||Description:Drain/inject joint/bursa||Average Price:$167.00||Average Price Allowed
|HCPCS Code:20550||Description:Inj tendon sheath/ligament||Average Price:$138.00||Average Price Allowed
|HCPCS Code:20605||Description:Drain/inject joint/bursa||Average Price:$142.48||Average Price Allowed
|HCPCS Code:20612||Description:Aspirate/inj ganglion cyst||Average Price:$131.50||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$127.00||Average Price Allowed
|HCPCS Code:73030||Description:X-ray exam of shoulder||Average Price:$82.00||Average Price Allowed
|HCPCS Code:73120||Description:X-ray exam of hand||Average Price:$70.00||Average Price Allowed
|HCPCS Code:73100||Description:X-ray exam of wrist||Average Price:$70.00||Average Price Allowed
|HCPCS Code:73110||Description:X-ray exam of wrist||Average Price:$76.00||Average Price Allowed
|HCPCS Code:73140||Description:X-ray exam of finger(s)||Average Price:$60.00||Average Price Allowed
|HCPCS Code:Q4010||Description:Cast sup sht arm adult fbrgl||Average Price:$30.00||Average Price Allowed
|HCPCS Code:J3301||Description:Triamcinolone acet inj NOS||Average Price:$3.00||Average Price Allowed
|HCPCS Code:J0702||Description:Betamethasone acet&sod phosp||Average Price:$2.00||Average Price Allowed
HCPCS Code Definitions
- Application, cast; elbow to finger (short arm)
- Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
- Aspiration and/or injection of ganglion cyst(s) any location
- Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous
- Neuroplasty and/or transposition; median nerve at carpal tunnel
- Endoscopy, wrist, surgical, with release of transverse carpal ligament
- Arthroscopy, shoulder, surgical; with rotator cuff repair
- Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (ie, arch) release, when performed (List separately in addition to code for primary procedure)
- Application of short arm splint (forearm to hand); static
- Radiologic examination, shoulder; complete, minimum of 2 views
- Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
- Radiologic examination, finger(s), minimum of 2 views
- Radiologic examination, hand; 2 views
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- Radiologic examination, wrist; complete, minimum of 3 views
- Radiologic examination, wrist; 2 views
- Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without contrast material(s)
- Injection, triamcinolone acetonide, not otherwise specified, 10 mg
- Cast supplies, short arm cast, adult (11 years +), fiberglass
- Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia")
Medical Malpractice Cases
Medical Board Sanctions
Physical Medicine And Rehabilitation
*These referrals represent the top 10 that Dr. Lewis has made to other doctors
Sleep quality and the treatment of intestinal microbiota imbalance in Chronic Fatigue Syndrome: A pilot study. - Sleep Science (SaÌƒo Paulo, Brazil)
Chronic Fatigue Syndrome (CFS) is a multisystem illness, which may be associated with imbalances in gut microbiota. This study builds on recent evidence that sleep may be influenced by gut microbiota, by assessing whether changes to microbiota in a clinical population known to have both poor sleep and high rates of colonization with gram-positive faecal Streptococcus, can improve sleep. Twenty-one CFS participants completed a 22-Â day open label trial. Faecal microbiota analysis was performed at baseline and at the end of the trial. Participants were administered erythromycin 400Â mg b.d. for 6 days. Actigraphy and questionnaires were used to monitor sleep, symptoms and mood. Changes in patients who showed a clinically significant change in faecal Streptococcus after treatment (responders; defined as post-therapy distribution<6%) were compared to participants who did not respond to treatment. In the seven responders, there was a significant increase in actigraphic total sleep time (p=0.028) from baseline to follow up, compared with non-responders. Improved vigour scores were associated with a lower Streptococcus count (Ï=-0.90, p=0.037). For both the responders and the whole group, poorer mood was associated with higher Lactobacillus. Short term antibiotic treatment appears to be insufficient to effect sustainable changes in the gut ecosystem in most CFS participants. Some improvement in objective sleep parameters and mood were found in participants with reduced levels of gram-positive gut microbiota after antibiotic treatment, which is encouraging. Further study of possible links between gut microorganisms and sleep and mood disturbances is warranted.
Support for the Microgenderome: Associations in a Human Clinical Population. - Scientific reports
The 'microgenderome' provides a paradigm shift that highlights the role of sex differences in the host-microbiota interaction relevant for autoimmune and neuro-immune conditions. Analysis of cross-sectional self-report and faecal microbial data from 274 patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) suggests that commensal gut microorganisms may play both protective and deleterious roles in symptom expression. Results revealed significant sex-specific interactions between Firmicutes (Clostridium, Streptococcus, Lactobacillus and Enterococcus) and ME/CFS symptoms (including neurological, immune and mood symptoms), regardless of compositional similarity in microbial levels across the sexes. Extending animal studies, we provide support for the microgenderome in a human clinical population. Applied and mechanistic research needs to consider sex-interactions when examining the composition and function of human microbiota.
Long-term open-label safety study of rizatriptan acute treatment in pediatric migraineurs. - Headache
To evaluate the safety/tolerability of rizatriptan in the long-term acute treatment of migraine in pediatric patients.Acute migraine treatment options for children are limited. A recent single-attack trial demonstrated that rizatriptan is effective in eliminating migraine headache pain in this population. We evaluated the long-term safety and efficacy of rizatriptan when used for intermittent acute treatment.Open-label study in pediatric migraineurs ages 12-17 years. Patients weighing <40â€‰kg received rizatriptan (orally disintegrating tablet) 5â€‰mg, and those weighing â‰¥40â€‰kg received 10â€‰mg. Patients could treat up to 8 mild/moderate/severe migraine attacks per month for up to 12 months. One dose of study medication was allowed in a 24-hour period.A total of 674 patients were enrolled, and 606 patients were treated with study medication (Nâ€‰=â€‰583 for 10â€‰mg, Nâ€‰=â€‰23 for 5â€‰mg). The mean duration in the study was 292 days, and the mean number of doses of study medication taken was 20. Over the course of the study within 14 days post-any-dose, 66.0% (400) of the 606 treated patients had any adverse event, 2.3% (14) discontinued due to an adverse event, 2.6% (16) had a serious adverse event, and 23.4% (142) had a triptan-related adverse event. Of the 16 patients with serious adverse events within 14 days post-any-dose, the adverse events in 3 were considered drug-related; all 3 patient's adverse events were classified as serious only because they were associated with an overdose (use of >1 dose of study medication in a 24-hour period). The mean percentage of patient's attacks with pain freedom at 2-hours post-dose was 46.3%; this was relatively consistent over time (Months 1-3â€‰=â€‰43.7%, Months 4-6â€‰=â€‰51.9%, Months 7-9â€‰=â€‰49.9%, Months 10-12â€‰=â€‰49.5%).Rizatriptan was generally safe and well tolerated in the long-term acute treatment of migraine in pediatric patients aged 12-17 years and demonstrated a consistent treatment effect over time.Â© 2012 American Headache Society.
Efficacy and tolerability of rizatriptan in pediatric migraineurs: results from a randomized, double-blind, placebo-controlled trial using a novel adaptive enrichment design. - Cephalalgia : an international journal of headache
Treatment options for children and adolescents with migraine are limited. This study evaluated rizatriptan for the acute treatment of migraine in children and adolescents.Randomized, double-blind, placebo-controlled, parallel-group trial in migraineurs 6-17 years old with unsatisfactory response to nonsteroidal anti-inflammatory drugs or acetaminophen/paracetamol. The trial included a double-blind run-in with weight-based rizatriptan dosing (5â€‰mg for < 40â€‰kg, 10â€‰mg for â‰¥ 40â€‰kg). In the Stage 1 run-in, patients were randomized in a ratio of 20:1 placebo:rizatriptan and were instructed to treat within 30 minutes of a moderate/severe migraine. Patients with mild/no pain after 15 minutes of treatment (responders) took no further study medication, whereas patients with moderate/severe pain (non-responders) proceeded to take study medication in Stage 2. Non-responders who received placebo in Stage 1 were randomized 1:1 to rizatriptan:placebo, whereas non-responders who received rizatriptan in Stage 1 were allocated to placebo in Stage 2. The primary efficacy endpoint was pain freedom at 2 hours after Stage 2 dose in 12-17-year-olds.A higher proportion of 12-17-year-olds on rizatriptan had pain freedom at 2 hours compared with those on placebo: 87/284 (30.6%) versus 63/286 (22.0%), odds ratioâ€‰=â€‰1.55 [95% CI: 1.06 to 2.26], pâ€‰=â€‰0.025. Adverse events within 14 days of dose in 12-17-year-olds were similar for rizatriptan and placebo. The pattern of findings was similar in 6-17-year-olds.Rizatriptan demonstrated a statistically significant improvement over placebo in eliminating pain and was generally well tolerated in migraineurs aged 12-17 and 6-17 years.ClinicalTrials.gov NCT01001234.
Randomized trial of sumatriptan and naproxen sodium combination in adolescent migraine. - Pediatrics
Treatment of adolescent migraine remains a significant unmet medical need. We compared the efficacy and safety of 3 doses of sumatriptan and naproxen sodium (suma/nap) combination tablets to placebo in the acute treatment of adolescent migraine.This randomized, parallel group study in 12 to 17 year olds required 2 to 8 migraines per month (typically lasting >3 hours untreated) for â‰¥ 6 months. Subjects entered a 12-week run-in phase, treating 1 moderate-to-severe migraine (attack 1) with single-blind placebo. Subjects reporting headache pain 2 hours after dosing were randomly assigned into a 12-week double-blind phase, treating 1 moderate-to-severe migraine (attack 2) with placebo (n = 145), suma/nap 10/60 mg (n = 96), 30/180 mg (n = 97), or 85/500 mg (n = 152). The primary end point was the percentage of subjects pain-free at 2 hours.The attack 2 adjusted (age; baseline pain severity) 2-hour pain-free rates were higher with suma/nap 10/60 mg (29%; adjusted P = .003), 30/180 mg (27%; adjusted P = .003), and 85/500 mg (24%; adjusted P = .003) versus placebo (10%). Posthoc primary end-point analyses did not demonstrate differences among the 3 doses or an age-by-treatment interaction. Statistically significant differences were found for 85/500 mg versus placebo for sustained pain-free 2 to 24 hours (23% vs 9%; adjusted P = .008), 2-hour photophobia-free (59% vs 41%; adjusted P = .008), and 2-hour phonophobia-free (60% vs 42%; adjusted P = .008). Analyses of other pain, associated symptoms, rescue medication use, and health outcome end points supported higher efficacy for active doses versus placebo. All active doses were well tolerated.All doses of suma/nap were well tolerated, providing similarly effective acute treatment of adolescent migraine pain and associated symptoms, as compared with placebo.
Long-term evaluation of sumatriptan and naproxen sodium for the acute treatment of migraine in adolescents. - Headache
To evaluate the long-term safety, tolerability, effectiveness, impact on quality of life, and medication satisfaction of sumatriptan/naproxen sodium in the acute treatment of migraine headache in adolescents.This 12-month, multicenter, open-label, safety study was conducted in adolescents (aged 12-17 years) with an average of 2-8 migraines/month typically lasting >2 hours untreated for >6 months prior to initiation. Subjects were instructed to treat migraines as early as possible and were allowed to rescue 2 hours post dose with a single dose of a naproxen-containing product, over-the-counter pain reliever, or anti-emetics. Subjects were advised not to take a second tablet of sumatriptan/naproxen sodium without at least a 24-hour headache-free period. Safety evaluations included adverse events, laboratory tests, and vital signs and electrocardiogram evaluation. Other evaluations included freedom from pain, quality of life, and medication satisfaction.Of the 656 subjects enrolled, 622 (95%) treated at least 1 migraine with sumatriptan/naproxen sodium, of which 435 (70%) and 363 (58%) completed 6 and 12 months of the study, respectively. Overall, there were 12,927 exposures to sumatriptan/naproxen sodium: on average 2.5 tablets were taken per month per subject. The most common treatment-related adverse events were nausea (7%), dizziness (3%), muscle tightness (3%), and chest discomfort (3%). There were no deaths; 4 subjects had 5 serious adverse events (suicide attempt, hemolytic anemia and syncope, suicidal ideation, spontaneous abortion) unrelated to sumatriptan/naproxen sodium and resolved without sequelae. Seven percent of subjects discontinued participation in the study because of an adverse event; 5% of subjects discontinued due to lack of efficacy. Overall, 42% of the migraine attacks were pain-free within 2 hours of treatment with sumatriptan/naproxen sodium, subjects reported improvements from baseline in 2 of 3 quality of life domains over time, and were generally satisfied with the efficacy and overall treatment at the end of the study.In adolescent migraineurs, after up to 12 months and over 12,000 exposures to sumatriptan/naproxen sodium, there were no new or clinically significant findings in the safety parameters, including the frequency and nature of adverse events, as compared to the individual components or to the adverse event profile in adults. In addition, sumatriptan/naproxen sodium provided freedom from pain over time, improvements in quality of life and medication satisfaction.Â© 2011 American Headache Society.
Abdominal migraine: an under-diagnosed cause of recurrent abdominal pain in children. - Headache
Our objective was to demonstrate that, despite recognition by both the gastroenterology and headache communities, abdominal migraine (AM) is an under-diagnosed cause of chronic, recurrent, abdominal pain in childhood in the USA.Chronic, recurrent abdominal pain occurs in 9-15% of all children and adolescents. After exclusion of anatomic, infectious, inflammatory, or other metabolic causes, "functional abdominal pain" is the most common diagnosis of chronic, idiopathic, abdominal pain in childhood. Functional abdominal pain is typically categorized into one, or a combination of, the following 4 groups: functional dyspepsia, irritable bowel syndrome, AM, or functional abdominal pain syndrome. International Classification of Headache Disorders--(ICHD-2) defines AM as an idiopathic disorder characterized by attacks of midline, moderate to severe abdominal pain lasting 1-72 hours with vasomotor symptoms, nausea and vomiting, and included AM among the "periodic syndromes of childhood that are precursors for migraine." Rome III Gastroenterology criteria (2006) separately established diagnostic criteria and confirmed AM as a well-defined cause of recurrent abdominal pain.Following institutional review board approval, a retrospective chart review was conducted on patients referred to an academic pediatric gastroenterology practice with the clinical complaint of recurrent abdominal pain. ICHD-2 criteria were applied to identify the subset of children fulfilling criteria for AM. Demographics, diagnostic evaluation, treatment regimen and outcomes were collected.From an initial cohort of 600 children (ages 1-21 years; 59% females) with recurrent abdominal pain, 142 (24%) were excluded on the basis of their ultimate diagnosis. Of the 458 patients meeting inclusion criteria, 1824 total patient office visits were reviewed. Three hundred eighty-eight (84.6%) did not meet criteria for AM, 20 (4.4%) met ICHD-2 formal criteria for AM and another 50 (11%) had documentation lacking at least 1 criterion, but were otherwise consistent with AM (probable AM). During the observation period, no children seen in this gastroenterology practice had received a diagnosis of AM.Among children with chronic, idiopathic, recurrent abdominal pain, AM represents about 4-15%. Given the spectrum of treatment modalities now available for pediatric migraine, increased awareness of cardinal features of AM by pediatricians and pediatric gastroenterologists may result in improved diagnostic accuracy and early institution of both acute and preventative migraine-specific treatments.Â© 2011 American Headache Society.
Almotriptan for the acute treatment of adolescent migraine. - Expert opinion on pharmacotherapy
Migraine is a common problem affecting 10 - 20% of adolescents. Its treatment has three fundamental components: bio-behavioral interventions, preventive measures, and acute drug therapy. In June 2009, the US FDA approved almotriptan, a 5-HT1B/1D receptor agonist, for the acute treatment of migraine in adolescents aged 12-17 years--the first 'triptan' to be approved for adolescents.This review will provide an overview of migraine in adolescents focusing on epidemiology, pathophysiology, classification and a review of treatment options with attention on the evidence from the past 5 years surrounding almotriptan.Given its recent FDA approval, it is important to for clinicians and pharmacists to become familiar with the clinical spectrum of migraine in teenagers and with recent evidence on this newly approved agent, almotriptan.Almotriptan is a safe, effective, and approved agent for the acute treatment of migraine headache in adolescents.
Secondary headaches in children and adolescents. - Seminars in pediatric neurology
A majority of the children presented for evaluation of headache complaints, will have one of the primary headache disorder such as tension-type or migraine. During the course of the evaluation, consideration must be given to the diverse collection of other medical and systemic disorders which may also cause headache in children and adolescents. The purpose of this article is to review the spectrum of secondary headaches. In majority of the instances, a thorough medical and headache history coupled with physical and neurologic examination will uncover clues to the presence of these other disorders. This will also guide clinical decision making regarding the need for further diagnostic testing, including neuroimaging, electrophysiological testing, or specific laboratory testing.Copyright 2010 Elsevier Inc. All rights reserved.
Identifying the "tipping point" age for overweight pediatric patients. - Clinical pediatrics
According to the National Health and Nutrition Examination Survey in 2007, nearly half of all American children are either overweight or obese. Retrospective chart review identified patients with the diagnostic codes for overweight, obese, and/or excessive weight gain. Inclusion criteria were current age between 2 and 20 years, a minimum of 5 visits with weight and height measurements, and a body mass index (BMI) at or above the 85th percentile. A total of 184 patients met inclusion criteria. More than half the children became overweight before age 2, and all patients were obese or overweight by age 10. The rate of gain is approximately 1 excess BMI unit/year, therefore causing most children to be overweight by age 2 (R (2) = .53). This study indicates that the critical period for preventing childhood obesity in this subset of identified patients is during the first 2 years of life and for many by 3 months of age.
Map & Directions
2405 Shadelands Dr Walnut Creek, CA 94598
365 Lennon Ln Ste 290
Jmmc 3-East 1601 Ygnacio Valley Road
1575 Treat Blvd Suite 115
1399 Ygnacio Valley Rd Suite 12
1601 Ygnacio Valley Rd
1888 Appia Ct