Patient presents with a history of chemotherapy for [Primary cancer diagnosis, e.g., breast cancer,  non-Hodgkin's lymphoma, acute myeloid leukemia]. The patient completed a regimen of [Specific chemotherapy regimen, e.g., CHOP, R-CHOP, FOLFOX, BEACOPP] from [Start date] to [End date].  This regimen consisted of [List specific chemotherapeutic agents, e.g., cyclophosphamide, doxorubicin, vincristine, prednisone].  The patient tolerated the chemotherapy [Well, moderately, poorly] and experienced [List specific side effects, e.g., neutropenia, nausea, vomiting, alopecia, mucositis, peripheral neuropathy, cardiotoxicity].  [Specify if any dose reductions or treatment delays were necessary due to side effects].  Current symptoms related to prior chemotherapy include [List ongoing symptoms, e.g., fatigue, neuropathy, cognitive impairment].  Physical exam findings relevant to prior chemotherapy are [Document relevant findings, e.g., decreased sensation in extremities, signs of cardiac dysfunction].  The patient's current performance status is [ECOG performance status, Karnofsky performance status].  Assessment includes history of chemotherapy-induced [Specific long-term complications, e.g., peripheral neuropathy, cardiomyopathy, secondary malignancy]. Plan includes continued surveillance for late effects of chemotherapy, including [Specify monitoring plan, e.g., echocardiograms, neurological exams, complete blood counts].  Patient education provided regarding management of long-term side effects and importance of follow-up care.  ICD-10 code Z85.1 (personal history of malignant neoplasm) and Z92.21 (personal history of chemotherapy] are applicable.  Medical billing codes will be determined based on the specific services provided during this encounter.