| Patient | Dx Den5Edge Supp | Sex | Female |
| Date of birth | April 8th, 1998 08:00 | Date of expiration | |
| Race | White | Ethnicity | Not Hispanic or Latino |
| Insurance Providers | Other | Patient IDs | 581a9eebf081f30738000346 Cypress |
| Contact info | |||
| Document Id | 581a9eebf081f30738000346 2.16.840.1.113883.3.72 |
| Document Created: | December 15th, 2016 17:54 |
| Author | Auto Generated |
| Contact info |
Tel: +1-781-271-3000 |
| Document maintained by | Cypress |
| Contact info | 202 Burlington Rd. Bedford, MA 01730 Tel: +1-781-271-3000 |
| Description | Codes | Time | Status | Results | Fields |
|---|---|---|---|---|---|
| Diagnosis |
ICD-9-CM:
042
SNOMED-CT: 111880001 ICD-10-CM: B20 |
March 31st, 2012 12:00 - present |
| Description | Codes | Time | Status | Results | Fields |
|---|---|---|---|---|---|
| Encounter |
CPT:
99393
|
October 1st, 2012 11:00 - October 1st, 2012 11:30 | performed |