| Patient | Dx Den4Edge Supp | Sex | Male |
| Date of birth | September 12th, 1974 08:00 | Date of expiration | |
| Race | Black or African American | Ethnicity | Not Hispanic or Latino |
| Insurance Providers | Other | Patient IDs | 581a9d4af081f3073800020a Cypress |
| Contact info | |||
| Document Id | 581a9d4af081f3073800020a 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 |
December 31st, 2011 08:00 - present |
| Description | Codes | Time | Status | Results | Fields |
|---|---|---|---|---|---|
| Encounter |
CPT:
99386
|
March 30th, 2012 13:00 - March 30th, 2012 13:30 | performed |