| Patient | Dx Num2 Supp | Sex | Male |
| Date of birth | September 7th, 1988 09:00 | Date of expiration | |
| Race | White | Ethnicity | Not Hispanic or Latino |
| Insurance Providers | Other | Patient IDs | 581aa08cf081f3073800054c Cypress |
| Contact info | |||
| Document Id | 581aa08cf081f3073800054c 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 |
January 5th, 2012 10:00 - present |
| Description | Codes | Time | Status | Results | Fields |
|---|---|---|---|---|---|
| Encounter |
CPT:
99395
|
July 5th, 2012 10:30 - July 5th, 2012 11:00 | performed |
| Description | Codes | Time | Status | Results | Fields |
|---|---|---|---|---|---|
| Laboratory Test |
LOINC:
10351-5
|
July 5th, 2012 11:00 - July 5th, 2012 11:00 | performed |
165 {copies}/mL |