Broken Nose Soccer Mask - Madrid Model to New York City

12/30/16
PA: Hakim S. / New York City
DG :fracture of nasal bones ICD-10-CM - S02.2
RX: Broken Nose / Soccer Mask / Madrid model
Supplier: www.indianabrace.com / 1-800-253-6217 -
URL : http://indianabrace.com/basketballfacemask.aspx
Clyde Peach, CO (ABC Certified Orthotist #1321)
ABC - American Board for Certification in Orthotics & Prosthetics