3/8/17
Website Order Taken : 3/8/17 @ 10;15 AM PM Shipped: 3/8/17 @ 5:00 PM FedEx First Overnight
PA: Annette K.'s son /Austin, TX
RX: Protective Mask for Broken Nose
DX: Fractures of Nasal Bones
ICD-10-CM Diagnosis Code: S02 2XXA
HX: Athlete has sustained nasal fracture during contact sport.
Plan:
Custom-fabricate Hoosier model (color: clear) using shatter proof
DuPont Surlyn that will not re-injure recent fractures, will shape to
face naturally and avoid eye injuries. Customize design for maximum
nasal protection and minimum obstruction of peripheral and downward
vision. Add gentle contact bumper pads internally. Baseball design.
Sport: Baseball
Comment: Clyde, we are ordering this STAT so you can get it out today. Thanks. Annette
Website: www.indianabrace.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321 - 1979
Contact: Call: 800.253.6217 Text: 317.445.1475 Email: clyde.peach@indianabrace.com
American Board for Certification in Orthotics & Prosthetics
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