Order Taken: WebSite Order 5/25/17 / Shipped 5/26/17 UPS Priority Mail
PA: Gail K./ Noblesville, IN
RX: Clyde's X1 GoBlade for Great Toe Pain Left
DX: Great Toe Pain
ICD-10-CM Billing Code : S93.521A
Gail's TriZone X1 GoBlade
Plan: Fabricate TriZone X1 GoBlade#7475
women's size 7 1/2 left with StifFlex midfoot (zone 2) for
unrestricted ankle motion during ice skating. Create .06" great toe pocket (zone 3)
and heel relief (zone 1) . Maintain extra kick rocker shape
forefoot (zone 3) for assisted natural toe off. Pad heel (zone 1)
with1/8" perf plastizote for heel strike relief to prevent plantar
fasciitis. Cover great toe relief zone 3 with ShearBan to prevent
blistering during golf shifting and walking activity. Specs: thickness
and weight of X1 GoBlade#7475- (1/25 ") thin! - 0.9357 oz light!
Country of Origin: Made in USA / Indianapolis, IN
Sport: ice skating
Comments: none
Website: www.indianabrace.com
Contact: Call: 800-253-6217 Text: 317-445-1475 Email: clyde.peach@gmail.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321
American Board for Certification in Orthotics & Prosthetics
Order Taken: WebSite Order 5/25/17 / Shipped 5/26/17 UPS Priority Mail
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