Orbit Fracture - Raptor Mask by Clyde to Polly/Waco, TX

1/8/18
PA: Polly's son/ Waco, TX
Diagnosis: Orbit frature left side
RX:Clyde's Hoosier Model Raptor Mask - STAT
http://indianabrace.com/basketballfacemask.aspx
Sport: Soccer
www.indianabrace.com
Call Clyde 800.253.6217 TXT: 317.445.1475

Broken Nose Mask / Madrid Model Soccer Mask to James in Brandon, MS

Published on Apr 17, 2017

Website Order Taken : 4/14/17 @ 12:51 PM Shipped: 4/17/17 @ 5:00 PM UPS 2nd Day Air
PA: James R. (son) /Brandon, MS
RX:  Madrid Model Protective Mask for Broken Nose
DX: Fractures of Nasal Bones
ICD-10-CM Diagnosis Code: S02 2XXB
HX: Athlete has sustained nasal fracture during a recent soccer match.
Plan: Custom-fabricate Madrid model (color: black) using shatter proof LDP 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. Low profile design to allow for headers both side and front. Add gentle moleskin felt contact bumper pads internally for impact comfort.
Sport: soccer
User Comments: Male / 5'7" / 140 lbs. /
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@gmail.com

James's Actual Madrid Mask

American Board for Certification in Orthotics & Prosthetics

Broken Nose Mask / Clyde's Face Masks 800.253.6217 Text 317.445.1475

3/1/17
PA: Betty H. (son) / Daniels, WV
RX: Protective Mask for Broken Noses
DX: Multiple Fractures of Nasal Bones
ICD-10-CM Diagnosis Code: S02 2XXA
HX: Athlete has sustained multiple nasal fractures over the years.
Plan:
Custom-fabricate Hoosier mask (color: black) using shatter proof low
density polyethalene 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 bumper contact pads internally.
Sport: Basketball
Website: www.indianabrace.com
Practitioner: Clyde Peach, CO - ABC Certified Orthotist #1321 - 1979
American Board for Certification in Orthotics & Prosthetics

Hoosier Custom Face Mask/Broken Nose/ Madrid Soccer mask

Hoosier Custom Face Mask/Broken Nose/ Madrid Soccer mask
Website Order for Normal 24/48 hour delivery Placed: - 1/19/17 Shipped: 1/20/17
By:  D.B./Henderson, CO
RX: Madrid Protective Face Mask for Nasal Fracture - click here
Diagnosis: Broken Nose / Unspecified Injury of Nose
ICD-10-CM Diagnosis Code: S09.92XA - click here for insurance coding
Sport: Soccer
Website: www.indianabrace.com - click here
Phone: 1-800-253-6217 ask for Clyde
Email: clyde.peach@indianabrace.com
Clyde Peach, CO - ABC Certified Orthotist #1321
ABC - American Board for Certification in Orthotics and Prosthetics - click here
Made in Indianapolis, Indiana USA

Hoosier Custom Face Mask/Broken Nose/ Madrid Soccer mask

Published on Jan 11, 2017
Website Normal Delivery 24-48 hours:  - Taken: 1/12/17 9:13 PM - Shipped: 1/13/17 3:45 PM
By: Valicia R./Pensacola, FL
RX: Protective Face Mask for Nasal Fracture
Diagnosis: Broken Nose / Unspecified Injury of Nose
ICD-10-CM Diagnosis Code: S09.92XA
Sport: Soccer
Hoosier Mask Model: Madrid (custom made) - click here
Website: www.indianabrace.com
Phone: 1-800-253-6217 ask for Clyde
Email: clyde.peach@indianabrace.com
Clyde Peach, CO - ABC Certified Orthotist #1321
ABC - American Board for Certification in Orthotics and Prosthetics - click here
Made in Indianapolis,  Indiana USA - click here

Broken Nose Mask /Custom Hoosier Model / ICD-10 S09.92XA

Published on Jan 11, 2017
Website STAT Order Placed:  - 1/11/17 Shipped: 1/11/17
By: Jacksonville University/Ponte Vedra, FL  - click Here
RX: Protective Face Mask for nasal Fracture
Diagnosis: Broken Nose / Unspecified Injury of Nose
ICD-10-CM Diagnosis Code: S09.92XA
Sport: Basketball
Hoosier Mask Model: Hoosier (custom made) - click here
Website: www.indianabrace.com - click here
Phone: 1-800-253-6217 ask for Clyde
Email: clyde.peach@indianabrace.com
Clyde Peach, CO - ABC Certified Orthotist #1321
ABC - American Board for Certification in Orthotics and Prosthetics - click here
Made in Indianapolis,  Indiana USA - click here

Custom Broken Nose Mask / Madrid Model / ICD-10 - S09.92XA

Website Order Placed: 1/8/2017
By: Asher L./Beverly Hills, CA
RX:  Hoosier Protective Face Mask for nasal Fracture - click here
Diagnosis: Broken Nose / Unspecified Injury of Nose
ICD-10-CM Diagnosis Code: S09.92XA
Sport: Soccer
Hoosier Mask Model: Madrid
Website: www.indianabrace.com - click here
Phone: 1-800-253-6217 ask for Clyde
Email: clyde.peach@indianabrace.com
Clyde Peach, CO - ABC Certified Orthotist #1321
ABC - American Board for Certification in Orthotics and Prosthetics - click here
Made in Indiana USA

Hoosier Custom Face Mask to Duke Baseball

Rx: 2/25/16 custom protective face mask #5701 for Duke Baseball

Diagnosis: fracture of nasal bones / ICD-10-CM diagnosis code group S02.3XXA

History: Broken nose playing baseball. 6'3" tall / 190 lbs. male. No facial fractures.

Plan: Fabricate Hoosier model broken nose face mask. Fabricare clear shell from DuPont Surlyn shatter proof material for eye safety and endurance, install internal Moleskin impact bumper pads, attach black WBC Velcro elastic straps for suspension. Broken nose only used for baseball.
http://indianabrace.com/basketballfacemask.aspx

Sx: Order received 2/25/16 9:27 AM via website www.indianabrace.com. Shipped UPS 2nd Day Air 2/25/ 16 to Durham, NC Expect delivery in 1 day.

FU: email customer satisfaction questionnaire on 03/4/16.

Clyde Peach, CO
www.indianbrace.com