Cypress Certification Patient Test Record: Jeremy Mendez

Patient Jeremy Mendez Sex Male
Date of birth January 27th, 2001 23:29 Date of expiration
Race American Indian or Alaska Native Ethnicity Not Hispanic or Latino
Insurance Providers Other Patient IDs 5304df1d983a954fed000431 Cypress
Contact info
Document Id 5304df1d983a954fed000431 2.16.840.1.113883.3.72
Document Created: February 21st, 2014 16:20
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

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Diagnoses

Description Codes Time Status Results Fields
Diagnosis, Active: Major Depressive Disorder-Active (Code List: 2.16.840.1.113883.3.526.3.1491) SNOMED-CT: 14183003
ICD-9-CM: 296.20
ICD-10-CM: F32.0
January 10th, 2012 20:49 - January 10th, 2012 20:49 active

Encounters

Description Codes Time Status Results Fields
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
January 10th, 2012 20:29 - January 10th, 2012 21:29 performed
Encounter, Performed: Office Visit (Code List: 2.16.840.1.113883.3.464.1003.101.12.1001) CPT: 99201
October 10th, 2012 20:29 - October 10th, 2012 21:29 performed

Medications

Description Codes Time Status Results Fields
Medication, Dispensed: ADHD Medications (Code List: 2.16.840.1.113883.3.464.1003.196.12.1171) RxNorm: 1009145
January 10th, 2012 21:29 - January 10th, 2012 21:29 dispensed