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al Nadu of Prisons • NYM Rego 1 o! 1 EFTA00049314 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 ••• Sensitive But nclasslfleds** Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 0112W1953 Sex M Facility MCC New York Orde
Initiated Format Hand MitiTO0 la 07/1412019 Counseling Diagnosis Copay Required: No Cosign Required: No TelephoneNerbai Order NO Completed by Beaudouin, Robert MD on 07/14/2019 18:11 Provider Beaudouin, Robe Outcome Verbalizes Understanding Generated 07/14/2019 18:11 by Beaudostn, Robert Mn Bur
e. Copay Required:No Cosign Required: Yes TelephoneNerbal Order: No Completed by Joaquin, Y. MLP on 07/09/2019 13:03 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. GenetaloO 07/09/2019 13:03 by Joaquin, MLP Bureau of Prisons - NYM Pag
Bureau of Prisons • NYM Page I of 1 EFTA00049722 O Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874.1621 "' Sensitive But Unclassified "' Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Ord
g Copay Required: No Cosign Required: Yes TelephoneNerbal Order: No Completed by Joaquin. Y. MLP on 07/24/2019 13:24 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be disp:ayed on the following page. Generale(' 01/2412019 13:24 by Joaquin. Y. MLP Bureau of Prisons - NYM
TO HAVE AN OPTOMETRIST EVALUATION. HE REFUSED. REFUSAL FORM SIGNED. Copay Required:No Cosign Required: No TelephoneNerbal Order No Completed by Beaudouin, Robert MD on 07/24/2019 15:17 Generated 07/24/2019 15:17 by fleautloon. Robert MD Bureau M Prisons - NYM Page 1 ol 1 EFTA00049663 Bureau of Pr
Bureau of Prisons - NYM Page 2 of 2 EFTA00045617 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order
g Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by Joaquin, Y. MLP on 07/23/2019 09:05 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 07/23/2019 09:05 by Joaquin, Y. MLP Bureau of Prisons - NYM P
macy Dispensings: 10 TAB in 22 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) by mouth twice daily for 30 days Rx#: 121823-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Exp: 08/11/19 Pharmacy Dlspensings: 60 CAP in 19 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) twice dail
Bureau of Prisons - NYM Page 2 of 2 EFTA00045706 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order
macy Dispensings: 10 TAB in 15 days Docusate Sodium 100 MG Cap Take one capsule (100 MG) by mouth twice daily for 30 days Rx#: 121823-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Exp: 08/11/19 Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 2 tablespoonful twice daily by mouth Rx#:
Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by Columbo, Joseph RN on 08/10/2019 08:10 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 08/10/2019 08:10 by Columbo, Joseph RN Bureau of Prisons - NYM
; Bureau or Prison • NYM Pogo 1 o! 1 EFTA00050835 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 ••• Sensitive Out nclasslfied Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order
D FOLLOW-UP. Patient Education Topics: Date Initiated Format 07/12/2019 Counseling Copay Required:No TelephoneNerbal Order: o FK Completed by Beaudouin, Handout/Topic Diagnosis Cosign Required: No n 07/12/2019 14:20 Provider Outcome Verbalizes Understanding Generated 07/12/2019 14:20 by MD
-nt's Sign- Date NYM-NEW YORK MCC EFTA00049633 O Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417.874-1621 ••• Sensitive But Unclassified ••s Name EPSTEIN. JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York
-054 Date of Birth: 01/20/1953 Sex: M Race: WHITE Encounter Date: 07/10/2019 16:58 Provider: Lab Result Receive Facility: NYM Cosigned by Beaudouin, Robert MD on 07/14/2019 18:12. Bureau of Prisons • NYM EFTA00049635 BP-5358.C60 SEP 05 MEDICAL TREATMENT REFUSAL CDFRM U.S. DEPARTMENT OF JU
Bureau of Prisons - NYM Page 2 of 2 EFTA00045854 Federal Bureau of Prisons U.S. Medical Center for Federal Prisons 1900 W. Sunshine Street Springfield, MO 65807 417-874-1621 "' Sensitive But Unclassified Name EPSTEIN, JEFFREY Reg # 76318-054 DOB 01/20/1953 Sex M Facility MCC New York Order
. Copay Required:No Cosign Required: Yes Telephone/Verbal Order: No Completed by Joaquin, Y. MLP on 07/09/2019 13:03 Requested to be cosigned by Beaudouin, Robert MD. Cosign documentation will be displayed on the following page. Generated 07/0912019 13:03 by Joaquin. Y. MUD Bureau of Prisons • NYM P
0 W. Sunshine Street Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Providerl(b)C5>; lbit7Jtc> I MD CHEMISTRY 137 4.7 99 27 17 1.05 >60 G
ests-U-Urinalysis w/Reflex to Microscopic Additional Information: 66 y/o male, elevated BP Frequency One Time Labs requested to be reviewed by: Beaudouin, Robert MD New Laboratory Requests: Details Chronic Care Clinics-Diabetic-CBC w/diff Chronic Care Clinics-Diabetic-Lipid Profile Chronic Care Cl
0 W. Sunshine Street Name EPSTEIN, JEFFREY Reg# 76318-054 DOB 01/20/1953 Sex M Sodium Potassium Chloride CO2 BUN Creatinine eGFR (IDMS) Springfield, MO 65807 417-874-1621 Facility MCC New York Order Unit E06-547U Provider r )(6); (b)(7)(C) f MD CHEMISTRY 137 4.7 99 27 17 1.05 >60 G
s: 30 CAP in 290 days Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 2 tablespoonful twice daily by mouth Rx# : 121835-NYM Doctor: Beaudouin, Robert MD Start: 07/12/19 Exp: 07/14/19 Milk of Magnesia Susp (OTC) (473ML) 400MG/5ML shake well take 10ml by mouth twice daily AS NEEDED Rx#:
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