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Cosign encounter performed at HeaIth Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider. Beaudouin, Robert MD MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Petailt Frequency Lab Tests-H-Hemoglobin A1C One Time Lab Tests-C-CBC w/diff Lab Tests-L-Lipld Profile Lab Tests-C-Comprehensive Met

/2 Lab Tests-R-RPR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP) New Radiology Request Orders: Dela Frequency endlUate General Radiology-Chest-2 Views One Time Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Required: No Co

ormed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 MED CL:1 Provider: .... f b_,(6_>; <_b;c_7)(_c > ___ _.I MD NO CCC APPT. Discontinued Laboratory Requests: Details Lab T ests-H-Hemog/obin A 1 C Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab T ests-C-Comprehensive Metabolic Profile (

New Radiology Request Orders: Frequency One Time Details Frequency End Date Due Date 08/05/2019 00:00 Due Date 07/25/2019 00:00 Due Date General Radiology-Chest-2 Views One Time 07/25/2019 Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Requ

ake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 MED CL:1 Provider: fbX6>: (b)(7)(C) NO CCC APPT. Discontinued Laboratory Requests: Details Lab T ests-H-Hemog/obin A 1 C Lab Tests-C-CBC w/diff Lab Tests-L-Lipid Profile Lab T ests-C-Comprehensive Metabolic Profile (

rders: Frequency One Time Details Frequency End Date Reg#: Facility: Unit: Due Date 08/05/2019 00:00 Due Date 07/25/2019 00:00 Due Date General Radiology-Chest-2 Views One Time 07/25/2019 Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX , REFERRED FOR ROUITNE CXR. Copay Requ

Cosign Note - Intake Cosign encounter performed at Health Services. Administrative Notes: ADMINISTRATIVE NOTE 1 Provider. MED CL:1 NO CCC APPT. Discontinued Laboratory Requests: Details Frequency Due Date Lab Tests-H-Hemoglobin A1C One Time 08/05/2019 00:00 R• no Lab Tests-C-CBC w/diff Lab Tests-L-Llpld Pro

PR Chronic Care Clinics-Diabetic-Comprehensive Metabolic Profile (CMP) New Radiology Request Orders: Details Frequency End aak Due Pate Edo* General Radiology-Chest-2 Views One Time 07/25/2019 Ftouline Specific reason(s) for request (Complaints and findings): 66 YR OLD MALE WITH NO PMHX REFERRED FOR ROUITNE CXR. Co