Benjamin Morgan

00022 
 Countryside Regional 
 25889 Samuel Islands
Margaretchester, IN 77355 
 Tel: 302-366-9709 
 Countryside Regional 
 Fax: 903-438-3932 
 www.landswickpt.com 
 PHYSICAL THERAPY. INC. 
 Quick SOAP 
 Patient name (ID 1 D.O.B): Benjamin Morgan (cazaresa I 1997-07-05) 
 Treatment Date: 2018-10-10 11:30 AM 
 Insurance: 
 Gallagher Bassett Services - California 
 Visits: 
 2 
 Episode: 
 R elbow 
 Re-Eval Due: 
 Referrer: 
 Dr Michael Bridges MD 
 Next Follow-up: 
 Diagnosis Codes: 
 Parkinson's Disease (K85), Osteoarthritis (K85), Migraine (I63)
 SOAP 
 Subjective 
 Pt reports that she was a little sore after last session.
 Objective 
 Tx: STM triceps, wrist extensors, wrist supinators, biceps; CFM along medial and lateral epicondyles; 
 Plan 
 Cont per POC. 
 EXERCISE FLOWSHEET 
 See hard copy for list of exercises. 
 CHARGESHEET 
 Time Information 
 Total Direct Time 
 30 Minutes 
 Billing Codes 
 Code 
 Description 
 Units 
 Comments 
 83976 
 Joint Mob/STM/Manual Therapy 
 2 
 ELECTRONICALLY SIGNED BY: Timothy Miller, PT, DPT (Random_7_digit_number) 
 Date: 2017-03-01 
 (This document was electronically signed on 2017-03-01 by Timothy Miller) 
 Note written with MWTherapy I Patient ID/Patient name (D.O.B): cazaresa/Benjamin Morgan (1997-07-05) I DOS: 2018-03-14 11:30 AM 
 Page 1 of 1 
 83976 
 32286314031 
 Received 2023-03-27
