Richard Martin

 
 04/28/2023 12:28 
 P.010/023 
 Specialty Meds (Final): Pred Forte 1% 1 gtt qid OS. Ofloxacin 0.3% Ophthalmic Solution 1 gtt qid os. 
 Follow Up: Dr Michelle Smith, MD 6-7 Weeks . 
 CPT Codes: 99484. 
 ICD-9 Codes: V45.48s, 848.9s, 
 ICD-10 Codes: Z48.890s, 
 S05.48XDs, H48.052s, S05.48XSs, 
 P. Feme 
 Signed: 
 SIGNATURE Dr Michelle Smith, MD 
 Tech: nm 
 14/07/22 7:56:22 PM 
 Assist: ap 
 Page 3 of 3 
 PATIENT NAME: Richard Martin (DATE OF BIRTH 00/10/26) 
 Wednesdav. June 1. 2022
