Scott Hansen

 
 Scott Hansen DOB: 09/1995/08 (56 yo M) Acc No. 42568 
 03/2017/02 
  Scott Hansen DOB: 09/1995/08 (56 yo M) Acc No. 42568  DOS: 12/2020/14 
 97140 MANUAL THERAPY, Modifiers: 59 
 72040 X-RAY OF CERVICAL SPINE 3 view 
 72070 X-RAY OF THORACIC SPINE AP/LAT 
 72100 X-RAY OF LUMBAR SPINE 2 view 
 Follow Up 
 2 - - 3 Days 
 Electronically signed by Dr. Nicholas DiGerolamo Jr, DC on 04/2023/06 at 01:40 PM CDT 
 Sign off status: Completed 
 Visit Status: CHK (Check Out) 
 Provider: Matthew Laudun, D.C. 
 Date: 12/2023/08 
 Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com) 
 Scott Hansen DOB: 09/1995/08 (56 yo M) Acc No. 42568 
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