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Page 2677 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Encounter Date: 07/14/2019 17:36 FASTING. Lab Tests-H-Hep B surface Ab Lab Tests-H-Hep B surface Ag Lab Tests-H-Hep C Ab Lab Tests-H-Hepatic Profile Schedule: Activity Clinical Encounter Reg #: 76318-054 Sex: M_ Race: WHITE Facility: NYM Provider; |?) Unit: 205 One Time 08/08/2019 00:00 Routine Date Scheduled Scheduled Provider 07/24/2019 00:00 Optometrist 66 YR OLD MALE FOR ROUTINE SCREENING. Chronic Care Visit 6 MONTH F/U. Chronic Care Visit Other: 01/07/2020 00:00 Mid-Level Provider 07/01/2020 00:00 Physician 01 PENDING EKG AND FOBT. CXR WAS REFUSED. Patient Education Topics: Date Initiated Format Han i Outcome 07/14/2019 Counseling Diagnosis Verbalizes Copay Required: No Telephone/Verbal Order: No Kb MG} (by pC) Generated 07/14/2019 18:11 by)?" PMC) Understanding Cosign Required: No MD on 07/14/2019 18:11 Bureau of Prisons - NYM Page 3 of 3 DOJ-OGR-00026333