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Page 2677 Inmate Name: EPSTEIN, JEFFREY EDWARD Date of Birth: 01/20/1953 Sex: M Race: WHITE Reg #: 76318-054 Encounter Date: 07/14/2019 17:36 Provider: (b)(6); (b)(7)(C) MD Facility: NYM Unit: Z05 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 One Time 08/08/2019 00:00 Routine Schedule: Activity Date Scheduled Scheduled Provider Clinical Encounter 07/24/2019 00:00 Optometrist 66 YR OLD MALE FOR ROUTINE SCREENING. Chronic Care Visit 01/07/2020 00:00 Mid-Level Provider 6 MONTH F/U. Chronic Care Visit 07/01/2020 00:00 Physician 01 Other: PENDING EKG AND FOBT. CXR WAS REFUSED. Patient Education Topics: Date Initiated Format Handout/Topic Provider Outcome 07/14/2019 Counseling Diagnosis (b)(6); (b)(7)(C) Verbalizes Understanding Copay Required: No Cosign Required: No Telephone/Verbal Order: No Completed by (b)(6); (b)(7)(C) MD on 07/14/2019 18:11 Generated 07/14/2019 18:11 by (b)(6); (b)(7)(C) MD Bureau of Prisons - NYM Page 3 of 3 DOJ-OGR-00026333