Amendment 0002 Attachment_0002.pdf

(x)

140P1521R0001 x x

1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted ; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE

RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR

OFFER. If by virtue of this amendment you desire to change an offer already submitted , such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

x

PIA

Flagstaff AZ 86001-2694 1824 S Thompson St, Ste 200 NPS, IMR - Arizona MABO

04/22/20210002

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended , by one of the following methods: (a) By completing

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

7. ADMINISTERED BY (If other than Item 6)CODE 6. ISSUED BY

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

03/31/2021

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

E. IMPORTANT: Contractor is not is required to sign this document and return __________________ copies to the issuing office.

ORDER NO. IN ITEM 10A.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

The purpose of Amendment 0002 is to provide answers to questions submitted against the solicitation.

Please note a clarification on when the quotes are due. Quotes are due on 4/30/2021 by 1500

MDT and not 1500 MT as stated under Amendment 0001.

See attachment to the amendment for the answers to questions along with provider data.

Legacy Doc #: NPS

POC: Saki Beswick, Contract Specialist

520.988.1285

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 15B. CONTRACTOR/OFFEROR 16C. DATE SIGNED

(Signature of person authorized to sign) (Signature of Contracting Officer)

Martin Hauch

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 64

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

140P1521R0001/0002

Rasaki_Beswick@nps.gov

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

RFP: 140P1521R0001, NPS GRCA Medical Clinical Operations

# Section Name Page Number Question

1 PWS Part 3.d Housing 6 of 18

Please confirm the quoted housing rates are monthly costs.

Government Response – The housing costs listed in the PWS on page 6 are monthly rental rates.

2 PWS Part 4.f 9 of 18

Will the Government please provide a list of equipment currently needed at the clinic?

Government Response – The original solicitation has a Government property list, so please refer to that to determine what Government equipment is provided. The Contractor is responsible for maintaining this property. If more equipment is needed than what the Government provides, then that is for the Contractor to determine and provide. If the Government property currently provided breaks or can no longer be utilized, it is the Contractor’s responsibility to repair and/or replace. Please refer to page 9 of the PWS for more information. The building diagram included with the original solicitation could also be helpful in determining needed equipment.

3 PWS Part 4.j 10 of 18

Please confirm the Contractor is not responsible for the costs associated with pharmaceuticals. If the contractor is responsible for this cost, please provide historical data on the types/names of medications and costs/utilizations associated with each.

Government Response – The Contractor is responsible for all costs associated with pharmaceuticals. The Government does not have detailed historical data related to medications and costs. The current contractor does keep common, over-the-counter medications, including pain relievers, cold and flu medicine, digestive aids, on site. They also keep some more common prescription drugs on site. Prescription drugs not kept on site are delivered to the Grand Canyon Clinic when needed during normal business hours.

4 PWS Part 4.j 10 of 18

Please confirm the pharmaceutical records/utilization software will be provided by the Government.

Government Response – The Contractor is responsible for providing all software related to pharmacy services. The Government will not provide software to support this effort.

5 PWS Part 4.m 11 of 18

What type of telehealth equipment needs to be provided by the Contractor, if any?

Government Response – The Contractor needs to provide all software and hardware and IT support related to telehealth services. It is the Contractor’s responsibility to figure out what equipment and support is needed for that endeavor.

6 PWS Part 4.r 13 of 18

Please confirm the electronic medical records software will be provided by the Government.

Government Response – The Contractor is responsible for providing any electronic medical records software. The Government will not provide software to support this effort.

As outlined in the PWS:

The Contractor must maintain all new and existing patients' medical records in an electronic format. The Contractor is responsible for supplying all staff and equipment necessary to store and maintain electronic medical records.

7 PWS Part 4.f 9 of 18

Please confirm all computer(s) and medical-related electronic hardware will be provided by the Government.

Government Response – The Contractor is responsible for providing all computers and medical-related electronic hardware for all Clinic operations. The Government will not provide this equipment.

8 Pricing Table 3 of 5

Can the Government please explain what “*Not a CLIN (Option to Extend Services)” means with respect to the pricing tables? If and when would these line items be exercised?

Government Response – these CLIN’s are specific to anytime clause 52.217-8, Option to Extend Services is utilized over the resultant contract period of performance. Regulations require us to evaluate the pricing that may or may not be used at time of award and therefore is the reason for the CLINS.

9 General

Would NPS support the pursuit of 24 hour ER operations (either on call or select staffing availability) and/or extended Urgent care hours during peak park visitation, is there NPS support for this?

Government Response – The Government is not going to consider these services/operations at this time in the resultant contract.

General

With PHI removed, can we have the approximate patient payer mix: Provider to Patient Ratios, Patient Daily Volume, Procedures completed records/historical data? Number of daily/monthly ER visits, Urgent Care visits and Provider visits? Number of international visits to the clinic?

Government Response – The Government included historical patient data in the original solicitation, so please refer to those figures. This patient data can be used to determine some of these questions. For example, if one looks at the patient date, there were 699 total patients in January of 2019. Since there are 31 days in January, one could estimate there were 22-23 patients per day in January of 2019. The Clinic does not have ER visits. On the patient data, urgent care visits are already captured. The category “Grand Canyon Clinic” figures are provider visits. The Government does not have provider to patient ratios or numbers of international patients. One thing to note is that during prepandemic times, international visitors constituted 30-40% of all park visitors on an annual basis. The Government has provided documentation on provider visit procedures completed monthly in 2019; these documents will be provided with the Government’s responses.

Are IT or custodial services available through NPS?

Government Response – IT or custodial services are not available through the NPS. The Federal Government cannot provide or maintain IT equipment or software for non-government entities. The Contractor is responsible for providing custodial service and performing the preventative maintenance outlined in the PWS on pages 13-14.

What percentage of current healthcare providers reside in offered housing?

Government Response – The Government does not have an exact percentage or number of providers residing in offered housing, but most live on site when they are working. There may be one or two employees who live off site and commute to and from the park each day.

RFP: 140P1521R0001, NPS GRCA Medical Clinical Operations

How does the current contractor deal with international visitors who do not hold private insurance?

Government Response – The current contractor has a sliding scale for patients and gives international visitors all the paperwork to be reimbursed by an insurance provider or whatever entity covers them.

What additional clinical services, if any, are needed from the community or NPS?

Government Response – Currently, there are not identified needed services; however, the NPS is monitoring how many people are using the telehealth mental health services to see if there is a need to have a behavioral health specialist on site regularly.

Does updating equipment fall under the new contract? Is there an agreement on percentage supplied by NPS if new equipment were acquired?

Government Response – The Contractor is responsible for all new equipment needed except for the x-ray machine. Please refer to page 9, section 4f of the PWS for language detailing this.

What is the range of current and future in house services that would be provided under the contract?

Which staff are required to be on-site seasonally, weekly, daily?

Government Response – Currently, all basic level services and physical therapy are provided in house. The only services done via telemed are those outlined in section m. of the PWS and a few educational/support group meetings. The Government expects this to remain the same for at least the near future. As outlined on page 7 of the PWS, Basic Level Services are all services outlined in this PWS, excluding those in section m. Telehealth Mental Health Services and Crisis Intervention. It is primary, urgent, preventive and employment related health care and supporting the operation of the Grand Canyon National Park Branch of Emergency Services. All staff needed to support the required basic level services outlined in the PWS are required to be on site during regular hours of operation as outlined on page 7 of the PWS. Please also refer to page 8, section 4d of the PWS to see which personnel are required and how often they need to be on site.

Is there a scope of Urgent care provided by the contractor? Will emergency services be requested at a later time or will the contractor need to provide a board licensed ER doctor either on-site or oversight?

Government Response – There is not a defined scope of urgent care. The contractor is expected to provide typical urgent care, which is the treatment of injuries or illnesses requiring immediate care but not serious enough to require an emergency department. The contractor is also expected to work with NPS EMS and follow the transportation decision matrix, which was attached to the original solicitation, so please refer to that document. The contractor is also expected to provide other services, including primary, preventative and employment related health care. The PWS outlines all required services starting on page 7. The provider visit procedures from 2019 included with these responses may also paint a clearer picture of the type of urgent care provided at the clinic.

EMS personnel are hired by the Government and in-park concessioners. The contractor works closely with the NPS Branch Chief of Emergency Services and EMS personnel as outlined on page 9 of the PWS. At this time, no board licensed ER doctor is required on site nor does the Government anticipate requesting emergency services. Please refer to page 8, section 4d of the PWS for a list of required personnel.

Payor Mix (Multiple Items)

January 2019

Count of PatientVisitID Column Labels

Row Labels 2019 Grand Total

Grand Canyon Clinic 636 636

2019‐01 636 636

A54.9 Gonococcal infection, unspecified 1 1

B34.9 Viral infection, unspecified 4 4

B35.3 Tinea pedis 4 4

C02.9 Malignant neoplasm of tongue, unspecified 1 1

E03.9 Hypothyroidism, unspecified 13 13

E10.9 Type 1 diabetes mellitus without complications 3 3

E11.65 Type 2 diabetes mellitus with hyperglycemia 4 4

E11.9 Type 2 diabetes mellitus without complications 9 9

E29.1 Testicular hypofunction 3 3

E55.9 Vitamin D deficiency, unspecified 4 4

E78.2 Mixed hyperlipidemia 4 4

E78.5 Hyperlipidemia, unspecified 19 19

E86.0 Dehydration 1 1

E87.5 Hyperkalemia 4 4

F17.200 Nicotine dependence, unspecified, uncomplicated 1 1

F32.1 Major depressive disorder, single episode, moderate 1 1

F41.8 Other specified anxiety disorders 6 6

F43.10 Post‐traumatic stress disorder, unspecified 4 4

G43.919 Migraine, unspecified, intractable, without status migrainosus 2 2

G47.00 Insomnia, unspecified 3 3

G89.4 Chronic pain syndrome 3 3

H01.006 Unspecified blepharitis left eye, unspecified eyelid 1 1

H10.31 Unspecified acute conjunctivitis, right eye 2 2

H11.31 Conjunctival hemorrhage, right eye 5 5

H53.9 Unspecified visual disturbance 2 2

H57.89 Other specified disorders of eye and adnexa 1 1

H61.21 Impacted cerumen, right ear 1 1

H61.23 Impacted cerumen, bilateral 7 7

H66.90 Otitis media, unspecified, unspecified ear 2 2

H66.92 Otitis media, unspecified, left ear 2 2

H81.10 Benign paroxysmal vertigo, unspecified ear 3 3

H93.8X9 Other specified disorders of ear, unspecified ear 4 4

I10 Essential (primary) hypertension 17 17

I82.90 Acute embolism and thrombosis of unspecified vein 1 1

J01.00 Acute maxillary sinusitis, unspecified 1 1

J01.10 Acute frontal sinusitis, unspecified 3 3

J06.9 Acute upper respiratory infection, unspecified 17 17

J20.9 Acute bronchitis, unspecified 23 23

J31.0 Chronic rhinitis 3 3

J32.9 Chronic sinusitis, unspecified 2 2

J35.8 Other chronic diseases of tonsils and adenoids 4 4

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation 2 2

J44.9 Chronic obstructive pulmonary disease, unspecified 1 1

J45.901 Unspecified asthma with (acute) exacerbation 1 1

J45.909 Unspecified asthma, uncomplicated 7 7

J96.00 Acute respiratory failure, unspecified whether with hypoxia or hypercapnia 2 2

K40.90 Unilateral inguinal hernia, without obstruction or gangrene, not specified as 3 3

Z02.5 Encounter for examination for participation in sport 4 4

Z02.9 Encounter for administrative examinations, unspecified 1 1

Z09 Encounter for follow‐up examination after completed treatm 3 3

Z11.3 Encounter for screening for infections with a predominantly 1 1

Z23 Encounter for immunization 2 2

Z30.09 Encounter for other general counseling and advice on con 1 1

Z30.9 Encounter for contraceptive management, unspecified 1 1

Z51.89 Encounter for other specified aftercare 1 1

Z56.9 Unspecified problems related to employment 1 1

Z79.0 Long term (current) use of anticoagulants and antithrombo 1 1

Z79.3 Long term (current) use of hormonal contraceptives 3 3

Z95.2 Presence of prosthetic heart valve 3 3

(blank) 23 23

Grand Canyon Physical Therapy 32 32

2019‐02 32 32

M25.511 Pain in right shoulder 3 3

M25.512 Pain in left shoulder 1 1

M25.561 Pain in right knee 3 3

M25.562 Pain in left knee 2 2

M25.60 Stiffness of unspecified joint, not elsewhere classified 1 1

M25.612 Stiffness of left shoulder, not elsewhere classified 4 4

M54.31 Sciatica, right side 4 4

M62.830 Muscle spasm of back 4 4

R07.81 Pleurodynia 1 1

R53.1 Weakness 4 4

R53.81 Other malaise 1 1

S83.249A Other tear of medial meniscus, current injury, unspecifi 3 3

Z48.89 Encounter for other specified surgical aftercare 1 1

Grand Canyon Telehealth 1 1

2019‐02 1 1

(blank) 1 1

Grand Canyon Urgent Care 20 20

2019‐02 20 20

H10.9 Unspecified conjunctivitis 1 1

H44.89 Other disorders of globe 1 1

I10 Essential (primary) hypertension 1 1

J01.90 Acute sinusitis, unspecified 1 1

J02.9 Acute pharyngitis, unspecified 3 3

J06.9 Acute upper respiratory infection, unspecified 1 1

J45.901 Unspecified asthma with (acute) exacerbation 1 1

L02.222 Furuncle of back [any part, except buttock] 1 1

M25.561 Pain in right knee 2 2

R00.0 Tachycardia, unspecified 2 2

R06.02 Shortness of breath 1 1

R10.9 Unspecified abdominal pain 1 1

R11.0 Nausea 1 1

R11.2 Nausea with vomiting, unspecified 2 2

Payor Mix (All)

March 2019

Count of PatientVisitID Column Labels

Row Labels 2019 Grand Total

Grand Canyon Clinic 619 619

2019‐03 619 619

B07.0 Plantar wart 2 2

B34.9 Viral infection, unspecified 2 2

B35.1 Tinea unguium 4 4

B35.4 Tinea corporis 2 2

B35.6 Tinea cruris 3 3

E03.9 Hypothyroidism, unspecified 9 9

E04.9 Nontoxic goiter, unspecified 2 2

E10.65 Type 1 diabetes mellitus with hyperglycemia 2 2

E11.65 Type 2 diabetes mellitus with hyperglycemia 3 3

E11.9 Type 2 diabetes mellitus without complications 6 6

E53.8 Deficiency of other specified B group vitamins 2 2

E55.9 Vitamin D deficiency, unspecified 2 2

E66.9 Obesity, unspecified 3 3

E78.5 Hyperlipidemia, unspecified 7 7

F17.200 Nicotine dependence, unspecified, uncomplicated 3 3

F32.9 Major depressive disorder, single episode, unspecified 1 1

F41.8 Other specified anxiety disorders 5 5

F41.9 Anxiety disorder, unspecified 1 1

F90.0 Attention‐deficit hyperactivity disorder, predominantly inattentive type 2 2

G43.909 Migraine, unspecified, not intractable, without status migrainosus 2 2

G47.00 Insomnia, unspecified 1 1

G81.90 Hemiplegia, unspecified affecting unspecified side 4 4

H10.9 Unspecified conjunctivitis 4 4

H60.502 Unspecified acute noninfective otitis externa, left ear 4 4

H66.90 Otitis media, unspecified, unspecified ear 4 4

H69.80 Other specified disorders of Eustachian tube, unspecified ear 1 1

I10 Essential (primary) hypertension 9 9

I26.99 Other pulmonary embolism without acute cor pulmonale 2 2

I48.91 Unspecified atrial fibrillation 4 4

J01.00 Acute maxillary sinusitis, unspecified 1 1

J01.90 Acute sinusitis, unspecified 16 16

J02.9 Acute pharyngitis, unspecified 16 16

J04.0 Acute laryngitis 4 4

J06.9 Acute upper respiratory infection, unspecified 2 2

J09.X2 Influenza due to identified novel influenza A virus with other respiratory manifestatio 1 1

J11.1 Influenza due to unidentified influenza virus with other respiratory manifestations 6 6

J20.9 Acute bronchitis, unspecified 24 24

J30.2 Other seasonal allergic rhinitis 13 13

J31.0 Chronic rhinitis 1 1

J45.998 Other asthma 1 1

K21.9 Gastro‐esophageal reflux disease without esophagitis 2 2

K52.9 Noninfective gastroenteritis and colitis, unspecified 2 2

K59.00 Constipation, unspecified 5 5

L02.91 Cutaneous abscess, unspecified 3 3

L02.92 Furuncle, unspecified 5 5

L03.115 Cellulitis of right lower limb 3 3

L05.91 Pilonidal cyst without abscess 1 1

L25.9 Unspecified contact dermatitis, unspecified cause 2 2

L40.0 Psoriasis vulgaris 2 2

L50.9 Urticaria, unspecified 1 1

M10.9 Gout, unspecified 4 4

M25.50 Pain in unspecified joint 1 1

M25.511 Pain in right shoulder 4 4

M25.522 Pain in left elbow 2 2

M25.531 Pain in right wrist 6 6

M25.539 Pain in unspecified wrist 2 2

M25.551 Pain in right hip 4 4

M25.561 Pain in right knee 8 8

M25.562 Pain in left knee 6 6

M25.569 Pain in unspecified knee 9 9

M25.571 Pain in right ankle and joints of right foot 1 1

M25.572 Pain in left ankle and joints of left foot 13 13

M50.30 Other cervical disc degeneration, unspecified cervical region 5 5

M54.2 Cervicalgia 6 6

M54.31 Sciatica, right side 11 11

M54.5 Low back pain 14 14

M54.6 Pain in thoracic spine 6 6

M54.9 Dorsalgia, unspecified 7 7

M62.830 Muscle spasm of back 5 5

M67.40 Ganglion, unspecified site 1 1

M70.70 Other bursitis of hip, unspecified hip 5 5

M75.02 Adhesive capsulitis of left shoulder 4 4

M76.62 Achilles tendinitis, left leg 1 1

M79.602 Pain in left arm 2 2

M79.645 Pain in left finger(s) 1 1

M79.672 Pain in left foot 1 1

M89.8X8 Other specified disorders of bone, other site 1 1

N18.5 Chronic kidney disease, stage 5 2 2

N18.9 Chronic kidney disease, unspecified 1 1

N39.0 Urinary tract infection, site not specified 6 6

N40.1 Enlarged prostate with lower urinary tract symptoms 3 3

N89.8 Other specified noninflammatory disorders of vagina 1 1

O03.9 Complete or unspecified spontaneous abortion without complication 1 1

R05 Cough 11 11

R06.02 Shortness of breath 1 1

R06.2 Wheezing 2 2

R07.81 Pleurodynia 6 6

R07.89 Other chest pain 2 2

R09.89 Other specified symptoms and signs involving the circulatory and respiratory system 2 2

R10.2 Pelvic and perineal pain 4 4

R10.9 Unspecified abdominal pain 12 12

R11.10 Vomiting, unspecified 1 1

R11.2 Nausea with vomiting, unspecified 8 8

R15.2 Fecal urgency 3 3

R19.7 Diarrhea, unspecified 2 2

R32 Unspecified urinary incontinence 7 7

R33.9 Retention of urine, unspecified 3 3

R42 Dizziness and giddiness 1 1

R50.9 Fever, unspecified 6 6

R51 Headache 6 6

R52 Pain, unspecified 1 1

R53.81 Other malaise 1 1

R53.82 Chronic fatigue, unspecified 1 1

R53.83 Other fatigue 2 2

R55 Syncope and collapse 2 2

R56.9 Unspecified convulsions 3 3

R60.0 Localized edema 4 4

R68.84 Jaw pain 3 3

R73.9 Hyperglycemia, unspecified 1 1

R74.8 Abnormal levels of other serum enzymes 3 3

S01.80XA Unspecified open wound of other part of head, initial encounter 1 1

S05.01XA Injury of conjunctiva and corneal abrasion without foreign body, right eye, initial e 1 1

S06.0X9S Concussion with loss of consciousness of unspecified duration, sequela 3 3

S60.559A Superficial foreign body of unspecified hand, initial encounter 1 1

S65.516S Laceration of blood vessel of right little finger, sequela 2 2

S65.517D Laceration of blood vessel of left little finger, subsequent encounter 4 4

T70.29XA Other effects of high altitude, initial encounter 1 1

Z00.00 Encounter for general adult medical examination without abnormal findings 4 4

Z00.129 Encounter for routine child health examination without abnormal findings 3 3

Z00.8 Encounter for other general examination 93 93

Z01.812 Encounter for preprocedural laboratory examination 1 1

Z02.5 Encounter for examination for participation in sport 1 1

Z02.89 Encounter for other administrative examinations 2 2

Z20.2 Contact with and (suspected) exposure to infections with a predominantly sexual mod 1 1

Z23 Encounter for immunization 6 6

Z30.09 Encounter for other general counseling and advice on contraception 4 4

Z33.1 Pregnant state, incidental 3 3

Z79.0 Long term (current) use of anticoagulants and antithrombotics/antiplatelets 4 4

Z79.01 Long term (current) use of anticoagulants 3 3

Z80.3 Family history of malignant neoplasm of breast 2 2

Z91.19 Patient's noncompliance with other medical treatment and regimen 1 1

(blank) 28 28

Z12.11 Encounter for screening for malignant neoplasm of colon 1 1

Grand Canyon Physical Therapy 26 26

2019‐03 26 26

M25.561 Pain in right knee 1 1

M25.562 Pain in left knee 5 5

M25.571 Pain in right ankle and joints of right foot 2 2

M54.5 Low back pain 1 1

M75.101 Unspecified rotator cuff tear or rupture of right shoulder, not specified as traumat 6 6

M77.9 Enthesopathy, unspecified 3 3

R53.1 Weakness 3 3

R53.81 Other malaise 2 2

Z48.89 Encounter for other specified surgical aftercare 3 3

Grand Canyon Telehealth 3 3

2019‐03 3 3

G47.00 Insomnia, unspecified 3 3

Grand Canyon Urgent Care 83 83

2019‐03 83 83

G47.00 Insomnia, unspecified 1 1

H10.31 Unspecified acute conjunctivitis, right eye 1 1

H10.9 Unspecified conjunctivitis 1 1

H60.502 Unspecified acute noninfective otitis externa, left ear 2 2

H66.90 Otitis media, unspecified, unspecified ear 1 1

I47.9 Paroxysmal tachycardia, unspecified 1 1

J01.00 Acute maxillary sinusitis, unspecified 1 1

J01.10 Acute frontal sinusitis, unspecified 1 1

J01.90 Acute sinusitis, unspecified 1 1

J02.9 Acute pharyngitis, unspecified 3 3

J06.9 Acute upper respiratory infection, unspecified 2 2

J11.1 Influenza due to unidentified influenza virus with other respiratory manifestations 1 1

J20.9 Acute bronchitis, unspecified 6 6

J30.2 Other seasonal allergic rhinitis 1 1

J45.901 Unspecified asthma with (acute) exacerbation 1 1

J45.909 Unspecified asthma, uncomplicated 2 2

K52.9 Noninfective gastroenteritis and colitis, unspecified 1 1

L02.92 Furuncle, unspecified 1 1

L08.9 Local infection of the skin and subcutaneous tissue, unspecified 3 3

L23.9 Allergic contact dermatitis, unspecified cause 1 1

L60.8 Other nail disorders 1 1

M25.521 Pain in right elbow 1 1

M25.531 Pain in right wrist 1 1

M25.532 Pain in left wrist 1 1

M25.561 Pain in right knee 3 3

M25.569 Pain in unspecified knee 1 1

M25.571 Pain in right ankle and joints of right foot 2 2

M25.572 Pain in left ankle and joints of left foot 6 6

M54.32 Sciatica, left side 1 1

M54.5 Low back pain 2 2

M79.1 Myalgia 1 1

M79.642 Pain in left hand 1 1

M79.646 Pain in unspecified finger(s) 1 1

M79.672 Pain in left foot 1 1

M79.675 Pain in left toe(s) 1 1

M79.676 Pain in unspecified toe(s) 1 1

N39.0 Urinary tract infection, site not specified 2 2

Q74.1 Congenital malformation of knee 1 1

R00.0 Tachycardia, unspecified 1 1

R07.89 Other chest pain 1 1

R09.89 Other specified symptoms and signs involving the circulatory and respiratory system 1 1

R11.2 Nausea with vomiting, unspecified 3 3

R19.7 Diarrhea, unspecified 2 2

R30.0 Dysuria 2 2

R31.9 Hematuria, unspecified 1 1

R39.11 Hesitancy of micturition 1 1

R50.9 Fever, unspecified 3 3

R53.81 Other malaise 2 2

S01.01XA Laceration without foreign body of scalp, initial encounter 1 1

S01.511A Laceration without foreign body of lip, initial encounter 1 1

S06.0X9A Concussion with loss of consciousness of unspecified duration, initial encounter 1 1

S82.845A Nondisplaced bimalleolar fracture of left lower leg, initial encounter for closed fra 1 1

T31.0 Burns involving less than 10% of body surface 1 1

W57.XXXA Bitten or stung by nonvenomous insect and other nonvenomous arthropods, init 1 1

Grand Total 731 731

April 2019

Count of PatientVisitID Column Labels

Row Labels 2019 Grand Total

Grand Canyon Clinic 691 691

2019‐04 691 691

A54.9 Gonococcal infection, unspecified 2 2

B02.9 Zoster without complications 7 7

B09 Unspecified viral infection characterized by skin and mucous membrane lesions 1 1

B34.9 Viral infection, unspecified 3 3

B35.3 Tinea pedis 2 2

B37.3 Candidiasis of vulva and vagina 2 2

E03.9 Hypothyroidism, unspecified 2 2

E11.9 Type 2 diabetes mellitus without complications 13 13

E29.1 Testicular hypofunction 5 5

E34.9 Endocrine disorder, unspecified 4 4

E55.9 Vitamin D deficiency, unspecified 5 5

E78.5 Hyperlipidemia, unspecified 3 3

F25.9 Schizoaffective disorder, unspecified 2 2

F32.9 Major depressive disorder, single episode, unspecified 2 2

F41.9 Anxiety disorder, unspecified 2 2

F60.5 Obsessive‐compulsive personality disorder 1 1

G43.919 Migraine, unspecified, intractable, without status migrainosus 2 2

G47.61 Periodic limb movement disorder 2 2

H10.10 Acute atopic conjunctivitis, unspecified eye 1 1

H10.33 Unspecified acute conjunctivitis, bilateral 7 7

H10.9 Unspecified conjunctivitis 7 7

H11.31 Conjunctival hemorrhage, right eye 1 1

H57.11 Ocular pain, right eye 1 1

H61.20 Impacted cerumen, unspecified ear 2 2

H61.23 Impacted cerumen, bilateral 2 2

H66.91 Otitis media, unspecified, right ear 1 1

H69.80 Other specified disorders of Eustachian tube, unspecified ear 2 2

H69.82 Other specified disorders of Eustachian tube, left ear 1 1

H70.90 Unspecified mastoiditis, unspecified ear 1 1

H81.10 Benign paroxysmal vertigo, unspecified ear 6 6

I10 Essential (primary) hypertension 16 16

I48.91 Unspecified atrial fibrillation 1 1

I65.23 Occlusion and stenosis of bilateral carotid arteries 4 4

I70.90 Unspecified atherosclerosis 2 2

I73.00 Raynaud's syndrome without gangrene 2 2

J01.00 Acute maxillary sinusitis, unspecified 1 1

J01.90 Acute sinusitis, unspecified 8 8

J02.9 Acute pharyngitis, unspecified 11 11

J03.90 Acute tonsillitis, unspecified 2 2

J04.0 Acute laryngitis 5 5

J06.9 Acute upper respiratory infection, unspecified 1 1

J09.X2 Influenza due to identified novel influenza A virus with other respiratory manifest 1 1

J18.9 Pneumonia, unspecified organism 1 1

J20.9 Acute bronchitis, unspecified 20 20

J30.2 Other seasonal allergic rhinitis 10 10

J30.9 Allergic rhinitis, unspecified 9 9

J31.0 Chronic rhinitis 2 2

J32.9 Chronic sinusitis, unspecified 2 2

J35.8 Other chronic diseases of tonsils and adenoids 1 1

J40 Bronchitis, not specified as acute or chronic 4 4

J44.1 Chronic obstructive pulmonary disease with (acute) exacerbation 5 5

J45.21 Mild intermittent asthma with (acute) exacerbation 2 2

J45.30 Mild persistent asthma, uncomplicated 2 2

J45.901 Unspecified asthma with (acute) exacerbation 1 1

J45.909 Unspecified asthma, uncomplicated 2 2

K04.7 Periapical abscess without sinus 3 3

K21.9 Gastro‐esophageal reflux disease without esophagitis 2 2

K29.70 Gastritis, unspecified, without bleeding 3 3

K52.9 Noninfective gastroenteritis and colitis, unspecified 1 1

K57.32 Diverticulitis of large intestine without perforation or abscess without bleeding 1 1

K61.1 Rectal abscess 3 3

K62.5 Hemorrhage of anus and rectum 2 2

K64.9 Unspecified hemorrhoids 2 2

K92.0 Hematemesis 2 2

K92.1 Melena 1 1

K92.2 Gastrointestinal hemorrhage, unspecified 1 1

L03.011 Cellulitis of right finger 3 3

L03.019 Cellulitis of unspecified finger 2 2

L03.031 Cellulitis of right toe 3 3

L03.115 Cellulitis of right lower limb 3 3

L03.90 Cellulitis, unspecified 1 1

L04.8 Acute lymphadenitis of other sites 1 1

L08.9 Local infection of the skin and subcutaneous tissue, unspecified 4 4

L23.9 Allergic contact dermatitis, unspecified cause 1 1

L25.9 Unspecified contact dermatitis, unspecified cause 1 1

L30.9 Dermatitis, unspecified 8 8

L42 Pityriasis rosea 1 1

L50.9 Urticaria, unspecified 3 3

L90.5 Scar conditions and fibrosis of skin 1 1

M06.9 Rheumatoid arthritis, unspecified 2 2

M10.9 Gout, unspecified 2 2

M19.90 Unspecified osteoarthritis, unspecified site 1 1

M25.521 Pain in right elbow 1 1

M25.522 Pain in left elbow 6 6

M25.531 Pain in right wrist 11 11

M25.532 Pain in left wrist 9 9

M25.561 Pain in right knee 7 7

M25.562 Pain in left knee 4 4

M25.569 Pain in unspecified knee 10 10

M25.572 Pain in left ankle and joints of left foot 3 3

M54.2 Cervicalgia 7 7

M54.31 Sciatica, right side 6 6

M54.32 Sciatica, left side 1 1

M54.5 Low back pain 13 13

M54.6 Pain in thoracic spine 9 9

M70.70 Other bursitis of hip, unspecified hip 5 5

M70.90 Unspecified soft tissue disorder related to use, overuse and pressure of unspecif 7 7

M75.41 Impingement syndrome of right shoulder 2 2

M76.62 Achilles tendinitis, left leg 1 1

M79.601 Pain in right arm 2 2

M79.632 Pain in left forearm 2 2

M79.644 Pain in right finger(s) 5 5

M79.645 Pain in left finger(s) 7 7

M79.646 Pain in unspecified finger(s) 4 4

M79.671 Pain in right foot 1 1

M79.672 Pain in left foot 7 7

M79.675 Pain in left toe(s) 3 3

M79.676 Pain in unspecified toe(s) 1 1

M84.434S Pathological fracture, left radius, sequela 1 1

M89.8X8 Other specified disorders of bone, other site 1 1

N18.4 Chronic kidney disease, stage 4 (severe) 2 2

N39.0 Urinary tract infection, site not specified 3 3

N52.9 Male erectile dysfunction, unspecified 2 2

O20.0 Threatened abortion 2 2

Q15.9 Congenital malformation of eye, unspecified 1 1

R00.0 Tachycardia, unspecified 5 5

R00.2 Palpitations 1 1

R04.0 Epistaxis 1 1

R05 Cough 3 3

R06.2 Wheezing 1 1

R07.81 Pleurodynia 6 6

R07.89 Other chest pain 5 5

R10.13 Epigastric pain 3 3

R10.9 Unspecified abdominal pain 1 1

R11.2 Nausea with vomiting, unspecified 15 15

R21 Rash and other nonspecific skin eruption 1 1

R25.8 Other abnormal involuntary movements 1 1

R30.0 Dysuria 6 6

R35.0 Frequency of micturition 3 3

R42 Dizziness and giddiness 6 6

R50.9 Fever, unspecified 1 1

R51 Headache 2 2

R59.0 Localized enlarged lymph nodes 1 1

R68.83 Chills (without fever) 6 6

R73.02 Impaired glucose tolerance (oral) 10 10

S01.409A Unspecified open wound of unspecified cheek and temporomandibular area, i 1 1

S01.81XS Laceration without foreign body of other part of head, sequela 3 3

S61.012A Laceration without foreign body of left thumb without damage to nail, initial e 3 3

S61.219A Laceration without foreign body of unspecified finger without damage to nail, 2 2

S61.411A Laceration without foreign body of right hand, initial encounter 1 1

S61.412A Laceration without foreign body of left hand, initial encounter 3 3

S81.819A Laceration without foreign body, unspecified lower leg, initial encounter 6 6

T24.291A Burn of second degree of multiple sites of right lower limb, except ankle and fo 3 3

T70.20XA Unspecified effects of high altitude, initial encounter 2 2

W46.0XXA Contact with hypodermic needle, initial encounter 3 3

W57.XXXA Bitten or stung by nonvenomous insect and other nonvenomous arthropods, 1 1

Z00.00 Encounter for general adult medical examination without abnormal findings 11 11

Z00.129 Encounter for routine child health examination without abnormal findings 1 1

Z00.8 Encounter for other general examination 98 98

Z01.818 Encounter for other preprocedural examination 2 2

Z02.0 Encounter for examination for admission to educational institution 4 4

Z09 Encounter for follow‐up examination after completed treatment for conditions othe 3 3

Z13.0 Encounter for screening for diseases of the blood and blood‐forming organs and ce 1 1

Z13.29 Encounter for screening for other suspected endocrine disorder 3 3

Z13.9 Encounter for screening, unspecified 2 2

Z23 Encounter for immunization 2 2

Z30.9 Encounter for contraceptive management, unspecified 6 6

Z33.1 Pregnant state, incidental 3 3

Z72.89 Other problems related to lifestyle 2 2

Z76.0 Encounter for issue of repeat prescription 3 3

Z79.01 Long term (current) use of anticoagulants 7 7

Z79.899 Other long term (current) drug therapy 1 1

Z86.718 Personal history of other venous thrombosis and embolism 2 2

Z95.0 Presence of cardiac pacemaker 1 1

Z95.828 Presence of other vascular implants and grafts 1 1

(blank) 20 20

Z02.89 Encounter for other administrative examinations 1 1

Grand Canyon Physical Therapy 32 32

2019‐04 32 32

M25.511 Pain in right shoulder 1 1

M25.512 Pain in left shoulder 5 5

M25.551 Pain in right hip 3 3

M25.562 Pain in left knee 1 1

M25.569 Pain in unspecified knee 4 4

M25.571 Pain in right ankle and joints of right foot 2 2

M25.572 Pain in left ankle and joints of left foot 3 3

M54.31 Sciatica, right side 2 2

M54.5 Low back pain 1 1

M75.101 Unspecified rotator cuff tear or rupture of right shoulder, not specified as traum 6 6

M77.9 Enthesopathy, unspecified 3 3

(blank) 1 1

Grand Canyon Urgent Care 82 82

2019‐04 82 82

B02.9 Zoster without complications 1 1

B97.89 Other viral agents as the cause of diseases classified elsewhere 1 1

E10.9 Type 1 diabetes mellitus without complications 1 1

E78.5 Hyperlipidemia, unspecified 1 1

E86.0 Dehydration 1 1

H10.9 Unspecified conjunctivitis 1 1

H44.89 Other disorders of globe 1 1

H57.9 Unspecified disorder of eye and adnexa 1 1

H69.82 Other specified disorders of Eustachian tube, left ear 1 1

H74.8X2 Other specified disorders of left middle ear and mastoid 1 1

I10 Essential (primary) hypertension 2 2

I48.91 Unspecified atrial fibrillation 1 1

J01.00 Acute maxillary sinusitis, unspecified 2 2

J01.90 Acute sinusitis, unspecified 5 5

J02.9 Acute pharyngitis, unspecified 5 5

J06.9 Acute upper respiratory infection, unspecified 3 3

J20.9 Acute bronchitis, unspecified 3 3

J30.2 Other seasonal allergic rhinitis 2 2

J31.0 Chronic rhinitis 1 1

J40 Bronchitis, not specified as acute or chronic 1 1

J45.909 Unspecified asthma, uncomplicated 2 2

K52.9 Noninfective gastroenteritis and colitis, unspecified 2 2

L02.91 Cutaneous abscess, unspecified 1 1

L08.89 Other specified local infections of the skin and subcutaneous tissue 1 1

L25.9 Unspecified contact dermatitis, unspecified cause 2 2

L50.9 Urticaria, unspecified 2 2

L55.9 Sunburn, unspecified 1 1

L95.9 Vasculitis limited to the skin, unspecified 1 1

M25.529 Pain in unspecified elbow 1 1

M25.551 Pain in right hip 1 1

M25.561 Pain in right knee 1 1

M25.562 Pain in left knee 1 1

M54.31 Sciatica, right side 1 1

M79.671 Pain in right foot 1 1

M79.672 Pain in left foot 1 1

M79.675 Pain in left toe(s) 2 2

N39.0 Urinary tract infection, site not specified 2 2

N48.1 Balanitis 1 1

R05 Cough 3 3

R10.9 Unspecified abdominal pain 1 1

R11.0 Nausea 1 1

R11.10 Vomiting, unspecified 1 1

R11.2 Nausea with vomiting, unspecified 4 4

R21 Rash and other nonspecific skin eruption 2 2

R30.0 Dysuria 1 1

R50.9 Fever, unspecified 2 2

R55 Syncope and collapse 1 1

S00.81XA Abrasion of other part of head, initial encounter 1 1

S01.01XA Laceration without foreign body of scalp, initial encounter 1 1

S39.011A Strain of muscle, fascia and tendon of abdomen, initial encounter 1 1

S81.819A Laceration without foreign body, unspecified lower leg, initial encounter 1 1

T70.20XA Unspecified effects of high altitude, initial encounter 1 1

Z86.79 Personal history of other diseases of the circulatory system 1 1

(blank) 1 1

Grand Total 805 805

May 2019

Count of PatientVisitID Column Labels

Row Labels 2019 Grand Total

Grand Canyon Clinic 762 762

2019‐05 762 762

B02.9 Zoster without complications 4 4

B09 Unspecified viral infection characterized by skin and mucous membrane lesions 1 1

B20 Human immunodeficiency virus [HIV] disease 3 3

B34.9 Viral infection, unspecified 3 3

B35.1 Tinea unguium 8 8

B37.0 Candidal stomatitis 1 1

C43.61 Malignant melanoma of right upper limb, including shoulder 1 1

D50.9 Iron deficiency anemia, unspecified 1 1

E03.9 Hypothyroidism, unspecified 5 5

E10.9 Type 1 diabetes mellitus without complications 2 2

E11.9 Type 2 diabetes mellitus without complications 27 27

E55.9 Vitamin D deficiency, unspecified 7 7

E78.2 Mixed hyperlipidemia 4 4

E78.5 Hyperlipidemia, unspecified 5 5

E86.0 Dehydration 1 1

F10.10 Alcohol abuse, uncomplicated 1 1 F32.9 Major depressive disorder, single episode, unspecified 2 2

F41.0 Panic disorder [episodic paroxysmal anxiety] without agoraphobia 3 3

F41.8 Other specified anxiety disorders 6 6

F41.9 Anxiety disorder, unspecified 4 4

G43.909 Migraine, unspecified, not intractable, without status migrainosus 4 4

G47.00 Insomnia, unspecified 3 3

H02.9 Unspecified disorder of eyelid 1 1

H10.30 Unspecified acute conjunctivitis, unspecified eye 1 1

H10.33 Unspecified acute conjunctivitis, bilateral 1 1

H11.31 Conjunctival hemorrhage, right eye 1 1

H16.009 Unspecified corneal ulcer, unspecified eye 7 7

H40.9 Unspecified glaucoma 3 3

H43.392 Other vitreous opacities, left eye 2 2

H54.62 Unqualified visual loss, left eye, normal vision right eye 3 3

H61.20 Impacted cerumen, unspecified ear 1 1

H66.009 Acute suppurative otitis media without spontaneous rupture of ear drum, 1 1

H66.90 Otitis media, unspecified, unspecified ear 6 6

H66.93 Otitis media, unspecified, bilateral 1 1

H69.80 Other specified disorders of Eustachian tube, unspecified ear 1 1

H69.92 Unspecified Eustachian tube disorder, left ear 4 4

H92.01 Otalgia, right ear 2 2

I10 Essential (primary) hypertension 14 14

I25.83 Coronary atherosclerosis due to lipid rich plaque 1 1

I26.99 Other pulmonary embolism without acute cor pulmonale 2 2

I48.0 Paroxysmal atrial fibrillation 3 3

I48.91 Unspecified atrial fibrillation 4 4

I50.9 Heart failure, unspecified 4 4

I63.9 Cerebral infarction, unspecified 2 2

I65.23 Occlusion and stenosis of bilateral carotid arteries 4 4

J01.00 Acute maxillary sinusitis, unspecified 1 1

J01.90 Acute sinusitis, unspecified 10 10

J02.0 Streptococcal pharyngitis 1 1

J02.9 Acute pharyngitis, unspecified 14 14

J03.90 Acute tonsillitis, unspecified 1 1

J04.0 Acute laryngitis 7 7

J06.9 Acute upper respiratory infection, unspecified 15 15

J09.X2 Influenza due to identified novel influenza A virus with other respiratory 3 3

J15.9 Unspecified bacterial pneumonia 1 1

J20.9 Acute bronchitis, unspecified 18 18

J30.2 Other seasonal allergic rhinitis 7 7

J40 Bronchitis, not specified as acute or chronic 1 1

J44.9 Chronic obstructive pulmonary disease, unspecified 4 4

J45.909 Unspecified asthma, uncomplicated 2 2

K04.7 Periapical abscess without sinus 1 1

K21.9 Gastro‐esophageal reflux disease without esophagitis 3 3

K52.9 Noninfective gastroenteritis and colitis, unspecified 4 4

K80.00 Calculus of gallbladder with acute cholecystitis without obstruction 1 1

L02.91 Cutaneous abscess, unspecified 5 5

L03.011 Cellulitis of right finger 3 3

L03.113 Cellulitis of right upper limb 1 1

L03.114 Cellulitis of left upper limb 4 4

L03.115 Cellulitis of right lower limb 3 3

L03.90 Cellulitis, unspecified 6 6

L23.9 Allergic contact dermatitis, unspecified cause 3 3

L30.9 Dermatitis, unspecified 11 11

L40.9 Psoriasis, unspecified 2 2

L60.8 Other nail disorders 2 2

L72.9 Follicular cyst of the skin and subcutaneous tissue, unspecified 3 3

L73.9 Follicular disorder, unspecified 5 5

L82.1 Other seborrheic keratosis 1 1

M05.79 Rheumatoid arthritis with rheumatoid factor of multiple sites without organ or 2 2

M06.9 Rheumatoid arthritis, unspecified 3 3

M10.031 Idiopathic gout, right wrist 2 2

M10.9 Gout, unspecified 3 3

M17.12 Unilateral primary osteoarthritis, left knee 2 2

M25.541 Pain in joints of right hand 5 5

M25.551 Pain in right hip 4 4

M25.552 Pain in left hip 5 5

M25.561 Pain in right knee 8 8

M25.562 Pain in left knee 3 3

M54.2 Cervicalgia 2 2

M54.5 Low back pain 22 22

M54.6 Pain in thoracic spine 2 2

M54.9 Dorsalgia, unspecified 5 5

M60.9 Myositis, unspecified 2 2

M62.838 Other muscle spasm 1 1

M75.102 Unspecified rotator cuff tear or rupture of left shoulder, not specified as traumatic 2 2

M75.41 Impingement syndrome of right shoulder 2 2

M75.42 Impingement syndrome of left shoulder 4 4

M75.52 Bursitis of left shoulder 4 4

M77.11 Lateral epicondylitis, right elbow 1 1

M77.9 Enthesopathy, unspecified 3 3

M79.601 Pain in right arm 1 1

M79.602 Pain in left arm 2 2

M79.605 Pain in left leg 6 6

M79.641 Pain in right hand 2 2

M79.644 Pain in right finger(s) 2 2

M79.645 Pain in left finger(s) 1 1

M79.672 Pain in left foot 4 4

M79.674 Pain in right toe(s) 3 3

M84.434S Pathological fracture, left radius, sequela 2 2

M85.80 Other specified disorders of bone density and structure, unspecified site 3 3

N18.5 Chronic kidney disease, stage 5 2 2

N39.0 Urinary tract infection, site not specified 4 4

N40.0 Enlarged prostate without lower urinary tract symptoms 2 2

N48.1 Balanitis 1 1

N89.8 Other specified noninflammatory disorders of vagina 2 2

N92.0 Excessive and frequent menstruation with regular cycle 1 1

O20.0 Threatened abortion 2 2

O91.23 Nonpurulent mastitis associated with lactation 1 1

R00.0 Tachycardia, unspecified 3 3

R00.2 Palpitations 6 6

R03.0 Elevated blood‐pressure reading, without diagnosis of hypertension 3 3

R04.0 Epistaxis 3 3

R05 Cough 8 8

R06.02 Shortness of breath 9 9

R06.2 Wheezing 5 5

R07.81 Pleurodynia 8 8

R07.89 Other chest pain 6 6

R07.9 Chest pain, unspecified 4 4

R09.02 Hypoxemia 1 1

R10.11 Right upper quadrant pain 1 1

R10.13 Epigastric pain 3 3

R10.31 Right lower quadrant pain 12 12

R10.84 Generalized abdominal pain 1 1

R10.9 Unspecified abdominal pain 11 11

R11.0 Nausea 2 2

R11.2 Nausea with vomiting, unspecified 5 5

R19.7 Diarrhea, unspecified 9 9

R21 Rash and other nonspecific skin eruption 6 6

R22.1 Localized swelling, mass and lump, neck 1 1

R25.1 Tremor, unspecified 2 2

R30.0 Dysuria 3 3

R35.0 Frequency of micturition 3 3

R42 Dizziness and giddiness 4 4

R50.9 Fever, unspecified 9 9

R53.81 Other malaise 5 5

R53.83 Other fatigue 5 5

R60.9 Edema, unspecified 1 1

S01.01XA Laceration without foreign body of scalp, initial encounter 1 1

S01.81XA Laceration without foreign body of other part of head, initial encounter 1 1

S06.0X9D Concussion with loss of consciousness of unspecified duration, subsequent 2 2

S66.929S Laceration of unspecified muscle, fascia and tendon at wrist and hand level, 2 2

S90.112A Contusion of left great toe without damage to nail, initial encounter 2 2

S99.292A Other physeal fracture of phalanx of left toe, initial encounter for closed fracture 3 3

T14.8XXA Other injury of unspecified body region, initial encounter 1 1

Z00.00 Encounter for general adult medical examination without abnormal findings 10 10

Z00.8 Encounter for other general examination 80 80

Z02.9 Encounter for administrative examinations, unspecified 7 7

Z11.1 Encounter for screening for respiratory tuberculosis 2 2

Z11.3 Encounter for screening for infections with a predominantly sexual mode of 3 3

Z13.0 Encounter for screening for diseases of the blood and blood‐forming organs and 5 5

Z13.9 Encounter for screening, unspecified 2 2

Z20.3 Contact with and (suspected) exposure to rabies 4 4

Z23 Encounter for immunization 7 7

Z28.3 Underimmunization status 2 2

Z30.09 Encounter for other general counseling and advice on contraception 5 5

Z34.80 Encounter for supervision of other normal pregnancy, unspecified trimester 3 3

Z34.81 Encounter for supervision of other normal pregnancy, first trimester 4 4

Z3A.14 14 weeks gestation of pregnancy 6 6

Z3A.27 27 weeks gestation of pregnancy 2 2

Z56.5 Uncongenial work environment 4 4

Z71.1 Person with feared health complaint in whom no diagnosis is made 1 1

Z71.89 Other specified counseling 1 1

Z72.89 Other problems related to lifestyle 1 1

Z79.01 Long term (current) use of anticoagulants 4 4

Z86.711 Personal history of pulmonary embolism 2 2

(blank) 20 20

Grand Canyon Physical Therapy 15 15

2019‐05 15 15

M25.511 Pain in right shoulder 1 1

M25.512 Pain in left shoulder 1 1

M25.551 Pain in right hip 3 3

M25.562 Pain in left knee 1 1

M25.569 Pain in unspecified knee 4 4

M54.9 Dorsalgia, unspecified 1 1

M79.671 Pain in right foot 1 1

R53.81 Other malaise 1 1

Z48.89 Encounter for other specified surgical aftercare 2 2

Grand Canyon Telehealth 4 4

2019‐05 4 4

F31.64 Bipolar disorder, current episode mixed, severe, with psychotic features 2 2

F41.1 Generalized anxiety disorder 2 2

Grand Canyon Urgent Care 110 110

2019‐05 110 110

A09 Infectious gastroenteritis and colitis, unspecified 1 1

E86.0 Dehydration 2 2

G43.909 Migraine, unspecified, not intractable, without status migrainosus 1 1

H10.30 Unspecified acute conjunctivitis, unspecified eye 1 1

H69.80 Other specified disorders of Eustachian tube, unspecified ear 1 1

I10 Essential (primary) hypertension 1 1

I50.9 Heart failure, unspecified 1 1

J01.90 Acute sinusitis, unspecified 3 3

J02.9 Acute pharyngitis, unspecified 3 3

J03.90 Acute tonsillitis, unspecified 1 1

J06.9 Acute upper respiratory infection, unspecified 2 2

J20.9 Acute bronchitis, unspecified 5 5

J30.9 Allergic rhinitis, unspecified 1 1

J40 Bronchitis, not specified as acute or chronic 4 4

K04.7 Periapical abscess without sinus 1 1

K52.9 Noninfective gastroenteritis and colitis, unspecified 2 2

L03.90 Cellulitis, unspecified 1 1

L08.89 Other specified local infections of the skin and subcutaneous tissue 1 1

L30.9 Dermatitis, unspecified 1 1

M24.419 Recurrent dislocation, unspecified shoulder 1 1

M25.561 Pain in right knee 2 2

M25.562 Pain in left knee 2 2

M25.571 Pain in right ankle and joints of right foot 1 1

M25.572 Pain in left ankle and joints of left foot 1 1

M53.3 Sacrococcygeal disorders, not elsewhere classified 1 1

M54.31 Sciatica, right side 1 1

M54.32 Sciatica, left side 1 1

M54.5 Low back pain 1 1

M54.89 Other dorsalgia 1 1

M54.9 Dorsalgia, unspecified 1 1

M62.82 Rhabdomyolysis 1 1

M79.642 Pain in left hand 1 1

M79.644 Pain in right finger(s) 1 1

M79.662 Pain in left lower leg 1 1

N39.0 Urinary tract infection, site not specified 5 5

Q64.9 Congenital malformation of urinary system, unspecified 2 2

R00.0 Tachycardia, unspecified 1 1

R05 Cough 1 1

R06.02 Shortness of breath 1 1

R07.81 Pleurodynia 1 1

R07.89 Other chest pain 1 1

R10.9 Unspecified abdominal pain 3 3

R11.0 Nausea 1 1

R11.2 Nausea with vomiting, unspecified 2 2

R19.7 Diarrhea, unspecified 4 4

R30.0 Dysuria 2 2

R31.9 Hematuria, unspecified 1 1

R39.15 Urgency of urination 1 1

R41.0 Disorientation, unspecified 1 1

R42 Dizziness and giddiness 1 1

R50.9 Fever, unspecified 2 2

R51 Headache 1 1

S01.80XA Unspecified open wound of other part of head, initial encounter 1 1

S61.219A Laceration without foreign body of unspecified finger without damage to nail, 1 1

S65.211A Laceration of superficial palmar arch of right hand, initial encounter 1 1

S65.515A Laceration of blood vessel of left ring finger, initial encounter 1 1

T62.94XA Toxic effect of unspecified noxious substance eaten as food, undetermined, initial 1 1

T70.20XA Unspecified effects of high altitude, initial encounter 1 1

Z33.1 Pregnant state, incidental 1 1

Z48.02 Encounter for removal of sutures 2 2

(blank) 20 20

Grand Total 891 891

June 2019

Count of PatientVisitID Column Labels

Row Labels 2019 Grand Total

Grand Canyon Clinic 630 630

2019‐06 630 630

AHCCCS

I50.9 Heart failure, unspecified 2 2

Z00.8 Encounter for other general examination 2 2

J20.9 Acute bronchitis, unspecified 2 2

H69.80 Other specified disorders of Eustachian tube, unspecified ear 1 1

F32.9 Major depressive disorder, single episode, unspecified 1 1

J01.10 Acute frontal sinusitis, unspecified 1 1

I82.509 Chronic embolism and thrombosis of unspecified deep veins of unspecified lower 1 1

R42 Dizziness and giddiness 1 1

J02.9 Acute pharyngitis, unspecified 1 1

(blank) 1 1

S86.919S Strain of unspecified muscle(s) and tendon(s) at lower leg level, unspecified leg, 1 1

F99 Mental disorder, not otherwise specified 1 1

L93.0…