Health Department:________________________________ Date
V72.19 Hearing/Ear exam. V72.2 Dental exam. V72.31 Gynecological exam, routine. V72.40 Suspected Pregnancy. V73.88 Special screen-Chlamydial Dis. V74.5 Special screen-Venereal Disease. V81.1 Special screen for HTN. HEALTH EDUCATION (V65) V65.3 Dietary surveillance and counseling. V65.41 Exercise counseling. V65.42 Substance use & abuse counseling ................
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