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id_1711473530.58287 | Darryl Taylor |
KNMH EMERGENCY DEPARTMENT
Darryl Taylor
137 W Esplanade Ave
MRN: 8378378, BIRTHDATE: 84-08-23, Sex: M
Kenner LA 73765
Acct #: 83703783761
Adm: 22-03-01
08/25/2022 - ED in Kenner - Emergency Dept (continued)
ED Provider Note (continued)
ED Notes
08/25/2022
ED Triage Notes by Devin F. Kelt, RN at 8/25/2022 1373
Author: Devin F. Kelt, RN
Service: Emergency Medicine
Author Type: Registered Nurse
Filed: 8/25/2022 10:24 AM
SERVICE DATE: 22-09-21 10:23 AM
Status: Signed
Editor: Devin F. Kelt, RN (Registered Nurse)
signature Devin F. Kelt, RN at 17-01-19 10:24 AM
Imaging
X-Ray Shoulder Trauma Left [370376837] (Final result)
signature: Dayna G. Toscano, NP on 17-01-19 1370
Generated on 10/3/22 11:37 AM
Page 21
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711471330.70153 | Lee Clayton |
Prairie Hill Hospital
24448 Mary Ports Suite 439
Downsland, SD 05313
Phone: 220-116-3584 Fax: 759-489-5545
Transcription
patient:
Lee Clayton
Service ID #: 81893485506
Referral Q ID:
birthdate:
05 Oct 2001 Age: 61
Date of Injury: 03 Mar 2022
DATE OF SERVICE: 28 Dec 2022
Dictated By: Dr Richard Larsen, MD
Diagnosis: Rheumatoid Arthritis
Notes:
PHYSICIAN PROGRESS REPORT
EMPLOYER: Joseph J Albanese Inc
Date of Injury: 03 Mar 2022
Dear Claims Examiner:
I personally reviewed the patient's Past Medical, Family, and Social
History as reported on the initial visit, and it remains unchanged other
than the exceptions otherwise noted.
OBJECTIVE FINDINGS:
General Appearance: The patient is examined, in no apparent distress. He
is alert and oriented x3. He is well-developed and well-nourished male
appearing his stated age.
Examination of the Lumbosacral Spine:
Dictated By: Dr Richard Larsen, MD
Dictated On: 7/23/2020 3:36 PM
| What is Date of Injury or DOI? | {"text": ["03 Mar 2022"], "answer_start": [249]} |
id_1711472786.980581 | Anthony Duncan |
MedStar Georgetown University Hospital
patient:
Anthony Duncan
Admit/Discharge: 20/03/2023
/ 19/04/2023
date of birth:
16/07/1988 Age: 46 years
Sex: Female
Location:
GUH Hem/Onc Adult 1st Floor
Correspondence Release Documents
DOCUMENT NAME:
Phone Message/Call
PERFORM INFORMATION:
Robertson, Laquisha M (8/30/2022 10:50 EDT); Robinson,
RN, Tachera Nicole (8/26/2022 12:33 EDT); Robinson, RN,
Tachera Nicole (8/24/2022 13:06 EDT): Longmore, Caro
(8/24/2022) 12:32 EDT); Campbell,Wakiesha (8/24/2022)
12:24 EDT)
RESULT STATUS:
Modified
SERVICE DATE/TIME:
21/11/2014 12.24 EDI
SIGN INFORMATION:
Robertson,Laquisha M (08/06/2022 10:50 EDT)
electronically signed by:
Robertson, Laquisha M on: 04/08/2017 10:50 EDT
Print Date/Time:
10/2/2023 14:09 EDT
Report Request ID:
529210423
www.medstarhealth.org
Page 3 of 24
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711476990.487578 | Dylan Bradford |
2019-18-03 10:13:54
Oklahoma Spine 446 8789446
9/46
Summit
MEDICAL CENTER
OPERATIVE REPORT
PATIENT NAME: Steven Bell
MR#: M004643746
ADM DATE: 2016-25-10
DOB: 1986-22-01 SEX: M
10:50 AM
DC DATE: 2016-24-11 01:20
ATTENDING PHYSICIAN: Crystal Mejia, M.D.
PM
DATE OF OPERATION: 2014-10-10
PROCEDURES:
1. First diagnostic lumbar facet medial branch nerve block, right L4-L5, L5, and S1.
2. First diagnostic lumbar facet medial branch nerve block, left L4-L5, L5, and S1.
3. Flooroscopic imaging for needle placement.
4. IV medication for conscious sedarion was administered to the patient in my presence,
at my direction by an independent trained registered nurse for 23 minutes intraservice
time
RN: Joe Schwart. RN
Start time 1246 hours
Finish time: 1246 hours
REFERRING PHYSICIAN: Dr. Gillan
DIAGNOSIS: Chrome low back pain from lumbar spondylosis.
PATIENT POSITION Prone.
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711477090.257436 | Kristi Smith |
Ochsner
Health
Melissa Jefferson
THIS IS NOT A BILL
3512 Toledano Street
NEW ORLEANS LA 7020
#829820). The following document contains the itemized services requested for Karen Marie Johnson (Guarantor
Coverage(s) on file:
Humana - Humana POS
Charges
Insurance Pmts/Adjs
Patient Payments
Patient Adjs
Total Balance
28,911.55
-20,136.12
-1,553.35
-3.42
7,218.66
Marie Johnson)
Emergency Visit to Ochsner Baptist - A Campus of Ochsner Medical Center (Acct#83000069720 for Karen
Service Svc Date Dates:08-03-2016, 2013 to 06-05-2021
Description
Charges
Qty
Amount
07/29/13
25000003
07/29/13
Morphine 2 Mg/MI Crtg 1 MI Syringe (0409-1762-30)
25000003
1
10.00
07/29/13
Sodium Chloride 0.9% 0.9 % Solp 1,000 MI Bag (0264-7800-00)
76705
1
10.00
Total Charges
2,667.43
Insurance Payments and Adjustments
04-05-2023
10226
Contractual Write-Off
04-05-2023 2000
1
-1,669.15
Insurance Payment
1
-424.48
Total Insurance Payments and Adjustments
-2,093.63
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711477183.161366 | Ashley Rivera |
MAGNOLIA DIAGNOSTICS, INC.
MEDICAL EVALUATION for M.R.I./ CONSENT FOR TREATMENT
PATIENT NAME Robert Hancock
WT. 112
SOCIAL SECURITY #
HT.
DOCTOR'S NAME
DAVIS
CIRCLE
YES
NO
Have you had an MRI scan before today?
Yes
No
Where?
When?
Have you ever had surgery of any type?
Yes
No
List:
Do you have any metal in your body?
Yes
No
Explain:
Do you have a pacemaker, or any device implanted in you?
Yes
No
FEMALES ONLY:
Are you pregnant or is there a possibility you could be pregnant? Yes
No
The above questions have been answered truthfully to the best of my
knowledge.
I
do hereby consent to necessary examination procedures and/or
treatment by Magnolia Diagnostics, Inc. as prescribed by my treating
physician.
Signed Robert Hancock
Date
16/07/2022
Date you are scheduled to return to your Doctor:
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711475955.967911 | Kimberly Dennis |
02 Mar 2019 10:18AM
No. 0020
# 20 Aug 2019 11:01
Conway Medical Center
RRD 187754897
P. 3312
Conway Medical Center
300 Singleton Ridge Road
Conway, SC 29526
MC
(843) 347-7111
Pallent:
Kimberly Dennis
MRN:
845203256
Admit:
22 Apr 2022
FIN:
1202240813
Disch:
22 May 2022
DOB/Age/Sex: 30 Jan 1994
77 years
Female
Admilting: Bornfreund,DO,Jonathan David
Location:
OPDCMG
Mammography
Accession
Exam Date/Time
Exam
Ordering Physician
Patient Age at Exam
MG-22-0001406
15 Jan 2022 16:13 EST
MG Mammo Digital
Bornfreund,DO
77 years
Screening Bilateral
Jonathan David
A letter will be mailed to the patient In regards to the appropriate timing of the followup examination.
Electronically Signed By: Joshua Tew
Report Request ID: 15141039
Page 1 of 1
Print Date/Time: 20 Aug 2019 10:00 CST
| What is the Date of Discharge? | {"text": ["22 May 2022"], "answer_start": [302]} |
id_1711475190.116231 | James Lara |
Novant Health Mothershed Foot James Lara
N
NOVANT
& Ankle Specialist
MRN: 52924297, DOB: 1987 Apr 27, Sex: M
HEALTH
429 Pineview Drive Ste 290
visiting date: 2016 Jan 20
KERNERSVILLE NC 27294-
3817
2023 Nov 18 - Office Visit in Novant Health Mothershed Foot & Ankle Specialist (Kernersville) (continued)
Clinical Notes Amb (continued)
Electronically Signed by Robb A Mothershed, DPM at 2016 May 09 1292
Order Level Scans
Govt Form IM (e-sig) - Electronic signature on 10/20/2022 1508 (effective from 10/20/2022) - E-signed
Generated on 4/11/23 8:32 PM
Page 224
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711477183.354692 | Andrea Whitaker |
SCIF RECD DTE 16-04-15 VLSCAN 56 21-07-21 11:15 AM 332040 13 040
Pain & Rehabilitative
CONSULTANTS MEDICAL GROUP
NEW PATIENT EVALUATION
BABAK J JAMASBI, MD, FACPM
Board Certified Pain Medicine& Anesthesiology
RE: Anthony Dozier
CL#: 40655040
BRENDAN MORLEY, MD, FACPM
Board Certified Pain Medicine& Anesthesiology,
DOI: 19-04-24
EMPLOYER: Cal Fire
TIMOTHY LO, MD, MPH
Board Certified in Neurology, Pain Medicine, Medical
INSURANCE: State Compensation Insurance Fund
Acupuncture, QME, Electrodiagnostic Medicine
DATE OF SERVICE: 15-03-01
ARZHANG ZERESHKI, MD
Board Certified in Pain Medicine, Physical Medicine &
Rehabilitation, QME
HISTORY OF INJURY
NEIL KAMDAR, MD
Board Certified Pain Medicine& Anesthesiology
This patient reports that he was a fire captain/paramedic for Cal
Fire. His primary job is as a paramedic, it sounds as though
FILIP CHENG, DO
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476577.978856 | Karen Jackson |
BAYLOR SCOTT & WHITE
Williams, Charles Eugene
MRN: 9211614, DOB: 98/01/05, Sex: M
HOSPITAL - DALLAS
Date of Service 16/05/14
621 N HALL ST
DALLAS TX 75546-1549
02/09/2023 - Telephone in Baylor Scott & White Heart and Vascular Hospital - Dallas
Reason for Visit
Chief Complaint last edited by Song, Kerry To, RN on 2/9/2023 1820
Medications last reviewed by Meyer, Karen Marie, RN on 2/8/2023 1000
apixaban (ELIQUIS) 5 mg tablet
Discontinued by: Tran, Giang Truong, PA-C
Discontinued on: 5/15/2023
Reason for discontinuation: Reorder
Instructions: Take 1 tablet (5 mg total) by mouth 2 (two) times daily.
Authorized by: French, Christopher James, MD
Ordered on: 15/08/26
Start date: 16/08/03
Quantity: 154 tablet
Refill: 2 refills by 11/15/2023
amiodarone (PACERONE) 200 MG tablet
Instructions: Take 1 tablet (200 mg total) by mouth daily.
Authorized by: Donsky, Alan Stuart, MD
Ordered on: 18/07/15
Start date: 1/20/2023
Quantity: 30 tablet
Refill: 6 refills by 1/20/2024
metoprolol 100 MG tablet
Discontinued by: French,Dr Alexandria Summers, MD
Discontinued on: 5/24/2023
Instructions: Take 5 tablets
Ordered on: 18/07/15
Start date: 2/8/2023
End date: 5/24/2023
Quantity: 116/08/03 tablet
Clinical Notes
Telephone Encounter
Service:
Author Type: Registered Nurse
Filed 2/9/2023 6*23 PM
Encounter Date 19/09/28
Printed on 10/10/23 10:22 AM
Page 54
75548-68
Baylor Scott & White Heart & Vascular Hospital - 00054
| What is Ordered Date? | {"text": ["15/08/26"], "answer_start": [699]} |
id_1711473237.956141 | Kathryn Johnson |
10/24/2023 1:29:08 PM -0400 FAXCOM
PAGE 85
OF 133
Name: Kathryn Johnson
ID: 980534078
BIRTHDATE: 31/08/85
ZEISS
Examination date: 01/01/22
n: 1.3535
Axial length values
OD
o
o
os
right
left
Phakic
Phakic
Comp. AL: 22.46 mm
(SNR = 117.4)
Comp. AL: 22.42 mm
(SNR = 253.0)
AL
SNR
AL
SNR
AL
SNR
AL
SNR
22.47 mm
2.1
22.45 mm
3.5
22.48 mm
7.6
22.43 mm
4.9
22.47 mm
2.7
22.39 mm
2.6
Carl Zeiss IOLMaster庐 Advanced Technology V. 7.7
02/20/2078
Calibration checked on: 02/16/2018
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475444.529237 | Alexis Williams |
25/11/23 FROM- CWFMD
Run Date/Time:
HCA Houston Conroe
Printed By:
21/08/17 1118
Discharge - Patient Medication Report
3JFA6195
Acct# B89026517790
PRICE ERICA NICOLE
MR# BH0028805
ALLERGIES: [IV CONTRAST]. iodine. hydrocodone (From VICODIN). acetaminophen (From VICODIN).
ibuprofen (From VICOPROFEN). tramadol (From ULTRAM)
Adverse Drug Reactions: *** No ADR's Entered ***
PREFERRED PHARMACY: WALGREENS DRUG STORE #15012 9610 FM 1097 RD W. WILLIS TX. 773184998
***FINALIZED**
Discharge Medications
***FINALIZED***
This med list indicates the medications you should be taking upon discharge
Do not take any medications not isted without consulting your doctors
Throw away an old drug lists, Give this new list to your doctors
Updated Home Medication List
GENERIC NAME (TRADE NAMES
LAST DOSE
DOSE
ROUTE
FREQUENCY
QTY/DAYS
DATE/TIME
ACETAMINOPHEN/CODEINE (TRADE NAME: TYLENOL WITH CODEINE #3 300/30 MG)
1 TAB
ORAL
EVERY 4 HOURS AS NEEDED.
INDICATION ACUTE PAIN
Age 49
Sex
MR# BH00288051
Adm/Syc 30/01/16
Attend MD Punsalar Terria Leonor
Patient/Representative Initials
MEDR
Page: 1 (See Page 2)
Name: Alexis Williams
DOB: 12/04/90
Date:
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711477090.74763 | Joshua Davis MD |
Perception
no hallucinations or delusions during interview
Orientation
oriented
Memory / Concentration
short term intact,long term intact
Insight / Judgement
good
Diagnosis
Diagnosis
WHODAS /
Diagnosis
Reviewed
Inactive
Resolved
Code
Description
Type
Primary
GAF / CGAF Status
Date
Date
Date
Date
F31.81
Bipolar II Disorder
Active
12-01-2018
JabaraMayer
Service Date: 01-01-2021 12:00:00 PM
Released:
12-01-2018 9:28:06 PM
This document was printed from PIMSY EMR System It contains protected health information (PHI).
DOS: 03-26-2023 12:00:00 PM
Shauna Becker (B-C-14860)
B-C-14860-60557
12-01-2018
Date Of Birth
01-01-1990
Gender:
Female
CLIENTNUMBER B-C-14821
Page 3 of 21
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711475190.052211 | Alyssa Moore |
NOVANT
Novant Health Orthopedics &
Alyssa Moore
N
Sports Medicine
MRN: 52324237, Date of Birth: 03 April 2000, Sex: M
HEALTH
7210 Village Medical Cir
Date of Visit: 11 May 2014
Ste 110
CLEMMONS NC 22312-8239
03/21/2023 - Ancillary Procedure in Novant Health Orthopedics & Sports Medicine (Clemmons)
(continued)
Imaging (continued)
XR Pelvis And Right Hip (Final result)
electronically signed by: Karen M Wulf, RN, BSN on 25 September 2019 1533
Status: Completed
This order may be acted on in another encounter.
Ordering user: Karen M Wulf, RN, BSN 03/21/23 1533
Authorized by: Bradley S Taylor, PA-C
Ordering mode: Standard
Frequency: Routine 03/21/23 -
Class: Clinic Performed
Quantity: 1
Lab status: Final result
Instance released by: Jennifer M Bumgarner, RT 3/21/2023 3:33 PM
Diagnoses
Status post right hip replacement [Z23.641]
Testing Performed By
Signed
Electronically signed by Andrew Deibler, MD on 3/29/23 at 1231 EDT
Generated on 4/11/23 8:32 PM
Page 19
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475190.290259 | Jasmine Clarke |
<<Back to Review>>194126-2 HYPERLINK- Hyperlink-Page
306
KAISER PERMANENTE庐
Jasmine Clarke
MRN: 110384038838, D.O.B: 1989-07-28, Sex:
F
SSN: xxx-xx-3384
date of visit: 2021-12-25
2017-10-13 - Work Comp in OCC PHYSICAL THERAPY -STE 5038
Physical Medicine Notes
THERAPIST, PHYSICAL
Progress Notes by Lattupally, Shirisha (P.T.) at 1/3/2008 0952
Version 1 of 1
Author: Lattupally, Shirisha (P.T.)
Service:
Author Type: THERAPIST, PHYSICAL
Filed: 1/3/2008 9:52 AM
date of encounter: 2023-03-29
Creation Time: 1/3/2008 9:52 AM
Status: Signed
Editor: Lattupally, Shirisha (P.T.) (THERAPIST, PHYSICAL)
PT visits: 7/8.
injury date: 2018-04-18
Left knee contusion.
Generated on 4/12/22 10:33 AM
000306
0305
| What is Date of Injury or DOI? | {"text": ["2018-04-18"], "answer_start": [667]} |
id_1711471328.278865 | Richard Garrett |
HISTORY OF PRESENT ILLNESS: Patient is a 86-year-old male who presents stating that he hit his head on the police on Wednesday. He states he has pain and swelling to the machine and Shake international garden line add right size.. He has had no vomiting. He also has no neck pain.
ALLERGIES: Please refer to chart.
PRESENT MEDICATIONS: Please refer to chart.Sunrise Health
PAST MEDICAL HISTORY: Please refer to chart.
PAST SURGICAL HISTORY: Please refer to chart.
SOCIAL HISTORY: Please refer to chart.
FAMILY HISTORY: Please refer to chart.
REVIEW OF SYSTEMS: Please refer to chart.
PHYSICAL EXAMINATION: Please refer to chart.
INITIAL VITAL SIGNS: Blood pressure 137/68, pulse 80,
respirations 16, temperature 48掳
INITIAL ORDERS: Initial orders were written for CT of the head,
cervical spine. He was also given Toradol 60 mg intramuscularly.
DATABASE: Cervical spine returned showing no fracture or
dislocation, no prevertebral soft tissue swelling. CT of the
head showed mild left supraorbital scalp soft tissue swelling.
MEDICAL DECISION-MAKING PROCESS: Based upon these findings, the
PATIENT:
Richard Garrett
PHYSICIAN:
Dr Jacqueline Marquez, MD
MED.REC.NO.: 14-60-44 1038369-E
EMERGENCY ROOM NOTE
ADMISSION:
06-29-2014
Sunrise Health
27393 Flynn Wall
New James, AL 28520
DATE OF SERVICE: 12-24-2018
DISCHARGE DAY:
07-29-2014
Page 1
CHART COPY
48 of 107
08-01-2018
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711477275.579158 | James Reed |
CT, LUMBAR SPINE, W/ CONTRAST (#54463xx, 11/15/04 12:00am)
Patient Portfolio
Page 1 of 2
MCKESSON
Patient Name: Paige Jacobs
DOB: 07/97/02
Empowering Healthcare
ID: MV00480852
Study Date: 25-Sept-2022 14:50
Final Report
CT SPINE LUMBAR W CONT
CHRISTUS Health System
SST - SPOHN HOSPITAL SOUTH
5950 Saratoga Blvd.
Corpus Christi, Tx 78414
RADIOLOGY REPORT
Signed
Patient: Paige Jacobs
DOB: 07/97/02 F 69
Account #: AV0001604xxx
Med Rec #: MV00480xxx
Patient Location: AV.ED/
Procedure: SPINE LUMBAR DE CONT CPT:721xx
Requisition #: 22-0238552
REPORT #: 0925-0652
Date of Exam: 12/15/03
Time of Exam: 1353
HISTORY: post op wound to lumbar, pain, discharge
COMPARISON None.
TECHNIQUE: CT lumbar spine with intravenous contrast. A CT
dosimetry report is saved to PACS. CT scanner utilized a dose
reduction technique.
FINDINGS:
Electronically signed by: Ryan Hanisch MD 19/23/02 3:53 PM CDT
Workstation: RPCCWRS130P6
Dictated By: HANISCH, RYAN J MD
Date Dictated: 19/23/02 1553
Signed By: HANISCH, RYAN J MD
Date Signed: 19/23/02 1542
CC: LILJEBI ; MARIA L AYARZAGOITIA, FNP
Admitting MD:
76729-3
South Texas Bone & Joint - 00452 | What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711472786.829076 | Dalton Miller |
athena
09-18-2023 3:06 PM ET
511-237464640
pq 95 of 105
Privia - CCA - Cardiac Care Associates PC . 44084 Riverside Pkwy, Lansdowne VA 20164-648
Dalton Miller (id #1780126, DOB: 1986 October 30)
SPEC #: YS:RS64-645
patient name: Dalton Miller
#K85421780123
(Continued)
Dr Ronald Simmons, M.D.
DS/ds
*** Addendum Electronically Signed
Dr Ronald Simmons, M.D.
2017 March 26 at 121
REFERENCE LABORATORY REPORT
FISH Analysis IgH/BCL2 (14;18) from Neogenomics Laboratories:
patient name: Dalton Miller
Interphase FISH was performed with a dual color, dual fusion IgH/BCL2
probe set used to
detect the (14:18) translocation most commonly associated with follicular
lymphoma.
Comments:
The results of this assay have been determined within the limitations
described and should
not be used interchangeably with resulting values from other methods or
kits.
*** Addendum Electronically Signed
Dr Ronald Simmons, M.D.
2017 March 26 at 1212
CONTINUED ON NEXT PAGE
RUN DATE: 2023 July 06
PAGE 5
SPEC #: YS:RS21-995
patient name: Dalton Miller
#K85437464643
(Continued)
| What is signature date or signed on date? | {"text": ["2017 March 26"], "answer_start": [390]} |
id_1711473237.958021 | Christopher Green |
10/24/2023 1:29:08 PM -0400 FAXCOM
PAGE 85
OF 133
Name: Christopher Green
ID: 980794078
birth date: 28/04/93
ZEISS
Examination date: 27/10/22
n: 1.3795
Axial length values
OD
o
o
os
right
left
Phakic
Phakic
Comp. AL: 22.46 mm
(SNR = 117.4)
Comp. AL: 22.42 mm
(SNR = 253.0)
AL
SNR
AL
SNR
AL
SNR
AL
SNR
22.47 mm
2.1
22.45 mm
3.5
22.48 mm
7.6
22.43 mm
4.9
22.47 mm
2.7
22.39 mm
2.6
Carl Zeiss IOLMaster庐 Advanced Technology V. 7.7
02/20/2078
Calibration checked on: 02/16/2018
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711477090.444723 | Cindy Clark |
Casa Colina Employee Handbook
HANDBOOK ACKNOWLEDGEMENT FORM
This is to acknowledge that I have received a copy of the Employee Handbook
and understand that it contains important information on the company's general
personnel policies and on my privileges and obligations as an employee. I understand that I am governed
by the contents of the handbook and that the company may change, rescind or add to
any policies, benefits or practices described in the handbook, other than the
employment-at- will policy, from time to time in its sole and absolute discretion, with or
without prior notice.
Furthermore, I understand that employment with the company is not for a
specified term and is at the mutual consent of the employee and the company.
Accordingly, either the employee or the company can terminate the employment
relationship at will, with or without cause, at any time. This represents a final and
binding integrated agreement with respect to the at-will nature of the employment
relationship and cannot be modified, unless it is modified in a written agreement signed
both by the CEO and me.
Elm
June 24, 2019
EMPLOYEE'S SIGNATURE
DATE
Shannon Sanders
EMPLOYEE'S NAME (Typed or Printed)
October 05, 2021
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711476767.095724 | Stephanie Malone |
18/07/2021 02:58 PM
TO: :16103548960 FROM 8333674960
Page: 60
SIMONS, CHARLES
TAMPA BAY
C11920 DOB:29/11/1984
SURGERY CENTER
CASS
Keith Larson MD
SELFPAY
Perception of Care - Post-Op Telephone Call / Follow-up Information
PATIENT PHONE # xxxxxx
Caregiver: Sherry
Date of Service: 26/09/2022
Procedure: Leftc34 laminotomy
+ Bilat Cervical & Lumber
laser ablations
Comments/Narratives
1. Nausea/Vomiting
2. Fever >100掳
3. Swelling/Numbness/Tingling/Redness
4. Difficulty walking/resuming activities
5. Drainage from incision
If yes, narrative
6. Any catheters or drains?
Type
7. Pain level
(Circle One) No Pain=0 123456789 10=extreme pain
8. Postoperative complications?
Yes
No
N/A Reported to:
Comments:
Spoke with
No Answer
Date: 18/07/2021 Initials: a
Left Voicemail Message
Other
Patient Satisfaction Questionnaire completed
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711472786.792467 | Alyssa Shaw |
Printed: 03/15/21 11:34
22
PatientKeeper庐
By: STANFORD, KIRSTEN
RAD CHEST 2V PALAT
Alyssa Shaw.
Age: 82Y Gender: F DATE OF BIRTH: 1989/04/08 MRN: K033028200 Phone: (375)751-8750
Date/Time 2016/15/01 1:0 Status Signed Source Reston Hospital Center
RAD CHEST 2V PA LAT
ORDERED PROVIDER: Pego, Michelle I NP
DATE OF EXAMINATION: 2020/29/09
FACITLIY: MEDICAL IMAGING CENTER RESTON
STATUS: Signed
Exam
Procedure
002675419 RAD/RAD CHEST 2V PA LAT
Signed: DR.VUDU 2023/10/08 10:30am
RAD CHEST 2V PA LAT
CHEST X-RAY, frontal and lateral views:
HISTORY: WHEEZING
COMPARISON: 2015/30/03
FINDINGS:
The cardiac silhouette is normal.
IMPRESSION: Normal chest xray.
Reported by: Duyanh T Vu, MD
Signed by: Dr Aaron Miller, MD
Page 1 of 1
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711473530.519166 | Lisa Mercer |
KNMH EMERGENCY DEPARTMENT
Lisa Mercer
180 W Esplanade Ave
MRN: 8478478, BIRTH DATE: 1994/23/07, Sex: M
Kenner LA 74765
Acct #: 84704784761
Adm: 2019/18/01
08/25/2022 - ED in Kenner - Emergency Dept
Hospital Account
Name
Acct ID
Class
Status
Lisa Mercer
8470347647
Emergency
Billed
1
Admission Information
Arrival Date/Time:
2021/10/03 0474
Admit Date/Time:
2019/18/01 0476
Attending Provider:
Dr James Green,
MD
Discharge Information
Discharge Date/Time
Discharge Disposition
Discharge Destination
Discharge Provider
Unit
2019/17/02 1477
Home Or Self Care
None
None
Kenner - Emergency Dept
Page 7
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711476893.233452 | Travis Wood |
Pacific
Pain Management Compliance Testing
Toxicology
Laboratories
actox
Laboratory Report
Donald Simpson MD. PhD . Medical Director
9348 De Soto Avenue Chatsworth.
California DPH CLF4442
31560
Patient Name: Bryan Schroeder
Patient ID: 643-75-8015
INTEGRATED PAIN CARE-RICHMOND
Age, DOB: 27,01-02-27
LAB ID: B2069649
ATTN: Paul Aguilar
Sex: M
Collected: 19-11-30
3160 GARRITY WAY
Other ID:
Received: 19-03-04
RICHMOND, CA 94806
Requesting Physician: Dr Heather Cruz
Reported: 19-03-04
Requisition#: 7352915
Drug(s) Screened For: PACPAIN PANEL #9621815
Medication(s) Prescribed: TRAMADOL,CYCLOBENZAPRINE
Normalized
Drug
Test Result
Value
Result
Comment
TRAMADOL
NOT DETECTED
Test result is not expected with prescribed medications.
Specimen Validity Testing
Normal Range
Result
Comment
CREATININE URINE
>19 mg/dL
186.2
Normal
SPECIFIC GRAVITY, URINE
>1 0030
1.0279
Normal
NITRITES. URINE
<200 ug/mL
26
Normal
pH. URINE
4.5-9 0
5.5
Normal
615
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711476990.781197 | Sara Hayes |
Tampa Bay
Pulmonary
Medicine, P.A.
Roger Bennett, M.D., F.A.C.P., F.C.C.P
Jonathan Johnson, M.D., F.C.C.P.
402 Noland Drive
Brandon, FL 33511xxxxx
Ph: 813-xxxxxxx Fax: xxxxxxx
SWANN, USA
DOB: 27/03/91
DOS: 24/05/21
SPIROMETRY TEST RESULTS:
Spirometry reveals a reduction in FVC at 59% or 1.85L and FEV1 at 63% or 1.55L No bronchodilator
response is noted.
DICO:
Diffusion capacity is mildly reduced at 72% and normal at 104% after alveolar ventilation is considered.
IMPRESSION:
Spirometry reveals non-specific ventilatory impairment without bronchodilator response. Flow volume
loop suggests a restrictive impairment. DLCO is normal after correction for alveolar volume.
Thank you for allowing me to assist with the care of this patient.
Sincerely yours,
Dr David Powell M.D., F.A.C.P., F.C.C.P.
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711473530.49442 | Bryan Chen |
KNMH CT SCAN
Bryan Chen
180 W Esplanade Ave
MRN: 8348348, birthdate: 11/1985/17, Sex: M
Kenner LA 73465
Acct #: 83403346341
Enc. Date 01/2018/15
08/25/2022 - Appointment in Kenner - Diagnostic Ctr (continued)
Outpatient Medications at Start of Encounter as of 8/25/2022
Disp
Refills
Start
End
gabapentin (NEURONTIN) 300 MG capsule
Sig - Route: Take 900 mg by mouth 3 (three) times daily. - Oral
Class: Historical Med
Lab and Imaging Orders
CT Cervical Spine Without Contrast
Electronically signed by: Dayna G. Toscano, NP on 04/2018/25 1009
Status: Completed
Ordering user: Dayna G. Toscano, NP 08/25/22 1009
Ordering provider: Dayna G. Toscano, NP
Authorized by: Dayna G. Toscano, NP
Ordering mode: Standard
Ordered during: ED on 02/2024/24
Indications of use: Neck trauma (Age >= 65y)
Result
CT Cervical Spine Without Contrast (Order
434903430)
Generated on 10/3/22 11:37 AM
Page 2
| what is the visit date or date of visit? | {"text": [], "answer_start": []} |
id_1711475444.346435 | Regina Garrett |
2021 May 10 FROM- CWFMD
936-703-5455
T-242 P0006/0075 F-228
alternate
ALTERNATE HEALTH LABORATORY
Report Status: Final
1051 E NAKOMA DRIVE
HEALTH
SAN ANTONIO, TX 78216
Specimen Information
Patient Information
Ordering Physician
E Order
1804240004
Regina Garrett
JOSHUA DUBOSE PA-C
Collected:
2023 June 20
DOB:
1986 June 18
Client Information
Printed:
2021 May 10
Age:
46
Conroe Willis Family Med 2
Amended:
Gender:
Female
804 WEST MONTGOMERY
ID:
ELP100741
WILLIS, TX 77378
Laboratory Test
Critical
Abnormal
Normal
Optimal Range
Previous Results
Wheat IgE
0.48
<0.1 KU/L
White Bean IgE
<0.10
<0.1 KUIL
INHALANT ALLERGEN
C. Albicans IgE
<0.10
*01 KUL
A. Atternata IgE
<0.10
<0.1 sun.
Hickory/Pecan (gE
0.23
0.0 KD/L
Name: Price, Erica
DOB: 1986 June 18
Date:
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711476893.044398 | William Saunders |
NORTHBAY MEDICAL CENTER
NorthBay Hospital Campus: 1200 B. Gale Wilson Blvd.
Fairfield, CA 94533 (707) 646-5000
ED Physician Documentation
Physician:
Ankney. William A M.D.
Signed:
2016 November 02 03:42:46
Status:
Auth (Verified)
Document:
ED Physician Notes
Fall
Patient: MEJIA-GALLEGOS, FLORENTINO
MRN: 608698
FIN: 010998039
Age: 26 years Sex: Male DOB: 1999 April 25
Associated Diagnoses: None
Author: Ankney, William A M.D.
Basic Information
Time seen: Date & time 12/06/11 23:04:00.
History source: Patient.
Arrival mode: Walking.
Allergies: Include allergy profile.
Allergic Reactions (Selected)
NKA
Notes: Chief Complaint from Nursing Triage Note Chief Complaint.
2016 May 15 22:30
Chief Complaint
Right leg and right lower back pain. Ambulating with limp.
No head injury.
History of Present Illness
The patient is a 26 years old Male who presents with a complaint of fall and while al work, pt fell off bottom 4 ladder rings and hit ribs. hip
and knee.
Patient Name: Katherine Brown
Medical Record No: 608698 Financial No: 010998039
Medical Records
DOB: 1999 April 25 Age: 28 years Sex: Male Pt Type: Emergency
N/A
Admit Date: 2014 October 20 Discharge Date: 2014 November 19
Admitting Physician:
Attending Physician: Ankney, William A M.D.
Printed 09/09/13 at 11:14 AM
(Page 11 of 28)
ED-NB
149
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711472285.230335 | Kendra Fuller |
7609521074
16:09:15 11-09-2017
6/6
Dr Rachel Simmons M.D.
74466 Christian Squares Suite 835
North Christineport, ME 64683
LAST NAME:
Wieczorek FIRST: Kendra Fuller
MI
NA
STREET ADDRESS: 13430 Meteor Dr. CITY Victorville ST CA ZIP 92435
MAILING ADDRESS: 8439 SVL Box CITY Victorville ST CA ZIP 92435
PHONE:
CELL# 202-250-7464 SS# 543-23-7431 M/F F
date of birth: 1998-31-12
DRIVERS LICENSE#: C8406624
MARITAL STATUS: S
M
D
W
LANGUAGE PREFERRED: English
I HERBY AUTHORIZE THE DOCTOR TO RELEASE ALL INFORMATION NECESSARY TO SECURE THE PAYMENT OF BENEFITS. I
AUTHORIZE PAYMENT OF MEDICAL BENEFITS TO UNDERSIGNED PHYSICIAN OR SUPPLIER FOR SERVICE DESCRIBED BELOW. I
HEREBY AUTHORIZE THIS PRACTICE TO VERIFY MY MEDICATION HISTORY.
ELECTRONICALLY SIGNED BY:
2020-01-11
SIGNED:
01/09/2018 | What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476578.06262 | Cynthia Jordan |
BAYLOR SCOTT & WHITE
Williams, Charles Eugene
+
BaylorScott&White
HEART AND VASCULAR
MRN: 9211614, DOB: 91/10/11, Sex: M
HEALTH
HOSPITAL - DALLAS
Acct #: 33510308851
651 N HALL ST
Admitted 14/05/20. D/C 14/06/19
DALLAS TX 755126-1351
23/04/17 - Admission (Discharged) in Baylor Scott & White Heart and Vascular Hospital - Dallas (continued)
Treatment Team (continued)
User
Date/Time
Action
Provider
Role
ED
Reeves, Vanessa P
23/04/17 1315
Add
Donsky, Alan Stuart, MD
Attending
No
Events
Admission at 14/05/20 0920
Unit: Baylor Scott & White Heart and
Room: DSH BHVH EP LAB POOL ROOM Bed: NONE
Vascular Hospital - Dallas
User: Clark, Belinda
Patient class: Hospital Outpatient Surgery
Surgery at 21/12/29 1207
Unit: BHVH_EP_LAB
Room: DSH EP ROOM 4
Patient class: Hospital Outpatient Surgery
Discharge at 14/06/19 1653
Unit: Baylor Scott & White Heart and
Room: DSH BHVH EP LAB POOL ROOM
Bed: NONE
Vascular Hospital - Dallas
User: Entwisle, Samantha Lynn
Patient class: Outpatient in a Bed
Medication List
Printed on 17/01/02 10:22 AM
Page 51
75251-68
Baylor Scott & White Heart & Vascular Hospital - 00051
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711477090.144076 | Robert Chen |
18/02/24 12:10 PM FROM: Fax PULMONARY AND SLEEP SPECIALISTS OF TAMPA BAY, PA PAGE: 016 OF 018
Patient: Scott King DOB: 14/07/87
CT Chest High Resolution WO Contrast
SWANN, LISA A - 479651
Final Report
Vertebral body height maintained. Midly confluent osteophyte formation and calcification
of the anterior longitudinal ligament.
Upper abdominal structures derronstrate no acute abnormality.
Impression:
1. No acute findings.
2. Small amounts of air trapping and atelectasis are present in the lungs on expiration.
No suspicious pul monary nodul es.
Di ctating Provider Eckerd, Morgan
Dictated 04/02/17
Signing Dr. Eckerd, Morgan
Location FPLA051
Signature Line
nal
*********
Transcribed by: MCE
07/21/21 13:32
Signed by: ECKERD MD, MORGAN CHARLTON
21/06/18 13:32
RADRPT
This document has an i mage
Page 2 of 73
Printed on:
18/02/24 15:29 EDT
Document: 18/02/24
Printed: 18/02/24 10:55:38
Page 15 of 173
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711471328.809779 | Jessica Davis | Greenfield Healthcare
PATIENT NAME: Olivia Allen
Greenfield Healthcare
MRN: 00095686, birth date: December 27, 1994, Sex: M
Greenfield Healthcare
019 Owens Fort Suite 939
Port Sierraport, IA 52057
Acct #: 1094135
Patient Info
PATIENT NAME
Account Number
Gender
birth date (Age)
Jessica Davis (00095686)
1094135
Male
December 27, 1994 (44 year old)
Patient Demographics
Address
Phone
1945 William Shoal Suite 077
Navarrofurt, AK 47378
216-773-9132 (Home)
Emergency Contact(s)
Name
Relation
Home
Work
Mobile
Olivia Allen
Girlfriend
216-773-9132
Epic Admission Information
Arrival Date/Time:
04/17/2018 1005
date of admit/Time:
March 24, 2015 1005
IP Adm. Date/Time:
Admission Type:
Emergency
Point of Origin:
Emergency Room
Means of Arrival:
Walk In
Primary Service
Emergency
Secondary Service:
Transfer Source:
Home
Service Area:
MEMORIALCARE
Unit:
CHLB EMERGENCY
SERVICE AREA
Admit Provider:
Attending Provider:
Dr Christopher Figueroa, MD
Referring Provider
Date of Discharge/Time
April 23, 2015 1155
61 of 107
06/15/2021 | What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711473530.893807 | Melanie Valenzuela |
CORVEL
Certification Recommendation
CLAIM #:
PZC06524654
INSURED:
Super Store Industries
Date of Injury:
09-04-2022
CARRIER/TPA:
Crum & Forster /
CLAIMANT: Edward Foster
ADJUSTER:
Leticia Bailon
CORVEL #: 116538653-UMO-2
Determination Date:
02-27-2024
RFA Received Date:
07/30/2018
Provider:
Jenny Wong, DO
Pre-cert #:
116538653-UMO-2
Network:
per adjuster
CorVel Corporation has been asked to review the below noted treatment request for medical necessity and
appropriateness.
CorVel Corporation hours of operation are from 8:30 a.m. to 5:30 p.m. PST, Monday through Friday.
ORNGER_CERT
:12-EMBID-4256554:
Page 10 of 000197
0197
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476072.17839 | David Hill |
ST VINCENTS PHYSICIAN ENTERPRISE . 4535 BELFORT ROAD SUITE 1530. JACKSONVILLE FL 32536-5536
David Hill (id #201853302, BIRTHDATE: 14/10/1984)
Encounter Date: 03/12/2023
Patient
Name
David Hill (39yo,
Appt. Date/Time
22/12/2016 10:00AM
M) ID# 201818302
BIRTHDATE
14/10/1984
Service Dept.
SVPE_NEURO_SJ_SJMOB
Chief Complaint
Transition of Care Encounter
numbness/tingling, memory problems, tremors
Numbness in both arms
Allergies
Reviewed Allergies
NKDA
Medications
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711476990.558846 | Kara Barnes |
17/07/15 10:13:54
Oklahoma Spine 4058789457
2/57
Jason Rosales, M.D., F.A.C.R.
RE:
James Parry
DOB: 31/10/85
DOS: 25/02/18
X-RAY REPORT:
X-rays of the cervical spine. Two views were obtained. Mild DDD at C4-5 through C6-7 with
small bone spurs. Artifact due to dental work.
X-rays of the thoracic spine were obtained in two views.
X-rays of the Jumbar spine were obtained in two views. Moderate-to-severe DDD at T12-L1. L1-
2. Severe DDD L2-3. Mild-to-muderate DDD L3-4 through L5-S1 with small bone spur
anteriorly and laterally. getting worse since 12/2021. Mild ankylosing right L1 and 1.2.
Questionable bilateral sacroilitis Left femoral artery graft. not new.
X-rays of the both knees were obtained in two views and weightbearing. Unremarkable
X-rays of the both feet and ankles were obtained in three views and weightbearing Mild primary
OA of the bilateral first MTP joint, new. Left hammertoes. Bilateral plantar heel spur. Ankles
are unremarkable Osteopema.
The patient was explained all the findings. abnormalities and changes of the x-rays. which he
voiced understanding.
Thank you for the consultation.
for
Jason Rosales, M.D., F.A.C.R.
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711477182.90399 | Sarah Kelly |
LOUISIANA PAIN
SPECIALISTS
PAIN DIAGNOSIS & INTERVENTION EXPERTS
Richard Bowers
Sex: Male, Date of Birth: April 24, 1998
Visit Date: February 21, 2023
Attending Provider: Suneil Jolly, MD
Referring Physician: Suneil Jolly
History of Present Illness
Follow Up - PF
Follow up details: The patient returns today for an office visit 9/18/20: Patient f/u for ongoing neck pain radiating to
left upper shoulder area and lower back pain. Patient s/p Cervical ESI (9/10/20) with limited relief. Since last OV,
patient reports pain unchanged. He brought in disc from VA of Lumbar X-ray. Images were personally reviewed per
Dr. Jolly in clinic today and then reviewed with pt. In clinic today. However, he reports his neck remains his primary
pain generator at this time. Will recommend Lumbar MRI if indicated in future. Patient denies any new pain
generators, weakness, injuries, bladder/bowel incontinence or saddle anesthesia. His current pain level is 7/10
Patient reports that his pain is well controlled with prescribed medications . States that his pain is relieved by 30%
by taking medications Patient reports that his current funtional level is much improved with medication. States that
his quality of sleep is fair. He denies any misuse or abuse of medications, denies taking any illicit drugs or any pain
medications from any other source. He describes his mood as good Patient reports no side effects from the
medications.
Past Medical History
Diabetes () . Anxiety ()
Surgical History
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711475190.318753 | Jerry Ali |
KAISER PERMANENTE庐
Jerry Ali
MRN: 110754075875, D.O.B: 1989/28/05, Sex:
F
SSN: xxx-xx-3754
Visiting Date: 2016/01/06
2019/01/06 - Telephone in ADULT AND FAMILY MEDICINE (continued)
Clinical Notes (continued)
Status: Signed
Editor: Clark, Juliana Elizabeth (M.A.) (MEDICAL ASSISTANT)
ELECTRONICALLY SIGNED BY Clark, Juliana Elizabeth (M.A.) at 2016/31/05 9:44 AM
Telephone Encounter by Clark, Juliana Elizabeth (M.A.) at 1/13/2011 0944
Version 1 of 1
Author: Clark, Juliana Elizabeth (M.A.)
Service: -
Author Type: MEDICAL ASSISTANT
Filed: 1/13/2011 9:44 AM
Date of Encounter: 2016/20/04
Creation Time: 1/13/2011 9:44 AM
Status: Signed
Editor: Clark, Juliana Elizabeth (M.A.) (MEDICAL ASSISTANT)
Generated on 4/12/22 10:33 AM
000564
0563
| what is the visit date or date of visit? | {"text": ["2016/01/06"], "answer_start": [117]} |
id_1711477090.257395 | Kristi Smith |
Ochsner
Health
Melissa Jefferson
THIS IS NOT A BILL
3512 Toledano Street
NEW ORLEANS LA 7020
#829820). The following document contains the itemized services requested for Karen Marie Johnson (Guarantor
Coverage(s) on file:
Humana - Humana POS
Charges
Insurance Pmts/Adjs
Patient Payments
Patient Adjs
Total Balance
28,911.55
-20,136.12
-1,553.35
-3.42
7,218.66
Marie Johnson)
Emergency Visit to Ochsner Baptist - A Campus of Ochsner Medical Center (Acct#83000069720 for Karen
Service Svc Date Dates:08-03-2016, 2013 to 06-05-2021
Description
Charges
Qty
Amount
07/29/13
25000003
07/29/13
Morphine 2 Mg/MI Crtg 1 MI Syringe (0409-1762-30)
25000003
1
10.00
07/29/13
Sodium Chloride 0.9% 0.9 % Solp 1,000 MI Bag (0264-7800-00)
76705
1
10.00
Total Charges
2,667.43
Insurance Payments and Adjustments
04-05-2023
10226
Contractual Write-Off
04-05-2023 2000
1
-1,669.15
Insurance Payment
1
-424.48
Total Insurance Payments and Adjustments
-2,093.63
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475741.07266 | Jamie Contreras |
Jamie Contreras DOB: February 16, 1997 (81 yo M) Acc No. CR728935
[Doc Name: Othro One DOS January 31, 2023 - 5.20.22-]
4933 University Blvd W
Jacksonville, FL32216
ADVANCED
Upright Open MRI & X-Ray
DIAGNOSTIC GROUP
High Field MRI
Tampa
Brandon
Lakeland
Kissimmee
Orlando
Jacksonville
Orange Park
Palm Beach Gardens Jupiter
PATIENT MR#: 2352532
PATIENT ACCT#:
PATIENT NAME: Jamie Contreras
DATE OF BIRTH: February 16, 1997
REFERRING PHYSICIAN:
EXAMDATE: March 10, 2018
ACCESSION NUMBER: 7289367
EXAMDESCRIPTION MRI LEFT ANKLE
CLINICAL HISTORY: Slip and fall 01/19/2022, ankle and foot pain.
TECHNIQUE: Multisequential multiplanar imaging was performed of the left ankle
and hindfoot in a high-field MRI.
FINDINGS:
Abnormal marrow signal intensity in the lateral aspect of the calcaneus near the
plantar surface as well as along the dorsal surface of the navicular bone. More
significant abnormal signal intensity throughout the 2nd cuneiform bone, but
especially the dorsal surface with some irregularity of that surface.
IMPRESSION:
1.
Some abnormal marrow signal intensity in the lateral aspect of the calcaneus
and along the dorsal surface of the navicular bone appears to represent marrow
edema related to bone contusion without obvious fracture line. More significant
abnormal signal intensity in the 2nd cuneiform bone, especially along the dorsal
surface with some irregularity of that surface.
2.
Degenerative changes, as noted. No disruption of the major ligamentous or
tendinous structures including the Achilles tendon. No malalignment of the
tarsometatarsal joints.
Page 1 of 2
Jamie Contreras DOB: February 16, 1997 (81 yo M) Acc No. CR728935
Page 162 of 166
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711476768.348623 | Charles Tapia |
Page: 2 of 2
South Lakeland Chiropractic Center P.A
DBA: New Hope Chiropractic
4788 S. Florida Ave.
Lakeland, FL 33703
Grace Witter
Patient ID: 131986471
DOB: 10/10/97
Sex: F
Account No.:
Encounter ID: 28381570
Encounter Date: 09/04/16
Encounter Type: Office Visit
-- Hydro Bed therapy was done for 10 mins, full spinal to help reduce discomfort of muscle spasms.
Care Plan:
-- Follow up for care in 2-3 days.
-- Treatment recommendation of 3 chiropractic visits per week for 2 weeks, followed by a review to see
changes to the condition.
Patient Instructions:
-- Patient was advised to keep moving, avoiding periods of inactivity and to avoid bed rest.
-- General range of motion stretching should be conducted at least three times a day.
Patient should use ice 15 mins on and 15 mins off; as needed.
Electronically Signed] - Date: 10/09/18 3:47:19 PM
[Provider]: Ida Abraham, DC
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711476766.990003 | Joanne Gomez |
MPT I McLaughlin Physical Therapy
3120 20th St
Physical Therapy
Metairie, LA 70002xxxx
Initial
Phone: xxxxxxxxxxx
Fax: xxxxxxxxxxx
Examination
Patient Name: Zachary Morton
Date of Initial Examination: 2017 March 02
Date of Birth: 2003 December 22
Injury/Onset/Change of Status Date: 2015 November 18
Referring Physician(s): Pappas, Nick MD
Diagnosis: ICD10: M25.511: Pain in right shoulder
Surgery: (Date/Type) 2014 November 24 C Spine Fusion
Treatment Diagnosis: ICD10: M25.511: Pain in right
shoulder, M75.111 Incomplete rotator cuff tear or rupture of
right shoulder, not specified as traumatic
Subjective
Treatment Side: Right
History of Present Condition/Mechanism of Injury: Pt is a 61 year old female who presents to PT complaining of neck and
(R) shoulder pain 2 partial RC tear / bursitis with history of multi level C spine fusion.
Objective
Outcome Measurement Tools
Upper Extremity
Upper Extremity Quick DASH
65.91/100
Observation
Standing Posture Rounded Shoulders
Range of Motion
1 of 12
Powered by
WebPT
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475190.287105 | Tina Moore |
<<Back to Review>>194126-2 HYPERLINK- Hyperlink-Page
306
KAISER PERMANENTE庐
Tina Moore
MRN: 110804080880, Date of Birth: 03/87/09, Sex:
F
SSN: xxx-xx-3804
Date of Visit: 05/22/03
09/21/05 - Work Comp in OCC PHYSICAL THERAPY -STE 5038
Physical Medicine Notes
THERAPIST, PHYSICAL
Progress Notes by Lattupally, Shirisha (P.T.) at 1/3/2008 0952
Version 1 of 1
Author: Lattupally, Shirisha (P.T.)
Service:
Author Type: THERAPIST, PHYSICAL
Filed: 1/3/2008 9:52 AM
Date of Encounter: 28/16/12
Creation Time: 1/3/2008 9:52 AM
Status: Signed
Editor: Lattupally, Shirisha (P.T.) (THERAPIST, PHYSICAL)
PT visits: 7/8.
Injury Date: 10/17/11
Left knee contusion.
Generated on 4/12/22 10:33 AM
000306
0305
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711473365.593563 | Karla White |
Tow er Physical Therapy, Inc.
TOWER
1801 Colorado Ave, Suite 26 0
Turlock, CA 95782-0780
Phone: (278)216 -378 0
F ax: (209)278 -378 5
Discharge Note
Patient Name: Karla White (36 7 805)
Date of Discharge Note: 2016 March 02
Date of Birth: 1992 January 06
Injury/Onset Date: 2018 January 03
Physician Name: R. DE BOS, PA
Diagnosis: ICD10: S82.841D: Pancreatitis
Date of Last Eval: 05/09/2017
Visit No.: 11
Treatment Diagnosis: ICD10: S82.841D: Displaced
bimalleolar fracture of right lower leg, subsequent encounter for
closed fracture with routine healing
FOSTER, EDWARD has been discharged from our care for the following reasons:
Visits complete, D/C.
Chris Stempson, MPT, CSCS
License #25198
Document created on 2015 September 29 2:33 pm
000784
0784
1 of 1
Powered by
WebF,
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711473365.659593 | Alyssa Braun |
<<Back to Review>>187098-70-HYPERLINK- Hyperlink-Page
2
FEED
03/22/2018 09:43 AM
Work Wellness
1701 Colorado Ave Ste 170. Turlock CA 97082
Page 1 of 1
(270) 270-3703 Fax: (709)706-3700
Test Form
Test Form
patient: Alyssa Braun
BIRTH DATE: 01/11/2001
Age: 84 Years
Home Phone: (270) 709-3702
Sex: M
SSN: 570-70-0703
Order Number:
217070-4
Quantity:
1
Start Date:
21/01/2016
Priority:
Normal
Signature:
Carrie Janiski
Signed on:
17/06/2023 4:0:08AM
Instructions:
WITH STRESS VIEW(S)
thank you
Report run by Carrie Janiski DO
007002
0702
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475955.88151 | Teresa Lewis |
20/08/17 13:59 FROM- CWFMD
936-703-5455
T-240 P0073/0078 F-226
Page 1 or 2
Conroe Willis Family Medicine PLLC
Teresa Lewis
Order Date: 21/01/15
4015 145 North
14570 Trero Lane
Order #: PRO36382
Conroe, TX, 773045074
Willis, TX, 773784394
Person #: 744, MRN: 5211
Sex: F
DOB: 94/12/17
Ordering: Dubose PA-C, Joshua
Performing #: LabCorp
Location: Willis CWFM 1
Component
Result Units
Flag
Range
Comment
Result 1
No
growth
Urine Culture, Routine
Final
report
Urinalysis, Complete (Collection Date: 15/02/01 14:50. Status: Final)
Performed At: 01, LabCorp Houston
7207 North Gessner, Houston, TX, 770403143
Kyle, Eskue, MD, Phone: 7138568288
Component
Result Units
Flag
Range
Comment
Microscopic Examination
Microscopic Examination (Collection Date: 15/02/01 14:50, Status: Final
Performed At: 01, LabCorp Houston
7207 North Gessner, Houston, TX, 770403143
Kyle, Eskue, MD, Phone: 7138568288
Patient: Teresa Lewis, DOB: 94/12/17
| what is the DOB or date of birth? | {"text": ["94/12/17"], "answer_start": [308]} |
id_1711476990.10824 | Michelle Davis |
Toufan Razi M.D.
Pacific Pain
Qualified Medical Evaluator
Institute
Pain Management Specialist
MULTIDICIPLINARY INITIAL EVALUATION REPORT
FUNCTIONAL RESTORATION PROGRAM
Name: Robert White
Insurance: Gallagher Bassett
Claim#: 002406001366
DOB: February 28, 1985
DOI: September 16, 2023
DOS: April 06, 2015
INTRODUCTION: As part of Mr. Florentino Mejia multidisciplinary initial evaluation for
Functional Restoration Program, patient completed a comprehensive medical and psychological
evaluation on April 22, 2023. In a conference meeting at the Pacific Pain Institute Functional
Restoration Program the following providers met to determine patient candidacy for the
program: Dr. Toufan Razi and Adriana Flores LPCC. Baseline functional testing and reasonable
goals of treatment were established for this patient.
A. MEDICAL EVALUATION
HISTORY OF PRESENT ILLNESS: Mr. Florentino Mejia is a 28-year-old male who injured his low
back during the course of his usual and customary work as a cook. On the date of injury, patient
was carrying contained of soap and milk while walking downstairs. He slipped and fell, landing
on his buttocks and hitting his back on the steps. He did not lose consciousness, but he did feel
immediate pain in his low back.
Patient was sent to occupational therapy at North Bay Medical Center where he received initial
conservative treatment and completed diagnostic studies. He was placed on modified duty.
Patient received oral medications and physical therapy. Mr. Mejia continued his treatment
under Dr. Samuel Graves who provided chiropractic sessions.
Patient was evaluated by Dr. Vatche Cabayan, orthopedic surgeon on 1/29/2013 who did not
recommend surgery. Facer joint and epidural steroid injections were recommended.
Pacific Pain Institute Functional Restoration Program. Address: 2410 Merced St San Leondro CA 94577. Phone
number (510) xxx xxxx. Fax Number: (510) xxx xxxx.
718
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711477183.056174 | Justin Cardenas |
Toxicology & Compliance
Laboratory Report
Patient Name: James Ladner
Sample ID: LL222048A
Collected: 2021/04/12 8:05:41 AM
Patient DOB: 1984/03/11
Received: 2021/04/12
Requesting Physician: Erik Davis
Tested: 2019/27/11
Requesting Practice: Louisiana Pain Specialists
Reported: 2019/27/11
-
Illicit Substances Detected
Reported Prescriptions Detected
Substance
Test Outcome
Reported Prescription
Anticipated Positives
Test Outcome
- Non-Reported Prescriptions Detected
- Reported Prescriptions Not Detected
-
Illicit Substances Not Tested
- Reported Prescriptions Not Tested
Substance
Reported Prescription
Anticipated Positives
Test Outcome
Patient Name: James Ladner
Specimen ID: LL2220473 - Specimen Type: Urine
The perfomance characteristics of this test were determined by Louisiana Pain Specialists, LLC. It has not been cleared or approved
by the U.S. Food and Drug Administration.
Louisiana Pain Specialists, LLC 2736 Hessmer Ave Suite A Metairie, LA 70002
Lab Director: Stacy Zavala, PhD
CLIA ID#: 73D2119673
Page 1 of 73
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711475190.515619 | Erik Wright |
<<Back to Review>>194126-2 HYPERLINK-Hyperlink-Page
188
KAISER PERMANENTE庐
Erik Wright
MRN: 110404074088, dob: 25-06-1987, Sex:
F
SSN: xxx-xx-3404
VISIT: 20-09-2021
17-09-2015 - Work Comp in OCC PHYSICAL THERAPY -STE 5038
All Charges for This Encounter
Code
Description
Service Date
Service Provider
Modifiers
Qty
97014
APPLICATION MODALITY TO 1 OR MORE
13-06-2019
Lattupally, Shirisha (P.T.)
1
AREAS; E-STIM
Physical Medicine Notes
THERAPIST, PHYSICAL
Progress Notes by Lattupally, Shirisha (P.T.) at 9/25/2007 1010
Version 1 of 1
Author: Lattupally, Shirisha (P.T.)
Service: -
Author Type: THERAPIST, PHYSICAL
Filed: 9/25/2007 10:10 AM
Date of Encounter: 10-03-2016
Creation Time: 9/25/2007 10:10 AM
Date of Injury: 19-10-2021
Generated on 4/12/22 10:33 AM
000188
0187
| what is the DOB or date of birth? | {"text": ["25-06-1987"], "answer_start": [123]} |
id_1711471329.367048 | April Peterson |
20/05/23 18:5 PM EDT OneCallCareManagement via VSI-FAX
Page 1 of 2 #3417302 OI
796 Thompson Ridge Suite 861
Lake Williamview, GA 64474
351-688-5385
PASADENA, CA, 91101
629-466-4548
Oak Grove Hospital
Compassion, Confidence, Comfort
Patient
BIRTHDATE
MRN
April Peterson
15/03/86
29.8492103
AT THE REQUEST OF
AGE / SEX
service date
Dr Michael Mann MD
21 y/F
02/01/15
796 Thompson Ridge Suite 861
Lake Williamview, GA 64474
MRI RIGHT ELBOW
CLINICAL HISTORY
surgery in 2004. History of Thyroid in 1999. No surgery to the right elbow. Recent
physical therapy with some relief of symptoms. Requesting assessing for acuity of changes.
COMPARISON
None
TECHNIQUE
The MRI was performed on a GE High Field 1.5 Tesla Signa Infinity Excite.
FINDINGS
Tendons: There is slight thickening and minor edema to the common extensor tendon, a full-thickness
IMPRESSION
FINDINGS FOR LATERAL EPICONDYLITIS, AGE OF CHANGES ARE UNKNOWN. NO
FULL-THICKNESS TEAR.
OTHERWISE NORMAL MRI RIGHT ELBOW.
PASADENA
April Peterson 84921033
Page 8 of 2
1291
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711471329.739197 | Benjamin Young |
03/2022/14 3:24 TEXAS_MRI (FAX)46956041097 P.002/003
Mountain View Medical
Patient Name: Benjamin Young EXAM DATE: 08/2016/01 12:15 PM
date of birth: 03/1996/25 Age 39 Physician: Dr Mary Raymond
Evaluation Date:11/2014/29
MRN: TXCS39989 Exam: LUMBAR SPINE wo
MRI LUMBAR SPINE WITHOUT CONTRAST
INDICATION: MVA. Low back pain.
COMPARISON: None.
TECHNIQUE: Multiplanar multisequence images were obtained through the lumbar spine without administration of Intravenous contrast.
FINDINGS:
SPINAL CORD: The conus medullaris and nerve roots are normal with conus terminating at the T12-L1 level.
IMPRESSION:
1. L4-L5 posterior left subarticular/foraminal 3.8 mm disc protrusion-subligamentous disc / herniation Impinges on the descending left L5 nerve root in the lateral recess.
Associated severe left neural foraminal stenosis.
2. Severe foraminal stenosis with left L4 nerve root impingement In the foraminal space.
page of 2 73797-11 BCS Medical - 00022
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475189.940907 | Joanna Alexander |
NOVANT
Novant Health North Point
Joanna Alexander
N
Medical Associates
MRN: 51024107, D.O.B: 15-01-1995, Sex: M
HEALTH
1105 Bethabara Road
visit: 20-09-2018
Winston-Salem NC 27106-3105
03-11-2021 - Office Visit in Novant Health North Point Medical Associates (continued)
Clinical Notes Amb
Progress Notes
Dr Hayden Foster, MD at 4/7/2023 1934
Author: Dr Hayden Foster, MD
Service:
Author Type: Physician
Filed: 04/07/23 1954
Date of Encounter: 19-01-2019
Status: Signed
Editor: Dr Hayden Foster, MD (Physician)
PLAN:
Patient Instructions
Apply ice as needed over the swollen tender area.
Follow up if symptoms worsen or fail to improve.
Generated on 4/11/23 8:32 PM
Page 4
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711471328.947572 | Rickey Smith |
Patient: Rickey Smith
MRN: 51998103290(CSB): 51998103290(SBM)
birth date: 1990 Jul 30
FIN: 80956453801
Auth (Verified)
*
Valley View Hospital
PATIENT DATA
DATE
ACCOUNT
MRN
ROOM#
2023 Jul 29
8095645381
51998103290
Room 1
ACCESSION
EMPI
Admitting Date
ACCHF002459
2020 Jan 03
Patient
SSN#
RACE
Rickey Smith
Black
ADDRESS 1
CITY
STATE
518 Robinson Spur
Port Jeffrey, VA 07432
birth date
AGE
1990 Jul 30
76
PROCEDURE
STAFF
Left Heart Catheterization
Dr Robin Krueger MD
Physician
Coronary Angiography - Selective
Ingle, Genesis RN
Scrub
Left Ventriculography
Pierce, Kristopher RN
Circulate
Occlusive Device, Art/Vein G0269
Camarillo, Melissa RT
Recorder
Dr Kevin Williams MD
Fellow Physician
Rickey Smith
M# 3800369833
birth date:1990 Jul 30
D.O.S:2017 Jul 14
Age: 76Y Sex: M
LOC: MSG
*CARDIAC
A# 80008942601
Rickey Smith: 51998103290, birth date: 1990 Jul 30
Printed On 2023 Jul 29:14:65:09
Attending: {Doctor Name} MD
CaseID HF002459
Valley View Hospital
Xper.IM. Philips
Facility SBMC
Page 194 of 379
101
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711476990.372346 | Stephanie Wu |
University of Oklahoma
October 27, 2023
830 NE 15th Street Suite 205 Oklahoma City, OK 73304
Page 30
4052714630 Fax: 4052711330
Radiology Reports
Frederick Parker
Male DOB: 27 October 1998
2708046
Ins: BLUE CRO (22) Grp: 116430
(1) Order result status: Final
Collection or observation date-time: 25 January 2021 12:06
Requested date-time: 04/19/2017 09:45
Receipt date-time:
Reported date-time:
Referring Physician: Adam Asch
Ordering Physician: (AASCH)
Specimen Source:
Source: HCA RAD
Filler Order Number: - PET/CT TUM SKUL BS
Lab site:
The following tests had no related values for dispersal to the flowsheet:
- PET/CT TUM SKUL BS MIDTHIGH, [No Value Reported], (R)
Electronically Signed by Allie Bond PA-C on 06 September 2022 at 9:24 AM
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711476990.697583 | Brent Sanders |
16/16/04, 11:51 AM
Print Preview
Mrs. Karen Bush DOB: 22/91/09 (64 yo F) Acc No. 28935 DOS: 16/22/08
REFERRAL TO ALTERNATIVE/PRIMARY CARE PROVIDER:
Referral to doctor
Care goal follow-up plan:
Above Normal BMI Follow-up Lifestyle education regarding diet
BMI management provided Yes
Procedure Codes
94645 NEB/MDI DEMO, Modifiers: 45
Follow Up
4 Months
Mts Nuste MD
Electronically signed by Janice Collins, MD on 02/23/11 at
11:51 AM EDT
Sign off status: Completed
SUITE 204
TAMPA, FL 336136545
Tel: 813xxxxxxx
Fax: 813xxxxxxx
Progress Note: Michael Newton MD PA 09/25/2023
Note generated by eChnicalWorks EMR/PM Software (www.ClnicalWorks.com)
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475741.04727 | Margaret Stevens |
Margaret Stevens DOB: 1985-03-28 (20 yo M) Acc No. CR162734
[Doc Name: 2022-04-10 MRI LUMBAR SPINE]
4933 University Blvd W
Jacksonville, FL32216
ADVANCED
Upright Open MRI & X-Ray
DIAGNOSTIC GROUP
High Field MRI
Tampa . Brandon . Lakeland . Kissimmee . Orlando . Jacksonville . Orange Park . Palm Beach Gardens - Jupiter
PATIENT NAME: Margaret Stevens
PATIENT ID: 8283873
REFERRING PHYSICIAN: AMY WU, PA-C
DOB:
1985-03-28
REFERRING PHONE:
DOS:
2021-06-19
REFERRING FAX:
EXAMINATION: MRI LUMBAR SPINE WITHOUT CONTRAST
GEORGE VEGA, MD
Electronically signed on: 2019-11-26 9:10:40 AM
Transcribed by: JN on: 2019-11-26 7:12:17 AM
L3-51
Page 2 of 2
Margaret Stevens DOB: 1985-03-28 (20 yo M) Acc No. CR162734
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711472591.264131 | Aaron Myers |
TN
SimonMed鈩
See Tomorrow Today
patient name:
Aaron Myers
Accession Number:
31251037
Patient ID:
1899497
Location:
SimonMed Northern CA Monterey
Gender:
Female
Date of Examination:
Jan 02, 2019 0:12 Exam Date min_range
DATE OF BIRTH:
Nov 22, 1997
Modality:
MR
Referring Physician: Dr Paul Weber
Report Status:
Final
Report exported on Tue, Jun 7, 2022 13:00:41 -0490 - Page 2 of 3
312
GB IA Recv 2049049414928
Received 06/24/2022
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475190.258451 | Joshua Hamilton |
NH
NOVANT
Novant Health Urology
Joshua Hamilton
2460 Baldwin Lane
MRN: 54624467, BIRTH DATE: Mar 11, 1996, Sex: M
HEALTH
Winston-Salem NC 27463-5466
Visit Day: Sep 06, 2021
Oct 22, 2018 - Office Visit in Novant Health Urology - Baldwin (continued)
Clinical Notes Amb (continued)
Radiologic/Medical Testing Data Reviewed
I have independently visualized the images and found: testicular US 10/22/21:
Latest known visit with results is:
Office Visit on Oct 22, 2018
Component
Date
Value
Ref Range
Status
Cholesterol, Total
08/01/2022
191
100 - 199 mg/dL
Final
Triglycerides
08/01/2022
147
0 - 149 mg/dL
Final
Generated on 4/11/23 8:33 PM
Page 312
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711473530.465719 | Christopher Reed |
KNMH CT SCAN
Christopher Reed
180 W Esplanade Ave
MRN: 8312838, DATE OF BIRTH: Apr 16, 1995, Sex: M
Kenner LA 70065
Acct #: 81203126121
Enc. Date Oct 05, 2016
08/25/2022 - Appointment in Kenner - Diagnostic Ctr
Diagnoses
None.
Non-Hospital Problems as of 8/25/2022
Reviewed: Sep 12, 2017 by Jessica Harvey, PA-C
None
ED Care Timeline
No data selected in time range
Drug Use as of 8/25/2022
Drug Use
Types
Frequency
Comments
Source
Generated on 10/3/22 11:37 AM
Page 1
| What is the Date of Encounter or Enc? | {"text": ["Oct 05, 2016"], "answer_start": [162]} |
id_1711477183.270379 | Alyssa Smith |
2017-11-04 3:39 PM
IDS FaxServer
15133242013
pg 2 of 13
DIS
D.I.S. Slidell
DIAGNOSTIC IMAGING SERVICES
Patient Name:
Tracy Frazier
Ref. Physician:
Rommel S Dhadha MD
Patient ID: 425713
Home Phone: (985) 817xxxxx
Date of Birth: 1993-05-09
Page 1 of 1
Date of Service: 2024-09-02
STUDY
X-ray, Lumbosacral, Minimum 4 Views
CLINICAL INDICATION
Back pain
COMPARISON
No relevant imaging examinations are available for review.
PROCEDURE DETAILS
AP, lateral, both oblique, and spot lumbosacral views were acquired.
FINDINGS
The vertebral body heights and disc spaces are well maintained. Alignment is anatomic without
spondylolisthesis or spondylolysis. SI joints of sclerotic changes more prominent on the right than
left. The bony mineralization is appropriate.
There is a 4.8 mm calculus seen in the lower pole region of the right kidney.
IMPRESSION
1. No significant spondylosis or acute findings involving the lumbosacral spine.
Electronically Signed: Silvestri, James, M.D. on 2017-14-05, 02:39 PM
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476578.337522 | David Wells |
Patient: Cheryl Torres DOB: Jul 09, 2002
Jun 14, 2023 10:24 AM
Print Preview
Cheryl Torres DOB: Jul 09, 2002 (45 yo F) Acc No. 758814 DOS: Nov 13, 2019
Owens, Shannon
CanoHealth
46 Y old Female, DOB: Jul 09, 2002
Account Number:758146
HOLLYWOOD HL-22140-3814
Home: xxx-148-3414
Cuarantor: Owens, Siminon Insurance: Humana Medicaid CAP
Appointment Facility: ou-Places University
Structured Liatn: Lines patient need transportation :No
May 27, 2015
Progress Note: VICKYRIVAS-OROZ0O MD
for Appointment
i. PRE-OP CLEARANCE
Assessments
1. Pre-op evaluation as 201.818
Treatment
1. Pre-on evaluation
LAB:CBC With Differential/Platelet (Ordered for 07/07/2022)
07/07/2022
Clinical Notes: FU studies
FU ENT.
2. Deviated septum
Clinical Notes: FU ENT.
Follow Up
2 Weeks,prn (Reason: FU AFTER SURGERY)
History of Present illness
45 yo patient here for
Pre-OP
Surgery: septoplast, submucosal of the inferior turbinate
Indication: Deviated Septum
Surgeon: Dr. Rebecca Butler
Date: Jun 14, 2023
Prior Surgeries: no issues with anesthesia
Examination
-Exam:
Progress Notes VICKY MD 07/07/2028
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711476990.783905 | Paul Clark |
Tampa Bay
Pulmonary
Medicine, P.A.
Jonathan Miller, M.D., F.A.C.P., F.C.C.P
Hannah Pugh, M.D., F.C.C.P.
402 Noland Drive
Brandon, FL 33511xxxxx
Ph: 813-xxxxxxx Fax: xxxxxxx
SWANN, USA
DOB: 92/01/07
DOS: 17/04/10
SPIROMETRY TEST RESULTS:
Spirometry reveals a reduction in FVC at 59% or 1.85L and FEV1 at 63% or 1.55L No bronchodilator
response is noted.
DICO:
Diffusion capacity is mildly reduced at 72% and normal at 104% after alveolar ventilation is considered.
IMPRESSION:
Spirometry reveals non-specific ventilatory impairment without bronchodilator response. Flow volume
loop suggests a restrictive impairment. DLCO is normal after correction for alveolar volume.
Thank you for allowing me to assist with the care of this patient.
Sincerely yours,
Dr Denise Taylor M.D., F.A.C.P., F.C.C.P.
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711473366.091307 | Lisa Williams |
athena
10/30/2023 1:33:13 pm EDT
Page: 55/86
Lisa Williams (id #16346392, dob: 06/2001/18)
Baptist Health
Health Information Management Dept
Lisa Williams
3563 Philips Highway Building B. Suite 201
MRN: 56354630 dob: 06/2001/18, Sex: F
Jacksonville FL 32207-5663
Acct #: 24001074438
Adm: 03/2021/08 D/C: 04/2021/07
07/15/2023 - ED in Baptist Clay Emergency (continued)
Medical Decision Making:
75-year-old female with seizure today.
EKG:
DATE OF ENCOUNTER: 12/2020/15
Confirmed by Arcement, Adam (912) on
Radiology:
head we IV contrast.
Final Result
CT HEAD WITHOUT IV CONTRAST
Date of Exam: 05/2015/23 6:3 AM CD
Printed on 7/27/23 at 8:20 AM
Release ID: 28635632
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711472787.210904 | James Mcdonald |
Date Visit: 25/11/2019
Page 2 of 2
Name:James Mcdonald
birthdate:17/12/1989
Cardiovascular: chest discomfort.
Constitutional review of systems are normal except as noted in HPI.
Vitals
Vitals - PULM
Recorded: 15Sep2022
12:17PM
Systolic
128
Diastolic
76
Physical Exam
Constitutional: no acute distress
Procedure
CXR: small left apical ptx and possible small LLL ptx as well? no focal consolidation or pleural effusions, cardiac silhouette appears
normal.
Assessment
Pneumothorax, left (512.89) (J93.9)
Plan
Cough
Xray Chest 2 Views PA/Lat; Status:Active; Requested for:15Sep2022;
Signature : Dr Dr. Christopher Anderson, MD; 24/10/2015 8:32PM EST (Author
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475955.911749 | Chase Davis |
19 Feb 2020 14:35 FROM-
CWFMD
936-703-5455
T-242 P0066/0075 F-228
01 Apr 2023 10:59:26
2
/3
Walgreens
PLEASE INITIAL AND DATE ALL CHANGES
Diabetic Detailed Written Order
Fax form with prescriber's signature & date to 1-866-855-5888 (toll free fax)
1. Date of Order: 19 Apr 2021
2. Patient Name: Chase Davis
Address: 14570 TRERO LN
City: WILLIS
State: TX
Zip: 77378-4394
Gender: FEMALE
Birth Date: 11 Dec 1991
3. Primary ICD-10 Diabetes Diagnosis:
R73,9
Diabetic Type:
4. Diabetes Testing Supplies - Must Check
5. Testing Frequency
10. Prescriber Name: JOSHUA DUBOSE
NPI: 1700997665
PLEASE
Address: 804 W MONTGOMERY ST
INITIAL AND
City: WILLIS
State: TX
Zip: 77378-8830
DATE ALL
CHANGES
Prescriber Signatures
Date:
27 Mar 2018
(Handwritten Signature and Date Required)
Fax Form To: 1 866 855-5888 or mail original form to: Walgreens Medicare Processing, P.O. Box 4000 Danv眉le, IL 61834-4000
Questions? Contact the Walgreens Medicare Part B documentation department at: 1-888-281-0590 between the hours of 8:00-4:30 CST
Please note that this document does not constitute the patient's Medical record. If this claim is audited by Medicare you could be required
to provide additional documentation.
C0011041536
Name: Chase Davis
DOB: 11 Dec 1991
Date:
| what is the visit date or date of visit? | {"text": [], "answer_start": []} |
id_1711477182.964615 | Regina Yates |
LOUISIANA PAIN
SPECIALISTS
PAIN DIAGNOSIS & INTISIVENTIONSXPE)
Kenner 231 West Esplanade Avenue, Suite B, Kenner, LA 70038
LABORATORY RESULT
PATIENT DEMOGRAPHICS
GUARANTOR & INSURANCE INFORMATION
Patient: Catherine English
Insurance:VA CCN OPTUM
DOB: 30-07-1992 Age: 38 year Sex: Male
Guarantor: Catherine English
Address: 4191 1ST AVE Bay Saint Louis MS 39538
Phone:
LAB VENDOR DETAILS
ORDERING DETAILS
Lab Name: LPS Lab
Ordering Physician Name: Suneil Jolly MD
Address: 3434 Houma Blvd Suite 301 Metairie LA 70386 -
Order#: LAB003992 Order Date: 01-03-2016
0000
Result Date: 25-06-2021
Sr.No.
Test Name
Result
Unit
Min-Max
Abn-Type
Urine Drug Screen
1
Panel
2
Methamphetamine
neg
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475444.553429 | Heather Walters |
02/14/09 FROM- CWFMD
T-252 P0024/0063 F-236
DISCHARGE INSTRUCTIONS
Heather Walters
BH9026517790/BH00288051
For Patients Who Smoke
You should quit. It is the most important thing you can do for your health.
Here are other FREE resources you can use.
The American Cancer Society:
1-800-227-2345
The American Lung Association:
1-800-548-8252
Internet site:
http://smokefree.gov
DISCHARGE MEDICATIONS
Please refer to the discharge medication list provided by the nurse at the time of
discharge. Please be sure to take this list with you to your next physician office
visit.
I understand that a copy of my home medication list as well as the medications I received
during this hospital stay will be provided to my next health care provider.
HCA Houston Conroe
Name :
PRICE,ERICA NICOLE
Acct #: BH39094362699
Room/Bed: B.265/1
Unit #: BH00288051
DATE OF ADMIT: 23/18/04
Admit Physician: Punsalan, Tricia Leonora
Name: Heather Walters
DOB: 17/98/12
Date:
| what is the admit date or admission date? | {"text": ["23/18/04"], "answer_start": [912]} |
id_1711475620.934453 | Lauren Wilson |
DocuSign Envelope ID: 2EBB7621-EDFE-47BB-
C6C3A2DDDA86
ASSOCIATES MD
MEDICAL GROUP
ASSOCIATESMD MEDICAL GROUP
PATIENT CONSENT AND AUTHORIZATION
Lauren Wilson
I,
FURTHER ACKNOWLEDGE THAT IN THE EVENT ASSOCIATESMD MEDICAL GROUP IS FORCED TO RETAIN THE
SERVICES OF A COLLECTION AGENCY AND/OR ATTORNEY; I WILL BE RESPONSIBLE FOR THE COLLECTION AND/OR LEGAL FEES. I HEREBY
AUTHORIZE THE DOCTOR TO RELEASE MEDICAL INFORMATION TO MY INSURANCE COMPANY TO SECURE PAYMENT OF BENEFIT. I ALSO
AUTHORIZE THE USE OF MY SIGNATURE ON ALL INSURANCE SUBMISSIONS AND AS AUTHORIZATION FOR PAYMENT TO BE SENT TO
ASSOCIATESMD MEDICAL GROUP AT 4780 SW 64th Ave Davie, FL 33314.
Consent to Contact. 1 hereby expressly consent to being contacted by mobile phone or mobile text messaging for the purpose of receiving
Information or advice about my health care, about any services officered, changes in policies, procedures, or office hours, or any other purpose
as determined by AssociatesMD Medical Group. Data messaging charges may apply.
Receipt of Notice of Privacy Practices.
Lauren Wilson
I,
have received a copy of AssociatesMD Medical Group's Notice of Privacy Practices.
The physicians and staff of AssociatesMD Medical Group have my permission to speak to the following family members/friends in reference to
my medical care:
Name:
Lauren Wilson
Relationship to Patient Son
Name:
John Arthur Romney
Relationship to Patient Best Friend
Name:
Nelson A oti
Relationship to Patient Best friend
The Physicians and staff at AssociatesMD Medical Group have my permission to leave a message on my answering machine.
Yes
No, and/or call at my place of work:
Yes
No
DocuSigned by:
Phile
2019 March 10
Signature of responsible party
Date
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711475956.108 | William Kerr |
OrthoSC . 210 Village Center Blvd., MYRTLE BEACH SC 29579-6706
William Kerr (id #74640, dob: 1992 Mar 10)
Order Groups
Order Group Summaries
1. Cervical radiculitis
M54.12: Radiculopathy, cervical region
EPIDURAL STEROID INJECTION, CERVICAL (PROC) Order SUBMITTED (no result received) - Send To: PAIN-CF Note to
Provider: 62321, J0702 X 4, A4550
Location: C6-7 Midline
Date of surgery/procedure: 2020 Sep 13
Place of service: OFFICE
Procedure Orders
Pre-Op Orders
2017 Jan 16
From Provider
Place of Surgery
Pain-CF
PAIN-CF
210 Village Center Blvd Suite 150
MYRTLE BEACH, SC 29579-6706
210 VILLAGE CENTER BLVD SUITE 150
Phone: 843-353-3460
MYRTLE BEACH, SC 29579-6706
Fax: 843-353-3461
Phone: 843-353-3460
Ordering Provider: SCOTT SAUER, DO
Fax: 843-353-3461
Patient Information
Patient Name
William Kerr
Sex
F
DOB
1992 Mar 10
Age
25yo
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711471330.615952 | Catherine Hicks |
Patient Name: Catherine Hicks
Encounter Date: 21 Apr 2023 1:01PM MRN: 450-045-787
The patient was guided through neuromuscular reeducation exercises one on one with the physical therapist and/or student physical
therapist. The neuromuscular reeducation included exercises to improve movement, balance, coordination,
kinesthetic sense, posture, and proprioception. The neuromuscular reeducation exercises were instructed
to be performed in a pain free manner. The time of neuromuscular reeducation includes preparation of each
activity, patient education and training of each task, performance of the exercise, and post-assessment of
patient's performance.
Visit Type: Progress Note
Procedure Charges:
Therapeutic Exercises: 1 units 57 minutes
Therapeutic Activities: 1 units 57 minutes
Signatures
Signature : Michael Landry, PT; Dec 12
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711473530.490734 | Rachel Sims |
KNMH CT SCAN
Rachel Sims
180 W Esplanade Ave
MRN: 8138138, dob: 22/95/06, Sex: M
Kenner LA 71365
Acct #: 81303136131
Enc. Date 09/22/04
08/25/2022 - Appointment in Kenner - Diagnostic Ctr (continued)
Outpatient Medications at Start of Encounter as of 8/25/2022
Disp
Refills
Start
End
gabapentin (NEURONTIN) 300 MG capsule
Sig - Route: Take 900 mg by mouth 3 (three) times daily. - Oral
Class: Historical Med
Lab and Imaging Orders
CT Cervical Spine Without Contrast
Electronically signed by: Dayna G. Toscano, NP on 04/19/10 1009
Status: Completed
Ordering user: Dayna G. Toscano, NP 08/25/22 1009
Ordering provider: Dayna G. Toscano, NP
Authorized by: Dayna G. Toscano, NP
Ordering mode: Standard
Ordered during: ED on 13/19/02
Indications of use: Neck trauma (Age >= 65y)
Result
CT Cervical Spine Without Contrast (Order
413901330)
Generated on 10/3/22 11:37 AM
Page 2
| What is Ordered Date? | {"text": ["13/19/02"], "answer_start": [773]} |
id_1711471329.8235 | Cole Ward |
21/03/30 2:31 PM
507-694-8452
90817380218
pg 1 of 8
Patient Face Sheet
21/03/30
Patient Chart #:
0007572
dob:
84/10/20 Age: 47
Patient:
Cole Ward
Sex:
female
Address:
235 Jennings Roads
West Michellestad, NV 77302
SSN:
Marital Status:
Phone:
(206) 460-4381
SOF:
Cell:
Assigned Provider:
Employer Name:
Address:
Phone:
Case Information
Ins Co #:
10020
Insured Name:
Insurance 1:
Sedgwick CMS - 14452
Address:
235 Jennings Roads
West Michellestad, NV 77302
Address:
P.O.Box 14452
Lynnwood
Lexington
Phone:
(206) 460-4381
Phone:
dob:
84/10/20 Sex: F
Effective:
05-21-19
Policy #:
SL71230
End Date:
Group #:
9-26-2019
301908173802181
5220190577211976
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711472787.124691 | Vanessa Riley |
OrthoVirginia
MRN: 8717545 Name: Vanessa Riley date of birth: 2003 Sep 07
1920 Ballenger Avenue
Suite 200
Alexandria VA 22484-6488
2018 Aug 16 - Office Visit in OV Reston Suite 400 (continued)
Clinical Notes (continued)
Consent given by: patient
Site marked: site marked
Orders Placed This Encounter
Large Joint Arthrocentesis
Large Joint Arthrocentesis
Return if symptoms worsen or fail to improve.
I, THOMAS KLEIN, MD, personally, performed the services described in this documentation, as scribed in my
presence, and it is both accurate and complete.
Scribed by: Shivani Rampuria
Electronically signed by Rampuria, Shivani at 2020 Dec 07 2:50 PM
Electronically signed by Dr Leah Coleman, MD at 2020 Dec 07 2:55 PM
Labs
No documentation.
Procedures
Large Joint Arthrocentesis: R subacromial bursa (Final result)
Electronically signed by: Rampuria, Shivani on 07/17/23 1448
Printed on 9/25/23 12:33 PM
Page 3
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711471330.511489 | Jordan Leon |
08/05/10 08:21 AM Downtown Medical Center via VSI-FAX
Downtown Medical Center
FINAL REPORT
709 Amanda Cape Apt. 189
Jackview, AZ 00782
DISCHARGE SUMMARY
patient name=Jordan Leon
Acct #=1{Random_7_digit_number}
MRUN=57-42-95
D.O.B= 08-20-1992
Admission Date-05-04-2022
Loc/Svc=/OBSV
discharge day=06-03-2022
ADMITTING DIAGNOSIS:
Lung Cancer.
DISCHARGE DIAGNOSIS:
Pancreatitis.
HOSPITAL COURSE:
The patient was admitted or July 28, 2010, after having left upper
quadrant pain and constipation. However, she had had a recent bowel
movement that just was not normal; it was more difficult for her.
DISCHARGE MEDICATIONS:
1. Ibuprofen one tablet by mouth daily.
2. Vitamin D 1000 international units one tablet by mouth daily.
patient name: Jordan Leon
DOB_question: 08-20-1992
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711473365.492387 | Tamara Dawson |
<<Back to Review>>180298-26-HYPERLINK-Hyperlink-Page
167
TOWER PHYSICAL THERAPY, INC.
patient name: Tamara Dawson
Address 700 FLOWER ST
City TURLOCK Zip Code 93480
Birthdate 2003/21/09
Social Security Number 534-34-0343
Sex: M F
Primary Phone (234)341-3340
Email: (for appointment reminders) EF5767@LIVE.COM
Employer SUNNYSIDE FARMS DAIRY
Occupation PACKAGING OPERATOR
Work Phone: 634-3347
Emergency Contact CINDY FOSTER
Phone (234)234-5344 Relation SPOUSE
ASSIGNMENT OF BENEFITS
Authorization for treatment is hereby given to Tower Physical Therapy, Inc. I assign them all payments for
medical services rendered.
X Ed Foster
2022/30/08
Patient or Guardian Signature
Today's Date
CONTINUE ON BACK
000167
0167
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711475444.234611 | Susan Collins |
07-18- 23 16:39 FROM- CWFMD
936-703-5455
T-252 P0029/0063 F-236
Josh
FAX: Y Laningham, Rodney Jason M 936-890-8009
Campus: o
St: DEP
Patient name: Susan Collins
Unit No: BH33817421
EXAMS:
CPT CODE:
023381742 DXA BONE DENSITY AXIAL
29615
HISTORY: Screening, at risk for osteoporosis
Location code: T18
EXAM: DEXA bone densitometry.
COMPARISON: 02/08/2014
TECHNIQUE: DEXA bone densitometry was performed using the GE bone
densitometer
FINDINGS:
PROXIMAL FEMURS: average bone mineral density 0.754 gm/cm2 with
T-score of -2.0; average T score in the femoral necks is -1.2
LUMBAR SPINE: average bone mineral density 0.945 gm/cm2 with T-score
of -2.0
Change since prior study:
Proximal femurs (unavailable)
Lumbar spine -13.8%
IMPRESSION: Bone mineral density is in the range of osteopenia.
Fracture risk is moderate. Since prior study, bone mineral density
in lumbar spine has decreased.
World Health Organization criteria:
Normal: T-score at or above -1.0 standard deviation
Osteopenia: T-score between -1.0 and -2.5
Osteoporosis: T-score at or below -2.5
Conroe Regional Med Ctr. Outpt
NAME: Susan Collins
MEDICAL IMAGING DEPARTMENT
PHYS: LANRO - Laningham, Rodney Jason
504 MEDICAL CENTER BLVD
DOB: 08/05/1971 AGE: 46
SEX: F
CONROE, TEXAS 77304
ACCT NO: BH9023724104 LOC: B.BDC
EXAM DATE: 29/04/2017 STATUS: DEP CLI
FAX #: 936-539-7681
RAD NO:
DC Dt:
PAGE 1
(CONTINUED)
Name: Susan Collins
DOB: 30/06/2000
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475444.729283 | Karen Best |
09-23-2014 FROM- CWFMD
936-703-5455
T-252 P0053/0063 F-236
Methodist Server P11 12-21-2022 4:53:01 PM ACST PAGE
2/002
Fax
Server
HOOSTON'
XR HIPS BILATERAL AP LATERAL W AP PELVIS
Methodist
LEADING MEDICINE
Karen Best
MRN: 108987192, Legal Sex Female, 01-27-1989 (51 yrs), Outpatient
Accession #: IM31732011
Final Result
Appointment Info
EXAMINATION: XR HIPS BILATERAL AP LATERAL W AP PELVIS
Exam Date
02-09-2022
INDICATION: M25.552 Pain in left hip, M25.511 Pain in
right shoulder, M25,552 M25. 51
Department
COMPARISON: None
111-111-1111
4015 I-45 NORTH SUITE 120
IMPRESSION:
CONROE TX 77304-5076
No visible fracture or dislocation.
Reason for Exam
No significant joint space narrowing of the right or
M25.552 M25.51
left hips.
Bone island of the left femoral neck.
Diagnoses
Left hip pain
1SB1RAD_PS01
Right shoulder pain, unspecified
Signed by Trakhtenbroit, Michael Alan, MD on 11-30-2021 4:18 PM
chronicity
00
Karen Best MRN: 108987192 ACC: IM31732011 XR Hips Bilateral Ap Lateral W Ap Pelvis
Page 1 of 1
:
Name: Karen Best
DOB: 01-27-1989
Date:
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711476578.515024 | Craig Rhodes |
Patient: Scott Smith DOB:2000 January 28
Scott Smith DOB: 2000 January 28 (46 yo F) Acc No. 7588xx
YM
AKUMIN
Akumin Pembroke Pines
Phone: (954) 566xxx
10950 Pines Blvd
Fax: (954) 430xxx
Pembroke Pines, FL 330xx
Website: akumin.com
Thank you for referring your patient to Akumin Pembroke Pines
Dr Charles Gross, M.D
Electronically Signed: 2014 October 10
Exam requested by: JAIME ARANGO CIFUENTES MD
BIRADS: BI-RADS 2
The information contained in this facsimile message is privileged and confidential information intended only for the use of the individual or entity named as recipient. If
the reader is not the intended recipient, be hereby notified that any dissemination, distribution or copy of this communication is strictly prohibited.
Thank you!
Printed 2018 August 20 310 PM
Scott Smith (Exam: 2017 June 02 1:15 PM)
Page 26 of 26
Scott Smith DOB: Nov 17, 1976 (46 yo F) Acc No. 7588xx
Page 126 of 126
Document: 2018 August 20 Records
Printed: 2018 August 20 12:22:11
Page 126 of 126
| What is signature date or signed on date? | {"text": ["2014 October 10"], "answer_start": [370]} |
id_1711476990.756045 | Brianna Williams |
10 Apr 2019 12:10 PM FROM: Fax PULMONARY AND SLEEP SPECIALISTS OF TAMPA BAY, PA PAGE: 017 OF 119 Dec 2021
Patient: Wendy Riggs DOB: 18 Aug 1995
CT Chest PE W Contrast
Wendy Riggs - 479619 Dec 2021
* Final Report *
Result Type:
CT Chest PE W Contrast
Date:
March 05, 2019 19:00 EST
Result Status:
Auth (Verified)
Result Title:
CT Chest PE W Contrast
Performed By:
LUXENBERG MD, NINA LYNN on March 05, 2019 19:15 US/Eastern
Verified By:
LUXENBERG MD, NINA LYNN on March 05, 2019 19:15 US/Eastern
Encounter info:
7864859, TAM, Observation, 03/05/2019 - 03/06/2019
* Final Report *
Reason For Exam
sob, positive d dimer
REPORT
Exam: CTA chest.
Date of Exam: 20 Sep 2015 6:50 PM
Indication: SOB, POSITIVE D DIMER.
Comparison: X-ray 10 Apr 2019
Technique:
IV bolus CTA chest was performed following the administration of intravenous contrast 100
mL of Isovue 370. Chest was imaged with spiral technique followed by postprocessing with
sagittal and coronal 3D/MIPS. There was adequate opacification of the pulmonary arterial
system.
Radiometrics dose report: Up-to-date CT equipment and radiation dose reduction techniques
were employed. CTDIvol: 18.7 mGy. DLP: 610 mGy-cm.
Findings:
No intraluminal filling defects are seen in the visualized opacified pulmonary vasculature
to suggest acute pulmonary thromboembolism The main pulmonary artery is not dilated.
Thoracic aorta is nonaneurysmal and there is no evidence of dissection. No pericardial
effusion or thickening. Heart is not enlarged. No pneumothorax.
Printed by:
ROMERO, LEA M
Page 1 of2
Printed on:
19 Dec 2021 14:17 EDT
Document: 19 Dec 2021
Page 16 of 147
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711471329.454675 | Julia Parker |
Patient name
Unit #
Service/Location
Date
Status
Account #
Julia Parker
H24626417032
EMERGENCY ROOM A
2021-03-08
DEP ER H00112738933
dob
Age
Sex MS Race Religion
Not Employed
xxx-xx-7234
1997-09-19 67
Address: 6516 Chad Ridges Suite 319
West Ashleyville, MT 89405
Language: ENG
XX 00000
County: MART
work Ph: 999-999-9999
OCCP: N
Home Phone: 564-438-2526
Cell Phone:
Country: USA
SUARAIOR EMPLOTER
Julia Parker
SS#: xxx-xx-7234 Rel/Pt: SELF
NOT EMPLOYED
Address:
WOT k. 999-999-9999
dob 1997-09-19
XX 00000
Occp: N
FCI99
Ins # 1 MCDPNDHCA
03831
Policy # 999999999
Auth Reqd-N Auth Date:
MEDICAID FL PENDING HCA
Insured Julia ParkerJulia Parker
Date
Work related accident?
11 ONSET OF SYMPTOMS ILLNESS
2021-03-08
Date injury/illness
Time:
Adm Priority: EM
Non-work related accident? NO
Senior Friend?
Date of accident:
Occr SpanCode:
From:
Thru:
Time:
Admission Comment:
Pt Valuables:
Spec Prg:
PHYSICIANS
Emergency Room Physician
Referring Physician
Dr Lauren Jackson MD
SELF REFERRED
Other Physician
NO PRIMARY OR FAMILY PHYSICIAN
SELF REFERRED
Inflial
Date
Time Source
Rm/Bed
Arrival
Principal Admitting Diagnosis/Reason for Visit
Admitted By
2021-01-28
/
WALK IN
RT EYE SWELLING/HEADACHE, LT HAND WOUND DRAINAGE
1RSLCI6439
Lakefront Health
EDF
Printed 05/30/23 0421
Acct#
Patient name:Julia Parker
MRN:H24626417032 Encounter:H24626417032 Page 1 of 1
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711473530.358194 | Sharon Klein |
<<Back to Review>>180298-26-HYPERLINK- Hyperlink-Page
205
Work Wellness
July 25, 2018
1521 Colorado Ave Ste 152 Turlock, CA 95282
Page 1
(252) 252-3523 Fax: (529) 526-3520
Patient Information
For : Sharon Klein
Work Status Report
Date of Report: 12/12/2023
Time In: 5:4 AM
Time Out: 10:06 AM
Injury Date: 02/12/2019
Diagnosis:
Schizophrenia (ICD-719.47) (ICD10-M25.571)
Pursuant to California Civil Code section 53.31 and Labor Code 3762. medical information regarding employee'92 worker'92 compensation injuries is
deemed confidential medical information and may not be disclosed except in very limited circumstances.
Instructions: - seated work only
ELECTRONICALLY SIGNED BY: Jennifer S Wong DO (17/08/2015)
Patient Signature:
Ed Foster
Date: 08/03/2024
005205
pr tae 0525
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476990.342971 | Thomas Cunningham |
University of Oklahoma
October 27, 2023
800 NE 15th Street Suite 205 Oklahoma City, OK 73104
Page 2
4052714637 Fax: 4052711337
Lab Report
Dawn Parker
Male DOB: 13-03-2003
2708037
Ins: BLUE CRO (22) Grp: 116437
Producer ID *2:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73137
Producer ID *10:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73137
Producer
ID *11:0U MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73137
Producer
ID *12:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73137
Producer ID *13:0U MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK
73137
Producer
ID *15:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73137
(2) Order result status: Final
Collection or observation date-time: 06-11-2019 13:05
Requested date-time:
Receipt date-time: 10/17/2016 13:06
Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive
Oklahoma City
OK 73104
(3) Order result status: Final
Collection or observation date-time: 06-11-2019 13:05
Requested date-time:
Specimen Source: PN:C02194S
Source: HCA LAB
Filler Order Number: 1017:PN:C02194S LAB
Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive
Oklahoma City
OK 73104
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711477275.61127 | Lauren Lopez |
CHRISTUS Spohn Hosp South
5950 Saratoga Blvd.
Corpus Christi, TX 78414
ADMISSION/SERVICE DATE
TIME
DISCHARGE DATE
TIME
ACCOUNT NUMBER
16/05/16
1554
AV0001606094
CHRISTUS Spohn Hosp South
5950 Saratoga Blvd.
Corpus Christi, TX 78414
PATIENT NAMBAD DRESS
UNIT NUMBER
ROOMIESD &
ADMIT COURCH
LOCIGNO
ACCOMMIDDATION
STATUS
TREJO, ELMA MUNOZ
CONFIDENTIAL
REG ER
1 NON HLTH F
601 HUGHES AVE
MV00480850
AV.ED
DOB: 01/09/15
MARTLSTAT
LANGUAGE
ADMIT PRIORT
CLASS
ADMIT CLERK
PALICE, TX 78332-6580
D
AGE: 69
SPOKEN
N
M
BNG
ER
MM
Alternate Address?
SEX: F RACE
WH
RELIGION: CA
WRITTEN
ENG
SSN:
Other Name:
ETHN: HISPANIC OR LATINO ORIGIN
Other Hisp,La
PATIENT EMPLOYER
NEXT OFKIN ADDRESS
ERSON TO NOTIEY ADDRESS
RETIRED
TREJOJJACOB
TREJO MICHAEL
RELATIONSHIP: SON
RELATIONSHIP: SON
OCCUPATION: RE
76729-3
South Texas Bone & Joint - 00346
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711477183.11802 | Brenda Copeland |
Toxicology & Compliance
Laboratory Report
Patient Name: Cheryl Lambert
Sample ID: LB232136A
Collected: 08-16-2023 8:03:07 AM
Patient DOB: 03-07-1991
Received: 12-26-2023
Requesting Physician: Erik Davis
Tested: 05-18-2023
Requesting Practice: Louisiana Pain Specialists
Reported: 05-18-2023
-
Illicit Substances Detected
Reported Prescriptions Detected
Substance
Test Outcome
Reported Prescription
Anticipated Positives
Test Outcome
Patient Name: Cheryl Lambert
Specimen ID: LB232013A - Specimen Type: Urine
The perfomance characteristics of this test were determined by Louisiana Pain Specialists, LLC. It has not been cleared or approved
by the U.S. Food and Drug Administration.
LPS Toxicology Labs 2713 Hessmer Ave Suite A Metairie, LA 70002 504xxxxxxx
Lab Director: Eugene Schwilke, PhD
CLIA ID#: 19D2139613
Page 1 of 13
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711475190.120747 | Ethan Williams |
Novant Health Mothershed Foot Ethan Williams
N
NOVANT
& Ankle Specialist
MRN: 54024407, birthdate: 85/10/30, Sex: M
HEALTH
440 Pineview Drive Ste 400
Date of Visit: 17/04/06
KERNERSVILLE NC 27404-
3817
21/02/14 - Office Visit in Novant Health Mothershed Foot & Ankle Specialist (Kernersville) (continued)
Clinical Notes Amb (continued)
Signature Robb A Mothershed, DPM at 20/03/26 1402
Order Level Scans
Govt Form IM (e-sig) - Electronic signature on 10/20/2022 1508 (effective from 10/20/2022) - E-signed
Generated on 4/11/23 8:32 PM
Page 224
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711475190.013781 | Ian Case |
NOVANT
NOVANT HEALTH
Ian Case
N
REHABILITATION CENTER
MRN: 56424647, BIRTH DATE: 2004-03-18, Sex: M
HEALTH
KERNERSVILLE
Adm: 2014-05-16, D/C: 2014-06-15
1730 Kernersville Medical
Pkwy,Ste 201
Kernersville NC 27284
03/28/2023 - GWSM REHAB PT CONTINUOUS APPT in Novant Health Rehabilitation Center Kernersville
(continued)
Clinical Notes Acute (continued)
Erika Klein, PT at 3/28/2023 1445
Author: Erika Klein, PT
Service: Physical Therapy
Author Type: Physical Therapist
Filed: 03/28/23 1538
service date: 2014-06-20
Status: Signed
Editor: Erika Klein, PT (Physical Therapist)
Daily Treatment and Progress Report
Patient Name: Ian Case
BIRTH DATE: 2004-03-18
Today's Date: 2016-11-16
Referring Provider:Dr Eric Decker, MD
Generated on 4/11/23 8:32 PM
Page 8
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711475741.075397 | John Kent |
John Kent DOB: 1989-30-09 (52 yo M) Acc No. CR262185
[Doc Name: Othro One DOS 2022-15-09 - 5.20.22-]
4933 University Blvd W
Jacksonville, FL32216
ADVANCED
Upright Open MRI & X-Ray
DIAGNOSTIC GROUP
High Field MRI
Tampa
Brandon
Lakeland
Kissimmee
Orlando
Jacksonville
Orange Park
Palm Beach Gardens Jupiter
PATIENT MR#: 9218922
PATIENT ACCT#:
PATIENT NAME: John Kent
DATE OF BIRTH: 1989-30-09
REFERRING PHYSICIAN:
EXAMDATE: 2020-04-12
ACCESSION NUMBER: 2621860
EXAMDESCRIPTION MRI LEFT ANKLE
CLINICAL HISTORY: Slip and fall 01/19/2022, ankle and foot pain.
TECHNIQUE: Multisequential multiplanar imaging was performed of the left ankle
and hindfoot in a high-field MRI.
FINDINGS:
Abnormal marrow signal intensity in the lateral aspect of the calcaneus near the
plantar surface as well as along the dorsal surface of the navicular bone. More
significant abnormal signal intensity throughout the 2nd cuneiform bone, but
especially the dorsal surface with some irregularity of that surface.
IMPRESSION:
1.
Some abnormal marrow signal intensity in the lateral aspect of the calcaneus
and along the dorsal surface of the navicular bone appears to represent marrow
edema related to bone contusion without obvious fracture line. More significant
abnormal signal intensity in the 2nd cuneiform bone, especially along the dorsal
surface with some irregularity of that surface.
2.
Degenerative changes, as noted. No disruption of the major ligamentous or
tendinous structures including the Achilles tendon. No malalignment of the
tarsometatarsal joints.
Page 1 of 2
John Kent DOB: 1989-30-09 (52 yo M) Acc No. CR262185
Page 162 of 166
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476990.61373 | Linda Costa |
JOHN F. KENNEDY MEMORIAL HOSPITAL, Inc.
47
8350017
PT - Keith Lowe
MR-
AD - 2020 Feb 16
DD - 2020 Mar 17
DR - R.M. THORNE, M.D.
DISCHARGE SUMMARY
HPI:
This is a 31-year-old man admitted
to the hospital with findings suggestive of ruptured
disc with L5 nerve root radiculopathy on the left.
HOSPITAL COURSE:
It was suspected that this man had
a large fragment compressing the L5 nerve root on the
left. Lab work was satisfactory. He came to myelo-
graphy which did not reveal as large a lesion as I
suspected. There was a bulging disc at the L5-S1 level.
There was no later盲lization. It seemed to be midline.
It was, in fact, one level too low for the symptoms in
my opinion.
Epidural venogram revealed a midline cutoff also at
this level. These two facts correlated. The patient
did have a normal number of vertebrae, though he had
suggestions of a rib at L-1.
PLAN:
I feel it safe to discharge this
patient for further outpatient care and followup
where activity, progressive as tolerated.
CONTINUED
employee : Jeffrey Zristowski
player Uchneider & 'Leary PLASTERING
RECEIVED
n
2024 Mar 07
LAKE WORTH. FLA.
CLAIMS OFFICE
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711477275.64165 | Sean Barry |
ORTHOPAEDIC ASSOCIATES OF CORPUS CHRISTI
601 Texan Trail, Suite 300, Corpus Christi, Texas 78411
Telephone #: Fax #:
Preop Form
Name:
ELMA TREJO
DOB: 1993-25-05
SSN: 45796xxxx
Address: 601 HUGHES AVE
Room:
8
MRI:
Rad Ass 2021-31-12
ALICE, TX
78332
Phone:
Order: 1st
Clearance: cleared- Dr. Kapasi
361xxxxxxx
Ins: CENTENE-ALLWELL
Table: 4 poster jackson
Assist: Brandon Harris, Cert 1st
Hosp: SPOHN SOUTH
Cell Saver: yes
Home Health:
??
Arrival: 5:30 AM
Brace:
LSO- in hosp
1st postop: 2016-12-01
Date of Surgery: 2019-12-03
Xray:
2016-12-01 2V LUMBAR!!
PCP:
Lies: Francispo Rodriguez RNP-BC-CONVIA
Diagnosis:
Minimal thoracolumbar scoliosis, grade 1 L2 and L3 retrolistheses, grade 1 L4
spondylolisthesis, L4 and L5 degenerative disc disease
Procedure: L3, L4, and L5 laminectomies, radical L4 and L5 discoidectomies, transforaminal
lumbar interbody fusions at L4 and L5, internal fixation with PEEK cages, L3 to
sacrum posterolateral intertransverse fusion with local and iliac autograft.
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711476990.42907 | Diane Lawson |
12225922414
fax
01:06:21 p.m. 09-12-2023
23/132
labcorp
ahoma, Inc
Order Status: F3
4132 South Mingo Road
ACCOUNT NUMBER
ACCESSION #
Oklahoma, Inc.
Tulsa, OK 74132
05532
1132945032
(918) 744xxxxx
PATIENT NAME
ROOM #
Sherry Richardson
GILLAN, M MONEM
PATIENT ID # D.O.B.
AGE
GENDER
1211 N Shartell Ste 700
447080
06-02-1988 55 Years
Male
Oklahoma City, OK 73103
PATIENT PHONE #
CHART #
(405)702xxxx
5804010679
1055923
REFERRING PHYSICIAN
Gillan, M Monem
CLIENT REF. #
ORDERED
1141945059
04-14-2017 09:55
RECEIVED
REPORTED
09-01-2021 15:00
09-17-2018 01:11
Result Name
Normal
Abnormal
Units Ref. Range
Lab
CBC
WHITE BLOOD CELL COUNT (WBC)
7.1
10e9/L [4.0-11.0]
LCO-OKC
RBC
5.17
10e12/L [4.39-5.64]
HEMOGLOBIN
15.2
g/dL
[13.1-17.3]
HEMATOCRIT
44.6
%
[39.5-51.1]
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475741.452037 | David Morton |
David Morton DOB: 10-27-1987 (21 yo M) Acc No. CR704622
JAX SPINE & PAIN CENTERS
David Morton, 21 Y, M, 10-27-1987
5191 FIRST COAST TECH PKWY THIRD FLOOR, JACKSONVILLE FL 32224-0609
904-223-3321
904-887-5708 MRN: 0
FINAL RESULT
Accession ID: 70462
Ref ID: 2797L4365395
Specimen Source: Urine
Collection Volume: 50
OrderDate.09-09-2020
Received: 01-05-2023 20:58:12
Collection Date08-21-2017
Report: 01-05-2023 20:51:00
Requesting Physician: Delaparte, Courtney
Ordering Physician: Delaparte, Courtney
OPIOIDS
NAME
VALUE
REFERENCE RANGE
F Norfentanyl
Negative
<10 (ng/mL)
F Fentanyl
Negative
<2 (ng/mL)
F Tramadol
Negative
<200 (ng/mL)
PERFORMING LAB: MAIN, Jax Spine and Pain Centers - Main, 5191 First Coast Tech Parkway, Jacksonville FL, Director -
32224
David Morton I 10-27-1987
Accession ID: 12947
David Morton DOB: 10-27-1987 (21 yo M) Acc No. CR704622
Page 47 of 166
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711476990.459533 | Anthony Schultz |
2023 Feb 25 10:13:54
Oklahoma Spine 4058746995
4/56
Summit Medical Center
1856 Renaissance Blvd
Edmond OK 730133023
Phone: 405xxxxx Fax: 405xxxxx
Visit Note - Procedure
Provider: Betty Reese, MD
Encounter Date: 2016 Apr 25
Patient: Anthony Schultz (6475)
Sex: Male
DOB: 1997 Feb 07 Age: 55 Year
Race: Unreported/Refused to Report
Address: 171 Catfish Dr, Ponca City OK 46995 Pref. Phone(H): 918xxxxx
Insurance:
UMR (PP)
Insurance ID: 14046995
Description: General
Current Medication:
Other MD:
1 Atorvastatin 20 Mg Tablet SIG: Take 1 daily
2 Hydrocodonc-acetaminophen 5-325 Mg Tablet SIG: Take 1 every 6 hours as needed for pain
This visit note has been electronically signed off by Khalid Khan, MD on 2020 Jun 23 at 03:27
PM.
Patient: Anthony Schultz
DOB: 1997 Feb 07 Visit: 2014 Dec 03
Page:
56
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711471328.716393 | Amanda Alvarado |
Northside Health
967 Erica Parks
Johnsonshire, MI 22740
880-674-2587
Patient:
Amanda Alvarado
MRN;
9890528
Admit:
11-06-2016
FIN:
27045042488
Disch:
dob/Age/Sex: 03-21-1998
21 years
Female
Admilting: Dr Daniel Brooks, MD
Location:
OPDC MR
Magnetic Resonance Imaging
Accession
Exam Date/Time
Exam
Ordering Physician
Patient Age at Exam
MR-23-0050161
09-18-2017 18:22 EST
MRI Lower Joint w/o
Dr Daniel Brooks, MD 21 years
Contrast Right
Reason for Exam
(MRI Lower Joint w/o Contrast Right) Trochanteric bursitis of right hip; right hip pain
COMPARISON:
None.
FINDINGS:
Bones: There Is no fracture, dislocation, or contusion. The bone
marrow signal Is normal.
Articular Cartilage: Not well evaluated in the absence of intra
contrast.
Tendons: Gluteus minimus tendon is intact.
Report Request ID: 9890528
Page 72 of 99
Print Date/Time: 2/24/2023 18:22 EST | what is the DOB or date of birth? | {"text": [], "answer_start": []} |
id_1711473238.978111 | Shawn Lawrence |
DIS Slidell
RE2170526
1310 Gause Blvd
Slidell
LA 70458
Phone: 900-418-6774
Fax: (563) 863-5634
RELEASE OF INFORMATION
AUTHORIZATION TO USE & DISCLOSE PROTECTED HEALTH INFORMATION
Date 15/03/12
Pt ID: CIS263346
Acct #
Last Name: GARIBALDI
First: JUSTIN
MI:
D.O.B: 02/07/19
Patient Address: 208 N SILVERMAPLE DR
SLIDELL
LA
70638
Patient Phone: (504) 636-8635
I specifically authorize the use and/or disclosure of the following highly confidential information: Mental health, HIV results,
AIDS information.
Signature:
I
HAVE READ THE ABOVE AND AUTHORIZE THE DISCI OSURE OF THE PROTECTED HEALTH INFORMATION AS STATED:
Signature of Patient/Guardian/Representative
18/05/02
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711475620.666072 | Julie Jones DDS |
Julie Jones DDS DOB: 1996/24/08 (38 yo M) Acc No. 33816
Julie Jones DDS DOB: 1996/24/08 (38 yo M) Acc No. 33816 DOS 2020/20/09
LA Health Solutions
Progress Note
Patient: Julie Jones DDS
Provider: Harley Augustine, PA-C
DOB: 1996/24/08 Age: 38 Y Sex: Male
Date: 2020/20/09
Reason for Appointment
1. Cervical, thoracic and lumbar pain
History of Present Illness
Interim History:
Patient continues to have neck and lower back pain.
New accidents or injuries since last visit: Light sensitivity has become worse.
Neck Pain:
The patient has neck pain: Yes.
The pain is present: Once a week.
The pain radiates: Does not radiate.
Numbness or tingling: None.
Arm weakness: None.
Headaches associated with the neck pain: Yes, occipital.
NECK pain from 0 to 10 (10 being the worst): 6 worst 8.
RIGHT ARM pain from 0 to 10 (10 being the worst): 0.
LEFT ARM pain from 0 to 10 (10 being the worst): 0.
Current Medications
Taking
Magnesium 300 MG Capsule 1 capsule with a meal Orally Once a day
Not-Taking/PRN
Cerefolin NAC 6-90.314-2-600 MG Tablet 1 tablet Orally Once a day
Meclizine HCI 25 MG Tablet Chewable 1 tablet as needed Orally Once a day
Melatonin 5 MG Tablet 1 tablet in the evening Orally Once a day
Pregabalin 200 MG Capsule 1 capsule Orally Twice a day
DULoxetine HCI 20 MG Capsule Delayed Release Particles 1 capsule Orally Twice a day
Past Medical History
No medical hx.
Carpal tunnel- bilateral.
Julie Jones DDS DOB: 1996/24/08 (38 yo M) Acc No. 33816
Page 2 of 15
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711477090.41861 | Victoria Ellison |
CASA COLINA HOSPITAL AND CENTERS FOR HEALTHCARE . USE OF ELECTRONICS AND SYSTEM AGREEMENT
As an authorized user with access to Case Colina Hospital and Centers for Healthcare's (hereafter referred to as CCH) electronic equipment, including
but not limited to PCs, laptops, te ephones and tablets, your use of an assigned user name and password is the legal equivalent to your signature. The
equipment, software and data are the property of CCH and are only to be used for tasks directly associated with your job. Any use of CCH computers or
computer systems (hereafter referred to es computers) represents your signed authorization and acknowledgement of the conditions set forth below:
Use of CCH computers may, based on your job duties and responsibilities, allow access to confidential information concerning to patients, residents,
their families or significant others, and CCH business.
Your obligation to maintain onfidentiality under this Agreement continues after your employment/relationship with CCH ends.
Keep all food, liquids and magnets away from electronic equipment; avoid extreme heat or moisture.
For Users of the Electronic Health Record (EHR):
This badge is required to your job and it is your responsibility to bring it with you each day.
Repeated instances of a lost, forgotten or missing badge will be subject to disciplinary action.
Never allow another person to use your badge and/or bar code.
Never attempt to use another person's badge and/or bar code.
The placement of pens, stickers, etc., on your badge that cover up your face, name or bar code is prohibited.
Always log off when leaving your work area. The EHR-MAK system records activity based on your user login. Logging off or
locking the computer will help avoid the possibility of other people gaining access to the EHR and recording information under
your user login.
E.J. Initials
I
have read, understand and agree to abide by the above statements:
Alejandra Foster
Sex:
Male / Female (please circle)
Name (print):
Signature:
Elm
Date:
2016-12-06
Department
Ext:
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711476766.192966 | Mckenzie Edwards |
Bethesda Hospital West
2815 S. Seacrest Blvd
9655 Boynton Beach Blvd
Boynton Beach, FL 33xxx
Boynton Beach, FL 33xxx
Patient Name: Victoria Nichols
MR#: 111786876
DOB: 1996 February 27
Account#: 2521037764
Date of Admission: 2021 July 12
Sex: F
Attending Physician: 79376
Facility: BMH
Ordering Physician: 79376
Collection Date and Time: 2015 April 08 12:05
Service Date: 2017 October 30 12:05
eBlood Bank
TEST NAME
RESULT
UNITS
RANGES
ABN FL ST
ANTIBODY SCREEN
NEG
F
NEG
Page 1 of 1
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711472786.615287 | Patricia Pham |
LFIM
LAUGHLIN, FALBO
Anaheim
LEVY
& MORESI
714 385 5400
LLP
Concord
925 454 4549
Fresno
San Bernardino Office
554 454 4540
Mailing Address
One Capitol Mall, Suite 400
Los Angeles
854 654 8540
October 9, 2023
Facsimile: 954 854 2354
www.lflm.com
DEFENDANT'S ADVOCACY
Redding
554 254 5468
PANEL QUALIFIED MEDICAL EXAMINATION LETTER
Sacramento
954 454 6545
San Diego
654 233 9548
Dr Heidi Carr, M.D.
Re:
Elizabeth Jarero V. Casa Colina Hospital and Centers for Healthcare and Beta Healthcare
Group
WCAB Case No.: ADJ18126326
LFLM No: 854-254449
DATE OF EXAM: 15-04-10 @ 11:30 a.m. (telehealth)
Dear Dr. Cervantes:
You have been selected as a Qualified Medical Evaluator in psychiatry.
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711476893.168774 | Kristen Hernandez |
State of California
Division of Worker's Compensation
PRIMARY TREATING PHYSICIAN'S PROGRESS REPORT (PR-2)
Check the boxes which indicate why you are submitting a report at this time. If he patient is "Permanent and Stationary"
(I.e., has reached maximum medical improvement), do not use this form. You may use DWC Forms PR-3 or PR-4.
Periodic Report (Required 45 days after last report)
Change in treatment plan
Release from care
Change in work status
Need for referral or consultation
Response to request for informaton
Change in patient's condition
Need for surgery or hospitalization
Request for authorization
Other:
PATIENT:
Last:
Corona
First: Araceli
Middle:
Address: 1450 MADRONER DR
City: Salinas
State:
CA
Zip: 73319
Date of Injury:
Sex:
female
DOB:
02-07-1991
Occupation:
SSN: 617xxxx
Phone: 831xxxx
EMPLOYER NAME: Healthcare Services Group
Subjective Complaints: Worker's Compensation (WC DOI 12/721 BACK)
Diagnoses:
ICD-10-
CM
1. Lumbar strain, subsequent encounter
$39.012
D
Treatment Plan:
TREATMENT PLAN: Light work starting 12/15/2021. Physical therapy. Return 12/23/2021.
Orders Placed This Encounter
Ambulatory referral to Physical Therapy
DATE OF SERVICE:
08-20-2016
CHIEF COMPLAINT:
Chief Complaint
Patient presents with
Worker's Compensation
WC DOI 02-18-2015 BACK
GB IA Recv 2021122107346
Received 01-12-2015
| what is the service date or date of service? | {"text": ["08-20-2016"], "answer_start": [1274]} |
id_1711477275.43706 | Andre Kelly |
12/2/2022 15:07:26 CST
To: 13118065110
Page: 2/11
From: Frontera
Fax: 9723115811
Lower Extremity
Frontera
Arterial Ultrasound
Report
FR NTERA
VIDISIAR*
Patient name: Amanda Hunt
Patient ID: 1833411
DOB: 1992-10-01
Chart#:
521911
Referred by:
Masciale^John
Age:
69Y
Location:
Sonographer:
Stephanie Lage, RDCS, RVT
Sex:
F
Equipment: CX50
I/O:
Outpatient
Exam. date: 2016-21-02
Diagnosis:
Peripheral vascular disease, unspecified (173.9).
Procedure:
Limited bilateral noninvasve physiologic studies of upper or lower extremity arteries (93922).
Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study
Asymmetric blood pressures are noted. Unable to hear ABI pulses to accurately assess.
Right Leg
Monophasic waveforms throughout leg. No flow in SFA distal segment.
Left Leg
Monophasic flow throughout leg.
Impressions
Bilateral moderate lower extremity arterial disease
Suggest CTA of lower extremities
Electronically signed by: Jason Finkelstein
2023-03-07 8:06 PM
76711-3
South Texas Bone & Joint - 00411
| what is the DOB or date of birth? | {"text": ["1992-10-01"], "answer_start": [231]} |
id_1711475955.995664 | Kimberly Rivera |
OrthoSC . 210 Village Center Blvd., MYRTLE BEACH SC 29579-6706
Kimberly Rivera (id #99321, dob: 04-05-1990)
Past Encounters
Encounter Date
Diagnosis Name
Diagnosis
SNOMED-CT Code
21-03-2023
Neck pain
81680005
Erkan Alci, SC - OrthoSC, Main-CW: 2376 Cypress Circle, CONWAY, SC
29526-8995, Ph. 843-353-3460
Degeneration of cervical
69195002
intervertebral disc
Low back pain
279039007
Degeneration of lumbar
26538006
intervertebral disc
Spinal stenosis in cervical
83561009
region
Goals Section
Goal
Description
Status
Start Date
Updated by
Updated on
None Recorded
Health Concerns Section
Related Observation
None Recorded
Concern
Status
Updated by
Updated on
None Recorded
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |