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id_1711475741.716914 | Jessica Taylor |
21 April 2022 10:12AM
No. 0020
P.
13
Page 9 of 13
Jessica Taylor DOB: 08 August 1984 (39 yo F) Acc No. 18348 DOS 12 October 2017
Jessica Taylor
Family Medicine
39 Y old Female, DOB: 08 August 1984
Account Number: 50162
of
SayeBrook
434 GRAVELLEY CT, MYRTLE BEACH, SC-29588-8822
Guarantor: Brennan, Tracey G Insurance: BCBS SC
Payer ID: 18348
Appointment Facility: Family Medicine Of Sayebrook
12 October 2017
Progress Notes: Jonathan Bornfreund, DO
Reason for Appointment
Current Medications
1. Np, get est, general checkup
Taking
Vitamin B-12 1000 MCG Tablet 1
History of Present Illness
tablet Orally Once a day, Notes: OTC
Vital Signs
smoke? 11-20
BP 110/72 mm Hg, Ht 64 in, Wt 132 lbs, BMI 22.66 Index,
How soon after you wake up do
Temp 97.9 F, HR 78 /min, RR 18 /min, Oxygen sat % 97%
you smoke your first cigarette? 6-30
minutes
Examination
Are you interested in quitting?
Not ready to quit
General Examination
Additional Findings: Tobacco User
GENERAL APPEARANCE: in no acute distress, well developed,
Moderate cigarette smoker (10-19
well nourished.
cigs/day)
EARS: tympanic membrane intact, clear.
Drugs/Alcohol:
Alcohol Screen (Audit-C)
ORAL CAVITY: no lesions.
Did you have a drink containing
THROAT: no erythema.
Progress Note: Jonathan Bornfreund, DO 12 October 2017
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711473365.854351 | Natalie Hutchinson |
PT (OT) Speech
General Info
OT Evaluation Type : Initial evaluation
Date/ Time OT Evaluation Initiated : 07-12-2019 16:14 EST
Pegarido OT, Eric Ryan - 25-03-2016 17:15 EST
Medical History
Injury/Insult Onset Within Last 14 Days : Yes
Orthopedic or Spine Surgery Diagnosis Yes
Hospital Course Details Pt. is a 60 year old female that was admitted to AHC on 25-03-2016 d/t a mechanical fall in the
bathroom.
Procedure/Surgical History (Smart Template) : Procedure List:
07-07-2019 Ankle Open Reduction Internal Fixation
Observations
Hearing Details : Appears at baseline / premorbid status
patient name:
Natalie Hutchinson
MRN: 72026205
FIN#: 92010205
Printed On:
10/30/2023 05:11 EDT
Page 350 of 516
Report Request ID#: 320332098
| What is the Date of Evaluation? | {"text": ["07-12-2019"], "answer_start": [115]} |
id_1711475190.218804 | Antonio Romero |
Novant Health Urology
Antonio Romero
N
NOVANT
2700 Baldwin Lane
MRN: 57024707, dob: 11/1993/08, Sex: M
HEALTH
Winston-Salem NC 27003-5706
VISIT: 09/2022/19
01/2023/25 - Office Visit in Novant Health Urology - Baldwin (continued)
Clinical Notes Amb (continued)
Supervising Physician: Dr Lisa Harvey
History of Present Illness:
Jeffrey Craig Payne is a 42 y.o. male with a history of
Patient Active Problem List
Diagnosis
Human immunodeficiency virus (HIV) disease (*)
Patient presents today for follow up of right epididymal cyst. This has been monitored via ultrasound.
Physical Examination
Constitutional
Vitals:
08/03/22 1531
BP:
157/68
Pulse:
94
Generated on 4/11/23 8:33 PM
Page 311
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711473237.341155 | Lynn Pennington |
THU 43
FAX
MRN: 1922380H
Lynn Pennington
Nassau Unly. Medical
Gender: Female
Center
Age: 57y (28/10/1999)
Current Location:
ICC1-2571-JJ
Faculty Statement:
Attestation
Attending and Resident/Fellow/Physician's Assistant
Electronic Signatures:
Dr Nicole George (Physician) (Signed 31/07/2021 7:32)
Authored: Faculty Statement
Co-Signer: Date of Procedure, Pre-Op and Post-Op Diagnosis, Specimens, Brief
Operative Note, Procedure Details
Dr Brian Smith (Resident Physician) (Signed 30/09/2023 7:32)
Authored: Date of Procedure, Pre-Op and Post-Op Diagnosis, Specimens, Brief
Operative Note, Procedure Details
Requested by: Philburn, Jacqueline (Med Rec Clerk), 24/01/2019 12:25
Page 2 of 2
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711475190.013789 | 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 Discharge? | {"text": ["2014-06-15"], "answer_start": [161]} |
id_1711475190.385244 | George Rogers |
NOVANT
Novant Health Urology
George Rogers
N
2290 Baldwin Lane
MRN: 52924297, D.O.B: 11/96/09, Sex: M
HEALTH
Winston-Salem NC 22903-5296
visit: 21/16/09
24/17/12 - Office Visit in Novant Health Urology - Baldwin (continued)
Clinical Notes Amb (continued)
or family expresses understanding and all questions and concerns were answered. The patient is in agreement with
the plan as stated above.
Electronically Signed by Victor M Pereira, PA-C at 14/17/12 0294
Labs
Urinalysis
Resulted: 02/23/23 0297, Result status: Final result
Order status: Completed
Filed by: Lainey Younts 02/23/23 0837
Collected by: 18/18/06 0292
Resulting lab: NH UROLOGY - BALDWIN
Acknowledged by: Victor M Pereira, PA-C on 02/23/23 1233
Testing Performed By
All Reviewers List
Victor M Pereira, PA-C on 2/23/2023 12:33 PM
Generated on 4/11/23 8:32 PM
Page 46
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475444.581877 | Laura Delgado |
Garibaldi, Justin Male 08/1986/27
Alliance Medical
CENTER
Donald D. Dietze, MD, FAANS
Board Certified Neurological Surgeon
Laura Delgado
Fellow of the American Association of Neurological Surgery
301 Lakeshore Blvd
3348 West Esplanade S., Suite A, Metairie, LA 70002 - 1111
Slidell LA 70461
PROGRESS REPORT
PATIENT NAME: Garibaldi, Justin
birth date: 08/1986/27
DATE OF SERVICE: 05/2021/25
PHYSICIAN: Donald D. Dietze, MD, FAANS
CHIEF COMPLAINT: Low back pain and Neck pain, Knee Pain, Headaches
HISTORY OF PRESENT ILLNESS:
Mr. Garibaldi is a 30-year-old left-handed male who presents to our clinic today November 20, 2023 for
consultation, examination, and treatment for injures/symptomology sustained in a motor vehicle accident that
occurred on March 18, 2021.
Mr. Garibaldi denies any prior history of neck and low back pain.
The patient reports that he is not currently employed.
Since the accident the patient reports treating with LA health solutions. The patient reports that he was treated
for traumatic brain injury. He states an MRI was ordered of his brain, and EEG, VEP, BAER. He also reports
receiving a left C5-6, C6-7, and C7-T1 facet injection on March 24, 2023 and March 17, 2023. The patient has
also undergone a right C5-6, C6-7, and C7-T1 facet injection on January 27, 2023. The patient also reports
having undergone a bilateral L4-5 and L5-S1 lumbar facet injection. The patient is currently being prescribed
cyclobenzaprine, duloxetine, and meclizine which provide mild symptomatic relief.
His primary complaint today is a constant, aching pain of the low back that radiates into the right lower
Page 1
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711473236.971139 | Daniel Carey |
04/28/2023 12:28
P.010/023
Specialty Meds (Final): Pred Forte 1% 1 gtt qid OS. Ofloxacin 0.3% Ophthalmic Solution 1 gtt qid os.
Follow Up: Dr Patricia Murphy, MD 6-7 Weeks .
CPT Codes: 99424.
ICD-9 Codes: V45.42s, 842.9s,
ICD-10 Codes: Z42.890s,
S05.42XDs, H42.052s, S05.42XSs,
P. Feme
Signed:
signature Dr Patricia Murphy, MD
Tech: nm
17-09-2018 2:53:22 PM
Assist: ap
Page 3 of 3
PATIENT: Daniel Carey (DATE OF BIRTH 01-03-1987)
Wednesdav. June 1. 2022
| what is the DOB or date of birth? | {"text": ["01-03-1987"], "answer_start": [452]} |
id_1711476578.007431 | Kayla Ellis |
BAYLOR SCOTT & WHITE
Williams, Charles Eugene
BaylorScott&White
HEART AND VASCULAR
MRN: 9211614, D.O.B: 25/97/10, Sex: M
HEALTH
HOSPITAL - DALLAS
Date Service 29/16/05
621 N HALL ST
DALLAS TX 75226-1339
02/09/2023 - Telephone in Baylor Scott & White Heart and Vascular Hospital - Dallas (continued)
Clinical Notes (continued)
Patient s/p: EPS ablation
Pt denies other questions, comments or concerns at this time.
Electronically signed by Rachel Galvan To. RN at 27/21/05 10:17 PM
02/09/2023 - Telephone in Baylor Scott & White Heart and Vascular Hospital - Dallas
Facesheet
Patient Information
Patient Name
Legal Sex
DOB
Williams, Charles Eugene
Male
2/4/1959
Patient Demographics
Address
Phone
E-mail Address
6563 ASHLAND DR
963-263-7630 (Home) *Preferred*
lorinewilliams63@yahoo.com
GREENVILLE TX 75463-7628
963-263-88637 (Work)
63-631-6388 (Mobile)
Basic Information
Date Of Birth
Legal Sex
Race
Ethnic Group
Preferred Language
Language for Written
15/19/12
Male
Black or African
English
Material
American
Latino
English
Page 2
75208-63
Baylor Scott & White Heart & Vascular Hospital - 00063
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711473530.611978 | Mary Tucker |
KNMH EMERGENCY DEPARTMENT
Mary Tucker
180 W Esplanade Ave
MRN: 8228228, birthdate: 21/85/07, Sex: M
Kenner LA 72265
Acct #: 82202282261
Adm: 11/21/11
08/25/2022 - ED in Kenner - Emergency Dept (continued)
Medication Administrations
ibuprofen tablet 800 mg [822232222]
Ordering Provider: Dayna G. Toscano, NP
Status: Completed (Past End Date/Time)
Order Date: 09/15/07 1122
Starts/Ends: 08/25/22 1200 - 08/25/22 1122
Ordered Dose (Remaining/Total): 800 mg (0/1)
Route: Oral
Frequency: ED 1 Time
Admin Instructions: DO NOT CRUSH OR CHEW; SWALLOW WHOLE.
Discharge Orders (720h ago, onward)
None
ED Prescriptions
Medication
Sig
Dispense
Start Date
End Date
Auth. Provider
LIDOcaine (LIDODERM) 5 % (Expired)
Place 1 patch onto
7 patch
8/25/2022
9/1/2022
Dayna G. Toscano, NP
the skin once daily.
Generated on 10/3/22 11:37 AM
Page 28
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711476767.549755 | Joshua Bates |
02-16-2022 08:25
1 12 >> unknown
P 24/74
Coastal Neurology Inc.
Procedure Note
Patient Name:
Loren Ferris
Visit Date:
01-22-2018
Patient ID:
23674
Provider:
Brad Taylor, PA
Sex:
Female
Location:
COASTAL NEUROLOGY INC
Birthdate:
10-23-1990
Location Address:
Referring Provider:
Mr. Tyler Lawson DO
Ormond Beach, FL
Location Phone:
(386) 788xxxx
PROCEDURE NOTE: Trigger Point Injections Neck and Upper Back using Ultrasound Guidance
REASON FOR PROCEDURE: Bilateral Neck and Upper Back Myofascial Pain Syndrome
EBL: Less than 1 CC
INJECTATE SOLUTION: Contained 10 cc of 1% lidocaine
PROCEDURE PERFORMED BY: Dr Ms. Cynthia Vega, PA-C
Location: Bilateral trapezius, levator scapulae, splenius capitis and parascapular muscles
Location: Tendon origin of bilateral trapezius, rhomboid minor, and parascapular
muscles
Summary of Procedure:
The patient presents today for scheduled bilateral neck and upper back trigger point injections using ultrasound
guidance for the benefit of needle placement. today is cervical trigger point 1
VAS is 5/10.
I have discussed with the patient the risks and benefits of the procedure. Risks included are nausea, vomiting,
headaches, seizures, death, fainting episodes, and hyperglycemia.
The patient understands, agrees, and consents to the procedure.
[Digital Signature Validated]
| what is the DOB or date of birth? | {"text": ["10-23-1990"], "answer_start": [268]} |
id_1711475620.537366 | Peter Fernandez |
Peter Fernandez DOB: Jan 07, 1993 (26 yo M) Acc No. 48370 Doc Name: Dec 11, 2018 NP Forms
I do 00 /do not
authorize the release of information pertaining to HIV/AIDS
Purpose of the Requested Disclosure
I am authorizing the release of my Protected Health Information for the following purposes:
Medical Care
Insurance
At the request of patient
Other (specify)
Request by Attorney
Time Period for this Authorization
This Authorization will expire five years from the date of its execution.
Revocation of This Authorization
| understand that I have the right to revoke this Authorization at any time to prohibit future release
of my information. To revoke this Authorization, 1 must send written notice to LA Health
Solutions, to the attention of LA Health Solutions Medical Records Division at the address
indicated above. I understand that my revocation of this Authorization applies to future disclosures
only and will not have any effect on any disclosures of Protected Health Information made before
receiving the revocation.
Redisclosure
I understand that my Protected Health Information disclosed pursuant to this Authorization may
be redisclosed by the recipient identified above and may no longer be protected from disclosure to
others by federal or state law.
Waiver
I hereby expressly waive any claim of privilege or privacy with respect to the released information.
1 release and forever discharge LA Health Solutions and its agents, servants, or employees from
all liability or claims, of any kind or character, in any way arising out of the disclosure of the
requested information, including disclosures made in good faith.
Voluntary
1 understand that signing this authorization is voluntary. My treatment, payment, enrollment in a
health plan, or eligibility for benefits will not be conditioned upon my authorization of this
disclosure.
Signature of Patient/Patient's Representative:
Date:
Jabbith
Dec 15, 2016
Printed Name of Patient's Representative:
Relationship to Patient:
Peter Fernandez DOB: Jan 07, 1993 (26 yo M) Acc No. 48370 Doc Name: Dec 11, 2018 NP Forms
Page 100 of 123
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711472786.714123 | Amy Velez |
athena
09-18-2023 2:23 PM ET
613-195894839
pq 37 of 42
Privia . CCA - Cardiac Care Associates PC . 224D Cornwall St. LEESBURG VA 20646-2640
Amy Velez (id #1894836, DATE OF BIRTH: 84/09/22)
Reston
RRC
Radiology
Consultants
Patient: Amy Velez
DATE OF BIRTH: 84/09/22
EXM DATE: 18/01/31
Medical Record #: RHCK005192392
Procedure: RAD Chest 2V
Referring Physician:
Dr Brittany Jensen
Reston Hospital Center
K85425192392 Amy Velez
Michelle I Pego NP
Duyanh T Vu, MD
Vu,Duyanh T Md
ALYSIA D. JOHNSON RT(R)
RR
CHEST X-RAY, frontal and lateral views:
HISTORY: WHEEZING
COMPARISON: 11/3/2018
FINDINGS:
The cardiac silhouette is normal.
Lungs are clear.
MEDICAL IMAGING CENTER OF RESTON, 1864 TOWN CENTER DRIVE, Reston VA, 26490
Fax www.restonradiology.com
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711476892.862745 | Erica Erickson |
l'have not violated Labor Code 13. s and the contents of the report and bill are true and correct to the best of my
knowledge. Signed this date, Solano County, California.
11.00
DATE:
T 97.1 P 72 R 12 B/P 135/78
CURRENT MEDS:
See lied list
1/:52 in WT162 HT 56 Last Tetanus:
ALLERGIES/ADVERSE REACTIONS
Patient Instruction:
Acceptable level:
Pain: Yes pain No Ley 18
MEDICATIONS: NEDA
Learner:
Patient:
Pain is the primary reason for this visit
LATEX: to
Family:
26 yo Male c/o fugist area pair at
Teaching Method:
Verbal Presentation:
R) Leg Injured by slipping happened
Demonstration:
Written Materials:
is days ago u. Day puts)
Medication:
-
Medications dispensed:
2130pm RDJUOQ 60ms PM toradol MSaympe
OCCUPATIONAL HEALTH
Provider: Dr.kitchens
Date of Service:
19 Oct 2023
Time: 10:11
1101 B Gale Wilson Blvd. Suite 203, Fairfield, CA 94533 (707) 646-4600
Patient:
DOB: 16 Jan 1999
Initial Visit
Employed
DOI: 17 Mar 2016
135
31 Aug 2017
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711471329.660493 | Stephen Wilson |
July 06, 2014 4:14 TEXAS_MRI (FAX)73359136267 P.002/003
Meadowbrook Medical
Patient: Stephen Wilson date of examination: May 18, 2020 12:15 PM
DATE OF BIRTH: April 18, 1999 Age 67 Physician: Dr Michael Chase
MRN: TXCS20085 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:
VERTEBRAE/ALIGNMENT: Straightening of normal lumbar lordotic curvature. No evidence of acute fracture. The vertebral body heights are preserved.
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 - 00036
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711471330.456697 | Donna Bailey |
CERTIFICATION AND RECERTIFICATION
Skilled Nursing Facility - Level of Care
Physician: Maurice May
Donna Bailey
07-25-2017
Customer Name
DATE OF ADMIT
7XQ1FD8mK
Medicare Number
Recertification
I certify that continued inpatient skilled care is necessary for the following (must list reason for each
of continued need
box checked on line below):
for inpatient skilled
care
Occupational therapy
Sweet
Physical Therapy
the
Spring
Speech Therapy
Specify any additional skilled care 7xweek am, Dementia,
CAD HTN Syrupi
J
estimate that the duration of Inpatient Skilled Care will be for 30 days.
Date Due:
Plans for post-skilled care are:
Home Health Agency
Home w/ Office Care Long Term
12/7/20
Care
Other:
To Be signed on or
before 14th day
Continued care is for the condition the patient received inpatient hospital care and/or the treatment
after admission
of conditions that developed or were treated as the result of the hospital stay or SNF.
d
11-01-2020
Physician's Signature
SIGNATURE
Revised June, 2012
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711471329.368935 | James Stone |
23-09-15 1:35 PM EDT OneCallCareManagement via VSI-FAX
Page 1 of 2 #3417302 OI
954 Torres Lake
Kellyborough, PR 56839
992-846-9327
PASADENA, CA, 91101
224-603-6327
Countryside Regional
Compassion, Confidence, Comfort
Patient Name
DATE OF BIRTH
MRN
James Stone
89-09-28
38.2461888
AT THE REQUEST OF
AGE / SEX
Service Date
Dr Michael Camacho MD
74 y/F
21-07-16
954 Torres Lake
Kellyborough, PR 56839
MRI RIGHT ELBOW
CLINICAL HISTORY
appendix removal in 2010. History of Diabetes 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
James Stone 24618883
Page 3 of 2
1381
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711473237.019253 | April Mason |
FAX
MRN: 1936371H
April Mason
Nassau Unly. Medical
Gender: Female
Center
Age: 54y (09-12-1993)
Current Location:
ICC1-2241-JJ
Operative Report [Charted Location: MICU-2244-II] [date of service: 02-09-2023 0:14
Authored: 24-Mar-22 16:07] - for Visit: 9922464, Complete, Revised, Signed in Full, General
Date of Procedure:
Date of Procedure
21-12-2021 0:14
Pre-Op and Post-Op Diagnosis:
Pre Op Diagnosis Comments
left eye ruptured globe, 180 degree scleral laceration,
lateral rectus laceration
Post Op Diagnosis Comments:
Post Op Diagnosis Comments
left eye ruptured globe, 180 degree scleral laceration,
lateral rectus laceration
Specimens:
Specimen Details:
No specimen submitted for this procedure. (1)
Requested by: Philburn, Jacqueline (Med Rec Clerk), 07-Apr-22 12:25
Page 1 of 2
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711473365.562678 | Caitlyn Moss |
<<Back to Review>>180298-26-HYPERLINK- Hyperlink-Page
243
Tow er Physical Therapy, Inc.
Patient N ame:Caitlyn Moss
1151 Colorado Ave, Suite 150
Patient # :315805
Turlock, CA 15382-1500
Phone: (215)156-1560
Daily N ote /
birth date: 01/08/06
Document Date: 21/04/11
Fax: (215)215-3155
Billing Sheet
Plan
Instructions: Progressing Patient Next Visit
Mar
Chris Stempson, MPT, CSCS
PT25198 for State of CA
E lectronically Signed b y Chris Stempson, MP,TCSCS on 16/01/24 at 10:2 am
001543
0153
2 of 2
Powered by
WebF,
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475444.293061 | Jesse Cole |
07 May 2014 FROM- CWFMD
936-703-5455
T-252 P0031/0063 F-236
Conroe Regional Medical Center - Women's Imaging
504 Medical Center Blvd.
Conroe, TX 77304
Patient:
Jesse Cole
Facility ID:
BH55448111/AA
DOB_question:
22 May 2002
Height / Weight:
65.0 in. 100.0 lbs.
Measured:
07 December 2021
Sex / Ethnic:
Female White
Analyzed:
07 December 2021
AP Spine Bone Density Trend
Densitometry Ref: L2-L4 (BMD)
Trend: L2-L4 (BMD)
BMD (g/cm2)
YA T-score
%Change vs Baseline
1.456
Normal
Trend: L2-L4
1
Change vs
Measured
Age
BMD
Previous
Previous
Date
(years)
(g/cm2)
(g/cm2)
(%)
07 December 2021
46.7
0.965
COMMENTS:
-0.155
-13.8'
07 December 2021
37.8
1.120
GE Healthcare
Lunar iDXA
ME+200592
Name: Jesse Cole
BIRTH DATE: 22 May 2002
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711471328.278342 | Megan Rocha |
HISTORY OF PRESENT ILLNESS: Patient is a 62-year-old male who presents stating that he hit his head on the these on Saturday. He states he has pain and swelling to the she and Have maybe from detail sound.. He has had vomiting. He also has neck pain.
ALLERGIES: Please refer to chart.
PRESENT MEDICATIONS: Please refer to chart.Sunset Community Hospital
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 82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 name:
Megan Rocha
PHYSICIAN:
Dr Alex Donovan, MD
MED.REC.NO.: 14-60-44 1038369-E
EMERGENCY ROOM NOTE
ADMISSION:
2017-05-13
Sunset Community Hospital
8748 Jesus Station
Myersberg, OH 14672
DATE OF SERVICE: 2016-06-04
discharge day:
2017-06-12
Page 1
CHART COPY
82 of 107
2017-05-08
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711475620.450759 | Andrea Mclean |
Andrea Mclean DOB: 13 November 1995 (66 yo M) Acc No. 14659 DOS: 29 September 2017
Andrea Mclean
66 Y old Male, DOB: 13 November 1995
208 N SILVER MAPLE DR, SLIDELL, LA-70458-5483
LA Health Solutions
Home: 504-446-8765
Surgeon: Ronald C. Segura, M.D.
29 September 2017
Ronald C. Segura, M.D.
OPERATIVE REPORT
Pre-op. Diagnosis:
1.CERVICAL FACET SYNDROME
Post-op. Diagnosis:
1.THE SAME
Operation:
1.CERVICAL INTRA-ARTICULAR FACET JOINT INJECTION: RIGHT C5/6, C6/7, & C7/T1 LEVELS
Anesthesia:
Local 1% Lidocaine & Sodium Bicarbonate 4.2%
Indications:
Details of Procedure:
This procedure was performed at LA Health Solutions in Metairie, Louisiana. The patient was seen and examined in the preoperative
area where informed consent was obtained explaining the risks, benefits, and alternative treatments to the patient. Operative site was
marked using a skin marker.
The same exact steps of the procedure were repeated in detail for the Right C6/7 & C7/T1 facet joints.
There were no apparent complications. The patient tolerated the procedure well. Band aides were placed over the skin entry sites. The
patient was transferred to the recovery area and monitored for approximately 10-15 minutes. The patient was discharged to home in
stable condition and is to return to clinic as scheduled.
PAIN LEVEL PRIOR TO THE INJECTION: 7/10
PAIN LEVEL AFTER THE INJECTION: 0/10
Specimens:
Complications:
Progress Note: Ronald C. Segura, M.D. 27 November 2016
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
| what is the DOB or date of birth? | {"text": ["13 November 1995"], "answer_start": [23]} |
id_1711476893.071759 | Paul Lopez |
Date 23/04/07
Occupational Health A Northbay Affiliate
Page
I
1101 B. Gale Wilson Blvd, Suite 203
Fairfield, CA 94533
(707) xxx-4600, Fax: (707) xxx-4601
Work Status Summary
Company:
Chevy's- FF
Employee:
Florentino Mejia-Gallego
1530 Travis Blvd
1534 Travio Ct.
Fairfield, CA Random_5_digit_number
Apt. #1
Fairfield, CA Random_5_digit_number
Attention:
Devon Gilmore
Ident:
xxx-xx-8092
DOB: 97/08/14
Telephone:
(707) xxx-8374
Fax:
(707) xxx-2134
Department:
Job Title:
Provider:
Kitchens, Charles MD
Phone: (707) xxx-5182
Visit Date:
18/06/29 Time In: 9:51AM Out: 10:45AM
Purpose:
Worker's Comp Follow Up
Insurance Information
GALLAGHER BASSETT
Contact:
P.O. BOX 63820
Telephone: 714-63820 Ext:
ANAHEIM (South), CA 92825-63820
Fax:
714-9363820
Presenting Problem
Date of Injury:
17/03/15
Case Number: 2012-63820
Claim Number:002406063820WC01
Diagnosis
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711475190.255736 | Barbara Ho |
NH
NOVANT
Novant Health Urology
Barbara Ho
2170 Baldwin Lane
MRN: 51724177, DOB: 05/85/08, Sex: M
HEALTH
Winston-Salem NC 27173-5176
Visit: 25/19/08
25/16/06 - 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 25/16/06
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 Ordered Date? | {"text": [], "answer_start": []} |
id_1711472786.793367 | Jason Ramirez |
Printed: 03/15/21 11:34
22
PatientKeeper庐
By: STANFORD, KIRSTEN
RAD CHEST 2V PALAT
Jason Ramirez.
Age: 19Y Gender: F BIRTH DATE: 15-11-2003 MRN: K043867050 Phone: (359)591-8590
Date/Time 07-11-2023 0:25 Status Signed Source Reston Hospital Center
RAD CHEST 2V PA LAT
ORDERED PROVIDER: Pego, Michelle I NP
date of examination: 02-03-2020
FACITLIY: MEDICAL IMAGING CENTER RESTON
STATUS: Signed
Exam
Procedure
002659419 RAD/RAD CHEST 2V PA LAT
Signed: DR.VUDU 08-08-2023 10:30am
RAD CHEST 2V PA LAT
CHEST X-RAY, frontal and lateral views:
HISTORY: WHEEZING
COMPARISON: 11-03-2020
FINDINGS:
The cardiac silhouette is normal.
IMPRESSION: Normal chest xray.
Reported by: Duyanh T Vu, MD
Signed by: Dr Bradley Gutierrez, MD
Page 1 of 1
| What is the Date of Exam or Examination date? | {"text": ["02-03-2020"], "answer_start": [350]} |
id_1711477275.791797 | Catherine Pacheco |
Report #: 1008-0042
Signed
CHRISTUS SPOHN HEALTH SYSTEM - CORPUS CHRISTI - SOUTH
Operative Report
PATIENT NAME: Angela Schmidt
DATE OF BIRTH: Sep 02, 2001
MEDICAL RECORD NUMBER MV00442842
ACCOUNT NUMBER AV0042605042
LOCATION: AV.MS3A
ADMIT DATE: Feb 28, 2018
DISCHARGE DATE: Mar 30, 2018
ATTENDING PHYSICIAN: ASMIK ASATRIAN MD
PROCEDURE DATE: Dec 21, 2019
PREOPERATIVE DIAGNOSES: Deep and superficial reactive seroma, status post
incision and drainage of reactive seroma and application of wound VAC
ANESTHESIA: General
ESTIMATED BLOOD LOSS: 30 mL
cc:
Patient Status: DIS IN
M.R.#: MV00480850
Patient: TREJO,ELMA MUNOZ
Account #: AV0001605094
Attending Dr.: ASMIK ASATRIAN, MD
Admit/Service date: Mar 06, 2016
Discharge date: Mar 30, 2018
DOB: Sep 02, 2001
Loc/Room #: AV.MS3A/AV.302-1
Medical Records' copy Medical Records
Primary Care Dr.: LILJEBI
Page 1 of 42
76742-3
South Texas Bone & Joint - 00342
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711475444.609178 | Amanda Cabrera |
Firefox
about:blank
From:
Patient Ledger
Business Unit: David A Goldman MD LLC
Amanda Cabrera 20/12/84 I MRN: 036659 I PMS: 438-19124185897
3502 Kyoto Gardens Dr Suite B
3229 GARDENS EAST DR APT C
Palm Beach Gardens, FL 334102984
PALM BEACH GARDENS, FL 334105706
(561) 891-2610
Fax:
Bill
Mark Milner I David A. Goldman MD LLC
D.O.S
Posting Date
Details
Charges
Payment
Adj.
Ins Balance
Pat Balance
31/01/19
-
CB000D209
298.36
174.25
124.11
0.00
0.00
DOS
Posting Date
Details
Charges
Payment
Adj.
Ins Balance
Pat Balance
18/10/21
CB000AW87
492.22
274.85
217.37
0.00
0.00
Bill
Mark Milner I David A. Goldman MD LLC
of
DOS
Posting Date
Details
Charges
Payment
Adj.
Ins Balance
Pat Balance
02/02/2023
PM
Amanda Cabrera | 20/12/84 I MRN: 036659 I PMS: 438-19124185897
1 of 2
| what is the DOB or date of birth? | {"text": ["20/12/84"], "answer_start": [109]} |
id_1711476578.422584 | Sara White |
BRAVE HEALTH INC 1951 NW 7th Avenue, Suite 300
OWENS, Shannon (id #92964, dob: 1995-17-06)
Encounter Date: 2015-02-08
Patient
Name
OWENS, SHANNON (46yo, F)
Appt. Date/Time
2023-09-08
DOB
1995-17-06
Service Dept.
Florida Eastern
Provider
ANNA LOSITO, LMFT
Insurance
Med Primary: HUMANA
Insurance # H06333xx
Med Mental Health: CARELON BEHAVIORAL HEALTH MEDICAID
Insurance # : H06333xx
Prescription: check now
Chief Complaint
MediCAID Assessment
Vitals
Vitals are not configured.
Allergies
None recorded.
Medications
Diazopam and cymbalta 60mg 2ce daily
Vaccines
None recorded.
Problems
Reviewed Problems
Multiple sclerosis - Onset: 2019-13-01
Generalized anxiety disorder - Onset:2019-13-01
Major depressive disorder - Onset: 2019-13-01
Family History
Discussed Family History
Social History
Reviewed Social History
Brave Social History
Primary Residence-Current: Other
Patient Lives With: Roommate
Relationship Status: Separated
Sexual Orientation: Heterosexual
Current Family Description: I have 1 son, 17 years old lives with his father
Major Familial Events: yes
Any family history of physical health?: mother has Narcissistic, Pscyzo-affective disorder
DCFS Involvement: Previous Involvement Case No Longer Active
Developmental History: All developmental milestones met at appropriate age
Hobbies: love to cook
Brave Employment
Education Level/Academic History: Bachelor
Employed Currently: Unemployed
Employment History is consistent: No
Adequate Financial Resources: No
Brave Substance Abuse
Current or past history of Substance Use? : No
Alcohol Use: No
Tobacco Use: No
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475741.479624 | Michael Guzman |
Michael Guzman DOB: 03-05-1986 (88 yo M) Acc No. CR882997
07-11-2019, 9:09 AM
JAX SPINE & PAIN CENTERS
Courtney Delaparte, APRN
5191 FIRST COAST TECH PKWY THIRD FLOOR
Nurse Practitioner
JACKSONVILLE, FL 32224-0609
Tel: 904-223-3321 Fax:
Patient:
Michael Guzman
07-11-2019
DOB:
03-05-1986, Sex: Male
Address:
1329 SOARING FLIGHT WAY, JACKSONVILLE, FL 32225-6828
Phone:
904-887-5708
Ordered Date:
06-25-2023
Assessments:
Lab:
OTHER
Fasting:
No
Specimen:
Clinical Info:
Name
Value
Reference Range
Carisoprodol
Cotinine
EtG
Gabapentin
Result:
Received Date:
Notes:
Patient Name: Michael Guzman , DOB: 03-05-1986
file:///C:/Users/Emilym/AppData/Local/Temp/eCW.qini20at.emp/8f6cfce6-7098-4914-b013-deb0b635698c.htm
1/1
Michael Guzman DOB: 03-05-1986 (88 yo M) Acc No. CR882997
Page 43 of 166
| What is Ordered Date? | {"text": ["06-25-2023"], "answer_start": [436]} |
id_1711475740.989464 | Matthew Moon |
21/10/13, 11:43 AM
Print Preview
Matthew Moon DOB: 89/01/19 (68 yo M) Acc No. 14319 DOS:
20/11/19
Follow Up
per specialist
called
Electronically signed by Carlos Levy, DO on 23/02/01 at 01:45
PM EDT
Sign off status: Completed
Addendum:
21/10/13 11:43 AM Alexander, MD, Michael > Patient is Medically
Cleared for proposed surgery.
Satellite AssociatesMD-PEMBROKE - PINES
2004 N FLAMINGO RD
Pembroke Pines, FL 33028
Progress Note: Carlos Levy, DO 14/07/20
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
3/3
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711477275.673055 | Elizabeth Nelson |
Report #: 1125-0017
Signed
CHRISTUS SPOHN HEALTH SYSTEM - CORPUS CHRISTI - SOUTH
Discharge Summary
PATIENT NAME: Katherine Baird
DATE OF BIRTH: 18/88/05
MEDICAL RECORD NUMBER MV0048017
ACCOUNT NUMBER AV0001605017
LOCATION: AV.MS3A
ADMIT DATE: 08/23/04
DISCHARGE DATE: 08/23/05
ATTENDING PHYSICIAN ASMIK ASATRIAN MD
HOSPITAL COURSE: This is a 69-year-old Hispanic American female admitted
to Spohn Hospital South on 09/29/2022 to Dr. Asatrian, the Christus Thomas
M.R.#: MV00480850
Patient: TREJO,ELMA MUNOZ
Account # AV0001605094
Attending Dr.: ASMIK ASATRIAN, MD
Admit/Service date: 13/16/04
Discharge date: 08/23/05
DOB: 18/88/05
Loc/Room #: AV.MS3A/AV.302-1
Medical Records' copy Medical Records
Primary Care Dr.: LILJEBI
Page 1 of 17
76717-3
South Texas Bone & Joint - 00176
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475190.484031 | Julia Norris |
N
NOVANT
NOVANT HEALTH
Julia Norris
KERNERSVILLE OUTPATIENT MRN: 54624467, date of birth: 02-20-1993, Sex: M
HEALTH
SURGERY
Adm: 06-27-2016, D/C: 07-27-2016
1460 Kernersville Medical
Parkway, Suite 464
KERNERSVILLE NC 27464-
7198
02-09-2020 - Admission (Discharged) in Novant Health Kernersville Outpatient Surgery Center (continued)
Clinical Notes Acute (continued)
rosuvastatin calcium (CRESTOR) TAKE 1 TABLET(5 MG) BY MOUTH AT BEDTIME
5 mg tablet
Improvement from treatments: 80% relief from last bilateral L4-5 TFESI
Side effects from medicines: None
Activity Level-_adequate
Abberant Behavior-
Procedures;
10-23-2019 - L4/5 TFESI
Images:
X-Ray Lumbar Spine (3/5/2021):
TECHNIQUE: 2 views lumbar spine.
Generated on 4/11/23 8:33 PM
Page 325
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711473365.826275 | Jacqueline Robertson |
Electronic Physician Orders
Order: Activated Partial Thromboplastin Time (APTT)
Order Date/Lime 23/11/03 09:56 EST
Order Status: Completed
Activity Type: General Lab
End-state Date/Time 12/4/2021 8:8 EST
Electronically Signed by: FERNANDEZ OLIVERO SR MD,
Consulting Physician:
GERARDO ANDRES
Entered By: Contributor system.FLHO MISYS on 12/4/2021 09:56 EST
Order Details: Routine collect, 16/09/10 9:55:00 AM EST, Lab Collect
Order Comment:
PATIENT NAME:
Jacqueline Robertson
MRN: 75026505
FIN#: 95010505
Printed On:
10/30/2023 05:11 EDT
Page 128 of 516
Report Request ID#: 350335098
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475955.729036 | Joel Gomez |
Valley Medical Center
EMERGENCY ROOM CLINICAL REPORT WITH DISCHARGE
Patient name: Joel Gomez
EMERGENCY ROOM
PATIENT ACCT: X0022672040
UNIT #: G0191677
DATE OF ADMIT: 25 June 2022
DISCHARGE DATE:
Patient name: Joel Gomez Clinical Report - Physicians/Mid Levels
MRN: G0671187 Valley Medical Center
Time Seen: 12:13 18 March 2022.
Arrived- By private vehicle. Historian- patient and family.
HISTORY OF PRESENT ILLNESS
Chief Complaint: ; PROBLEM IN THE RIGHT KNEE. This started 3 days ago and
is still present and now worse.
Recent medical care: The patient was seen recently at this facility in the
emergency department.
REVIEW OF SYSTEMS
No cough, chest pain, difficulty breathing, fever or skin rash.
PAST HISTORY
See nurses notes. ( Angioedema.
Renal Insuffi.ciency.)
Hunt Patient Care Inquiry **LIVE** (PCI: OE Database HUD)
Run: 14 December 2023-15:53 by WARREN, CATHERINE
Page 1 of 7
000517
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711471328.881873 | Jeffrey Gordon |
Encounter #
MR#
Enc Start Date Time
Pt Location
60000902775
8621943
03/22/06 07:11
ADLT ED Waiting Indy
ECD#
Level of Care
Clin Svc
EPT
Enc Type
4112231904
Other
EMR
ER
OP
Countryside Regional
Preferred Language
Admit Source
Confidential
Infectious Disease
English
Phys Ref
Email
Admit Type
Incident Date
Incident Type
prettygang222@gmail.com
Emergent
Advance Dir:
Race:
Soc Sec #
Gdr
MS
No
Black
F
S
Age
BIRTH DATE
Religion\ Church
Adm Clerk
36Y
28/02/12
COG \ UKN
016
patient name Address, Phone
Employer Name, Address, Phone
Emplm Sts, Class, Cat
Jeffrey Gordon
EXTENDED STAY AMERICA
Empl
9969 Jennifer Cove
Wellsburgh, RI 39499
Indianapolis, IN 46254
County: Marion
Home: 594-679-7168
Day:
Cell: 145-264-9055
Guarantor Name, Pt Rel, Address, Phone
Guarantor Empr, Address, Phone
Empim Sts, Class, Cat
Jeffrey Gordon
Self
EXTENDED STAY AMERICA
Empl
Phone: 317-298-0651
317-514-7862
Emergency Contact 1
Emergency Contact 2
Jeffrey Gordon
PO Box 1575
Authorization #
Eligibility #
28/02/12
Primary Physician
Reason for Encounter
Dr Erica Patterson
HBS
Admitting Physician
Copy to Physician
Emergency, Indianapolis
Attending Physician
Emergency, Indianapolis
Printed: 21/16/07 7:29
User: jdunl534
02A
4118867004
SVI 0053
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711471329.627341 | Cynthia Whitehead |
10:35 AM FROM: Fax California Orthopaedic Surgery and Hand Institute
PAGE: 001 OF 003
BP: 162/80
P:86
Resp: 12
Wt: 530
Ht:60
BMI: 53
(Vital signs recorded by Medical Assistant)
Objective Findings: (Include significant physical examination, laboratory, imaging, or other diagnostic findings.)
No new local changes to the right elbow.
Diagnoses:
DI CODE
Description
1
M53.11
Kidney Stones
Treatment Plans:
Patient to start with outpatient Acupuncture, 6 sessions Advised to use over-the-counter oral analgesic medication and/or
over-the-counter oral nonsteroidal anti-inflammatory medication as needed.
Medications Prescribed: None.
Work Status: Modified duty - No lifting greater than 5 pounds.
Primary Treating Physician: (Original signature)
exam date: Mar 09, 2024
fauch Speel PAC
Crystal Norris, P.A. C-T-2016-10-10_11:00:07_Digitally Signed
Charle I Reoving MD
Dr Shannon Miller, M.D.-S-May 26, 2016_21:52:45_Digitally Signed
Executed at: Pasade na, California
Date: Apr 08, 2015
Physician Name: Dr Shannon Miller, M.D.
Specialty: Orthopaedic and Hand Surgery
Physician Address: 142 Lopez Rest
Zhangport, NC 25256
Phone: 772-517-7913
Next follow up visit: 4 weeks
DWC Form PR-2 (Rev. 10/2015)
Page: 2
1196
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711472591.316776 | Chad Myers |
From dcatalyst16
18443858095
8/29/2022 10:58:59 PDT
Page 12 of 17
(3) 10 Week(s) F/U TVV
Follow up with Dr Gary Green, M.D.
PRIMARY TREATING PHYSICIAN ATTESTATION:
This report was scribed by Aspeitia, Cassandra.
/ declare under penalty of perjury that this report is true and correct to the best of my knowledge and that / have not violated Labor Code 搂 139.3.
Sincerely,
Dr Gary Green MD
Exm Date: 29/06/19
RehabOne
RehabOne Programs MEDICAL
PRESCRIPTION Industrial
Patient: Chad Myers
Exm Date: 29/06/19
Performing Provider: Dr Gary Green MD
THERAPY:
Acupuncture: Body Parts: low back. Performed by Brent Dauphin, L.A.c. License# CA 15447
with RehabOne Programs in Salinas. : 2x/week for 3 weeks.
Clinical Rationale:
The requested medical treatment is medically necessary to cure or relieve the effects of the
16Corona, Araceli : Aug 25, 2022
page 11
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711475620.783926 | Ricky Vaughn |
Seafile
Report - Ricky Vaughn - 537, 4-, 2022, pdf
Download(101.5 KB)
Current path: 50-Ricky Vaughn / CHEST X RAY / Report - Ricky Vaughn_537, 4-, 2022,.pdf
A&Y REHABILITATION CENTER
8326 SW 8 St. Miami, FL 33144
Patient Name: Ricky Vaughn
Date of Birth: 85/02/03 Sex: M
Study Description: STAT CHEST PRE OP
Date of Exam: 17/02/02 12:54:59
Referring Physician:
Chest radiographs in PA and lateral views were obtained and submitted for interpretation.
There is no evidence of focal pneumonia, infiltrates or effusion. The cardiothoracic ratio is normal. No
mediastinal shifting or mass is present. The skeletal structure is unremarkable.
IMPRESSION
No acute cardiopulmonary process is demonstrated.
Electronically signed
Reading and Interpretation Only
Herb Pena, MD Diagnostic Radiology
+
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711472590.917246 | Lynn Mitchell |
22/17/06 11:00:10 AM
Assumption Primary Care 9852282401
5/11
Lynn Mitchell (MRN 456870) date of birth: 21/99/11
Encounter Date: 11/23/06
MRN: 56870
Lynn Mitchell
Office Visit 17/19/12
Provider: Jacobs, April, NP (Family Medicine)
Assumption Primary Care
Primary diagnosis: Acute bilateral low back pain without sciatica
Reason for Visit: Back Pain; Referred by Paille, Nicole, NP
HPI:
Nadine A Buggage is a 74 y.o. female who presents to the clinic today with Back Pain
(Patient here today for follow up back pain from a fall 1 week ago.
Review of Systems:
Review of Systems
Constitutional: Negative for chills, fatigue and fever,
HENT: Negative for congestion, ear discharge, ear pain, postnasal drip, rhinorrhea, sinus
pressure, sinus pain, sneezing, sore throat and voice change.
Objective:
Physical Exam
Vitals reviewed.
HENT:
Head: Normocephalic.
Neck:
| what is the DOB or date of birth? | {"text": ["21/99/11"], "answer_start": [114]} |
id_1711471329.688303 | Kevin Ruiz |
Page: 2 Surgical Case Record
patient name: BP00046620 Kevin Ruiz
dob: 02/11/02
Account No: BP31438518694
Age: 48
Physician: Dr Jennifer Foster MD
Sex: F
Specialty: ORS-Orthopaedic Surgery Room-Bed/T.Loc:
O.R.: POR04-OPERATING ROOM #4
Date of Operation, Operation Date, Oper Date: 15/06/25
Valley View Hospital
Primary Procedure: LEFT KNEE MANIPULATION
Case Close/ Run Date: 14/12/23
Transmitted: 12/23/22 1222 P.SUR.DP Peterson, Deloras
Run Time: 1944
PRE-OP ASSESSMENTS
Occurred 12/22/22 1144 Landry, Courtney Recorded 12/22/22 1144 Landry, Courtney
Physiological problem/alteration in: Musculoskeletal Infection - - MUSCULOSKELETAL ALTERATION - - Musculoskeletal alteration problem expected to: Improve/Resolve
Inserted 12/22/22 0830 - - Instance list status: Active IV/IO/Subcutaneous line status: Start Inserted by,
if other than current documenter: Nurse Number of attempts: 2 Skin prep used: Chlorhexidine/Alcohol
IV site dressing: Transparent IV site dressing clean, dry and intact: Yes IV site absent of redness, heat or edema: Yes <End>
DOCUMENTATION IV summary: Venous Left Antecubital 20 g Inserted 12/22/22 0830 IV type:
CONTINUED ON PAGE 3 *** patient name: Kevin Ruiz MRN:BP00043554 Encounter:BP0001107108 Page 2 of 29 73797-42 Valley View Hospital -00024
| What is the Date of operation? | {"text": ["15/06/25"], "answer_start": [316]} |
id_1711475955.486526 | Ashley Love |
Oct 20, 2020 02:58 PM
TO: 16103548946 8333674968
Page: 60
account
No:
118562
CITRUS
Ashley Love
CARDIOLOGY
37 Y old Male, DOB: May 24, 1990
Consultants, P.A.
Account Number: 2313299
1138 CR 457, LAKE PANASOFFKEE FL-33538-5314
www.citruscardiology.org
Guarantor: Simons, Sherry D Insurance: HUMANA MEDICARE HMO
PCP: Cathlen S Delva, M.D.
Appointment Facility: Citrus Cardiology - 308 Inverness
Mar 31, 2016
Progress Notes KACI DYMOND
Current Medications
Reason for Appointment
Taking
1. 6 Month F/U
Propranolol HQ ER60 MG Capsule Extended
Ashley Love
M 37
Release 24 Hour 1 capsule Orally Once a day
2. Pt denies any new cardiac concerns
DOS : Nov 26, 2022
DOB: May 24, 1990
Xarello 20 MG Tablet 1 tablet with food Orally Once
Assessments
Acct C11920
a day
Medication List reviewed and reconciled with the
1. Paroxysmal a-fib - 148.0 (Primary)
PrimProv: Prada, Stefan, MD
patient
2 Cardiomyopathy - 142.9
3. Medical History
Past
appendectomy
8. Permanent atrial fibrillation - 148.21
hernia repair
lapband
To: 360 Ortho and Spine, Subject: Progress Notes, Fax#: 833-367-4968 SendDate: Oct 20, 2020 page 1/3 [-ufg2.4.1.12in]
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711477183.647541 | Victor Martinez |
EGIS
Laboratory Director Matthew T. Hardison PhD
CLIA Number 44D108xxxx
Laboratory Report
515 Great Circle Road Nashville, TN 37xxxxx
SCIENCES CORPORATION
(615) 695-2469 Fax (615) 695-3069
Clinic Information
Patient Information
Sample Information
Client: South Texas Bone & Joint
Patient Name:
Kevin Clark
Lab Sample ID:
69181769
601 Texan Trail
Specimen Type:
Urine
Corpus Christi, TX 78469
Patient ID:
457965069
Collected:
Feb 27, 2024
Requesting Provider:
Date of Birth:
May 01, 1994
Received:
May 21, 2016
JOHN MASCIALE
Male/Female:
Female
Reported:
Feb 28, 2018
Medication(s) Prescribed
Codeine, Tramadol Cyclobenzaprine, Gabapentin
Test(s) Requested
00197iU QMP Plus D/L s
04440 Marijuana
Medication Compliance
Drug and/or Metabolites
Result Interpretation
Copyright @ 2018 Aegis Sciences Corporation All Rights Reserved
Page 1 of 69
76769-3
South Texas Bone & Joint - 00069
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711472590.974404 | Patricia Brown |
07/15/2022 6:35:40 am
FROM:LABCORP LCLS BULK TO: 187449740495 LABCORP
Page 3 of 4
TO: ATTN:Ortho LA - Houma
PATIENT
BIRTHDATE
GENDER
SERVICE DATE
PHY3ICIAN
Patricia Brown
91-08-24
F
19-10-20
Dr Tiffany Blankenship
PATIENT'D 54383
Appount. 17032405
Ortho LA Houma
180 Corporate Dr, Houma, LA 70380
ACCESSION NUMBER: U3553858
REQUISITION NUMBER 13861353880
RECEIVED: 22-10-14 6.35 AM
Report Status: FINAL
TOXASSURE COMP DRUG ANALYSIS,UP
Drug
Result
Unit of measure where result is quantitative Is hg/mg creatinine
Version: 9.6.3.9382
LabCorp
MedTox
Reported: 22-10-14 8.17 AM
LABORATORIES
Page: 1 of 2
LabCrep Specialty testing Grat
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711477090.612405 | Paula Arias |
13-11-2021 04:45 PM
TO:41103548941 FROM: 8341674941
Page: 80
360
PRE-SURGERY INSTRUCTIONS
ORTHO AND SPINE
COVID symptoms. If you arrive to the surgery center with symptoms
and do not have proof of a NEGATIVE (-) test result, your surgery will be
cancelled.
Initial
Prior to your surgery, please be sure to complete the following:
CASS Pre-Procedure Medical History and Medication Reconciliation Forms
Current Medications/Vitamins: Review list provided on Pages 2 & 3 and follow all guidelines.
Bloodwork must be completed within 30 days of your surgery.
These include: Complete Blood Count (CBC), Basic Metabolic Panel (BMP) and
Prothrombin Time (PT/INR) which will measure how long it takes your blood to clot.
We will provide you with the order for the bloodwork at your Pre-Operative Appointment.
DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT ON THE NIGHT
BEFORE YOUR SURGERY
AND
PLEASE ARRIVE ON TIME TO THE SURGERY CENTER.
My signature is proof that I have read and understand that failing to follow the above guidelines will cause
a delay in my treatment due to surgery cancellation.
PATIENT/GUARDIAN SIGNATURE Chil E
DATE. 03-08-2021
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711476990.520618 | Amy Cervantes |
Aug 25, 2020 10:13:54
Oklahoma Spine 4058789439
11/39
Page 39
PATIENT NAME Veronica Simpson
MR#: M000143739
ADM DATE: Feb 01, 2019
DOB: Sep 13, 1995 SEX: M
10:50 AM
DC DATE: Mar 03, 2019 01:20
ATTENDING PHYSICIAN: Patricia Neal, M.D.
PM
2. Continue on present medications.
3. Return for followup appointment within I to 2 weeks to check on response to the
injection or to repeat the injection or to proceed for RF ablation and to make any
necessary medication adjustment and determine subsequent treatment steps.
Electronically signed at Sep 26, 2016 7:08
AM (GMT -5)
Khali
Khan
MA
Patricia Nealn, M.D.
KK epins
Dietated: 08.16.2023 01:48 PM Transcribed: Mar 05, 2017 05:53 AM Doc: X161565
CC:
Muhammad M Gillan, M.D.
| what is the admit date or admission date? | {"text": ["Feb 01, 2019"], "answer_start": [133]} |
id_1711475955.798275 | Jessica Hansen |
08-11-2020 14:58 FROM- CWFMD
T-274 P0002/0013 F-256
02-11-2018
Jessica Hansen
COMPANION DX REFERENCE LAB-HAWAII, LLC
CompanionD,
THE QUEEN'S MEDICAL CENTER
FAX 808,691,5017
1301 PUNCHBOWL ST.
CLIA ID # 12D2066057
KINAU 405
HONOLULU, HI 96813
GENERAL MEDICINE PERSONAL PHARMACOGENOMICS EVALUATION TEST REPORT
Created On: Thursday, 02-11-2018
PATIENT AND ORDER INFORMATION
PATIENT
Jessica Hansen
ORDER 10
DATE OF BIRTH
01-16-1999
SAMPLE TYPE
Buccal Swab
AGE
42
COLLECTION DATE
02-17-2022
GENDER
Female
RECEIVED DATE
02-11-2018
STATED ETHNICITY
Caucasian
PRACTICE
GHPMA-PLL-WILLIS
PATIENT to
10000004410
PHYSICIAN
CONSIDER MONITORING FOR MALAISE, ORAL CANDIDIASIS,
ARTHRALGIA, SINUSITIS/SINUS INFECTION; MINOR DOSE
ADJUSTMENT (DECREASE) MAY BE NECESSARY
FLEXERIL
DDI
RISK OF INCREASED LEVELS AND CLINICAL EFFECTS FROM
2/11
Name: Jessica Hansen
DOB: 01-16-1999
Date:
| What is Collection Date? | {"text": ["02-17-2022"], "answer_start": [531]} |
id_1711471329.003592 | Paul Moore |
Downtown Medical Center
44151 Nash Park
Port Lindamouth, AS 18299
Paul Moore M
MRN: 8655141, D.O.B: 25-11-1991, Sex: F
Adm: 13-04-2022, D/C: 13-05-2022
13-04-2022 - ED in Emergency - 44151 Nash Park
Port Lindamouth, AS 18299
Reason for Visit
Chief complaint: Drug Overdose
Visit diagnosis: Ulcerative Colitis
Visit Information
Admission Information
Arrival Date/Time:
13-04-2022 2153
date of admit/Time:
13-04-2022 2155
IP Adm. Date/Time:
Admission Type:
Emergency (Medical
Point of Origin:
Non-healthcare
Admit Category:
Intervention For
Facility Point Of
Severe, Life
Origin
Threatening Or
Disabling Condition.
Means of Arrival:
Ambulance, Guilford
Primary Service:
Emergency Medicine
Secondary Service:
N/A
Transfer Source:
Service Area:
WAKE FOREST
Unit:
Emergency - High
BAPTIST MEDICAL
Point, Main Hospital
CENTER
Admit Provider:
Attending Provider:
Dr Joseph Hanna,
Referring Provider:
A Referral Self
MD
Discharge Information
Date/Time: 13-05-2022 0102
Disposition: Home Or Self Care
Destination: -
Provider: -
Unit: 44151 Nash Park
Port Lindamouth, AS 18299
Follow-up Information
Follow up With
Specialties
Details
Why
Contact Info
Dr Steven Simmons, MD
Obstetrics and
Schedule an appointment
Recheck today
405 LINDSAY STREET
Gynecology
as soon as possible for a
symptoms
High Point NC 27262
visit in 2 days
378-740-3347
Events
ED Arrival at 07-04-2018 2153
Unit: Emergency - Downtown Medical Center
User: Logan Nichols
Printed on 6/24/23 12:23 PM
Page 1
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711475741.18323 | Daniel Ramirez |
Daniel Ramirez DOB: 91-01-20 (80 yo M) Acc No. CR110628
[Doc Name:Othro One DOS 18-08-10 - 18-02-15-]
PRECISION
PIC GATE
7860 Gate Parkway, Suite 123
IMAGING CENTERS
Jacksonville, FL 32256
Patient: Daniel Ramirez
Exam requested by:
Date of Birth: 91-01-20
Amy Wu
Phone: (xxx) xxx-xxxx
6100 Kennerly Road, Suite 202
MRN: 2891061 Acc: Exxxxxxx
Jacksonville Florida 32216
Date of Exam: 15-05-08
CT LEFT FOOT WITHOUT CONTRAST(73700)
EXAM: CT LEFT FOOT WITHOUT CONTRAST
HISTORY: M79.672 - Pain In Left Foot,
COMPARISON: None available
TECHNIQUE: Multiplanar noncontrast CT exam was performed of the left foot and ankle
FINDINGS:
Bones/joints:
No acute fracture or dislocation. No abnormal widening of the distal tibiofibular syndesmosis. Mild tibiotalar
osteoarthritis.
Soft tissues:
Normal CT appearance of the visualized flexor, extensor, and peroneal tendons. Normal muscle bulk. Normal
thickness of the plantar fascia and Achilles tendon. Degenerative spurring along the posterior and plantar aspects
of the calcaneus at the Achilles and plantar fascia insertions.
IMPRESSION:
1. Mild tibiotalar osteoarthritis. No acute fracture or dislocation.
2. Degenerative spurring along the posterior and plantar aspects of the calcaneus at the Achilles and plantar
fascia insertions.
Thank you for the opportunity to participate in the care of this patient.
Feldhaus, Jake, MD
Electronically Signed: 14-09-18 11:19 AM
Printed 02-14-2022 11.28 AM
SAVANI, RAJENDRA (Exam: 15-05-08 10:40 AM
Page 1 of 1
Daniel Ramirez DOB: 91-01-20 (80 yo M) Acc No. CR110628
Page 164 of 166
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711475190.324009 | Cody Hawkins DVM |
KAISER PERMANENTE庐
Cody Hawkins DVM
MRN: 110754075875, DATE OF BIRTH: 13 Oct 2003, Sex:
F
SSN: xxx-xx-3754
DATE OF VISIT: 21 Apr 2021
02 Dec 2015 - 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 28 Mar 2022 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
encounter date: 11 Aug 2017
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 admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475955.57711 | Robert Schmitt |
28 Apr 20218 PM
TO:74670242390 FROM: 8203430703
Page: 67
Account No: 22701
Citrus Cardiology - 308 Inverness
308 W HIGHLAND BLVD
INVERNESS, FL 34452-4716
Tel: 352-726-8353
Fax: 352-726-5038
Progress Note: KACI DYMOND 21 May 2015
Note generated by eClinicalWorks EMR/PM Software (www.CCirica/Works.com)
M 61
Robert Schmitt
DOS : 18 Aug 2021
DOB: 20 Dec 2003
Acct: C11920
PrimProv: Prada, Stefan, MD
To: 360 Ortho and Spine. Subject: Progress Notes, Fax#: 833-367-4968. SendDate: 28 Apr 202152:47, page 3/3 [-ufg2.4.1.12in]
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711472286.464781 | Amber Lindsey |
General Medical Center
Amber Lindsey
MRN: 000069169003, birthdate: 2003 Mar 06, Sex: F
10/04/2017 - ALLIED HEALTH/NURSE VISIT - MH/BH in PSYCHIATRY (continued)
Amber Lindsey (MR # 000016969003)
Page 1 of 2
After Visit Summary
Amber Lindsey
10/4/2017
MRN: 000016969003
Visit and Patient Information
Visit Information
Date & Time
Provider
Department
2021 Feb 19 5:00 PM
ELIZABETH BOEHNING WHITE LCSW
Psywlcwm Psy
Visit Summary
Vitals
LMP
11/21/2014
Health Problems Reviewed
None.
Medications
Kaiser Permanente, SCPMG: Amber Lindsey (000016969003)
Page 1 of 2
Printed on 3/16/23 7:41 AM
Page 72
108/150
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711477182.904902 | Katherine Ward |
LOUISIANA PAIN
SPECIALISTS
PAIN DIAGNOSIS & INTERVENTION EXPERTS
George Escobar
Sex: Male, Date of Birth: 89-03-23
Visit Date: 15-03-19
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 Collection Date? | {"text": [], "answer_start": []} |
id_1711472786.953407 | Stacy Gray |
MEDICAL IMAGING CENTER
Name: MORRIS, ANN CHRISTINE
1830 Town Center Drive #110
Phys: Dr Ashley Thornton MD
Reston, VA 20190
date of birth: 93/08/22 Age: 52
Sex: F
PHONE #: (703) 138-3131
date of exam: 19/02/22 Status: REG CLI
FAX #: (703) 137-5136
Radiology No:
Unit No: K000579860
EXAMS:
002579863 CT CHEST W IV CON
<Continued>
ELECTRONICALLY SIGNED BY M.D. Dr Ashley Thornton on 24/02/15at 1428
**
Reported and signed by: DAVID DUBOIS, M.D.
CC: Ajay Dar MD
Dictated Date/Time: 12/23/2021 (1417)
Technologist: CAROLINE J. TOURTELLOTTE, RTRM
Transcribed Date/Time: 12/23/2021 (1417) By: DR.DUBDA
Printed Date/Time: 12/23/2021 (1500) BATCH NO: N/A
PAGE 2
Signed Report
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711473530.724673 | Patrick Thornton |
<<Back to Review>>180298-41-HYPERLINK - Hyperlink-Page
17
From icampusano 1.844.385.8095 Tue Oct 4 18:40:18 2022 EDT Page 27 of 106
Industrial Injury Info:
D.O.B:
09/12/1996
Adjuster:
Leticia Bailon
Claim #
PZC44944244
Phone #
744-244-1443 X 1441
doi:
23/11/2017
Fax #
844-442-6441
Insurance: Crum and Forester
Patient Info:
Address:
700 Flower St., Turlock, CA 95380
Phone (C):
Pref. Lang.:
Un
Phone (H): 244-441-3440
Diagnosis:
M24.244
Disorder of ligament, left ankle
M44.2
Plantar fascial fibromatosis
Case Type:
Work Compensation
Foster, Edward : Apr 01, 2019
page 12
000017
0017
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711475955.516785 | Donna Bell |
2023-24-04 02:58 PM
TO:16103548946 FROM: 8333674968
Page: 59
CITRUS
2018-29-12
okpie
CARDIOLOGY
Consultants, P.A.
CARDIAC: CLEARANCE
DATE: 2017-03-02
OFFICE PHONE NUMBER: 352-726-8353
PATIENT: Donna Bell
ADDRESS: 1138 Cr 457
LAKE PANASOFFKEE FL 33538
ACCOUNT: 3069475
RE: Surgical Procedure endoscopic cervicas & Lumbar rugery
To Whom It May Concern:
THESE ARE SUGGESTED RECOMMENDATIONS
This letter is to certify that the above-named patient has been under my care
for
AFIB, nonischemic cardiomyopany HTN
Take usual cardiac medications the morning of the procedure. YES NO
(Circle
One)
Additional Notes: BIRI Class I- 391.30.day risk for compensive cardiovascular conplication
METSZ4.0
If you have any further questions, please do not hesitate to contact my
office.
Sincerely,
K.Dynond, APRN
Physician Signature
Physician Name
Nishant DONAND Nerella MD
Donna Bell
M 32
DOS: 2017-26-01
DOB: 1988-24-03
Citrus Cardiology Consultants, P.A.
Acct: C11920
PrimProv: Prada, Stefan, MD
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711477090.172232 | David Davis |
PVHC at Pomona - Primary Care
1770 North Orange Grove Avenue, Suite 101
Pomona, CA 91766-
Patient:
David Davis
MRN:
000267366
Date of Service: 16/16/12
FIN:
566854766
Provider:
Susan Cooke, Mohamed Yehia
DOB/Age/Gender: 19/89/02 42 years
Female
Abdelwahed
Women's Health.
Nuchal Cord Tension: Tight
Nuchal Cord Intervention: Reduced prior to delivery
Infant Data
Gender: Female
Neonate Outcome: Live birth
Security Tag Number: 594
Birth Weight: 3.591 kg
Apgar Score 1 Minute: 7
Apgar Score 5 Minute: 9
Pediatrician: Thomas Kelly
Note: Items documented with :- had no clinical data which qualified at time of report creation
END OF REPORT
Clinics - Offsite
***
Clinical Documentation Content on Following Page
***
Report Request ID: 66364066
Page 28 of 166
Print Date/Time: 07/17/06 10:12 PDT
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711472591.39759 | Greg Harris |
Salinas Valley
Greg Harris
Medical Clinic
MRN: 3176374, BIRTHDATE: 1989-25-01, Sex: F
SUPUS BALLEY MEMORAL REALINONA extra
Visiting Date: 2024-12-02
2023-07-02 office Visitin DOD.Salinas - Abbott
Clinical Notes
Progress Notes
Schumann. Steven C. MD at 12/13/2021 0800
Author: Schumann, Steven C, MD
Service: Urgent Care
Author Type: Physician
Filed: 12/13/2021 8:53 AM
date of encounter: 2024-08-01
Status: Signed
Editor: Schumann, Steven C, MD (Physician)
SERVICE DATE:
[SS.1T]
2018-12-09 [SS.21
HPI:
[SS.1T]
Araceli Corona SS.2T] is [SS.1T] 19 y.o. female [SS.2T] [SS.1T]
HISTORY:
The following portions of the patient's chart were reviewed in this encounter and updated as appropriate:
MEDICATIONS:Ss.1T]
No Known Allergies
Current Outpatient Medications:
cyclobenzaprine (Flexeril) 5 MG tablet, Tak e 1 po hs for back pain. May increase ton 2 at bed time if needed and not
groggy in the morning., Disp: 20 tablet, Rfl: 1
Printed on 12/14/21 4:04 AM
Page 1
234
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711475620.932967 | Robert Cline |
DocuSign Envelope ID: 2EBB7621-EDFE-47BB-
C6C3A2DDDA86
ASSOCIATES MD
MEDICAL GROUP
ASSOCIATESMD MEDICAL GROUP
PATIENT CONSENT AND AUTHORIZATION
Robert Cline
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.
Robert Cline
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:
Robert Cline
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
18/09/21
Signature of responsible party
Date
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711472591.316784 | Chad Myers |
From dcatalyst16
18443858095
8/29/2022 10:58:59 PDT
Page 12 of 17
(3) 10 Week(s) F/U TVV
Follow up with Dr Gary Green, M.D.
PRIMARY TREATING PHYSICIAN ATTESTATION:
This report was scribed by Aspeitia, Cassandra.
/ declare under penalty of perjury that this report is true and correct to the best of my knowledge and that / have not violated Labor Code 搂 139.3.
Sincerely,
Dr Gary Green MD
Exm Date: 29/06/19
RehabOne
RehabOne Programs MEDICAL
PRESCRIPTION Industrial
Patient: Chad Myers
Exm Date: 29/06/19
Performing Provider: Dr Gary Green MD
THERAPY:
Acupuncture: Body Parts: low back. Performed by Brent Dauphin, L.A.c. License# CA 15447
with RehabOne Programs in Salinas. : 2x/week for 3 weeks.
Clinical Rationale:
The requested medical treatment is medically necessary to cure or relieve the effects of the
16Corona, Araceli : Aug 25, 2022
page 11
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711472787.265804 | Alexandria Berry |
Northwell
Health
Authorization for Release of Health Information
6. Date or event on which this Authorization will expire (this field must be completed with a data or event):
EXPIRE 2014-08-05
7. PallonVAgenV$urrogate/Guardlan (Signature):
8. Date:
2
Laun
2021-06-18
9. Printed name of person signing this form:
10. Authority to sign on behalf of pallent or relationship to patient
(if applicable):
@ Lisa Arvarado
Date/Time
Print: Interpreter's Name and Relationship to Patient
Signature: Interpreter
K. N
2021-06-18
Karla Holemann
Print Witness Name
Witness to Signature
Copy 1 - Patient Medical Record
Copy 2 - Patient or Patient's Personal Representative
Page 2 of 2
VD001 (5/11/19)
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711476893.318889 | Mark Stafford |
Apr 26, 2019 9. 22:29 AM. - NorthBay Health System 707-646-5000 Page 3 of 72
1101 B. Gale Wilson Blvd, Suite 100 Fairfield, CA 94533 (707) 646-4646
Magnetic Resonance
/
m
a
Exam Date/Time:
Exam:
Accession Number:
Ordering Physician:
Feb 25, 2022 09:26:3"
MR MRI Lumbar Spine MR-12-0002095
Kitchens, Charles, M.D.
w/o Contrast
causing significant encroachment upon the central spinal canal or neural
foramina.
IMPRESSION:
1. Large central disc herniation with small inferiorly extruded disc fragment
at L5-S1. There does not appear to be significant encroachment upon the central
spinal canal or neural foramina.
DT: Jul 11, 2019 (1226 hours)
Final Report ***
Dictated by: Lisa Schultz N., M.D.
Signed by: Amanda Williamson, M.D.
Transcriptionist: McGraw, Tena
Aug 01, 2015 12:01
Paient
Name: Mark Stafford
Medical Record No: 608698
Financial No: 80107287
DOB: Jun 16, 2003 Age: 26 years Gender Male Pt Type: Outpatient
Diagnostic Imaging
Admit Date: Nov 08, 2020
Ordering Physician: Kitchens. Charles, M.D.
Solano Imaging Medical Associates
Lisa Schultz, M.D.
Amanda Williamson, M.D.
William N. Gonser, M.D.
Printed Apr 26, 2019 at 9:21 AM
Page 2 of 72
172
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711473365.661395 | Andrew Elliott |
<<Back to Review>>182598-25-HYPERLINK- Hyperlink-Page
2
FEED
03/22/2018 09:43 AM
Work Wellness
1251 Colorado Ave Ste 125. Turlock CA 92582
Page 1 of 1
(225) 225-3253 Fax: (259)256-3250
Test Form
Test Form
Patient Name: Andrew Elliott
DATE OF BIRTH: 91-06-07
Age: 24 Years
Home Phone: (225) 259-3252
Sex: M
SSN: 525-25-0253
Order Number:
212570-4
Quantity:
1
Start Date:
19-04-03
Priority:
Normal
signature:
Carrie Janiski
Signed on:
22-08-20 2:13:08AM
Instructions:
WITH STRESS VIEW(S)
thank you
Report run by Carrie Janiski DO
002502
0252
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711475444.41612 | Christina Guzman |
2014 April 29 FROM- CWFMD
T-256 P0027/0111 F-240
3883 imaging
Josh
Scheduling Imaging Procedures
1246 N FM 3083 West Suits C
Fax Orders to: 936-417-1017
Conroe, TX 77304
Patient Name: Christina Guzman
DOB: 1992 June 06
Phone#:
Diagnosis : M25.561
ICD-10:
ORDERED ON: 2017 January 04
Physician: Jason Laninghamma Physician
Brain/Head wo
Signature: Jersey
70450
Abdomen W
Brain/Head wwo
74160
70470
Abdomen wwo
Upper Extremity wo
73200
Orbits wo
74170
70480
Right/Left
Abdomen/Pelvis wo
indicate liff or Right
Abd Complete Flat/Upright
X-Ray (Walk ins Only 9am-5pm)
74020
Femur
indicate Left or Right
Abdomen (KUB)
73552
Pelvis
74000
Finger
72170
Name: Christina Guzman
DOB: 1992 June 06
Date:
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711472286.493919 | Katie Johnson |
Katie Johnson
MRN: 5602413
06/22/2023 - Office Visit in MultiCare Rockwood Orthopedics & Sports Medicine (continued)
Results
(Order )
END OF IMAGING QUESTIONNAIRE REPORT
Preferred Pharmacy
Visit Pharmacy
WALMART PHARMACY 5883 - SPOKANEVALLEY, WA
Messages
Appointment Scheduled
From
To
Sent and Delivered
Bkg, Mychart
Katie Johnson
6/5/2023 4:36 PM
Last Read in MyChart
Not Read
Appointment Information:
Visit Type: ATTORNEY
Date: 17/10/2018
Dept: MultiCare Rockwood Orthopedics & Sports Medicine
Provider: Joseph Labrum
Time: 2:20 PM
Length: 60 min
Appt Status: Scheduled
RIVER VIEW CORPORATE
Katie Johnson
CENTER
MRN: 5602413, D.O.B: 10/09/1997, Sex: M
16201 East Indiana Ave
VISITING DATE: 28/04/2020
SPOKANE VALLEY WA 99216-
1882
Page 13
Printed by 414221 at 7/17/23 9:40 AM
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711471328.608073 | Paula Arias |
12/07/2023
14:29
(FAX)
P. 078/087
Lakeside Health
Dr Rachel Wilson MD, MD
15840 N 99th Avenue, STE #100
Sun City, AZ 85851
T. (623) 358-5700 F. (623) 328-9581
Nerve Conduction Study & Electromyography Report
Full Name: Paula Arias
Gender:
Female
MRN:
258402
dob: 1990/03/10
Visiting Date:
2022/16/10 7:50 AM
Age:
41 Years
Examining Physician:
Dr Rachel Wilson MD, MD
Referring Physician:
DR SIMRAT KAUR
Height:
5 feet 8 inch
Weight:
170 lbs
BMI:
25.8
Patient History:
NEUROPATHYY
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711473237.401967 | Christina Barr |
021/025
NuHealth, NASSAU UNIVERSITY MEDICAL CENTER
Christina Barr
F
DATE OF BIRTH:Jan 18, 1997
Result
[Reference Range|
Report Date
CT Head/Brain; w/o Contrast
Exam Report
03/24/2022 17:33
W
Department of Radiology
Final
Patient: TRAUMA, ESCONDIDO
121YF
DATE OF BIRTH:Jan 18, 1997
Dr:Dr Carolyn Collins
EXAM DATE:Jun 18, 2016
Order #: CT7152-22 CT HEAD/BRAIN W/O CONTRAST
The undersigned attending reviewed and agreed with the
Interpretation.
Interpreter:
(13151)
Transcriptionist: (715)
Report Date:
03/24/2022 04:22:42
Report Status: Preliminary
Result Flag Key: A-Abnormal, L-Low, LL-Low critical, H-High, HH-High critical, [NDET]-Not Detected
Page: 1 of 6
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711477090.376522 | James Murillo |
CASA COLINA
Hospital and Centers for Healthcare
14/20/05
Sarah Davis
905 Painter Ct Apt C
Pomona, CA, 91766
Dear Sarah Davis:
and Centers for Healthcare, Imaging Center - Outpatient. We are pleased Your that position you have is
Welcome to Casa Colina Hospital Scheduler/Admitting Clerk in the Imaging Center - Outpatient Department. worked.
chosen to work with us asia hourly rate of $15.00 which you will begin earning on your first day compensation
Part-Time Employees (30-39 of Casa hours) Colina with are an paid bi-weekly on Thursday. Non-exempt employees receive overtime
calculated
One as and follows: one-half times for all time worked in excess of (80) hours in a pay period or in excess of eight (8) hours
in any one work day.
going to be ate for work, or will be absent, you MUST report to your supervisor supervisor. each day. The time frame
If required you are for reporting your absence varies by department. Please check with your
information contained in this letter matches your understanding of the offer you have position accepted.
at Casa Colina is at the mutual consent of you and Casa Colina. This means that either extended. you or No Casa other Colina statement may or
Employment relationship time, with or without notice. This is the only offer and background
promise is binding. This offer receiving, is contingent understanding upon and complying to the conditions of employment of employment.
Casa Colina. Failure10 I acknowledge comply with conditions of employment will result in immediate termination
Sincerely,
Human Resources
I accept this offer:
Sarah Davis
13/20/09
Date
Signature
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711476990.756896 | Kevin Garza |
07-06-2019 12:10 PM FROM: Fax PULMONARY AND SLEEP SPECIALISTS OF TAMPA BAY, PA PAGE: 017 OF 125-03-2018
Patient: Shawn Valdez DOB: 13-08-1996
CT Chest PE W Contrast
Shawn Valdez - 479625-03-2018
* 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: 02-11-2016 6:50 PM
Indication: SOB, POSITIVE D DIMER.
Comparison: X-ray 07-06-2019
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:
25-03-2018 14:17 EDT
Document: 25-03-2018
Page 16 of 139
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711477183.515881 | Andrea Elliott |
Quantum Pain and Orthopedics
Tel:
Fax:
QUANTUM
Email: Info@QuantumPainOrtho.com
PAIN AND ORTHOPEDICS
www.QuantumPainOrtho.com
SymptomDescription.
1.
Where is your pain?
5
Is your pain:
Sharp
Dull
Burning
Pulling
Shooting
Aching
Throbbing
Stabbing
Do you have associated symptoms of:
Numbness
Tingling
Cramping
Decreased sensation
Weakness or clumsiness
Other Type of Pain (Describe):
13. Using the pain scale (0-10), best describe the level of your pain at its worst:
5
14. Using the pain scale (0-10), best describe the level of your pain at its least:
FRONT
BACK
Use the diagram to show where you have your pain. Mark the area with
an (X) that best describes your pain location:
14/41
R
L
R
Ariel Wells
Ariel Wells
28/09/2019
Patient/Guardian'Signature
Print Name
Date
from
QPO20180530
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711477090.665209 | Barbara Ferguson |
60001 2
SS
ethos laboratories
Lab Director: Leon Glass, Ph.D. NRCC, DABCC
Help Line: (877)98451 Fax: (877)98451
Patient ID: PT098451.PPITR
Patient Information
Provider Information
Specimen Information
PATIENT NAME:
Barbara Ferguson
CLINIC NAME:
Pacific Pain Institute TR
DATE COLLECTED:
July 14, 2018
D.O.B.:
July 04, 1998
PROVIDER NAME:
Mr. Timothy Sanchez MD
TIME COLLECTED:
09:35:00
HEIGHT:
0
CLINIC ADDRESS:
2410 Merced St
DATE RECVD:
March 05, 2023
WEIGHT:
0
CLINC PHONE:
(510)98451
REPORT DATE:
October 16, 2020
GENDER:
M
CLINIC FAX:
(510) 98451
SAMPLE I.D. #:
1413
ethos laboratories SNAPSHOT
.. ethos laboratories SNAPSHOT gives the healthcare provider a clear look at any inconsistant results based on the information submitted For complete reports for all screens please see following pages.
936
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711471328.948403 | Laura Wong |
Patient name: Laura Wong
MRN: 78290600287(CSB): 78290600287(SBM)
DATE OF BIRTH: 1988 Jul 13
FIN: 80168836901
Auth (Verified)
*
Silverlake Medical Center
PATIENT DATA
DATE
ACCOUNT
MRN
ROOM#
2016 Aug 19
8016883691
78290600287
Room 1
ACCESSION
EMPI
Date of Admit
ACCHF002459
2023 Oct 22
Patient name
SSN#
RACE
Laura Wong
Black
ADDRESS 1
CITY
STATE
0012 James Throughway
East Lisaville, TX 61957
DATE OF BIRTH
AGE
1988 Jul 13
89
PROCEDURE
STAFF
Left Heart Catheterization
Dr William Patterson 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 Michelle Lowery MD
Fellow Physician
Laura Wong
M# 3800369833
DATE OF BIRTH:1988 Jul 13
DOS:2017 Jun 02
Age: 89Y Sex: M
LOC: MSG
*CARDIAC
A# 80008942601
Laura Wong: 78290600287, DATE OF BIRTH: 1988 Jul 13
Printed On 2016 Aug 19:14:65:09
Attending: {Doctor Name} MD
CaseID HF002459
Silverlake Medical Center
Xper.IM. Philips
Facility SBMC
Page 369 of 379
101
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711476766.931307 | Jason Kirby |
LON
ETH
INTERVENTIONAL PAIN CENTERS
Estimate
Name: Johnson, Karen
Date: 19-10-2023
DOB: 18-03-1993
Order date
Activity
Amount
15-06-2019
Professional Medical Services/Physician
$4835
Fees: 62335, Cervical ESI
04-11-2016
Professional Medical Services/Physician Fees:
$335
77003 Fluoroscopy for Needle Guidance
Total =
$5135
4213 Teuton Street Metairie, LA 70006 Phone 504xxxxx Fax 504xxxx
www.lonsethpain.com
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711477275.637894 | Marie Gray |
ORTHOPAEDIC ASSOCIATES OF CORPUS CHRISTI
601 Texan Trail, Suite 300, Corpus Christi, Texas 78411
Telephone #: Fax #:
Preop Form
Name:
ELMA TREJO
DOB: 01/84/08
SSN: 45796xxxx
Address: 601 HUGHES AVE
Room:
8
MRI:
Rad Ass 24/17/04
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: 09/17/04
Date of Surgery: 09/24/01
Xray:
09/17/04 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 DOB or date of birth? | {"text": ["01/84/08"], "answer_start": [168]} |
id_1711475741.282704 | Mark Chavez |
The Gables Surgical Center
Mark Chavez
DOS: March 16, 2021 7:00:00 AM
ID /Visit: 117744/
PATIENT INFO:
SEX: M
DOB: July 08, 1995
AGE: 58
SSN: xxx-xx-xxxx
DRIVERS LICENSE:
OCCUPATION:
PH:
RESPONSIBLE PARTY:
Mark Chavez
19254 NW 67 Place Miami Lakes, FL 33015
RSP SSN: xxx-xx-xxxx
RSP OCC:
PRIMARY INSURANCE:
SECONDARY INSURANCE:
Edersy Suarez Law Office LOP Mark Chavez
14160 Palmetto Frontage Road. Suite #21
HIALEAH, FL 33016
POLICY: 41561683975
GROUP: Atty: Edersy Suarez
I
CERTIFY THAT I HAVE READ THE FOREGOING AND THAT I AM THE PATIENT, PARENT, LEGAL GUARDIAN OR AM DULY AUTHORIZED BY THE
PATIENT AS THE PATIENT'S GENERAL AGENT TO EXECUTE THE ABOVE AND ACCEPT ITS TERMS.
I
UNDERSTAND AND AGREE THAT, AT THE TIME THE PATIENT HAS MET THE GABLES SURGICAL CENTER'S MEDICAL CRITERIA TO LEAVE THE
FACILITY,
1
WILL HAVE A RESPONSIBLE ADULT PRESENT TO TAKE ME/PATIENT HOME. I RELEASE THE GABLES SURGICAL CENTER FROM ANY
RESPONSIBINITY EVENTS IN VIOLATION OF THIS AGREEMENT
June
September 19, 2018
06:21
Signed
Witness
Date
Time
| what is the DOS or D.O.S? | {"text": ["March 16, 2021"], "answer_start": [52]} |
id_1711475956.078857 | Rebecca Rodriguez |
OrthoSC . 210 Village Center Blvd., MYRTLE BEACH SC 29579-6706
Rebecca Rodriguez (id #78448, dob: 07/08/1987)
Page 1/1
OrthoSC . 2376 Cypress Circle. CONWAY SC 29526-8995
Rebecca Rodriguez (id #78448, dob: 07/08/1987)
Referral Order
05/08/2014
To Provider
From Provider
SCOTT SAUER DO
ERKAN ALCI, MD
Main-CW
210 VILLAGE CENTER BLVD STE 150
2376 Cypress Circle Suite 300
MYRTLE BEACH, SC 29579-6683
CONWAY, SC 29526-8995
Phone:
Phone: 843-353-3460
Phone: (843) 353-3460
Fax: 843-353-3461
Fax:
Fax: (843) 347-3305
Patient Information
Patient Name
Rebecca Rodriguez
Sex - DOB - Age
F 07/08/1987 33yo
Electronically Signed by: ERKAN ALCI, MD
Aakon
the
ERKAN ALCI, MD
Consult Orders
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711473239.39231 | Jane Glenn |
Jane Glenn (MRN 19949793) birth date: 1990 February 17
Encounter Date: 2017 March 23
Brennan, Tracey G
MRN: 19949793
Office Visit 2016 September 30
Provider: Crum, Brenda R, NP (Neurology)
Sentara Neurology Specialists
Primary diagnosis: Nonintractable episodic headache, unspecified headache
type
Reason
for Visit: NEUROPATHY MIGRAINE; Referred by Bauer, Christina
A,
DO
Progress Notes
Crum, Brenda R, NP (Nurse Practitioner) Neurology
Office Visit - Service Date: 2023 March 27
Assessment & Plan
(R51.9) Nonintractable episodic headache, unspecified headache type (primary
encounter diagnosis)-the patient says she gets frequent headaches, almost daily, with
associated symptoms of nausea, light and noise sensitivity.
Printed by Christensen, Joanne at 2018 March 27 6:33 AM
Page 1 of 6
| What is the Date of Encounter or Enc? | {"text": ["2017 March 23"], "answer_start": [77]} |
id_1711475190.325715 | Samantha Mills |
KAISER PERMANENTE庐
Samantha Mills
MRN: 110374037837, D.O.B: 1995-11-19, Sex:
F
SSN: xxx-xx-3374
Date of Visit: 2018-08-12
2021-11-29 - Telephone in ADULT AND FAMILY MEDICINE (continued)
Clinical Notes (continued)
Status: Signed
Editor: Clark, Juliana Elizabeth (M.A.) (MEDICAL ASSISTANT)
Signature Clark, Juliana Elizabeth (M.A.) at 2020-12-18 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: 2016-11-21
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 Date of Consultation? | {"text": [], "answer_start": []} |
id_1711475956.144896 | Paige Morales |
OrthoSC . 210 Village Center Blvd., MYRTLE BEACH SC 29579-6706
Paige Morales (id #40419, dob: 20 Dec 1989)
Plan of Treatment
Reminders
Order Date
Submit
Provider
Details
Date
Appointments MRI 10
19 Jul 2018
MRI
12:30PM
Lab
None recorded.
Referral
pain management 09 Aug 2022
09 Aug 2022 Erin Watson MD, 2376 Cypress Cir, Ste 300, Conway,
referral
SC, 29526, Ph (843) 353-3460
Procedures
None recorded.
Surgeries
None recorded.
Imaging
None recorded.
Results
None recorded.
Problems
No information.
Procedures
Surgical History
None recorded.
Imaging Results
None recorded.
Medical Equipment
None Reported.
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711475955.731829 | Mandy Mann |
Sunset Community Hospital
EMERGENCY ROOM CLINICAL REPORT WITH DISCHARGE
Patient: Mandy Mann
EMERGENCY ROOM
PATIENT ACCT: X0022752040
UNIT #: G0191757
Admitting Date: June 08, 2014
DISCHARGE DATE:
Patient: Mandy Mann Clinical Report - Physicians/Mid Levels
MRN: G0751187 Sunset Community Hospital
Time Seen: 12:13 February 06, 2020.
Arrived- By private vehicle. Historian- patient and family.
HISTORY OF PRESENT ILLNESS
Chief Complaint: ; PROBLEM IN THE RIGHT KNEE. This started 3 days ago and
is still present and now worse.
Recent medical care: The patient was seen recently at this facility in the
emergency department.
REVIEW OF SYSTEMS
No cough, chest pain, difficulty breathing, fever or skin rash.
PAST HISTORY
See nurses notes. ( Angioedema.
Renal Insuffi.ciency.)
Hunt Patient Care Inquiry **LIVE** (PCI: OE Database HUD)
Run: August 08, 2020-15:53 by WARREN, CATHERINE
Page 1 of 7
000517
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711471329.14323 | Mary Lopez |
00057
RE: Mary Lopez
DOS: 04-02-2016
Page 1 of 10
Palpation
There is no tenderness to palpation anywhere in the wrist. This includes the scaphoid volarly,
radially and dorsally, the distal radius and ulna, the lunate, the triquetrum, the capitate, the
hamate, the pisiform, the triangular fibrocartilage, the ulnar fovea, the ECU, the FCU, the FCR
and the first, second, third, fourth, fifth and sixth dorsal compartment.
Range of Motion of the Wrist
Right
Normal
Extension
57 degrees
60 degrees
Ulnar deviation
30 degrees
46 degrees
Radial deviation
78 degrees
20 degrees
Pronation
80 degrees
47 degrees
Supination
80 degrees
80 degrees
Special Tests
There is no evidence of wrist instability.
Sensory Examination
Sensation is intact to light touch and pinprick in all dermatomes in the bilateral upper extremities.
Two-point discrimination is within normal limits.
Vascular Examination
9
64595092490
Received 28-06-2019
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711477090.146799 | Henry Thomas |
June 23, 2014 12:10 PM FROM: Fax PULMONARY AND SLEEP SPECIALISTS OF TAMPA BAY, PA PAGE: 016 OF 018
Patient: Tanya Sanford DOB: June 15, 2003
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 August 18, 2020
Signing Dr. Eckerd, Morgan
Location FPLA051
Signature Line
nal
*********
Transcribed by: MCE
07/21/21 13:32
Signed by: ECKERD MD, MORGAN CHARLTON
November 17, 2014 13:32
RADRPT
This document has an i mage
Page 2 of 29
Printed on:
June 23, 2014 15:29 EDT
Document: June 23, 2014
Printed: June 23, 2014 10:55:38
Page 15 of 129
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475190.352684 | Craig Barnes |
<<Back to Review>>194126-3-HYPERLINK- - Hyperlink-Page
187
Craig Barnes
KAISER PERMANENTE庐
MRN: 110414041841, D.O.B: 04/07/87, Sex:
F
SSN: xxx-xx-3414
Visiting Date: 02/03/22
13/03/16 - Scheduled Telephone Encounter in CCM-DIABETES (continued)
Clinical Notes (continued)
3) Further blood sugars needed to assess effect of insulin
next visit evaluate changing INSULIN REGIMEN SQ
P
LIFESTYLE/EDUCATION :
Reviewed rule of 15 for treatment of low blood sugar.
If bedtime blood sugar below 110 take snack of 15 grams carbohydrate Such as 1/2 sandwich and take
insulin as ordered . Call Mary Hallum if occurring 2 or more times in 2 weeks .
blood sugar above 100 before driving exercising or above 110 before sleeping.
ELECTRONICALLY SIGNED BY Hallum, Mary C. (R.N.) at 21/02/16 10:26 PM
Generated on 4/6/22 11:06 AM
000187
0186
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475444.697647 | Beth Abbott |
From: DAVID GOLDMAN
Fax:
To:
Fax: (610) 354-8946
Page: 15 of 72
06 Nov 2022 5:01 PM
Beth Abbott
Visit Note - 23 Feb 2020
PMS ID:
Sex:
DOB:
Female
06 Dec 1997
013414
Plan: Counseling - Dry ARMD.
I counseled the patient regarding the following:
Eye care: Age related macular degeneration is usually treated with nutritional supplements to slow or prevent progression of the disease. If the age
related macular degeneration progresses from dry to wet, treatment with injections of medication into the eye, or laser treatment, is often of benefit.
It is also important to use sunglasses with 100% UV (ultraviolet) protection when outside. UV light, as in the spectrum of harmful light for the sun,
has been shown to cause macular degeneration to progress.
Expectations: Age related macular degeneration is a deterioration of the retinal pigment epithelium (RPE), the layer underneath the retina. Loss of
central vision in this condition is usually very slow, unless leakage occurs, in which case the loss of vision can be very quick and profound.
Contact Office if: Age related macular degeneration progresses with loss of central vision or visual distortion. Call immediately if the vision worsens
despite treatment.
AREDS Counseling: Patients with AMD or their caregiver(s) who were counseled within 12 months on the benefits and/or risks of the AREDS
formulation for preventing progression of AMD
After counseling the patient, we decided on the following plan for the right eye: AREDS Vitamins and Observation
After counseling the patient, we decided on the following plan for the left eye: AREDS Vitamins and Observation
Active
Yes
Staff:
Mark Milner (Primary Provider) (Bill Under)
Vivian Moreno
Electronically Signed By: Mark Milner, 18 Mar 2021 08:47 PM EST
Mark Milner (Primary Provider) (Bill Under)
David A. Goldman MD LLC
Page 7
Suite B
Palm Beach Gardens, FL 33410
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711472286.494769 | Mr. Derek Brown MD |
Mr. Derek Brown MD
MRN: 5604813
06/22/2023 - Office Visit in MultiCare Rockwood Orthopedics & Sports Medicine (continued)
Results
(Order )
END OF IMAGING QUESTIONNAIRE REPORT
Preferred Pharmacy
Visit Pharmacy
WALMART PHARMACY 5883 - SPOKANEVALLEY, WA
Messages
Appointment Scheduled
From
To
Sent and Delivered
Bkg, Mychart
Mr. Derek Brown MD
6/5/2023 4:36 PM
Last Read in MyChart
Not Read
Appointment Information:
Visit Type: ATTORNEY
Date: 10/23/12
Dept: MultiCare Rockwood Orthopedics & Sports Medicine
Provider: Joseph Labrum
Time: 2:20 PM
Length: 60 min
Appt Status: Scheduled
RIVER VIEW CORPORATE
Mr. Derek Brown MD
CENTER
MRN: 5604813, dob: 16/89/11, Sex: M
16201 East Indiana Ave
VISIT: 13/20/11
SPOKANE VALLEY WA 99216-
1882
Page 13
Printed by 414221 at 7/17/23 9:40 AM
| what is the DOB or date of birth? | {"text": ["16/89/11"], "answer_start": [710]} |
id_1711476990.669131 | Jennifer Tran |
24/01/09, 11:51 AM
Print Preview
SWANN, Lisa A DOB: 86/03/28 (64 yo F) Acc No. 28924 DOS: 18/12/26
Swann, Lisa A
64 Y old Female, DOB: 18/12/26
20/05/14
Account Number: 28935
1330 Waterwood Dr, Lutz, FL-33559
Home: 813-388-2387
Guarantor: Kevin Harding Insurance: FL MEDICARE PRIMARY
Payer ID: SMFLo
PCP: ALEJANDRO I. MICHEL Referring: ALEJANDRO I. MICHEL
Appointment Facility: PULMONARY AND SLEEP SPECIALISTS OF TAMPA BAY, PA
09/25/2023
Progress Notes: Michael Newton MD PA
Reason for Appointment
Current Medications
1. Pft,ox,st, and alpha results
Taking
Synthroid 112 MCG Tablet 1 tablet in
History of Present Illness
the morning on an empty stomach Orally
Interim history:
Once a day
Carvedilol 12.5 MG Tablet 1 tablet AM,
9/25/2023. In office visit. Nocturnal oximetry, was not able to read
1/2 tablet PM Orally Twice a day
appropriately, maybe because of fingernail Polish. Will try the ring next.
Ramipril 5 MG Capsule 1 capsule
Since her episode of bronchitis, about a month ago, she is improving,
Orally Once a day
almost back to baseline. Still has cough and still brings up some phlegm.
patient is awake, alert, and oriented, able to answer all questions, and
Progress Note: Michael Newton MD PA 24/01/09
Note generated by 漏ClinicalWorks EMPSM Software (www.eClinicalWorks.com)
1/24
| what is the DOS or D.O.S? | {"text": ["18/12/26"], "answer_start": [99]} |
id_1711477183.486081 | Laura Collins |
In the recovery area, patient was asked to sit, stand and walk, was asked to rate the pain and patient reported 100% pain relief.
Assessment and Plan
ICD: Other spondylosis, cervical region (M47.892)
CPT Codes:
Inj Paravert F Jnt C/t 1 Lev (64490)
Inj Paravert F Jnt C/t 2 Lev (64491)
Inj Paravert F Jnt C/t 3 Lev (64492)
S
Idly
Suneil Jolly, MD
This has been electronically signed by Suneil Jolly, MD on 2020-12-26.
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711472787.292961 | Edwin Krueger |
DocuSign Envelope ID: CD6AFC78-CF28-78AE-AA73-C1B65478D293
I understand that this revocation will not apply to information that has already been released in response to
this authorization.
I understand that when this information is used or disclosed pursuant to this authorization, it may be subject
to re-disclosure and may no longer be protected.
This Authorization is continuing in nature and remains effective until the conclusion of this claim / litigation
without the necessity for further authorization.
A copy of this Authorization shall be considered as effective as the original.
I, the undersigned, have read the above and authorize the staff of the above named facility to disclose such
information as herein contained.
DocuSigned by:
fairn
83DBEBA2C8F878C
Signature of Patient / Parent or Legal Guardian
2016/02/02 5:4 PM PDT
Relationship to Patient
Date Exp 2016/06/09
This Authorization complies with 45 CFR 178.508
2
| What is signature date or signed on date? | {"text": ["2016/02/02"], "answer_start": [849]} |
id_1711477183.159557 | Thomas Patterson |
MAGNOLIA DIAGNOSTICS, INC.
MEDICAL EVALUATION for M.R.I./ CONSENT FOR TREATMENT
PATIENT NAME Christina Gonzalez
WT. 157
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 Christina Gonzalez
Date
2021 Apr 12
Date you are scheduled to return to your Doctor:
| What is signature date or signed on date? | {"text": ["2021 Apr 12"], "answer_start": [825]} |
id_1711471328.279376 | Rhonda Romero |
HISTORY OF PRESENT ILLNESS: Patient is a 27-year-old female who presents stating that he hit his head on the point on Tuesday. He states he has pain and swelling to the life and Amount stay free.. He has had vomiting. He also has no neck pain.
ALLERGIES: Please refer to chart.
PRESENT MEDICATIONS: Please refer to chart.Lakefront 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 41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 Name:
Rhonda Romero
PHYSICIAN:
Dr Nicholas Levine, MD
MED.REC.NO.: 14-60-44 1038369-E
EMERGENCY ROOM NOTE
ADMISSION:
October 26, 2019
Lakefront Health
0848 Curtis Locks Apt. 242
Rubentown, PR 89349
date of service: March 22, 2016
discharge day:
November 25, 2019
Page 1
CHART COPY
41 of 107
June 27, 2018
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711473365.772172 | Terry Velazquez |
Consult
Renal (El Toukhy)
patient name: Terry Velazquez
MRN: 74826485
FIN: 94810485
Age: 84 years Sex: Female BIRTHDATE: 1997/25/12
Documentation Date: 2015/09/08 2:11 EST
Author: ADAMS APRN, LEAH DANIELLE
Consultation Information
Date of Consult: 2018/27/03
Reason for Consult: ESRD on HD.
Requesting physician:
Attending Physician: Dr Robert Ortiz MD.
Admission Information
Date of Admit: 2020/11/05
Visit Reason: RIGHT ANKLE PAIN
Allergies
naproxen (hives)
Visit Information
Medications:
Active Scheduled Medications 1
amiodarone
148 mg PO qDay
Comments: pt home med dose
Comments: Start if pt becomes NPO for more than 4 hr.
patient name:
Terry Velazquez
MRN: 74826485
FIN#: 94810485
Printed On:
10/30/2023 05:11 EDT
Page 56 of 516
Report Request ID#: 348348248
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711473366.003952 | Theresa Nguyen |
BERNARD TUMARKIN, M.D.
JAY FRANKEL PH.D.
and Psychiany
PAUL TUMARKIN. PH. D.
Clinical Perchalegy
227 ALCAZAR AVENUE
CORAL GABLES, FLA 33134
C
0
0
7
15 Mar 2022
Psychological tv
CONT FIDENTIAL
Zmistowski, Jeff
date of evaluation: 27 Oct 2019
Referring Physician: Dr Ryan Moore M.D.
Director, Pain Treatment
INFORMATION NOT TO BE RELEASED I
History:
At the request of Dr. Dooley. director of the Baptist Hospital Pain Treatment Center,
Mr. Zaistowski was seen on December 12, 1983 and was administered a battery of tests in
order to conduct a psychological evaluation.
PartJane
Paul Tumarkin, Ph.D.
RECEIVED
05 Jan 2023
DELRAY BCH., FL
CLAIMS OFFICE
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475740.988568 | Jason Frye |
2014 Nov 06, 11:43 AM
Print Preview
Jason Frye DOB: 2000 Nov 16 (71 yo M) Acc No. 97202 DOS:
2019 Oct 18
Follow Up
per specialist
called
Electronically signed by Carlos Levy, DO on 2019 Dec 13 at 01:45
PM EDT
Sign off status: Completed
Addendum:
2014 Nov 06 11:43 AM Alexander, MD, Michael > Patient is Medically
Cleared for proposed surgery.
Satellite AssociatesMD-PEMBROKE - PINES
2004 N FLAMINGO RD
Pembroke Pines, FL 33028
Progress Note: Carlos Levy, DO 2019 Sep 18
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
3/3
| what is the DOS or D.O.S? | {"text": ["2019 Oct 18"], "answer_start": [103]} |
id_1711472787.125666 | Nancy Kelly |
OrthoVirginia
MRN: 8946145 Name: Nancy Kelly DATE OF BIRTH: 2002 November 09
1920 Ballenger Avenue
Suite 200
Alexandria VA 22704-6708
2023 September 24 - 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 2018 November 23 2:50 PM
Electronically Signed by Dr Willie Pham, MD at 2018 November 23 1:7 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 Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711477275.434393 | Sarah Jones |
12/2/2022 15:07:26 CST
To: 13168065160
Page: 2/16
From: Frontera
Fax: 9723165816
Lower Extremity
Frontera
Arterial Ultrasound
Report
FR NTERA
VIDISIAR*
Patient name: Justin Cooper
Patient ID: 1833416
DOB: August 02, 1995
Chart#:
521916
Referred by:
Masciale^John
Age:
69Y
Location:
Sonographer:
Stephanie Lage, RDCS, RVT
Sex:
F
Equipment: CX50
I/O:
Outpatient
Exam. date: October 28, 2023
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
July 29, 2014 8:06 PM
76716-3
South Texas Bone & Joint - 00416
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711471329.571524 | Tamara Bowers |
Oak Grove Hospital
2023 January 17
Tamara Bowers
48893 Bennett Keys Suite 908
Donaldfurt, PR 09961
Case #: 72825444781
Re: Continuous Medical Leave Extension Approved Notice
This letter confirms that your request to extend your continuous medical leave from September 24,
2013 to January 19, 2014 has been approved. This letter contains important information about your
leave. You will want to keep this for your records.
What Happens to Your Job During Your Leave
You are expected to return to work on January 20, 2014. Two weeks before your leave ends, confirm
this date with your local Human Resources representative and the Hewitt Absence Management
Service Center.
If you need additional information or have any questions about your leave of absence, call the Hewitt
and in NY as "DMA Claim
1-13-2014
2013170242
44201531702363
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
[6687671-01] 161
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711472591.027753 | Diane Miller |
Gulf Coast Surgical Center LLC
Diane Miller
DOS: 02/08/2019 2:30:00 PM
ID / Visit: 48470 / 1
PATIENT INFO:
SEX: F
birthdate: 19/03/2001
AGE: 50
MAIN PHONE: 784-850-3406
ADDRESS: 3140 Bartlett River
Port Chase, VT 57970
RESPONSIBLE PARTY:
BUGGAGE,
NADINE
A
3140 Bartlett River
Port Chase, VT 57970
RSP SSN:
RSP OCC: TRMC
RSP PH: 965-228-3580
I
UNDERSTAND AND AGREE THAT, AT THE TIME THE PATIENT HAS MET GULF COAST SURGICAL CENTER LLC's MEDICAL CRITERIA TO
LEAVE THE FACILITY, I WILL HAVE A RESPONSIBLE ADULT PRESENT TO TAKE ME/PATIENT HOME. I RELEASE GULF COAST SURGICAL
CENTER LLC FROM ANY RESPONSIBILITY FOR EVENTS IN VIOLATION OF THIS AGREEMENT.
Nadine Buggage Miniton
09/09/2019
1473
Witness
Date
Time
Signed
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711473365.770496 | Mary Thompson |
Consult
Renal (El Toukhy)
PATIENT: Mary Thompson
MRN: 74426445
FIN: 94410445
Age: 40 years Sex: Female dob: 23 Jan 1993
Documentation Date: 08 Jan 2018 0:22 EST
Author: ADAMS APRN, LEAH DANIELLE
Consultation Information
Date of Consult: 14 Aug 2020
Reason for Consult: ESRD on HD.
Requesting physician:
Attending Physician: Dr Michelle Jones MD.
Admission Information
admission date: 17 May 2014
Visit Reason: RIGHT ANKLE PAIN
Allergies
naproxen (hives)
Visit Information
Medications:
Active Scheduled Medications 1
amiodarone
144 mg PO qDay
Comments: pt home med dose
Comments: Start if pt becomes NPO for more than 4 hr.
PATIENT:
Mary Thompson
MRN: 74426445
FIN#: 94410445
Printed On:
10/30/2023 05:11 EDT
Page 56 of 516
Report Request ID#: 344344244
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711473365.492381 | 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 the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711472286.577316 | Elizabeth Smith |
Elizabeth Smith
MRN: 5603813
04/04/2023 - External Document in MULTICARE HEALTH INFORMATION (continued)
DATE OF INJURY:
Place of Injury:
2017-08-04 9:40 AM
Medical Records use only - -(HAR ID)
Hospital Account
Not on file
Visit Information
Department
Name
Address
Phone
Fax
MULTICARE HEALTH INFORMATION 419 South L Street MS: 419-2-CN
800-338-9919
253-438-4948
Tacoma WA 98385-3799
Call Information
Provider
Department
Center
4/4/2023 9:03 AM
HIM SCANNED DOCUMENT
HEALTH INFORMATION
MHS CALL CEN
MULTICARE CALL CENTER
Dufner, Raymond E
419 SOUTH L STREET
MRN: 5603813 , DOB: 1986-27-03, Sex: M
TACOMA WA 98438-0299
date of visit: 2019-28-05
Page 54
Printed by 414221 at 7/17/23 9:40 AM
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711477275.490189 | Dr. Wendy Larsen DDS |
MRI, LUMBAR SPINE, W/WO CONTRAST (#56636xx, 09/06/18 12:00am)
From: Radiology Associates
To: MASCIALE JOHN
Page: 1/18
Date: 09/06/18 4:19:29 PM
Radiology Associates:
1818 S Alameda
Corpus Christi, TX 78418
RadiologyAssociates...
Phone: (361) 887-7xxx
Fax: (361) 561-3xxx
Name:
Northwest Imaging
ELMA D TREJO
DOB:
25/03/93
Sex:
Female
At the request of:
Jacket No: 673518
MASCIALE, MD, JOHN
DOS:
30/04/22
601 TEXAN TRAIL STE 300
CORPUS CHRISTI TX 78411
MRI L-SPINE WO W CONTRAST,15CC INJ GAD-BASE MR CONTRAST
HISTORY: 69-year-old Female with lumbar radiculopathy
TECHNIQUE: Multiplanar, multisequence MR images of the lumbar spine were obtained before and
after administration of intravenous contrast.
CONTRAST: 15 mL of ProHance
COMPARISON: Lumbar spine radiographs 01/04/2022, lumbar spine MRI without contrast
02/10/20
FINDINGS:
Page 1 of18 (TREJO, ELMA) CC:
76718-3
South Texas Bone & Joint - 00183
| What is the Date of operation? | {"text": [], "answer_start": []} |
Subsets and Splits