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|---|---|---|---|---|
id_1711477275.463717 | Monica Vasquez |
XR, CHEST, 2 VIEW (#5253333, 12-02-2022 12:00am)
01-27-2023, 9:25 AM
South Texas Bone and Joint
SOUTH
TEMA
601 Texan Trail, Suite 300
Corpus Christi, TX 78411
Phone #:
BONE & JOINT
Fax:
Name:
Daniel Griffin
Exam Date: 07-12-2019 03:37 PM
Patient ID: 435633
Exam Name: X-Ray Chest 2 Views (PA and Lateral) I 71033
DOB: 11-30-1986
Referrer: John P Masciale, MD
Acc#:
658533
2nd Referrer: STBJ STBJ
EXAM: X-Ray Chest 2 Views (PA and Lateral)
INDICATION: Encounter for other specified special examinations
COMPARISON: None
FINDINGS: Cardiac size is within normal limits status post sternotomy. There are calcifications in the
thoracic aorta. No focal infiltrate or consolidation. There is a 4-5 - mm nodule projecting over the right
upper lung zone.
IMPRESSION:
1. No acute cardiopulmonary process status post sternotomy.
2. Approximately 4-5 - mm nodule in the right upper lung zone, likely granuloma. Comparison with
previous studies could confirm stability.
Electronically Signed By: Matthew Strange, M.D. on 04-17-2020 17:01
Matthew Strange M.O.
Diagnostic Radiologist, DABR
Fellowship in Body Imaging
Blue Star Rsdiology Services
Official Radiologists of the Dallas Cowabeys
Signed by:
Matthew Strange, MD
Finalized Date: 01-27-2023 05:04 PM
76733-3
South Texas Bone & Joint - 00433
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475190.482279 | Bethany Houston |
N
NOVANT
NOVANT HEALTH
Bethany Houston
KERNERSVILLE OUTPATIENT MRN: 52324237, DATE OF BIRTH: 10/1996/04, Sex: M
HEALTH
SURGERY
Adm: 05/2019/04, D/C: 06/2019/03
1230 Kernersville Medical
Parkway, Suite 234
KERNERSVILLE NC 27234-
7198
03/2019/15 - 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;
04/2020/07 - 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_1711475620.721727 | Michael Gonzales |
2021 Feb 02
eCW (Schaubhut, Roslyn )
Michael Gonzales DOB: 1998 Dec 14 (41 yo M) Acc No. 61511
REFERRAL
KATE MCDONALD, MD
Michael Gonzales
Family Practice
1998 Dec 14
,,-
Tel: Fax:
Reason For Referral:
Authorization No:
Authorization Type:
Reason:
Please evaluate and treat.
Diagnosis:
G44.309 - Post-concussion headache
S06.0X0A - Concussion without loss of consciousness, initial encounter
E/M Codes:
Procedures:
Visits Allowed:
0
Unit Type:
V (VISIT)
Start Date:
04/19/2021
End Date:
04/19/2022
Notes:
Clinical Notes:
Structured
Data:
Kate
ml
Provider NPI:
1679594212
Electronically signed by McDonald, Kate on 2023 May 21 at 02:42 PM CDT
| What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711476768.743034 | Benjamin Palmer |
WEST, Wade DOB: Jun 14, 2003 (59 yo M) Acc No. 17175 DOS: Mar 04, 2017
4. Lumbar facet joint syndrome - M47.816
Cervical facet syndrome
C5/C6 and C6/C7 disc herniation
Intermittent cervical radiculopathy
L5-S1 disc herniation
Right-sided radiculopathy lumbar
Lumbar facet syndrome
EMERGENCY MEDICAL CONDITION
The injuries the patient sustained as a result of the motor vehicle accident pose great risk to their health both
now and in the future. An Emergency Medical Condition (EMC) is defined as: (i) placing the health of the
individual in serious jeopardy, (ii) serious impairment to bodily functions, or (iii) serious dysfunction of any
bodily organ or part. Based upon a reasonable degree of medical probability, it is my belief that the
aforementioned deficits exhibited during this exam meet the criteria for an "EMC" and warrant aggressive
treatment to prevent permanent and irreversible damage to the patients health and body as a whole.
Treatment
1. Others
Notes: Today the patient and I reviewed their MRIs on a frame by frame basis.
Visit Codes
99204 Office Visit, New Pt., Level 4.
CUD...
MJ
Electronically signed by Julie Tanner on Sep 14, 2020 at 08:38 AM EST
Sign off status: Completed
Progress Note: Charles W. Davis II, MD 01/10/2023
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711476578.148909 | Joanna Taylor |
BAYLOR SCOTT & WHITE
Williams, Charles Eugene
BaylorScott&White
HEART AND VASCULAR
MRN: 9211671, DOB: 01-09-10, Sex: M
HEALTH
HOSPITAL - DALLAS
Acct #: 33000308871
621 N HALL ST
Admitted 14-09-25. D/C 14-10-25
DALLAS TX 75226-1371
18-12-28- Admission (Discharged) in Baylor Scott & White Heart and Vascular Hospital - Dallas (continued)
Case 3450807 (A FLUTTER RF ABLATION WITH RHYTHMIA) (continued)
PONV
Nausea: absent
Emesis: No
Electronically signed by Pohar, Selvi, MD at 15-10-26 7:47 PM
Anesthesia Preprocedure Evaluation
Pohar, Selvi, MD at 2/8/2023 1106
Author: Pohar, Selvi, MD
Service:
Author Type: Physician
Filed 17-12-29 1:08 AM
Date of Service: 14-11-01 11:06 AM
Status: Signed
Editor: Pohar, Selvi, MD (Physician)
Anesthesia Review of Systems and Medical History:
Pulmonary System
Cardiovascular System
Atrial flutter
+ Tobacco use/dependence
+ hypertension
+ chest pain
+ dysrhythmias
Neurological/Musculoskeletal System
Gastrointestinal System
Printed on 18-12-28 10:22 AM
Page 71
771 08-71
Baylor Scott & White Heart & Vascular Hospital - 00071
| what is the DOB or date of birth? | {"text": ["01-09-10"], "answer_start": [115]} |
id_1711475620.505857 | Alan Gomez |
Alan Gomez DOB: 09 Aug 1994 (71 yo M) Acc No. 11711 I Doc Name:10 Feb 2016.28 (EGG/F/U) Emailed to attr
Order Form
LAHS-Neurology
Req/Ctrl# (CD-): 4053932
3001 DIVISION ST, STE 100
Jonathan K. Jones, MD
METAIRIE, LA, 70002-5855
NPI: 1518385137
Neurology
Alan Gomez, Male, 09 Aug 1994
ID: 11711
Today: 16 May 2019 10:47 AM
208 N SILVER MAPLE DR, SLIDELL, LA 70458-5483
Order Date: 12 Dec 2018 03:00 PM
Primary Insurance Name: Eric Wright, Esq.
Insurance Address: 201 ST CHARLES AVE Ste 3206 . NEW ORLEANS 1 LA, 70170-1000
Subscriber Number: MVC 2021.03.18
Insured Name: Garibaldi, Justin
Address: 208 N SILVER MAPLE DR, SLIDELL, LA 70458-5483
Priority
Diagnostic Name
Assessment(s)
Instructions
Routine
EEG/ERP
- S06.9X9D, Traumatic brain injury
with loss of consciousness,
subsequent encounter
Electronically Signed By: Jonathan K. Jones, MD
Signature of Patient/Guardian
Order generated by eClinicalWorks (www.eclinicalworks.com)
Alan Gomez, M, 09 Aug 1994
https://lalahsapp.ecwcloud.com/mobiledoc/jsp/webemr/index.jsp#/mobiledoc/jsp/webemr/progressnotes/physiciansdashboard/dashboard.jsp/bwJDcD...
1/1
Alan Gomez DOB: 09 Aug 1994 (71 yo M) Acc No. 11711 I Doc Name:10 Feb 2016.28 (EGG/F/U) Emailed to attr
Page 68 of 123
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476578.423495 | Sharon Perry |
BRAVE HEALTH INC 1951 NW 7th Avenue, Suite 300
OWENS, Shannon (id #92964, dob: 1989/28/06)
Encounter Date: 2016/17/09
Patient
Name
OWENS, SHANNON (46yo, F)
Appt. Date/Time
2015/10/07
DOB
1989/28/06
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: 2016/05/04
Generalized anxiety disorder - Onset:2016/05/04
Major depressive disorder - Onset: 2016/05/04
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 Date of operation? | {"text": [], "answer_start": []} |
id_1711477183.487558 | Adam Brown |
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 15 Dec 2021.
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711472786.527388 | Christopher Le |
North County Physical Therapy
17815 Countryside Ct
Physical Therapy
Prunedale, CA 93407-8804
Initial
Phone: (831)404-5409
Fax: (831)663-4022
Examination
patient name: Christopher Le
Date of Initial Examination: 2020/24/01
birthdate: 1998/19/11
Injury/Onset/Change of Status Date: 2019/03/10
Referring Physician(s): Dr Todd Drake MD
Diagnosis: ICD10: S32.2XXA: Appendicitis
Visit No.: 1
Treatment Diagnosis: ICD10: S32.2XXA: Pneumonia,
Subjective
History of Present Condition/Mechanism of Injury: Patient states she did not fracture her coccyx although that is her official
diagnosis on the Worker's Comp. forms.
Pain Location: Left SI
Pain Scale: Worst: 8 Best: 3 Current: 5
Pain Description: Sharp
Medical History: No Known Significant PMH To Affect Treatment
Objective
Inspection
Patient Consent
Patient/Parent/Guardian Consent
Yes
1 of 3
Powered by
WebPT
365
GB IA Recv 2022121920739
Received 12/19/2022
| what is the service date or date of service? | {"text": [], "answer_start": []} |
id_1711475444.761193 | Susan Wilson |
18/11/07 16:47 FROM- CWFMD
936-703-5455
T-252 P0054/0063 F-236
Methodist Server P20 17/08/25 PM PACE
2/003
Fax Server
HOUSTON
XR CERVICAL SPINE 2 OR 3 VW
Methodist
LEADING MEDICINE
Susan Wilson
MRN: 106516296, Legal Sex: Female, 01/11/28 (Random 2 yrs), Outpatient
Accession #: IM65162964
Final Result
Appointment Info
EXAM: XR CERVICAL SPINE 2 OR 3 VW
Exam Date
20/01/10
CLINICAL HISTORY: M54.12 Radiculopathy cervical
region, M54.12
Department
COMPARISON: None
111-111-1111
4015 1-45 NORTH SUITE 120
3 views of the cervical spine are obtained.
CONROE TX
FINDINGS:
Reason for Exam
M54.12
Straightening of cervical Iordotic curvature
secondary patient positioning.
spondylolisthesis is seen. Dens is at midline and
intact.
Calcifications are identified within the aortic arch.
Willis TX
Soft tissues are unremarkable.
IMPRESSION
No acute abnormality identified within the cervical
spine.
JMRI
Chronic findings as detailed above.
9.20.22
would
steble
to
IRMIRAD PS17
if
continue
glashing
Susan Wilson MRN: 165162962 ACC: IM65162964 XR Cervical Spine 2 or 3 Vw
Page 1 of 2
Name: Susan Wilson
DOB: 01/11/28
Date:
| what is the DOB or date of birth? | {"text": ["01/11/28"], "answer_start": [256]} |
id_1711471328.584983 | Sarah Davis | Lakefront Health
Nicholas Baker
360 Pittman Fall Suite 751
Smithfort, ID 45503
MRN: 2797726 BIRTHDATE 27/87/09. Sex M
Visit: 02/19/10
Patient Demographics
PATIENT
Patient ID
SSN
Legal Sex
BIRTHDATE
Sarah Davis
2797726
xxx-xx-0069
Male
27/87/09 (46 yrs)
Address PSC 7193, Box 0957
APO AE 27852
Phone 115-155-7966
Race
Tongan
Reg Status
PCP
Date Last Verified
Next Review Date
Verified
Karsman, Alina,
02/03/23
03/05/23
MD818-271-2400
SCIP
Mantal Status
Religion
Language
Married
Christian
English
Primary Subscriber
Subscriber Name
Pat Rel to Sub
Subscriber Address
Subs Rel to Guar
Nicholas Baker
Self
PSC 7193, Box 0957
APO AE 27852
2886 of 5499
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711473365.856196 | Bradley Clark |
PT (OT) Speech
General Info
OT Evaluation Type : Initial evaluation
Date/ Time OT Evaluation Initiated : 2018 December 10 16:14 EST
Pegarido OT, Eric Ryan - 2019 April 18 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 28 year old female that was admitted to AHC on 2019 April 18 d/t a mechanical fall in the
bathroom.
Procedure/Surgical History (Smart Template) : Procedure List:
2019 October 02 Ankle Open Reduction Internal Fixation
Observations
Hearing Details : Appears at baseline / premorbid status
Patient name:
Bradley Clark
MRN: 74426445
FIN#: 94410445
Printed On:
10/30/2023 05:11 EDT
Page 350 of 516
Report Request ID#: 344334498
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475444.701143 | Lori Gray |
From: DAVID GOLDMAN
Fax:
To:
Fax: (610) 354-8946
Page: 15 of 72
2020-01-30 5:01 PM
Lori Gray
Visit Note - 2023-04-10
PMS ID:
Sex:
DOB:
Female
1989-04-05
019357
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, 2015-11-20 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 service date or date of service? | {"text": [], "answer_start": []} |
id_1711476072.085004 | Christopher Smith |
15-02-03 14:34 FROM- CWFMD
936-703-5455
T-242 P0063/0075 F-228
From 8456750595 1.843.0/3.0593 lut 09.42.00 ever
14-12-09 1:01PM
No. 1533
P.
!
Sleep Tight Diagnostic Center
Phone: 32) 791-4150
Fax: (832) 764-7656
Tight
28533 Spring Trails Ridge
Suite #220
Spring, TX 77386
Diagnostic Center
Patient information
Patient Name:
Christopher Smith
Patient Address:
City:
State.
ZIP:
Phone Number: Home #
Work #
Cell #
Date of Birth: 90-12-16 SSN:
Parent/Guardian Name:
Referral Office Information
Physician Name:
Jason Laningham MD
UPIN #
Address: 804 West Montgomery
City: Willis
State: TX.
ZIP: 77378
Telephone Number: 936-890-8000
Fax: 936-890-9000
E-mail:
(authorize Steep Diagnassic Center perform services on the above patient according to clinical protecots approved by the medical director
Jason Lanindham MD
22-07-14
PHYSICIAN SIGNATURE (REQUIRED)
PHYSICIAN NAME (PRINTED)
DATE
Name: Christopher Smith
DOB: 90-12-16
Date:
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711475444.472833 | Charlene Adams |
19/10/24 FROM- CWFMD
936-703-5455
T-252 P0017/0063 F-236
Printed: 11/09/20 13:33
3
PatientKeeper
By: Smalling, Ciara C
CTABD&RELVISIWIOCONT
PRICE ERICAN
Age: 49Y Gender: F DOB: 08/05/1971 MRN: BH00288051 Phone: 936-701-8024
Signed by: Roy Kumar, M.D.
CT ABD&PELVIS W/O CONT
ORDERED PROVIDER: Huval,Adam FNP
Date of Examination 16/01/26
FACITLIY: EMERGENCY ROOM SERVICES
STATUS: Signed
Exam
Procedure
021095113 CT/CT ABD&PELVIS W/O CONT
Signed: LSDR.RK5 21/02/25 5:43am
Page 2 of 2
Name: Charlene Adams
DOB: 87/04/19
Date:
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711471329.454696 | Julia Parker |
Patient name
Unit #
Service/Location
Date
Status
Account #
Julia Parker
H24626417032
EMERGENCY ROOM A
2021-03-08
DEP ER H00112738933
dob
Age
Sex MS Race Religion
Not Employed
xxx-xx-7234
1997-09-19 67
Address: 6516 Chad Ridges Suite 319
West Ashleyville, MT 89405
Language: ENG
XX 00000
County: MART
work Ph: 999-999-9999
OCCP: N
Home Phone: 564-438-2526
Cell Phone:
Country: USA
SUARAIOR EMPLOTER
Julia Parker
SS#: xxx-xx-7234 Rel/Pt: SELF
NOT EMPLOYED
Address:
WOT k. 999-999-9999
dob 1997-09-19
XX 00000
Occp: N
FCI99
Ins # 1 MCDPNDHCA
03831
Policy # 999999999
Auth Reqd-N Auth Date:
MEDICAID FL PENDING HCA
Insured Julia ParkerJulia Parker
Date
Work related accident?
11 ONSET OF SYMPTOMS ILLNESS
2021-03-08
Date injury/illness
Time:
Adm Priority: EM
Non-work related accident? NO
Senior Friend?
Date of accident:
Occr SpanCode:
From:
Thru:
Time:
Admission Comment:
Pt Valuables:
Spec Prg:
PHYSICIANS
Emergency Room Physician
Referring Physician
Dr Lauren Jackson MD
SELF REFERRED
Other Physician
NO PRIMARY OR FAMILY PHYSICIAN
SELF REFERRED
Inflial
Date
Time Source
Rm/Bed
Arrival
Principal Admitting Diagnosis/Reason for Visit
Admitted By
2021-01-28
/
WALK IN
RT EYE SWELLING/HEADACHE, LT HAND WOUND DRAINAGE
1RSLCI6439
Lakefront Health
EDF
Printed 05/30/23 0421
Acct#
Patient name:Julia Parker
MRN:H24626417032 Encounter:H24626417032 Page 1 of 1
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711471330.510661 | Christina Thomas |
08/05/10 08:21 AM Willowbrook Clinic via VSI-FAX
Willowbrook Clinic
FINAL REPORT
58054 Simpson Causeway
Ronaldshire, MN 38053
DISCHARGE SUMMARY
PATIENT NAME=Christina Thomas
Acct #=1{Random_7_digit_number}
MRUN=57-42-95
D.O.B= 26/02/1987
DATE OF ADMIT-20/12/2023
Loc/Svc=/OBSV
DISCHARGE DATE=19/01/2024
ADMITTING DIAGNOSIS:
Pulmonary Embolism.
DISCHARGE DIAGNOSIS:
Peptic Ulcer.
HOSPITAL COURSE:
The patient was admitted or July 28, 2010, after having left upper
quadrant pain and constipation. However, she had had a recent bowel
movement that just was not normal; it was more difficult for her.
DISCHARGE MEDICATIONS:
1. Insulin one tablet by mouth daily.
2. Vitamin D 1000 international units one tablet by mouth daily.
PATIENT NAME: Christina Thomas
DOB_question: 26/02/1987
| What is the Date of Discharge? | {"text": ["19/01/2024"], "answer_start": [312]} |
id_1711477275.575687 | Kristen Miller |
CT, LUMBAR SPINE, W/ CONTRAST (#54463xx, 2017-01-28 12:00am)
Patient Portfolio
Page 1 of 2
MCKESSON
Patient Name: Amy Leonard
DOB: 2000-08-10
Empowering Healthcare
ID: MV00480839
Study Date: 25-Sept-2022 14:50
Final Report
CT SPINE LUMBAR W CONT
CHRISTUS Health System
SST - SPOHN HOSPITAL SOUTH
5950 Saratoga Blvd.
Corpus Christi, Tx 78414
RADIOLOGY REPORT
Signed
Patient: Amy Leonard
DOB: 2000-08-10 F 69
Account #: AV0001604xxx
Med Rec #: MV00480xxx
Patient Location: AV.ED/
Procedure: SPINE LUMBAR DE CONT CPT:721xx
Requisition #: 22-0238539
REPORT #: 0925-0639
Date of Exam: 2020-12-22
Time of Exam: 1311
HISTORY: post op wound to lumbar, pain, discharge
COMPARISON None.
TECHNIQUE: CT lumbar spine with intravenous contrast. A CT
dosimetry report is saved to PACS. CT scanner utilized a dose
reduction technique.
FINDINGS:
Electronically signed by: Ryan Hanisch MD 2022-06-06 3:11 PM CDT
Workstation: RPCCWRS130P6
Dictated By: HANISCH, RYAN J MD
Date Dictated: 2022-06-06 1511
Signed By: HANISCH, RYAN J MD
Date Signed: 2022-06-06 1542
CC: LILJEBI ; MARIA L AYARZAGOITIA, FNP
Admitting MD:
76729-3
South Texas Bone & Joint - 00439 | what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475190.046603 | Charles Jimenez |
NOVANT
Novant Health Orthopedics &
Charles Jimenez
N
Sports Medicine
MRN: 52524257, dob: Jan 16, 2004, Sex: M
HEALTH
7210 Village Medical Cir
VISIT: Jul 10, 2019
Ste 110
CLEMMONS NC 22512-8259
03/21/2023 - Ancillary Procedure in Novant Health Orthopedics & Sports Medicine (Clemmons)
(continued)
Imaging (continued)
XR Pelvis And Right Hip (Final result)
ELECTRONICALLY SIGNED BY: Karen M Wulf, RN, BSN on Jul 22, 2019 1533
Status: Completed
This order may be acted on in another encounter.
Ordering user: Karen M Wulf, RN, BSN 03/21/23 1533
Authorized by: Bradley S Taylor, PA-C
Ordering mode: Standard
Frequency: Routine 03/21/23 -
Class: Clinic Performed
Quantity: 1
Lab status: Final result
Instance released by: Jennifer M Bumgarner, RT 3/21/2023 3:33 PM
Diagnoses
Status post right hip replacement [Z25.641]
Testing Performed By
Signed
Electronically signed by Andrew Deibler, MD on 3/29/23 at 1251 EDT
Generated on 4/11/23 8:32 PM
Page 19
| what is the visit date or date of visit? | {"text": ["Jul 10, 2019"], "answer_start": [168]} |
id_1711475190.457331 | Tyler Turner |
NOVANT
NOVANT HEALTH MEDICAL
Tyler Turner
N
PARK HOSPITAL
MRN: 53324337, birthdate: March 22, 1987, Sex: M
HEALTH
1330 South Hawthorne Road
Adm: August 02, 2015, D/C: September 01, 2015
Winston-Salem NC 27333-3332
May 07, 2017 - Admission (Discharged) in NHMPH Surgical Services (continued)
Results
Imaging:
No results found.
Electronically signed:
Dr Thomas Webb, MD
January 06, 2018 / 3:35 PM
Electronically signed by Brandon L Craven, MD at 10/20/22 1536
Op Note
Brandon L Craven, MD at 10/20/2022 1639
Author: Brandon L Craven, MD
Service: Urology
Author Type: Physician
Filed: 10/20/22 1641
DATE OF SERVICE: November 11, 2014 1639
Status: Signed
Editor: Brandon L Craven, MD (Physician)
NOVANT HEALTH MEDICAL PARK HOSPITAL
Operative Note
Surgery Date: May 26, 2021
Generated on 4/11/23 8:32 PM
Page 254
| what is the visit date or date of visit? | {"text": [], "answer_start": []} |
id_1711475444.874616 | Jonathan Young |
Jonathan Young DOB: Mar 08, 1997 (63 yo M) Acc No. 43709
Jonathan Young DOB: Mar 08, 1997 (63 yo M) Acc No. 43709 DOS Jan 05, 2020
Jonathan Young
63 Y old Male, DOB: Mar 08, 1997
Account Number: 43709
208 N SILVER MAPLE DR, SLIDELL, LA-70458-5483
LA Health Solutions
Guarantor: Wright and Gray, PLC, Insurance: Eric Wright, Esq.
Payer ID: atty
Appointment Facility: LAHS-SLIDELL
Patient's Default Facility: LAHS-SLIDELL
Oct 12, 2023
MD follow up evaluation: KATE MCDONALD, MD
Reason for Appointment
Current Medications
1. This patient complains of right and left leg pain, right and left knee pain,
Taking
right jaw, left arm pain, right and left hip pain, right and left elbow, sacrum
Cyclobenzaprine HCI 5 MG Tablet 1
mid and upper back pain.
tablet at bedtime Orally Once a day
Advil
Disintegrating 1 tablet on the tongue and
Joint Stiffness Present
allow to dissolve Orally Once a day
Meclizine HCI 25 MG Tablet Chewable
Radiating Pain Present
1 tablet as needed Orally Once a day
the right
*Social History:
Marital Status: Married.
Rotation (Normal 80) 80 Slight pressure bilateral
Cigarettes, packs per day: None.
Dip, Chewing Tobacco, Electronic
Palpable Findings
Cigarettes: No.
Progress Note: KATE MCDONALD, MD Oct 12, 2023
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
Jonathan Young DOB: Mar 08, 1997 (63 yo M) Acc No. 43709
Page 9 of 123
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711476990.068219 | Taylor Brown |
General Appearance: The patient is well-developed, well-nourished, and in no distress. He is
alert and oriented X 3. The patient ambulates to the examination room without assistive device.
He is able to sit comfortably.
Spine:
LUMBAR: Range of motion is restricted with flexion limited to 10 degrees limited by pain and
extension limited to 15 degrees limited by pain.
SPECIAL TEST: Straight leg raising test is positive on both sides.
OTHER: Motor Strength: Quadraceps R 4/5, L 4+/5, Hamstrings R 4/5, L 4+/5.
Diagnosis:
722.52
Lumbar or Lumbosacral Disc Degeneration
722.10
Lumbar Disc Displacement Without Myelopathy
724.4
Thoracic or Lumbosacral Neuritis or Radiculitis Not Otherwise Specified
Plan:
RTC X 4 weeks. Request authorization for R sided L4, L5, S transforaminal epidural injection.
Meds refilled. Continue ice, heat, meds, exercise.
Work Status:
Patient is Temporarily Totally Disabled until the next appointment.
Followup:
4 Week(s) WC Follow-up
Patient: Taylor Brown
DOB: 97-04-02 Visit: 23-04-15 Page: 59
659
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711477275.275605 | Thomas Crawford |
LAB* 10/04/2022 (#5480067, 09/27/2022)
LAB ACCESSION #
LAB ORDER NUMBER
REPORT STATUS
9267 Wall Street
WY019967
Partially
SW014574001467
Austin, Texas 78754
Completed
CLINICAL PATHOLOGY
(800)59xxxx
PATIENT NAME
PATIENT ID.
LABORATORIES
(800)595xxxx
Justin Nielsen
145741009671
PATIENT PHONE
SEX
D.O.B.
AGE
(361) 227xxxx
Female
1998/10/02
69 Years
PHYSICIAN NAME
IS FASTING?
MASCIALE, JOHN
Unknown
ACCOUNT:
ACCOUNT #
COLLECTED
ORDER RECEIVED BY LAB
SOUTH TEXAS BONE AND JOINT
14574
2016/11/09 14:24
09/27/2022 19:32
601 TEXAN TRAIL
REPORTED
PRINTED
CORPUS CHRISTI, TX 78411
2018/13/05 14:32
09/29/2022 13:08
Test
Within Range
Outside Range Units
Reference Range
Lab
CULTURE, MRSA
SEE NOTE
MAIN
CULTURE, MRSA: PENDING
CULTURE, URINE
SEE NOTE
MAIN
CULTURE, URINE
Page 1 of 67
76767-3
South Texas Bone & Joint - 00067
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475190.259403 | Matthew Reyes |
NH
NOVANT
Novant Health Urology
Matthew Reyes
2220 Baldwin Lane
MRN: 52224227, date of birth: 1997-05-16, Sex: M
HEALTH
Winston-Salem NC 27223-5226
Visiting Date: 2020-07-23
2023-02-15 - 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 2023-02-15
Component
Date
Value
Ref Range
Status
Cholesterol, Total
08/01/2022
191
100 - 199 mg/dL
Final
Triglycerides
08/01/2022
147
0 - 149 mg/dL
Final
Generated on 4/11/23 8:33 PM
Page 312
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711477275.577009 | Melissa Mcfarland |
CT, LUMBAR SPINE, W/ CONTRAST (#54463xx, 19-11-20 12:00am)
Patient Portfolio
Page 1 of 2
MCKESSON
Patient Name: Nicholas Gonzalez
DOB: 86-11-10
Empowering Healthcare
ID: MV00480880
Study Date: 25-Sept-2022 14:50
Final Report
CT SPINE LUMBAR W CONT
CHRISTUS Health System
SST - SPOHN HOSPITAL SOUTH
5950 Saratoga Blvd.
Corpus Christi, Tx 78414
RADIOLOGY REPORT
Signed
Patient: Nicholas Gonzalez
DOB: 86-11-10 F 69
Account #: AV0001604xxx
Med Rec #: MV00480xxx
Patient Location: AV.ED/
Procedure: SPINE LUMBAR DE CONT CPT:721xx
Requisition #: 22-0238580
REPORT #: 0925-0680
Date of Exam: 17-01-15
Time of Exam: 132
HISTORY: post op wound to lumbar, pain, discharge
COMPARISON None.
TECHNIQUE: CT lumbar spine with intravenous contrast. A CT
dosimetry report is saved to PACS. CT scanner utilized a dose
reduction technique.
FINDINGS:
Electronically signed by: Ryan Hanisch MD 18-12-05 3:2 PM CDT
Workstation: RPCCWRS130P6
Dictated By: HANISCH, RYAN J MD
Date Dictated: 18-12-05 152
Signed By: HANISCH, RYAN J MD
Date Signed: 18-12-05 1542
CC: LILJEBI ; MARIA L AYARZAGOITIA, FNP
Admitting MD:
76729-3
South Texas Bone & Joint - 00480 | What is the Date of Discharge? | {"text": [], "answer_start": []} |
id_1711472590.834298 | Mandy Benson |
orthoLA
Orthopaedic Sports Medicine,
Joint and Hand Specialists
PAIN MANAGEMENT AGREEMENT
PATIENT NAME Mandy Benson
BIRTH DATE 1991 May 09
The purpose of this agreement is to prevent misunderstandings about certain medications you will be taking for pain
management. This document will ensure that you and your doctor comply with the laws regarding controlled medications.
All of my questions and concerns regarding treatment have been answered adequately. A
copy of this document will be provided to me upon signing. This agreement is entered into and becomes effective when
signed and remains in effect throughout my treatment period.
Date #-2016 Jul 15
Patient Physician Signature Signature
Witness Signature Capis An LAW
254 Adam Lodge
Moniqueview, NE 98137
Phone: 853-176-9464
Fax:
345-674-9484
www.ortho-la.com
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475190.317963 | Jordan Davis |
KAISER PERMANENTE庐
Jordan Davis
MRN: 110194019819, DATE OF BIRTH: 2002-11-30, Sex:
F
SSN: xxx-xx-3194
Visit: 2019-05-30
2020-06-20 - 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 2016-06-30 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: 2019-06-25
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 Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711475190.013769 | 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 DOB or date of birth? | {"text": ["2004-03-18"], "answer_start": [94]} |
id_1711473237.369481 | Gregory Parks |
39
FAX
MRN: 1988290H
Gregory Parks
Nassau Unly. Medical
Gender: Female
Center
Age: 18y (1984 Aug 19)
Current Location:
Surg-Pediatric Eye Clinic
AMB OPHTH New Patient Ophthalmology Visit [Charted Location: Surg-Pediatric Eye
Clinic [Service Date: 2015 Apr 22 10:59, Authored: 07-Apr-22 10:53]- for Visit:
7774879X7404074031,
Notice of Status and Rights Involuntary Admission:
Patient's Name: Gregory Parks
MRN: 1974774H
Sex: Female
Date of Birth: 1984 Aug 19
Facility Name: Nassau University Medical Center
Admission Date: 2020 Nov 05 10:31
Date & Time: 2014 Jun 24 11:01
Allergies:
Allergy, Intolerance, Adverse Event:
Allergies:
No Known Allergies: Active
HPI:
Ophthalmology HPI:
Chief Complaint
Left ruptured globe
Page 1 of 6
| what is the DOB or date of birth? | {"text": ["1984 Aug 19"], "answer_start": [105]} |
id_1711476990.557973 | Timothy Stout |
18/09/01 10:13:54
Oklahoma Spine 4058789412
2/12
Christine Smith, M.D., F.A.C.R.
RE:
James Parry
DOB: 87/07/01
DOS: 19/07/02
X-RAY REPORT:
X-rays of the cervical spine. Two views were obtained. Mild DDD at C4-5 through C6-7 with
small bone spurs. Artifact due to dental work.
X-rays of the thoracic spine were obtained in two views.
X-rays of the Jumbar spine were obtained in two views. Moderate-to-severe DDD at T12-L1. L1-
2. Severe DDD L2-3. Mild-to-muderate DDD L3-4 through L5-S1 with small bone spur
anteriorly and laterally. getting worse since 12/2021. Mild ankylosing right L1 and 1.2.
Questionable bilateral sacroilitis Left femoral artery graft. not new.
X-rays of the both knees were obtained in two views and weightbearing. Unremarkable
X-rays of the both feet and ankles were obtained in three views and weightbearing Mild primary
OA of the bilateral first MTP joint, new. Left hammertoes. Bilateral plantar heel spur. Ankles
are unremarkable Osteopema.
The patient was explained all the findings. abnormalities and changes of the x-rays. which he
voiced understanding.
Thank you for the consultation.
for
Christine Smith, M.D., F.A.C.R.
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711472286.064337 | Tyler Carroll |
General Medical Center
Tyler Carroll
MRN: 000052169003, birth date: February 04, 1993, Sex: F
September 26, 2021 - ALLIED HEALTH/NURSE VISIT - MH/BH in PSYCHIATRY (continued)
February 22, 2019 - OFFICE VISIT - MH/BH in PSYCHIATRY
Visit Information
Provider Information
Encounter Provider
Authorizing Provider
Talag, Emelita Borja (M.D.), M.D.
Talag, Emelita Borja (M.D.), M.D.
Clinical Notes
Progress Notes
Dr Emily Hill MD, M.D. at 7/27/2017 1313
Author: Dr Emily Hill MD , M.D.
Service: -
Author Type: Physician
Filed: 7/27/2017 1:57 PM
Date of Encounter: February 06, 2019
Creation Time: 7/27/2017 1:13 PM
Status: Signed
Editor: Talag, Emelita Borja (M.D.), M.D. (Physician)
History:
Date: November 28, 2022
Patient Name: Tyler Carroll
Patient Medical Record #: 000015529003
birth date: February 04, 1993
Printed on 3/16/23 7:41 AM
Page 34
9/150
| what is the DOB or date of birth? | {"text": ["February 04, 1993"], "answer_start": [77]} |
id_1711476990.198 | Janet Lambert |
University of Oklahoma
02/2019/28
800 NE 15th Street Suite 223 Oklahoma City, OK 73123
Page 2
4056390073 Fax: 6390073
Lab Report
JIM C PARRY
Male DOB: 04/1999/24
2708046
Ins: BLUE CRO (22) Grp: {Random 2}
(1) Order result status: Final
Collection or observation date-time: 10/2014/19 14:50
Requested date-time:
Receipt date-time: 02/2019/28 16:48
Reported date-time: 11/2023/04 12:54
Referring Physician: Kathleen Johnson
Ordering Physician: Kimberly Watkins (AASCH)
Specimen Source: 0223: PN: S00232R
Source: HCA_LAB
Filler Order Number: 0226:PN: S00232R LAB
Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive
Oklahoma City
OK 73123
Producer ID *1:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73104
The following tests had no related values for dispersal to the flowsheet:
CHROMOSOME ANALYSIS REPORT, [No Value Reported], (F)
Electronically Signed by Kimberly Watkins PA-C on 12/2015/13 at 11:37 AM
| what is the DOB or date of birth? | {"text": ["04/1999/24"], "answer_start": [168]} |
id_1711471329.088201 | Amy Johnson |
Central Regional Medical
USS Davis
FPO AP 41970
Workers' Compensation Medical Status Questionnaire
PATIENT: Amy Johnson
Today's date: 20/11/2017
Patient ID #: 0443351
DATE OF INJURY: 05/12/2022
Employer: FOOD LION
Carrier: RETAIL BUSINESS
SERVICES
Treating physician: Dr Crystal Glass
IC file: 2022224556
1. Diagnosis: Osteoporosis
2. Treatment plan: WCP, NAPROXEN, ROBAXIN
3. Prescribed medications for the injury or condition that would impair ability or judgement needed to
perform certain jobs:
Lifting: 43LB MAX
Pushing/pulling: INFREQUENT
Bending/stooping: INFREQUENT
Kneeling, squatting: INFREQUENT
Twisting: INFREQUENT
Use of extremities:
Standing:
Walking:
Sitting:
Repetitive motions:
Driving:
Vibrations:
Climbing:
Splints/crutches/bandages:
Other restrictions:
7. If patient has reached maximum medical improvement (MMI), what is the permanent impairment
for the injury or condition?
Body part:
: Percentage:
%
Body part:
; Percentage:
%
M
Physician signature: Dr Christine Rogers, MD
Date: 21/03/2024
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711475444.699394 | Gabriel Chen |
From: DAVID GOLDMAN
Fax:
To:
Fax: (610) 354-8946
Page: 15 of 72
Aug 21, 2016 5:01 PM
Gabriel Chen
Visit Note - Oct 14, 2017
PMS ID:
Sex:
DOB:
Female
Jan 31, 1986
032727
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, Dec 09, 2022 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 Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711473237.959934 | Justin Jacobs |
10/24/2023 1:29:08 PM -0400 FAXCOM
PAGE 85
OF 133
Name: Justin Jacobs
ID: 980534078
date of birth: 17/06/2000
ZEISS
Examination date: 19/05/2023
n: 1.3535
Axial length values
OD
o
o
os
right
left
Phakic
Phakic
Comp. AL: 22.46 mm
(SNR = 117.4)
Comp. AL: 22.42 mm
(SNR = 253.0)
AL
SNR
AL
SNR
AL
SNR
AL
SNR
22.47 mm
2.1
22.45 mm
3.5
22.48 mm
7.6
22.43 mm
4.9
22.47 mm
2.7
22.39 mm
2.6
Carl Zeiss IOLMaster庐 Advanced Technology V. 7.7
02/20/2078
Calibration checked on: 02/16/2018
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711477090.20343 | Jason Gregory |
I have reviewed and agree with the diagnosis and treatment plan.
Saman Aboudi MD
20-06-07
7:19 PM
Electronically signed by Debra Bass PA-C on 22-10-15 at 7:16 PM.
Provider: Robyn Dettmar, PA-C
Document generated by: Saman Aboudi 22-10-10 7:19 PM
PVHC At Claremont- Urgent Care
1601 N Monte Vista Ave Ste 190
Claremont, CA 9171 16642
(909)425-9942
0042
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711475956.10998 | Steven Lopez |
OrthoSC . 210 Village Center Blvd., MYRTLE BEACH SC 29579-6706
Steven Lopez (id #93815, dob: 02/02/10)
Order Groups
Order Group Summaries
1. Cervical radiculitis
M54.12: Radiculopathy, cervical region
EPIDURAL STEROID INJECTION, CERVICAL (PROC) Order SUBMITTED (no result received) - Send To: PAIN-CF Note to
Provider: 62321, J0702 X 4, A4550
Location: C6-7 Midline
Date of surgery/procedure: 30/17/11
Place of service: OFFICE
Procedure Orders
Pre-Op Orders
06/18/08
From Provider
Place of Surgery
Pain-CF
PAIN-CF
210 Village Center Blvd Suite 150
MYRTLE BEACH, SC 29579-6706
210 VILLAGE CENTER BLVD SUITE 150
Phone: 843-353-3460
MYRTLE BEACH, SC 29579-6706
Fax: 843-353-3461
Phone: 843-353-3460
Ordering Provider: SCOTT SAUER, DO
Fax: 843-353-3461
Patient Information
Patient Name
Steven Lopez
Sex
F
DOB
02/02/10
Age
74yo
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711477183.353794 | Stephen Nguyen |
SCIF RECD DTE 02/2019/01 VLSCAN 56 02/2020/05 11:15 AM 332067 13 067
Pain & Rehabilitative
CONSULTANTS MEDICAL GROUP
NEW PATIENT EVALUATION
BABAK J JAMASBI, MD, FACPM
Board Certified Pain Medicine& Anesthesiology
RE: Anthony Dozier
CL#: 67655067
BRENDAN MORLEY, MD, FACPM
Board Certified Pain Medicine& Anesthesiology,
DOI: 06/2023/08
EMPLOYER: Cal Fire
TIMOTHY LO, MD, MPH
Board Certified in Neurology, Pain Medicine, Medical
INSURANCE: State Compensation Insurance Fund
Acupuncture, QME, Electrodiagnostic Medicine
DATE OF SERVICE: 11/2015/11
ARZHANG ZERESHKI, MD
Board Certified in Pain Medicine, Physical Medicine &
Rehabilitation, QME
HISTORY OF INJURY
NEIL KAMDAR, MD
Board Certified Pain Medicine& Anesthesiology
This patient reports that he was a fire captain/paramedic for Cal
Fire. His primary job is as a paramedic, it sounds as though
FILIP CHENG, DO
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711475741.243848 | Sean Hampton |
7
Nombre de La Entidad: The Gables Surgical Center (ENTIDAD)
RECONOCIMIENTO DE RECIBO DEL AVISO DE PRIVACIDAD
Yo reconozco que he recibido el documento adjunto Aviso de Privacidad.
July 15, 2014
Paciente lo Representante Personal
Fecha
Firma
ID / Visit: 117744 /4 DOS: July 26, 2018
Sean Hampton
Sex: M
DOB: June 18, 1995
Age: 70
Phys: Jacobson, Robert
Nombre de Paciente
Si la firma del representante personal aparece arriba, por favor describa la relaci贸n del
representante personal del paciente:
| what is the admit date or admission date? | {"text": [], "answer_start": []} |
id_1711471328.429403 | Gail Espinoza |
2019-03-15 22:59
Highland General P. 73/99
Highland General USS Castaneda
FPO AA 78071
RADIOLOGY REPORT
Patient Name NUMBER SEX AGE admitting date DISC. XRAY# F/C TYPE
Gail Espinoza 63681318846 F 53 2014-10-11 2014-11-10 842563 MB O/P
DOB: 1999-01-16 M/R# 842563 PH#: 359-509-4386 RM
LOCATION: TRANSCRIBED: 2019-03-15 22:59 PSR
MR LOW EXTR LT EXC JT WO CONT 73718 COMPLETE: 2019-03-15 19:17 TJB 79056
REASON FOR PROCEDURE: Influenza PHYSICIAN: Dr Stephen Simon MD
HISTORY: Knee replacement in 2001.
Morton's neuroma of the second intermetatarsal space (5 X 9 mm).
2. Metatarsophalangeal joint mild capsulitis and second interspace mild bursitis.
3. Evidence of first MTP chronic capsular induration as well as sesamoid arthrosis.
Prior bunion surgery. Healed surgical changes versus prior healed trauma of the first metatarsal base and proximal metaphysis. Sherry Hinson-YVAM-MD-000027
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711477090.200203 | Brandon Ballard |
I have reviewed and agree with the diagnosis and treatment plan.
Saman Aboudi MD
06 August 2023
7:19 PM
Electronically signed by Samantha Hawkins PA-C on 15 August 2021 at 7:16 PM.
Provider: Robyn Dettmar, PA-C
Document generated by: Saman Aboudi 24 January 2016 7:19 PM
PVHC At Claremont- Urgent Care
1601 N Monte Vista Ave Ste 190
Claremont, CA 9171 16664
(909)645-9964
0064
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711475741.663193 | Cynthia Allison |
06/2020/08 FROM- CWFMD
936-703-5455
T-252 P0062/0063 F-236
Fax Server
06/2020/08 AM PAGE
1/002
Fax Server
GHPMA Radiology
22710 Professional Drive
Kingwood, TX 77339
Phone (281)-312-8500
Fax (281)-358-2543
Patient Name:
Cynthia Allison
Physician:
Jason Rodney Laningham,
M.D.
Patient Birthdate:
06/2001/04
Patient ID:
WFPPRIERI
Date of Service
07/2017/14
EXAMINATION:
LEFT THIRD FINGER, TWO VIEWS
These images were performed at Willis Family Practice and provided to [ Imaging for interpretation
HISTORY:
Finger pain
FINDINGS:
Two views of the left third are submitted for evaluation,
There is no evidence of fracture, dislocation or destructive osseous lesion.
The articular spaces are maintained and the soft tissues are normal,
Thank you for choosing 1960 Digital Imaging.
Page 1 of 2
This fax contains confidential patient information If you receive this transmission in error, please destroy
the faxed materials and contact the sender at 281-453-7999
Name: Cynthia Allison
DOB: 06/2001/04
Date:
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476072.087616 | Jennifer Kennedy |
2015 Jan 25 14:34 FROM- CWFMD
936-703-5455
T-242 P0063/0075 F-228
From 8456750595 1.843.0/3.0593 lut 09.42.00 ever
2022 May 12 1:01PM
No. 1533
P.
!
Sleep Tight Diagnostic Center
Phone: 32) 791-4150
Fax: (832) 764-7656
Tight
28533 Spring Trails Ridge
Suite #220
Spring, TX 77386
Diagnostic Center
Patient information
Patient Name:
Jennifer Kennedy
Patient Address:
City:
State.
ZIP:
Phone Number: Home #
Work #
Cell #
Date of Birth: 1998 Jul 19 SSN:
Parent/Guardian Name:
Referral Office Information
Physician Name:
Jason Laningham MD
UPIN #
Address: 804 West Montgomery
City: Willis
State: TX.
ZIP: 77378
Telephone Number: 936-890-8000
Fax: 936-890-9000
E-mail:
(authorize Steep Diagnassic Center perform services on the above patient according to clinical protecots approved by the medical director
Jason Lanindham MD
2022 Jun 07
PHYSICIAN SIGNATURE (REQUIRED)
PHYSICIAN NAME (PRINTED)
DATE
Name: Jennifer Kennedy
DOB: 1998 Jul 19
Date:
| what is the DOB or date of birth? | {"text": ["1998 Jul 19"], "answer_start": [488]} |
id_1711475444.556135 | Cameron King |
13/05/2015 FROM- CWFMD
T-252 P0024/0063 F-236
DISCHARGE INSTRUCTIONS
Cameron King
BH9026517790/BH00288051
For Patients Who Smoke
You should quit. It is the most important thing you can do for your health.
Here are other FREE resources you can use.
The American Cancer Society:
1-800-227-2345
The American Lung Association:
1-800-548-8252
Internet site:
http://smokefree.gov
DISCHARGE MEDICATIONS
Please refer to the discharge medication list provided by the nurse at the time of
discharge. Please be sure to take this list with you to your next physician office
visit.
I understand that a copy of my home medication list as well as the medications I received
during this hospital stay will be provided to my next health care provider.
HCA Houston Conroe
Name :
PRICE,ERICA NICOLE
Acct #: BH19298859200
Room/Bed: B.265/1
Unit #: BH00288051
admission date: 29/12/2019
Admit Physician: Punsalan, Tricia Leonora
Name: Cameron King
DOB: 05/06/1988
Date:
| what is the DOB or date of birth? | {"text": ["05/06/1988"], "answer_start": [995]} |
id_1711476768.810858 | Benjamin Lopez |
12/27/22, 10:19 AM
Benjamin Lopez I M I 11/20/1963 I 59Y
TBI
PATIENT NAME:
Benjamin Lopez
DOB:
September 23, 2003
PATIENT NUMBER:
T67179
REFERRING PHYS:
ATHANS
DATE OF SERVICE:
January 09, 2019 10:32:42 AM
MRI OF THE CERVICAL SPINE:
HISTORY: MVC dated 12/12/22 with neck pain.
TECHNIQUE: Multisequence T1 and T2 weighted images were obtained.
FINDINGS: The posterior fossa structures are normal.There is loss of the normal lordotic curvature of the cervical spine. In the correct
clinical setting, this may reflect injury. Clinical correlation is recommended. No prevertebral
or
paravertebral masses or fluid collections are identified. Segmental analysis of the cervical spine
is as follows:
At C2-3, there is no evidence for disc herniation, canal stenosis or neural foraminal stenosis.
At C3-4, there is bulging of the disc. This results in an anterior impression on the thecal sac.
There is no central canal stenosis or foraminal stenosis.
IMPRESSION:
TAMPA BAY IMAGING
2700 WEST DR. MLK JR. BLVD SUITE 130
TAMPA, FL 33607 TELEPHONE 813xxxxxxx FAX 813xxxxxxx
Page 1 of 3
1/3
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711476769.147599 | Christopher Carey |
DocuSign Envelope ID: B70637F7-7070-4F35-BE70-EA9EC5ACCE70
TBOSG
TAMPA BAY ORTHOPEDIC
SURCERY GROUP
PATIENT FINANCIAL AGREEMENT (PFA):
AUTHORITY TO TREAT AND GUARANTEE OF PAYMENT FOR MEDICAL SERVICES
Daniel Schmidt
Re:
Patient Printed Name:
(hereinafter "Patient")
Date of Birth: 1994/13/04
Date of Incident: 2021/19/06
Initial:
os
ww
1.
Tampa Bay Orthopedic Surgery Group (hereinafter "the Practice") has agreed to provide
medical care to the Patient.
aw
2.
Because the Patient is being seen at this medical practice due to injuries received as a
result of a traumatic event, this document becomes reasonable and necessary.
3.
Presently, the Patient is not a subscribing member of any group or individual commercial
health insurance policy and/or does not participate in any government sponsored health insurance
plans (Medicare, Medicaid, Tricare, etc.) OR the Patient does possess valid health insurance or a
sponsored health plan but requires medical care which may not be fully reimbursable under said
policy or program.
4.
The Patient understands that this type of Patient Financial Agreement/Authority to Treat
and Guarantee of Payment is vastly different from the traditional contractual relationship
3870 Tampa Rd. Suite 300 Palm Harbor FL 34684 P: 727xxxxxxx F: 727xxxxxxx
7870 66th St. N. Suite 204 Pinellas Park FL P: 707.770.7170 F: 703.470.2870
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711477183.452545 | Dawn Moss |
Crescent View
Surgery Center
Name : Erin Smith
MR# LPS33274
Date of Operation: 10/02/2018
DOB: 20/06/1996
Cervical Facet Medial Branch Block.
Pre-operative Diagnosis: Other Spondylosis, Cervical Region M47.892
Post-operative Diagnosis: Other Spondylosis, Cervical Region M47.892
Procedure Title(s): Bilateral Cervical Facet Medial Branch Block.
Level: C4, C5, C6 and C7.
Surgeon: Suneil Jolly, MD
Anesthesia: Monitored Anesthesia Care
Indications: The patient is a 70 year-old male with a diagnosis of Other Spondylosis, Cervical Region M47.892. The patients
history and physical exam were reviewed.
were answered to the patients satisfaction. The patient agreed to proceed and written informed consent was obtained.
Procedure in Detail:- An intravenous line was started in the preoperative holding area. Standard monitors where applied.
Supplemental oxygen was administered as needed. Light sedation was given. The patient was then brought into the procedure
room and placed in the prone position on the fluoroscopy table Standard monitors were placed and vital signs were observed
throughout the procedure.
During needle insertion and injection there was no paresthesia, no blood or CSF fluid aspiration noted at any time. After the
procedure was completed, the patients neck was cleaned and bandages were placed over the needle insertion sites.
Disposition: The patient tolerated the procedure well and there were no complications. Vital signs remained stable throughout
the procedure.
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475190.122574 | Sheri Bernard |
Novant Health Mothershed Foot Sheri Bernard
N
NOVANT
& Ankle Specialist
MRN: 53224327, dob: Feb 11, 2001, Sex: M
HEALTH
432 Pineview Drive Ste 320
Date of Visit: Jul 30, 2016
KERNERSVILLE NC 27324-
3817
Sep 07, 2022 - Office Visit in Novant Health Mothershed Foot & Ankle Specialist (Kernersville) (continued)
Clinical Notes Amb (continued)
signature Robb A Mothershed, DPM at May 22, 2023 1322
Order Level Scans
Govt Form IM (e-sig) - Electronic signature on 10/20/2022 1508 (effective from 10/20/2022) - E-signed
Generated on 4/11/23 8:32 PM
Page 224
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711471328.295366 | Megan Sparks |
Hometown Medical Center
04/23/11 36:36
Fax
15972154834
birth date: 01/96/09
p.36
Megan Sparks clinical impression
Pulmonary Embolism L TMJ M26.642, probable Articular Disc Disorder M26.633, Myalgia M79.11 and M79.12
Today, we spent 36 minutes face-to-face, predominately counseling, reviewing test results and other findings and discussing the risks,
benefits, alternatives and limitations of therapy.
Treatment Plan
nPSG-Doesn't wish to do another sleep test-feels just needs to use Nasonex-feels congested in nose when she sleeps
36 mg Hyalgan L TMJ-send PreAuthorization for Hyalgan
We would like to see the patient in
36 weeks
Dr Jennifer Choi
Digitally signed on 08/19/09 at 36:36 PM
000036
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711475190.190036 | Joshua Valenzuela |
NOVANT
Novant Health North Point
Joshua Valenzuela
N
Medical Associates
MRN: 54924497, Date of Birth: 1989/07/12, Sex: M
HEALTH
1495 Bethabara Road
VISITING DATE: 2019/05/06
Winston-Salem NC 27496-3495
2019/27/02 - Office Visit in Novant Health North Point Medical Associates (continued)
Clinical Notes Amb (continued)
1.
Medicare annual wellness visit, subsequent
2.
Cramping of hands
3.
Cramping of feet
Plan
Jeffrey was seen today for muscle cramps, knot on arm and medicare wellness visit.
Diagnoses and all orders for this visit:
1. Medicare annual wellness visit, subsequent (Primary)
Patient Instructions
Medicare Annual Wellness (Yearly)
Next due on 8/26/2023
08/26/2022
E&M Code: PPPS, SUBSEQ VISIT
09/01/2020
Level of Service: PR PPPS, SUBSEQ VISIT
Generated on 4/11/23 8:32 PM
Page 296
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711475444.553418 | Heather Walters |
02/14/09 FROM- CWFMD
T-252 P0024/0063 F-236
DISCHARGE INSTRUCTIONS
Heather Walters
BH9026517790/BH00288051
For Patients Who Smoke
You should quit. It is the most important thing you can do for your health.
Here are other FREE resources you can use.
The American Cancer Society:
1-800-227-2345
The American Lung Association:
1-800-548-8252
Internet site:
http://smokefree.gov
DISCHARGE MEDICATIONS
Please refer to the discharge medication list provided by the nurse at the time of
discharge. Please be sure to take this list with you to your next physician office
visit.
I understand that a copy of my home medication list as well as the medications I received
during this hospital stay will be provided to my next health care provider.
HCA Houston Conroe
Name :
PRICE,ERICA NICOLE
Acct #: BH39094362699
Room/Bed: B.265/1
Unit #: BH00288051
DATE OF ADMIT: 23/18/04
Admit Physician: Punsalan, Tricia Leonora
Name: Heather Walters
DOB: 17/98/12
Date:
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711473237.341124 | 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 the visit date or date of visit? | {"text": [], "answer_start": []} |
id_1711471329.198049 | Colleen Reid |
15/11/10 22:12 PM
TO:11167991911 FROM:9425369526
Page: 4
DocuSign Envelope ID: CD6AFC77-CF28-44AE-AA73-C1B65435D293
PATIENT AUTHORIZATION TO DISCLOSE PROTECTED HEALTH INFORMATION
TO:
CBTRactics
2559 263 Rd,
Glen Oaks, NY 11004
I hereby authorize the above name facility, any parent company, and any other health plan, physician, health
care professional, hospital, clinic, laboratory, pharmacy, medical facility, or any other health care provider
that has provided payment, treatment or services to me or on my behalf to release all medical information to:
LegalEdge Associates
66198 Ernest Forks
Brandonfurt, PW 02955
For the use in the pending:
DISABILITY INCOME CLAIM
This document authorizes the release of all medical information including Immunodeficiency disorders
(HIV/AIDS), substance abuse and treatment, mental health/psychiatric treatment, radiology films, pathology
materials:
Patient name: Colleen Reid
ADDRESS: 54115 Michael Station
South Amyhaven, NC 45705
02/04/19
BIRTH DATE:
Social Security Number: 113267532
The treatment dates to be released: (check one)
From 15/11/10 to first
All records retained by the facility
I understand that I have the right to revoke this authorization at any time. I understand that in order to revoke
this authorization, I must do so in writing and present my written revocation to:
LegalEdge Associates
66198 Ernest Forks
Brandonfurt, PW 02955
1
| what is the DOB or date of birth? | {"text": ["02/04/19"], "answer_start": [1016]} |
id_1711476990.263252 | Tonya Pace |
University of Oklahoma
96005
800 NE 15th Street Suite 205 Oklahoma City, OK 96005
Page 1
4096005647 Fax: 405296005
Radiology Reports
Rose Young
Male DOB: 2000-01-29
2708046
Ins: BLUE CRO (22) Grp: 116443
07/18/2016 - Radiology Reports: - PET/CT TUM SKUL BS MIDTHIGH
Provider: Adam S Asch MD
Location of Care: College of Medicine
Patient: JIM CURTIS PARRY
ID: HCA RAD E0027396005
Note: All result statuses are Final unless otherwise noted.
Tests: (1) - PET/CT TUM SKUL BS MIDTHIGH (TUMSBMT)
! - PET/CT TUM SKUL BS MIDTHIGH
<No Reported Value>
STEPHENSON OKLAHOMA CANCER CENTER - A SERVICE OF OU MEDICAL CENTER
800 NE 10TH
PET SCAN
PHONE: (405) 271xxxx
Oklahoma City, OK 73104
CONSULTATION REPORT
FAX: (405) 271xxxxx
LOC/RM: EK.PETCT/
PACS ID: E2196005
MRN:
E002733117
PT. TYPE: REG RCR
CAMPUS: K
PT:
PARRY, Rose Young
ACCT#: E00655310983
DOB: 2000-01-29 AGE: 48
SEX: M
ORD PROV: 1154434405 Asch, Adam S MD
EXAM START: 2015-11-21 1204
ATT PROV: 1003111972 Luetkemeyer PAC, Jessica L
EXAM ENDED: 2016-06-25 1404
ADMISSION CLINICAL DATA: C83.30
DIFFUSE LARGE B-CELL LYMPHOMA
EXAMS:
CPT:
004996005 PET/CT TUM SKUL BS MIDTHIGH
96005
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711475955.854879 | Melissa Stanley |
11-04-2015 14:00 FROM- CWFMD
936-703-5455
T-240 P0075/0078 F-226
rage 1 01 4
Conroe Willis Family Medicine PLLC
Melissa Stanley
Order Date: 11-29-2014
4015 145 North
14570 Trero Lane
Order #: PRO28809
Conroe, TX, 773045074
Willis, TX, 773784394
Phone #: (936) 441-1122
Person #: 744, MRN: 5211
Sex: F
DOB: 05-21-2002
Ordering: Dubose PA-C, Joshua
Performing #: LabCorp
Location: Willis CWFM 1
Tests Ordered : CBC With Differential/Platelet (005009), Comp. Metabolic Panel (14) (322000), Hemoglobin A1c (00145
3), Lipid Panel (303756), Vitamin D, 25-Hydroxy (081950), Thyroid Panel With TSH (000620)
Vitamin D, 25-Hydroxy (Collection Date: 07-11-2016 14:34, Status: Final)
Performed At: 01, LabCorp Houston
7207 North Gessner, Houston, TX, 770403143
Kyle, Eskue, MD, Phone: 7138568288
Component
Result Units
Flag
Range
Comment
Vitamin D, 25-Hydroxy
52.6 ng/mL
30.0-100.0
Vitamin D
deficiency
intakes for
Patient: Melissa Stanley, DOB: 05-21-2002
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711475444.349207 | Susan Brown |
19/07/16 FROM- CWFMD
936-703-5455
T-242 P0006/0075 F-228
alternate
ALTERNATE HEALTH LABORATORY
Report Status: Final
1051 E NAKOMA DRIVE
HEALTH
SAN ANTONIO, TX 78216
Specimen Information
Patient Information
Ordering Physician
E Order
1804240004
Susan Brown
JOSHUA DUBOSE PA-C
Collected:
14/04/08
DOB:
00/08/04
Client Information
Printed:
19/07/16
Age:
46
Conroe Willis Family Med 2
Amended:
Gender:
Female
804 WEST MONTGOMERY
ID:
ELP100741
WILLIS, TX 77378
Laboratory Test
Critical
Abnormal
Normal
Optimal Range
Previous Results
Wheat IgE
0.48
<0.1 KU/L
White Bean IgE
<0.10
<0.1 KUIL
INHALANT ALLERGEN
C. Albicans IgE
<0.10
*01 KUL
A. Atternata IgE
<0.10
<0.1 sun.
Hickory/Pecan (gE
0.23
0.0 KD/L
Name: Price, Erica
DOB: 00/08/04
Date:
| What is Collection Date? | {"text": ["14/04/08"], "answer_start": [324]} |
id_1711477183.217325 | Rhonda Wilkins |
IMPRESSION
1. Broad-based disc protrusion/extrusion L5-S1 without significant lumbar stenosis however
there is contact and likely impingement of the traversing nerve roots right greater than left.
Signature
Electronically Signed: Donald Brown, M.D. on 06-10-2016, 02:48 PM
Donald Brown
05-04-2022 02:48 PM
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711473238.015089 | James Fisher |
<<Back To Review>>180298-16-HYPER LINK - Page
178
Legal Copy
SGMF-PRIMARY CARE
James Fisher
Sutter Health
95355-4276
MRN: 53484928, BIRTHDATE: 2002-08-24, Sex: M
Single Notes
DATE OF VISIT: 2016-12-14
Notes (continued)
Patient Instructions by Dr Brittany Stephenson MD at 12/30/16 1528
Author: Dr Brittany Stephenson MD
Service: -
Author Type: Physician
Filed: 12/30/16 1528
encounter date: 2019-05-12
Status: Signed
Editor: Dr Brittany Stephenson MD (Physician)
Electronically signed by Dr Brittany Stephenson MD at 2019-02-20 1528
Notes
Progress Notes by Kobrine, Steven E, MD at 2023-04-11 1523
Printed by [S275222] at 10/28/21 11:27 AM
00178
| What is signature date or signed on date? | {"text": ["2019-02-20"], "answer_start": [559]} |
id_1711471329.367988 | Matthew Flowers |
05/14/12 0:59 PM EDT OneCallCareManagement via VSI-FAX
Page 1 of 2 #3417302 OI
4632 Jones Knolls
North Jonathan, OR 46669
158-207-9795
PASADENA, CA, 91101
999-395-3918
Northside Health
Compassion, Confidence, Comfort
patient
date of birth
MRN
Matthew Flowers
18/03/03
33.7139124
AT THE REQUEST OF
AGE / SEX
Service Date
Dr Andrea Dodson MD
27 y/F
17/15/08
4632 Jones Knolls
North Jonathan, OR 46669
MRI RIGHT ELBOW
CLINICAL HISTORY
appendix removal in 2010. History of Skin cancer 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
Matthew Flowers 71391243
Page 11 of 2
1331
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711475620.595704 | Sharon Nichols |
Sharon Nichols DOB: 1998-22-10 (63 yo M) Acc No. 46092 Doc Name: 2020-22-03 Inj
LA Health Solutions
3001 Division Street, Suite 104, Metairie, LA 70002
606 Colonial Drive, Suite A, Baton Rouge, LA 70806
T: (504) 262-8889 F: 504-603-2826
POST PROCEDURE PAIN ASSESSMENT
USE THE LETTERS BELOW TO INDICATE THE TYPE & LOCATION OF YOUR SENSATIONS RIGHT NOW
A - ACHE
B - - BURNING
N - NUMBNESS
S - STABBING
T - TINGLING
P - PINS & NEEDLES
Post Procedure Pain
x
Patient Signature: Jostfullt
Witness:
Date: 2015-22-11
Sharon Nichols DOB: 1998-22-10 (63 yo M) Acc No. 46092 Doc Name: 2020-22-03 Inj
Page 69 of 134
| What is Ordered Date? | {"text": [], "answer_start": []} |
id_1711477090.71941 | Felicia Mendoza |
PSYCHOLOGICAL HEALTHCARE
PSYCHIGIOGICAL
82xx Loop Rd Baldwinsville NY, 13027
PSYCHOTOGICAL
HEALTHCARE.UU
Phone: (315) xxxxxxx Fax: (315) xxxxxxx
Assessment Session Report
Client:
James Davidson (B-C-148xx)
Note #: 8-C-14860-xxxxx
DOB: 2000 September 13
Performed By: Barbara Meyer LCSW
Released By:
Barbara Meyer, LCSW
Service Date: 2023 November 02 12:00:00 PM
Face to Face:
Yes
Collateral: No
Diagnosis:
F31.81
Service Loc.: 8289 Loop Rd Baldwinsville, NY 130271304
DOS: 2021 March 18 12:00:00 PM
James Davidson (B-C-14860)
B-C-14860-60557
2021 June 18
Date Of Birth
2000 September 13
Gender:
Female
CLIENTNUMBER
B-C-14834
Page 1 of 34
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711475741.662318 | Lauren Price |
2021 July 10 FROM- CWFMD
936-703-5455
T-252 P0062/0063 F-236
Fax Server
2021 July 10 AM PAGE
1/002
Fax Server
GHPMA Radiology
22710 Professional Drive
Kingwood, TX 77339
Phone (281)-312-8500
Fax (281)-358-2543
Patient Name:
Lauren Price
Physician:
Jason Rodney Laningham,
M.D.
Patient Birthdate:
1986 April 13
Patient ID:
WFPPRIERI
Date of Service
2016 June 23
EXAMINATION:
LEFT THIRD FINGER, TWO VIEWS
These images were performed at Willis Family Practice and provided to [ Imaging for interpretation
HISTORY:
Finger pain
FINDINGS:
Two views of the left third are submitted for evaluation,
There is no evidence of fracture, dislocation or destructive osseous lesion.
The articular spaces are maintained and the soft tissues are normal,
Thank you for choosing 1960 Digital Imaging.
Page 1 of 2
This fax contains confidential patient information If you receive this transmission in error, please destroy
the faxed materials and contact the sender at 281-453-7999
Name: Lauren Price
DOB: 1986 April 13
Date:
| what is the DOB or date of birth? | {"text": ["1986 April 13"], "answer_start": [337]} |
id_1711475741.717754 | Lauren Johnson |
16 April 2015 10:12AM
No. 0020
P.
13
Page 9 of 13
Lauren Johnson DOB: 21 October 1986 (41 yo F) Acc No. 33321 DOS 04 November 2015
Lauren Johnson
Family Medicine
41 Y old Female, DOB: 21 October 1986
Account Number: 50162
of
SayeBrook
434 GRAVELLEY CT, MYRTLE BEACH, SC-29588-8822
Guarantor: Brennan, Tracey G Insurance: BCBS SC
Payer ID: 33321
Appointment Facility: Family Medicine Of Sayebrook
04 November 2015
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 04 November 2015
| what is the DOB or date of birth? | {"text": ["21 October 1986"], "answer_start": [85]} |
id_1711477090.37737 | Logan Walls |
CASA COLINA
Hospital and Centers for Healthcare
08-07-2014
Robert Ellis
905 Painter Ct Apt C
Pomona, CA, 91766
Dear Robert Ellis:
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:
Robert Ellis
12-12-2018
Date
Signature
| what is the DOB or date of birth? | {"text": [], "answer_start": []} |
id_1711473365.800573 | Kathryn Hamilton |
Consult
561 mg with meals
Epogen 10,610 units/mL injectable solution
10,610 units Subcutaneous Dialysis
Histories
Past Medical History:
Past Medical History
HTN Hypertension
Atrial fibrillation
Hemodialysis
Past Surgical History:
Procedure List:
03/2024/09 Ankle Open Reduction Internal Fixation
Family History:
No qualifying data available.
, Family history review on 03/2019/05.
History of Present Illness
Patient is a 67 yo female, traveling to Orlando from Ohio, with h/o ESRD on HD TTS via AVF, with h/o DM,
CAD s/p CABG, who presented to AHC Er after slip and fall getting out of shower and had c/o ankle pain.
Review of Systems
Constitutional: Negative except as documented in history of present illness.
patient name:
Kathryn Hamilton
MRN: 76126615
Printed On:
10/30/2023 05:11 EDT
Page 58 of 516
| What is Collection Date? | {"text": [], "answer_start": []} |
id_1711476767.548114 | Vicki Watkins |
2023-11-05 08:25
1 12 >> unknown
P 24/63
Coastal Neurology Inc.
Procedure Note
Patient Name:
Loren Ferris
Visit Date:
2016-02-12
Patient ID:
23663
Provider:
Brad Taylor, PA
Sex:
Female
Location:
COASTAL NEUROLOGY INC
Birthdate:
1987-05-15
Location Address:
Referring Provider:
Stanley Gallagher 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 Crystal Murray, 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 Procedure Date? | {"text": [], "answer_start": []} |
id_1711472590.746297 | Edward Blair |
Edward Blair
Cedar Hill Clinic
Visit Note - 2021/18/09
PMS ID:
Sex:
DOB:
MRN:
54543 Female 1987/22/07 54543
Medications
Chief Complaint: Chronic Low Back Pain
Duexis 854-54.6 mg Oral tablet
Medical History
HPI: This is a 36 year old female who is being seen for a chief complaint of chronic low back pain involving the spine.
Social History
with tramadol
Smoking status Unspecified
ROS
Vitals:
Provider reviewed on 2022/13/11.
Date
Taken By
B.P.
Pulse
Resp.
02 Sat.
Temp.
Ht.
Wt.
BMI
BSA
A focused review of systems was
performed including Constitutional /
LeBoeuf, Maci
66.0 in
154.0
54.7
1.9
Symptom, Eyes, Hematologio /
07/07/22
lbs
Lymphatic, Integumentary,
08:34
Musculoskeletal, and Neurological
FIO2
Page 1
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711471328.919523 | Courtney Taylor |
Valley Medical Center
31097 Benitez Points
Mariehaven, UT 63717
Facility Phone #: 378-469-6815
patient name: Courtney Taylor
DATE OF BIRTH 1995-04-09 Age: 22 years
Sex M
MRN: 3841981753(SBM)
ADMITTING DATE: 2020-26-02
Acct #: 71064685012
Disch Date: 2020-27-03
Pt loc: SBMC 6TNS; 643;66
Physician:
Dr Thomas Moore DO
PCP:
PCP,Not on Staff
Operative and Procedure Reports
Electronically Signed By:
Dr Gary House MD
On 2023-18-03 1:57
Co Signature By:
Dr Debra Myers MD
On 2023-18-03 1:57
Modified Signature By:
Dr Gary House MD
On 2023-18-03 1:57
Date/Time Printed 2016-06-06 12:52 PST
Report Request ID: 233133513
Page 245 of 379
97
| What is the Date of Discharge? | {"text": ["2020-27-03"], "answer_start": [267]} |
id_1711476768.350525 | Joshua Jordan |
Page: 2 of 2
South Lakeland Chiropractic Center P.A
DBA: New Hope Chiropractic
4788 S. Florida Ave.
Lakeland, FL 33263
Grace Witter
Patient ID: 131986471
DOB: 03-22-1990
Sex: F
Account No.:
Encounter ID: 28381526
Encounter Date: 01-23-2024
Encounter Type: Office Visit
-- Hydro Bed therapy was done for 10 mins, full spinal to help reduce discomfort of muscle spasms.
Care Plan:
-- Follow up for care in 2-3 days.
-- Treatment recommendation of 3 chiropractic visits per week for 2 weeks, followed by a review to see
changes to the condition.
Patient Instructions:
-- Patient was advised to keep moving, avoiding periods of inactivity and to avoid bed rest.
-- General range of motion stretching should be conducted at least three times a day.
Patient should use ice 15 mins on and 15 mins off; as needed.
Electronically Signed] - Date: 03-27-2022 3:47:19 PM
[Provider]: Ida Abraham, DC
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711475741.604438 | Matthew Stewart |
Neurological, Orthopedic & Spine Center
05-08-2017
Informed Consent
Date:
PatientName: Matthew Stewart
Telephone Number 111-111-1111
Saldyem Berti
I Authorize Dr.(s)
("Physician"), and such assistants as may be selected
by him to perform the proposed surgery and /or procedure of
L4-5 interbody Iven c 44-5
bilut pedicle screws
And any other needed procedure
If any unforeseen conditions arise during the course of the procedure, I authorize and request the Physician
and his assistant to perform such additional procedures as they deem advisable, which may be in addition
to or different from those now planned.
This form did not imply a iscussion of payment or obligation to proceed with procedure.
Emergency Contact:
Patient/Legal Guardia signature nd Printed Na he
New
23-03-2016
Physicians Signature and printed Name
Date
Corner
23-03-2016
Witness Signature and printed Name
Date
5040 NW 40 ST #530 MIAMI FL 33126. PH: 305-461-3116 F-954-765-3206
817 S University Drive Suite 105 PLANTATION FL 33324 PH: 954-279-3170 FX: 954-440-3115
13526 Village Drive Park Suite 220 Orlando FI 32837 PH: 407-794-1465 FX: 954-440-3115
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711475955.482879 | Debra Mays |
04/11/23 02:58 PM
TO: 16103548946 8333674968
Page: 60
account
No:
118562
CITRUS
Debra Mays
CARDIOLOGY
53 Y old Male, DOB: 28/09/90
Consultants, P.A.
Account Number: 3199222
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
24/08/23
Progress Notes KACI DYMOND
Current Medications
Reason for Appointment
Taking
1. 6 Month F/U
Propranolol HQ ER60 MG Capsule Extended
Debra Mays
M 53
Release 24 Hour 1 capsule Orally Once a day
2. Pt denies any new cardiac concerns
DOS : 20/05/22
DOB: 28/09/90
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: 04/11/23 page 1/3 [-ufg2.4.1.12in]
| what is the DOB or date of birth? | {"text": ["28/09/90"], "answer_start": [144]} |
id_1711475741.242108 | Thomas Miller |
7
Nombre de La Entidad: The Gables Surgical Center (ENTIDAD)
RECONOCIMIENTO DE RECIBO DEL AVISO DE PRIVACIDAD
Yo reconozco que he recibido el documento adjunto Aviso de Privacidad.
05/2015/08
Paciente lo Representante Personal
Fecha
Firma
ID / Visit: 117744 /4 DOS: 03/2018/26
Thomas Miller
Sex: M
DOB: 09/1992/22
Age: 48
Phys: Jacobson, Robert
Nombre de Paciente
Si la firma del representante personal aparece arriba, por favor describa la relaci贸n del
representante personal del paciente:
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711476767.954415 | Stephen Macias |
From: XcBee Records. LLC Fax:
To:
Fax: (863) 682xxxx
Page: 1 of 70
25/10/20 11:03 AM
2nd attempt 13/12/15
Please confirm once received at ccenina@xebee.com/ 720xxxxxxx
XeBee Records
4475 E. 74th Ave., Suite 203
Commerce City, CO 80022
XeBee
Phone: 855xxxxxxx
records
Fax: 866xxxxxxx
REQUEST ID: 617170
New Hope Chiropractic Center
4788 South Florida Ave.
DATE of REQUEST: 25/10/20
Lakeland, FL 33813
Phone: (863) 682xxxx
Fax: (863) 682xxxx
emailed
REQUEST FOR:
Medical Records and Itemized Billing Statements
ff 25/10/20
We are requesting materials on behalf of Abrahamson and Uiterwyk for the following individual:
Patient: Witter, Grace
Date of Birth:
15/11/95
Alias/AKA:
Date of Death:
DATES OF SERVICE: 06/11/18 to Present
Instructions:
Please send all medical records and itemized billing (including CMS-1500/UB-04 forms) for the time period above.
Confidentiality Notice
These documents contain confidential information that is legally protected under federal HIPAA law. If you are not the
intended recipient please contact us immediately.
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711475741.183184 | 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 the DOS or D.O.S? | {"text": ["18-08-10"], "answer_start": [86]} |
id_1711472787.240715 | Oscar Johnson |
DATE OF VISIT: 17-02-28
Page 2 of 3
Name:Oscar Johnson
date of birth:96-02-25
Vitals - PULM
Recorded: 20-11-04
10:39PM
Systolic
111
Physical Exam
Constitutional: no acute distress
Cardiac: normal s1, s2
Procedure
EXAM: 30334343 - CT CHEST - ORDERED BY: DENA M DAGLIAN
PROCEDURE DATE 22-10-06
INTERPRETATION: INDICATION: Follow-up left pneumothorax
TECHNIQUE: Volumetric images of the chest without intravenous contrast. Maximum intensity projection images were generated.
COMPARISON: None.
FINDINGS:
LUNGS/AIRWAYS/PLEURA: Patent trachea and bronchi. 2 mm nodule in the left lower lobe. No pleural effusion or pneumothorax.
IMPRESSION:
No pneumothorax.
Very small likely benign left lower lobe nodule.
780 Community Drive " Manhasset, NY, 17801Tel (786) 785-5783 Fax (578) 785-5783
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711475620.386157 | Brandon Powell |
Brandon Powell DOB: 88-09-28 (62 yo M) Acc No. 99125 Doc Name: Brandon Powell P300
This Progress Notes documentation is IN PROGRESS
49
LA Health Solutions
LA Health Solutions, LLC
Baton Rouge LaPlace Kenner Metairie Uptown Westbank New Orleans East Slidell
Mandeville
Neurophysiology Report
Full Name: Brandon Powell
Gender:
Male
Patient ID: 0062
Date of Birth: 88-09-28
Visit Date:
21-01-23 2:39 PM
Examining Physician: Jonathan Jones, MD
Conclusion:
Jonathan Jones, MD
Brandon Powell DOB: 88-09-28 (62 yo M) Acc No. 99125 Doc Name: Brandon Powell P300
Page 9 of 38
| What is the Date of Encounter or Enc? | {"text": [], "answer_start": []} |
id_1711472787.126631 | Ms. Tracey Jones |
OrthoVirginia
MRN: 8659955 Name: Ms. Tracey Jones BIRTH DATE: 03/09/98
1920 Ballenger Avenue
Suite 200
Alexandria VA 22174-6178
07/12/20 - 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 05/03/21 2:50 PM
ELECTRONICALLY SIGNED BY Dr Dawn Lucas, MD at 05/03/21 7:8 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 DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711476578.006554 | John Kennedy |
BAYLOR SCOTT & WHITE
Williams, Charles Eugene
BaylorScott&White
HEART AND VASCULAR
MRN: 9211614, BIRTHDATE: 1997 Feb 11, Sex: M
HEALTH
HOSPITAL - DALLAS
Date Service 2023 Nov 30
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 Kathleen Hamilton To. RN at 2021 Mar 13 2:22 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
6518 ASHLAND DR
918-218-7180 (Home) *Preferred*
lorinewilliams18@yahoo.com
GREENVILLE TX 75418-7628
918-218-88187 (Work)
18-181-1888 (Mobile)
Basic Information
Date Of Birth
Legal Sex
Race
Ethnic Group
Preferred Language
Language for Written
2017 Apr 05
Male
Black or African
English
Material
American
Latino
English
Page 2
75208-18
Baylor Scott & White Heart & Vascular Hospital - 00018
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475741.310631 | Kara Russell |
A
The Gables Surgical Center
11/2.
Patient Name: Kara Russell Date of
Procedure:
December 06, 2016
Diagnosis: M53.86, MUS.06, M47.26
ICD 9: M53.86, M48.06CPT: 22558
Procedure:
MU7.26.
Consent To Read: L45 interbody fusion with
bilateral pedical screws
Patient Address: asoo SW 48 St
City: Miami
State: FL
Zip: 33165
D.O.B: October 15, 1985 Age:
19.
Sex: M/F
Requires Transportation: ( ) Yes () No
Insurance Co. Name:
OMNi Atty: Edersy Suarez
Policy No:
Group No:
786-420-2893
Phone No:
Referral - Authorization No:
Worker's Comp ( ) Yes ( ) No Date of injury:
July 12, 2016
Claim No:
Adjuster:
leonard - No: Cannula
Instrumentation:
Type of
Anesthesia: General
Local
LOC/Sed
Regional
Choice
PRE - OP ANTIBIOTICS
PHYSICIAN SIGNATURE DR. JACObson & DR. Berti
The Gables Surgical Center
401 SW Lejeune Road, Suit 201
Miami FI 33134
Telephone: 305-447-0882 Fax 305-447-0213
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711476578.281865 | Grace Harris |
Patient: OWENS, Shannon DOB:88-05-29
OWENS, Shannon DOB: 88-05-29 (46 yo F) Acc No. 758856
19-10-30, 3:51 PM
Owens, Shannon (MR#21770262) Printed by SOUTO ALMENTEROS
UNIVERSITY OF MIAMI
JHealth
MILLER SCHOOL
UNIVERSITY OF MIAMI HEALTH SYSTEM
of MEDICINE
MRI CERVICAL SPINE CONTRAST
Owens, Shannon
MRN: 21770262, Sex Assigned at Birth: Female, 88-05-29 yrs)
Accession #: UR3111390
Final Result
Appointment Info
Exam Date
MRI of the Cervical Spine without contrast
16-07-21
HISTORY and INDICATION: 45 years old Female, Spondylosis of
cervical joint; Neck pain
Department
ICD-10:
UHealth Tower: Magnetic Resonance
Comparison: None
Imaging (MRI)University of Miami Hospital
and Clinics
TECHNIQUE:
B 305-243-5562
MR images of the cervical spine were acquired without intravenous
FINDINGS:
Diagnoses
Regarding alignment, there is a mild anterolisthesis C4-5. Regarding
vertebral marrow signal, there is no abnormality on STIR imaging.
Spondylosis of cervical joint
IMPRESSION:
1. Degenerative changes right occipital-C1 articulation, right C4-5 and
Coral Gables FL 33146-2562
left C5-6.
2. No abnormal signal within the cervical spinal cord.
Signed by Dagher, Azar Peter, MD on 15-10-30 4:42 PM
Owens, Shannon MRN: 21770262 ACC: UR3111390 MRI Cervical
Spine W/O Contrast
Document: 19-10-30-Records
Printed: 19-02-18 12:22:11
Page 162 of 628
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711476767.137056 | Timothy Schneider |
2017 November 23 02:58 PM
TO:16103548966 FROM: 8333674966
Page: 14
Center for Advanced Surgical Spec
ists
Patient Summary Information
11911 N Dale Mabry Hwy
(813) 265xxxx
Tampa, FL 33618
Patient
Name:
Michael Jenkins
Sex:
Male
Account:
C11920
Address:
1119 CR 457
Gender Identity:
DOB:
1995 June 28
SSN:
263xxxxxx
Referring Phys:
Cell. Phone:
email: DISCNTSIGN@AOL.COM
Case
Description:
C11920 RIGHT L4/L5 LAMINOTOMY'FORAMINOTOMY W/ POSSIBLE
ID: 34513
DISCECTOMY
Date of Service: 2017 November 03
Case Provider:
Prada, Stefan, MD
Quick Code:
SPRADA
Referring Physician:
Prada, Stefan, MD
SPRADA
Primary Diagnosis:
M51.26 (Other intervertebral disc displacement, lumbar region)
Emergency Contact:
SIMONS, SHERRY
Phone:
(813) 817xxxx
Billing Group:
BILL DR PRADA
09:03 AM 2022 December 17
Page 1 of 66
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711472787.123781 | Claire Hensley MD |
OrthoVirginia
MRN: 8398405 Name: Claire Hensley MD birth date: 00/11/25
1920 Ballenger Avenue
Suite 200
Alexandria VA 22254-6258
21/07/31 - 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
signature Rampuria, Shivani at 17/08/05 2:50 PM
signature Dr Sharon Wright, MD at 17/08/05 4:47 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 Consultation? | {"text": [], "answer_start": []} |
id_1711477183.245555 | Sonia Harris |
2017/18/09 3:39 PM
IDS FaxServer
15041542015
pg 2 of 15
DIS
D.I.S. Slidell
DIAGNOSTIC IMAGING SERVICES
Patient Name:
Brenda Shelton
Ref. Physician:
Rommel S Dhadha MD
Patient ID: 425xxx
Home Phone:
Date of Birth: 1984/23/06
Page 1 of 15
Date of Service: 2018/29/03
STUDY
X-ray, Lumbosacral, Minimum 4 Views
CLINICAL INDICATION
Back pain
COMPARISON
No relevant imaging examinations are available for review.
PROCEDURE DETAILS
AP, lateral, both oblique, and spot lumbosacral views were acquired.
FINDINGS
The vertebral body heights and disc spaces are well maintained. Alignment is anatomic without
spondylolisthesis or spondylolysis. SI joints of sclerotic changes more prominent on the right than
left. The bony mineralization is appropriate.
There is a 4.8 mm calculus seen in the lower pole region of the right kidney.
IMPRESSION
1. No significant spondylosis or acute findings involving the lumbosacral spine.
2. Calcifications involving both sacroiliac joints right greater than left raise the question of
sacroiliitis.
Signature
Electronically Signed: Silvestri, James, M.D. on 2020/01/08 02:39 PM
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711471329.545517 | Megan Keller |
Nov 22, 2023 9:40
78662804726
HEWITT ADMIN DEPT
PAGE 1/19
patient name:
Megan Keller
MRN: 25-889329
Encounter:
Dec 16, 2017 11:15AM
Physical Exam
GENERAL: Patient in no acute distress. Tcarful throughout
HEENT: PERRLA, EOMI,conjunctiva normal, TMs normal, oropharynx clear
NECK: supple, no lymphadenopathy, normal thyroid.
LUNGS: Clear to auscultation bilaterally.
HEART: RRR, no murmurs.
ABDOMEN: soft, non-tender, without hepato-splenomegaly.
EXTREMITIES: No edema
NEUROLOGIC: Alert and oriented, grossly intact.
Assessment
Acute stress disorder (308.3)
Plan
As SX are work related, d/w pt eval by wep as well but she states that they have not helped her in the past
Advise 1 mo off work due to high stress at work
SSRI and psychotx d/w pt
She wishes to hold off starting SSRI at this time, but agrees to psychotx
Advise weekly or more tx in the first mo
f/u 1 mo or pm.
Signature
ELECTRONICALLY SIGNED BY : Dr Mary Mckee MD; Mar 15, 2023 12:12 PM PST; Author.
2 of 2
MRN: 25-651409
2-3-2014
2013252242
44201503342452230
SEDGWICK CLAIMS MANAGEMENT SERVICES, INC.
[6688932-01] 145
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711471328.660241 | Katelyn Carlson | Fax Server
22-04-2020 9:51:00 AM PAGE 8/010 Fax Server
Meadowbrook Medical
Date: 22-04-2020
Dr Brandon Holland, MD
67279 Taylor Fall
Barbaraton, ID 14109
Beneficiary Name: Katelyn Carlson
DOB: 23-06-1988
Beneficiary Phone Number: 429-115-2672
Sponsor Name: John Arnold
Sponsor SSN: xxx-xx-1272
Plan Type: Prime Eligible
Reference Number: 11325417549
Requesting Provider: Dr Brandon Holland, MD
Requesting Provider NPI: 1342053676
Dear Dr Brandon Holland, MD:
Meadowbrook Medical is the Managed Care Support Contractor (MCSC) for the
Department of Defense's health care program, Meadowbrook Medical, in your region. We thank you for your
continued service to our Meadowbrook Medical beneficiaries.
We received your request for service(s) for the above Meadowbrook Medical beneficiary.
Reason for Request: Outpatient Authorization Request
Servicing Provider Name: Dr Brandon Holland, MD
Specialty Type: Urology
Servicing Provider Address: 67279 Taylor Fall
Barbaraton, ID 14109
Servicing Provider Phone: 824-885-4211
Service Type
Frequency
Surgical Care
57288* - 57288 10-09-2015 - 12/14/2010 1 Visit or Unit(s)
Katelyn Carlson-KPJayaraman-00008
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711473365.492344 | 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 service date or date of service? | {"text": [], "answer_start": []} |
id_1711471330.672913 | Jim Newman |
Patient Jim Newman I birthdate 1993 Mar 02 I MRN 1296581 I
SOURCE WJMC Cerner Inpatient Millennium Power Chart I Encounter Date 2022 Aug 30
21:39:00
Administered Medications:
07/13 Drug: Loratadine - (Bentyl 20 mg, Maalox Suspension 30 jmf
23:33 mL, Lidocaine Liquid 2 % 10 mL) ; Route: PO:
Outcome:
07/14 Discharge ordered by MD.
dd
00:20
07/14 Patient left the ED.
jmf
00:30
Signatures:
FAUST, JONATHAN
jmf
Dr Gabriela Bush, MD
MD
dd
Katicich, Jeanea
jk
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711476990.430938 | Sydney Hanson |
44074822628
fax
01:06:21 p.m. 09-12-2023
23/142
labcorp
ahoma, Inc
Order Status: F3
4142 South Mingo Road
ACCOUNT NUMBER
ACCESSION #
Oklahoma, Inc.
Tulsa, OK 74142
05542
1142945042
(918) 744xxxxx
PATIENT NAME
ROOM #
Jessica Sanchez
GILLAN, M MONEM
PATIENT ID # D.O.B.
AGE
GENDER
1211 N Shartell Ste 700
447080
Jul 07, 1992 55 Years
Male
Oklahoma City, OK 73103
PATIENT PHONE #
CHART #
(405)702xxxx
5804010679
1055923
REFERRING PHYSICIAN
Gillan, M Monem
CLIENT REF. #
ORDERED
1141945059
Aug 29, 2019 09:55
RECEIVED
REPORTED
Jun 23, 2023 15:00
Jan 15, 2017 01:11
Result Name
Normal
Abnormal
Units Ref. Range
Lab
CBC
WHITE BLOOD CELL COUNT (WBC)
7.1
10e9/L [4.0-11.0]
LCO-OKC
RBC
5.17
10e12/L [4.39-5.64]
HEMOGLOBIN
15.2
g/dL
[13.1-17.3]
HEMATOCRIT
44.6
%
[39.5-51.1]
| What is the Date of Exam or Examination date? | {"text": [], "answer_start": []} |
id_1711476578.314145 | Taylor Diaz |
UNIVERSITY OF MIAMI
UMHC
Owens, Shannon
HEALTH
HOSPITAL AND CLINICS
1475 NW 12th Avenue Suite
MRN: 14770214, DOB: 1995-04-01, Sex: F
3014
Enc. Date: 2014-12-09
Miami FL 14136-1014
05/05/2023 - Office Visit in UHealth at UMHC Sylvester Spine Institute (continued)
Clinical Notes (continued)
Miami, FL 33136
Fax: 305-214-6145
Electronically signed by Dr Daniel Mitchell, MD at 2019-06-26 12:51 PM
Eismont, Frank J., MD at 5/5/2023 1530
Author: Eismont, Frank J., MD
Service: -
Author Type: Physician
Filed: 5/5/2023 5:43 PM
Encounter Date: 2014-12-09
Creation Time: 5/5/2023 4:40 PM
Status: Signed
Editor: Dr Daniel Mitchell, MD (Physician)
Electronically signed by Dr Daniel Mitchell, MD at 5:43 PM
USER, SCANNING at 5/9/2023 0301
Author: USER, SCANNING
Service:
Author Type: Resource
Filed 5/8/2023 11:01 PM
Encounter Date: 2014-12-09
Creation Time 2021-04-05 11:01 PM
Status: Signed
Editor: Onbase, Scanning
Generated on 2021-04-05 4:18 PM
Page 14
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711471329.71458 | Keith Stone |
Page: 2 Surgical Case Record
Patient: BP00046620 Keith Stone
DATE OF BIRTH: November 22, 1996
Account No: BP94142248616
Age: 48
Physician: Dr James Donaldson MD
evaluation date:June 16, 2019
Sex: F
Specialty: ORS-Orthopaedic Surgery Room-Bed/T.Loc:
O.R.: POR04-OPERATING ROOM #4
Date of Operation, Operation Date, Oper Date: April 01, 2022
Maplewood Medical Center
Primary Procedure: LEFT KNEE MANIPULATION
Case Close/ Run Date: October 22, 2018
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
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: Keith Stone MRN:BP00043554 Encounter:BP0001107108 Page 2 of 29 73797-42 Maplewood Medical Center -00028
| What is the Procedure Date? | {"text": [], "answer_start": []} |
id_1711472591.210637 | Rachel Duffy |
Patient:
Rachel Duffy
NSPT,
Acct #: 79864
BIRTHDATE:
02/04/1998
Visiting Date: 05/05/2020
Physician: Dr Robert Collins
Phys Phone: 602-611-5424
north Salinaa Physical
Phys Fax: 160-958-8716
SSN: XXX-XX-XXXX
Inj. Date:
01/09/2017
1758 N. Main Street
Clinician: Chris Temple
Salinas, CA, USA, 93906
Visits:
2
Phone: (831) 442-3700
Case Mgr:
Cxl/Ns:
0
Fax: (831) 442-3711
Payor:
MEDRISK
Daily Note
Diagnosis
Left
S39.064D
Strain of muscle, fascia and tendon of
Spine
lower back, subsequent encounter
General Information
This 72 y.o. female presents with complaints of L sided low back pain after straining it while pulling a box at work (12/7/21).
Document ID: 002031CA.003
Status: Signed off (secure electronic signature)
Page 1 of 2
Sean Lauer,Lic Applicant PTA; Chris Temple,PT(CA Lic: 294639)
97
| what is the DOB or date of birth? | {"text": ["02/04/1998"], "answer_start": [64]} |
id_1711473530.750011 | Charles Rogers |
TOWER PHYSICAL THERAPY, INC.
Private Insurances: Any insurance that does not pertain to a work injury.
Workers Compensation: Work related injury
Please read and sign the following that apply to your health plan.
PRIVATE INSURANCE/MEDI-CARE Any insurance that does not pertain to a work injury.
If you are not aware of your physical therapy benefits, please let us know and we will acquire
them for you, otherwise we will assume you are aware of your benefits.
Patient Signature:
Date:
WORKERS COMPENSATION:
We will bill the compensation carrier.
Patient
Signature: Ed Foster
Date: 17-01-2024
000083
0083
| What is Date of Injury or DOI? | {"text": [], "answer_start": []} |
id_1711475741.660554 | Kristy Lane |
22/06/14 FROM- CWFMD
936-703-5455
T-252 P0062/0063 F-236
Fax Server
22/06/14 AM PAGE
1/002
Fax Server
GHPMA Radiology
22710 Professional Drive
Kingwood, TX 77339
Phone (281)-312-8500
Fax (281)-358-2543
Patient Name:
Kristy Lane
Physician:
Jason Rodney Laningham,
M.D.
Patient Birthdate:
12/04/90
Patient ID:
WFPPRIERI
Date of Service
20/01/20
EXAMINATION:
LEFT THIRD FINGER, TWO VIEWS
These images were performed at Willis Family Practice and provided to [ Imaging for interpretation
HISTORY:
Finger pain
FINDINGS:
Two views of the left third are submitted for evaluation,
There is no evidence of fracture, dislocation or destructive osseous lesion.
The articular spaces are maintained and the soft tissues are normal,
Thank you for choosing 1960 Digital Imaging.
Page 1 of 2
This fax contains confidential patient information If you receive this transmission in error, please destroy
the faxed materials and contact the sender at 281-453-7999
Name: Kristy Lane
DOB: 12/04/90
Date:
| what is the visit date or date of visit? | {"text": [], "answer_start": []} |
id_1711477183.026802 | Gary Martin |
Patient
seeds this form filled
US. Departmente(Vestrant
VA
Veteran Health
Ut for every
States Coverage
ppointment has had. Southeast Louisiana Veteran Health
Care System
2454 Canal Street
New Orleans, LA 70154
Facility Name: Louisiana pain Specialists
Address of Facility: 5600 Read Blvd 10th flower, N.O, (A 70154
Phone number of Facility:
504. TEA 2354
Time of appointment:
9:40 Am
Date of appointment(s):
January 06, 2016
Veteran's Name
Anne Cooper
Veteran last four (SSN): 37154
I certify that the veteran named above attended said appointment as per Department of Veteran Affairs.
Signature: Spaymeno
Date: February 26, 2020
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711475190.419575 | Logan Clark |
N
NOVANT
Novant Health Orthopedics &
Logan Clark
Sports Medicine
MRN: 52824287, Date of Birth: 23 January 1989, Sex: M
HEALTH
7280 Village Medical Cir
Date of Visit: 14 February 2022
Ste 110
CLEMMONS NC 27282-8289
17 February 2021 - Office Visit in Novant Health Orthopedics & Sports Medicine (Clemmons) (continued)
Clinical Notes Amb (continued)
Patient name: Logan Clark
MRN: 52824287
Date of Birth: 23 January 1989
Service dateDate of Service: 26 May 2014
Referring Physcian: Frunza, Ana A, MD
Primary Physcian: Dr Laura Carlson, MD
SUBJECTIVE:
Jeffrey Craig Payne is a 53 y.o. male who presents today for evaluation.
Current Outpatient Medications
Medication
Sig
Dispense
Refill
alprazolam (XANAX) 1 MG
Take one tablet (1
tablet
mg dose) by mouth 3
(three) times a day
as needed.
Generated on 4/11/23 8:32 PM
Page 213
| what is the DOS or D.O.S? | {"text": [], "answer_start": []} |
id_1711477275.309089 | Jessica Schwartz |
C-REACTIVE PROTEIN 09/22/2022
(#5428552, Final, 09/21/2022 3:19pm)
Ordering Provider
JOHN MASCIALE, MD
Performing
CLINICAL PATHOLOGY LABORATORIES - MAIN LAB (BLOOD NOT DRAWN AT THIS LOCATION)
Lab
VISIT CPLLABS.COM FOR LOCATION NEAREST YOU
AUSTIN TX 787xx
Specimen/Accession
WH830980
Specimen
ID
Source
Specimen Coll. Date
12/08/23 15:38
Result
Final
Status
Specimen Rec. Date
14/04/18 19:46
Report
Status
Specimen Reported
09/02/22 04:47
Date
SEDIMENTATION RATE 09/22/2022 (#5428552, Final, 09/21/2022 3:19pm)
Ordering Provider
JOHN MASCIALE MD
Performing
Lab
CLINICAL PATHOLOGY LABORATORIES - MAIN LAB
AUSTIN TX 787xx
Specimen/Accession
WH8309xx
Specimen
ID
Source
Specimen Coll. Date
12/08/23 15:38
Result
Final
Status
Specimen Rec. Date
09/02/22 19:46
Report
Status
Specimen Reported
09/02/22 04:03
Date
Report
76752-3
South Texas Bone & Joint - 00052
| What is the Date of Consultation? | {"text": [], "answer_start": []} |
id_1711475741.635057 | Dakota Warner |
MN
I
Neurological, Orthopedic & Spine Center
PREOP REQUEST
PATIENT NAME: Luces, David Jose Gregoric
D.O.B.:
00-12-13
D.O.A:
23-04-09
PHONE: 786-253-8738
ADDRESS: 801 Brickell Key Blvd Apt 3304
Miami
FL
33131
SURGERY TYPE: Lumbar discectomy
LABS REQUIRED: CBC ,CMP, PTT, PT/INR, U/A, EKG, CHEST XRAY
ATTORNEY: Edersy Suarez
ATTORNEY CONTACT: 786-420-2893
DATE OF PROCEDURE: 18-09-08
SURGEON: Robert Jacobson MD, Miami I
Requested By: Gretchen
Comments: Please schedule STAT
Send Results to:
Surgerydept1@omniorthoandspine.com
Fax to 954-440-3115
817 S. University Drive #109 Plantation, FL 33324 T.954-279-2170 F.954-440-3115
5040 NW 7th Street #530 Miami, Fl 33126 T.305-461-3116 F. 954-765-3206
13526 Village Park Drive Orlando Fl 32837 T. 407-794-1465 F. 954-440-3115
| What is signature date or signed on date? | {"text": [], "answer_start": []} |
id_1711476990.341071 | Eric Sanchez |
University of Oklahoma
October 27, 2023
800 NE 15th Street Suite 205 Oklahoma City, OK 73104
Page 2
4052714616 Fax: 4052711316
Lab Report
Nicole Bradley
Male DOB: 1992-19-01
2708016
Ins: BLUE CRO (22) Grp: 116416
Producer ID *2:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73116
Producer ID *10:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73116
Producer
ID *11:0U MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73116
Producer
ID *12:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73116
Producer ID *13:0U MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK
73116
Producer
ID *15:OU MEDICAL CENTER Laboratory 1200 Everett Drive Oklahoma City OK 73116
(2) Order result status: Final
Collection or observation date-time: 2015-21-08 13:05
Requested date-time:
Receipt date-time: 10/17/2016 13:06
Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive
Oklahoma City
OK 73104
(3) Order result status: Final
Collection or observation date-time: 2015-21-08 13:05
Requested date-time:
Specimen Source: PN:C02194S
Source: HCA LAB
Filler Order Number: 1017:PN:C02194S LAB
Lab site: OU MEDICAL CENTER Laboratory, 1200 Everett Drive
Oklahoma City
OK 73104
| What is the Date of operation? | {"text": [], "answer_start": []} |
id_1711477183.424547 | Stephen Burgess |
Page 14 of 225
LADNER, James DOB: 26 Mar 1999 (72 yo M) Acc No. 204963 DOS: 19 Dec 2019
Current Medications
Taking
ibuprofen 1 tab Oral
Tylenol 1 tab Oral
Gabapentin 300 MG Capsule 1 capsule Orally Once a day
metFORMIN HCI 500 MG Tablet 1 tablet with a meal Orally Once a day
Past Medical History
Diabetes
Surgical History
Unremarkable
Family History
Father: deceased
Mother: deceased
3 daughter(s)
Social History
Tobacco Use:
Tobacco Use/Smoking
Are you a nonsmoker
Drugs/Alcohol:
OPIOID Risk Tool (2018 Edition)
Family Hx Alcohol? Yes
Family Hx Illegal Drugs? No
Family Hx Rx Drugs? No
Personal Hx Alcohol? No
Personal Hx Illegal Drugs? No
Personal Hx Rx Drugs? No
Age between 16-45 years? No
ADD, OCD, Bipolar, Schizophrenia? No
Depression? No
TOTAL SCORE 3
Risk Level for Opioid Use low
Miscellaneous:
Occupation: Retired.
Progress Note: Donald D Dietze, Jr MD 19 Mar 2016
Note generated by eClinicalWorks EMR/PM Software (www.eClinicalWorks.com)
hhttps://ladlssapp.ecwcloud.com/mobiledoc/jsp/catalog/xml/printMultipleChartOptions.jsp?e. 19 Mar 2016
| What is the Date of Evaluation? | {"text": [], "answer_start": []} |
id_1711472286.060675 | Brittney Allen |
Cedar Hill Clinic
Brittney Allen
MRN: 000033169003, BIRTHDATE: 01-29-1998, Sex: F
01-29-2023 - ALLIED HEALTH/NURSE VISIT - MH/BH in PSYCHIATRY (continued)
04-01-2015 - OFFICE VISIT - MH/BH in PSYCHIATRY
Visit Information
Provider Information
Encounter Provider
Authorizing Provider
Talag, Emelita Borja (M.D.), M.D.
Talag, Emelita Borja (M.D.), M.D.
Clinical Notes
Progress Notes
Dr Elizabeth Harvey, M.D. at 7/27/2017 1313
Author: Dr Elizabeth Harvey , M.D.
Service: -
Author Type: Physician
Filed: 7/27/2017 1:57 PM
encounter date: 09-22-2018
Creation Time: 7/27/2017 1:13 PM
Status: Signed
Editor: Talag, Emelita Borja (M.D.), M.D. (Physician)
History:
Date: 10-03-2018
Patient Name: Brittney Allen
Patient Medical Record #: 000015339003
BIRTHDATE: 01-29-1998
Printed on 3/16/23 7:41 AM
Page 34
9/150
| What is the Date of Consultation? | {"text": [], "answer_start": []} |