9 |
98 |
153 |
167 | Payer name | 173 |Policy type / Coverage type | 174 |Covered party ID | 175 |Authorization(s) | 176 |
---|---|---|---|
Good Health Insurance | 181 |Extended healthcare / Self | 182 |14d4a520-7aae-11db-9fe1-0800200c9a66 | 183 |Colonoscopy | 184 |
200 | Directive | 206 |Description | 207 |Verification | 208 |Supporting Document(s) | 209 |
---|---|---|---|
Resuscitation status | 214 |
215 | |
217 | Dr. Robert Dolin, Nov 07, 1999 | 218 |
219 | |
221 |
237 | Functional Condition | 243 |Effective Dates | 244 |Condition Status | 245 |
---|---|---|
Dependence on cane | 250 |1998 | 251 |Active | 252 |
Memory impairment | 255 |1999 | 256 |Active | 257 |
273 | Condition | 279 |Effective Dates | 280 |Condition Status | 281 |
---|---|---|
Asthma | 286 |1950 | 287 |Active | 288 |
Pneumonia | 291 |Jan 1997 | 292 |Resolved | 293 |
" | 296 |Mar 1999 | 297 |Resolved | 298 |
Myocardial Infarction | 301 |Jan 1997 | 302 |Resolved | 303 |
319 | Diagnosis | 326 |Age At Onset | 327 |
---|---|
Myocardial Infarction (cause of death) | 332 |57 | 333 |
Hypertension | 336 |40 | 337 |
Diagnosis | 345 |Age At Onset | 346 |
---|---|
Asthma | 351 |30 | 352 |
368 | Social History Element | 374 |Description | 375 |Effective Dates | 376 |
---|---|---|
Cigarette smoking | 381 |1 pack per day | 382 |1947 - 1972 | 383 |
" | 386 |None | 387 |1973 - | 388 |
Alcohol consumption | 391 |None | 392 |1973 - | 393 |
409 | Substance | 415 |Reaction | 416 |Status | 417 |
---|---|---|
Penicillin | 422 |Hives | 423 |Active | 424 |
Aspirin | 427 |Wheezing | 428 |Active | 429 |
Codeine | 432 |Nausea | 433 |Active | 434 |
450 |
513 | Supply/Device | 519 |Date Supplied | 520 |
---|---|
Automatic implantable cardioverter/defibrillator | 525 |Nov 1999 | 526 |
Total hip replacement prosthesis | 529 |1998 | 530 |
Wheelchair | 533 |1999 | 534 |
550 | Vaccine | 556 |Date | 557 |Status | 558 |
---|---|---|
Influenza virus vaccine, IM | 563 |Nov 1999 | 564 |Completed | 565 |
Influenza virus vaccine, IM | 568 |Dec 1998 | 569 |Completed | 570 |
Pneumococcal polysaccharide vaccine, IM | 573 |Dec 1998 | 574 |Completed | 575 |
Tetanus and diphtheria toxoids, IM | 578 |1997 | 579 |Completed | 580 |
596 | Date / Time: | 602 |Nov 14, 1999 | 603 |April 7, 2000 | 604 |
---|---|---|
Height | 609 |177 cm | 610 |177 cm | 611 |
Weight | 614 |86 kg | 615 |88 kg | 616 |
Blood Pressure | 619 |132/86 mmHg | 620 |145/88 mmHg | 621 |
637 | 643 | | March 23, 2000 | 644 |April 06, 2000 | 645 |
---|---|---|
650 | |
652 | ||
HGB (M 13-18 g/dl; F 12-16 g/dl) | 655 |13.2 | 656 |657 | |
WBC (4.3-10.8 10+3/ul) | 660 |6.7 | 661 |662 | |
PLT (135-145 meq/l) | 665 |123* | 666 |667 | |
670 | |
672 | ||
NA (135-145meq/l) | 675 |676 | | 140 | 677 |
K (3.5-5.0 meq/l) | 680 |681 | | 4.0 | 682 |
CL (98-106 meq/l) | 685 |686 | | 102 | 687 |
HCO3 (18-23 meq/l) | 690 |691 | | 35* | 692 |
708 | Procedure | 714 |Date | 715 |
---|---|
720 | |
722 | 1998 | 723 |
739 | Encounter | 745 |Location | 746 |Date | 747 |
---|---|---|
Checkup Examination | 752 |Good Health Clinic | 753 |Apr 07, 2000 | 754 |
770 | Planned Activity | 776 |Planned Date | 777 |
---|---|
Pulmonary function test | 782 |April 21, 2000 | 783 |
15 |
104 |
159 |
166 |
170 |
187 | Payer name | 193 |Policy type / Coverage type | 194 |Covered party ID | 195 |Authorization(s) | 196 |
---|---|---|---|
Good Health Insurance | 201 |Extended healthcare / Self | 202 |14d4a520-7aae-11db-9fe1-0800200c9a66 | 203 |Colonoscopy | 204 |
214 |
221 |
234 |
242 |
245 |
265 | Directive | 271 |Description | 272 |Verification | 273 |Supporting Document(s) | 274 |
---|---|---|---|
Resuscitation status | 279 |
280 | |
282 | Dr. Robert Dolin, Nov 07, 1999 | 283 |
284 | |
286 |
296 |
315 |
325 |
344 | Functional Condition | 350 |Effective Dates | 351 |Condition Status | 352 |
---|---|---|
Dependence on cane | 357 |1998 | 358 |Active | 359 |
Memory impairment | 362 |1999 | 363 |Active | 364 |
374 |
380 |
390 |
404 |
410 |
420 |
440 | Condition | 446 |Effective Dates | 447 |Condition Status | 448 |
---|---|---|
Asthma | 453 |1950 | 454 |Active | 455 |
Pneumonia | 458 |Jan 1997 | 459 |Resolved | 460 |
" | 463 |Mar 1999 | 464 |Resolved | 465 |
Myocardial Infarction | 468 |Jan 1997 | 469 |Resolved | 470 |
480 |
486 |
496 |
510 |
516 |
526 |
540 |
546 |
556 |
567 |
578 |
590 |
595 |
605 |
625 | Diagnosis | 632 |Age At Onset | 633 |
---|---|
Myocardial Infarction (cause of death) | 638 |57 | 639 |
Hypertension | 642 |40 | 643 |
Diagnosis | 651 |Age At Onset | 652 |
---|---|
Asthma | 657 |30 | 658 |
670 |
682 |
688 |
697 |
709 |
716 |
732 |
744 |
765 | Social History Element | 771 |Description | 772 |Effective Dates | 773 |
---|---|---|
Cigarette smoking | 778 |1 pack per day | 779 |1947 - 1972 | 780 |
" | 783 |None | 784 |1973 - | 785 |
Alcohol consumption | 788 |None | 789 |1973 - | 790 |
800 |
814 |
824 |
835 |
847 |
866 | Substance | 872 |Reaction | 873 |Status | 874 |
---|---|---|
Penicillin | 879 |Hives | 880 |Active | 881 |
Aspirin | 884 |Wheezing | 885 |Active | 886 |
Codeine | 889 |Nausea | 890 |Active | 891 |
901 |
907 |
913 |
921 |
930 |
944 |
950 |
956 |
964 |
973 |
987 |
993 |
999 |
1007 |
1016 |
1036 |
1106 | Albuterol inhalant
1107 |
1108 |
1109 |
1116 |
1139 | Clopidogrel
1140 |
1141 |
1165 | Metoprolol
1166 |
1167 |
1193 | Prednisone
1194 |
1195 |
1222 | Cephalexin
1223 |
1224 |
1234 |
1255 | Supply/Device | 1261 |Date Supplied | 1262 |
---|---|
Automatic implantable cardioverter/defibrillator | 1267 |Nov 1999 | 1268 |
Total hip replacement prosthesis | 1271 |1998 | 1272 |
Wheelchair | 1275 |1999 | 1276 |
1295 |
1316 |
1340 |
1357 | Vaccine | 1363 |Date | 1364 |Status | 1365 |
---|---|---|
Influenza virus vaccine, IM | 1370 |Nov 1999 | 1371 |Completed | 1372 |
Influenza virus vaccine, IM | 1375 |Dec 1998 | 1376 |Completed | 1377 |
Pneumococcal polysaccharide vaccine, IM | 1380 |Dec 1998 | 1381 |Completed | 1382 |
Tetanus and diphtheria toxoids, IM | 1385 |1997 | 1386 |Completed | 1387 |
1407 | Influenza virus vaccine
1408 |
1409 |
1430 | Influenza virus vaccine
1431 |
1432 |
1453 | Pneumococcal polysaccharide vaccine
1454 |
1455 |
1476 | Tetanus and diphtheria toxoids
1477 |
1478 |
1495 | Date / Time: | 1501 |Nov 14, 1999 | 1502 |April 7, 2000 | 1503 |
---|---|---|
Height | 1508 |177 cm | 1509 |177 cm | 1510 |
Weight | 1513 |86 kg | 1514 |88 kg | 1515 |
Blood Pressure | 1518 |132/86 mmHg | 1519 |145/88 mmHg | 1520 |
1530 |
1538 |
1549 |
1560 |
1571 |
1584 |
1592 |
1603 |
1614 |
1625 |
1644 | 1650 | | March 23, 2000 | 1651 |April 06, 2000 | 1652 |
---|---|---|
1657 | |
1659 | ||
HGB (M 13-18 g/dl; F 12-16 g/dl) | 1662 |13.2 | 1663 |1664 | |
WBC (4.3-10.8 10+3/ul) | 1667 |6.7 | 1668 |1669 | |
PLT (135-145 meq/l) | 1672 |123* | 1673 |1674 | |
1677 | |
1679 | ||
NA (135-145meq/l) | 1682 |1683 | | 140 | 1684 |
K (3.5-5.0 meq/l) | 1687 |1688 | | 4.0 | 1689 |
CL (98-106 meq/l) | 1692 |1693 | | 102 | 1694 |
HCO3 (18-23 meq/l) | 1697 |1698 | | 35* | 1699 |
1709 |
1717 |
1734 |
1754 |
1776 |
1784 |
1804 |
1824 |
1844 |
1872 | Procedure | 1878 |Date | 1879 |
---|---|
1884 | |
1886 | 1998 | 1887 |
1897 |
1898 |
1899 |
1900 |
1901 |
1902 |
1903 |
1904 |
1905 |
1928 | Encounter | 1934 |Location | 1935 |Date | 1936 |
---|---|---|
Checkup Examination | 1941 |Good Health Clinic | 1942 |Apr 07, 2000 | 1943 |
1953 | Checkup Examination
1954 |
1955 |
1980 | Planned Activity | 1986 |Planned Date | 1987 |
---|---|
Pulmonary function test | 1992 |April 21, 2000 | 1993 |
2003 |