M.D.

e-Mds_DocID_-914592140 English V1.0 2006-05-01T21:59:34-00:00 AA0001 AA0002 Provider Transfer of Patient Data EMD_INSURANCEID_BB0001 Subscriber Number w323232323 AA0001 Patient Group Number 123456 AA0001 Patient Individual Policy

IP

Health Insurance Active AA0001 patient AA0003 Payer AA0001 Patient: Policy Holder EMD_INSURANCEID_BB0002 Effective Date 2005-01-01T00:00:00-06:00 Subscriber Number 29350603103 AA0001 Patient Group Number 3114296SXZF06 AA0001 Patient Group Policy

GP

Health Insurance Active AA0001 patient AA0005 Payer AA0004 Child PID_BB0012 Onset 2006-03-17T16:12:22-06:00 Diagnosis Tuberculosis of bladder


            016.10
            ICD-9CM
            2006

Active AA0006 Healthcare Provider 7 AA0006 Healthcare Provider PID_BB0013 Onset 2006-03-17T16:12:22-06:00 Diagnosis Shigellosis, due to Shigella boydii


            004.2
            ICD-9CM
            2006

Active AA0006 Healthcare Provider 4 AA0006 Healthcare Provider PID_BB0014 Onset 2006-03-01T15:22:00-06:00 Diagnosis Acute nasopharyngitis


            460
            ICD-9CM
            2006

Active AA0006 Healthcare Provider 6 AA0006 Healthcare Provider PID_BB0015 Onset 2006-03-01T15:22:00-06:00 Diagnosis Shigellosis, due to Shigella flexneri


            004.1
            ICD-9CM
            2006

Active AA0006 Healthcare Provider 8 AA0006 Healthcare Provider PID_BB0016 Diagnosis Allergies


            477.0
            ICD-9CM
            2006

Active AA0007 Healthcare Provider SOCBB0039 Marital Status Single

Active AA0002 Primary Provider SOCBB0041 Employment Full-Time Student Active AA0002 Primary Provider SOCBB0044 Tobacco Use Tobacco/Alcohol/Supplements: Active AA0002 Primary Provider SOCBB0045 Drug Use Substance Abuse History: Active AA0002 Primary Provider AID_BB0003 Initial Occurrence 2006-03-01T00:00:00-06:00 Allergy Current AA0002 Primary Provider AID_BB0004 Penicillins AA0002 Primary Provider Penicillins anorexia Moderate AID_BB0006 Initial Occurrence 2006-03-01T00:00:00-06:00 Allergy Current AA0002 Primary Provider AID_BB0007 Sulfas AA0002 Primary Provider Sulfas dizziness Moderate AID_BB0009 Initial Occurrence 2006-03-01T00:00:00-06:00 Allergy Current AA0002 Primary Provider AID_BB0010 Peanuts AA0002 Primary Provider weight loss Moderate MID_BB0017 Medication Start Date 2003-05-19T00:00:00-05:00 Medication Nasacort AQ Nasal Spray 2 spray(s) in each nostril qd #1 16.5 gm bottle Active Healthcare Provider AA0008 Healthcare Provider Triamcinolone Acetonide Nasacort AQ 55 mcg 1 actuation 16.5 gm bottle 1 16.5 gm bottle 2 spray(s) in each nostril daily Intranasally Allergies Healthcare Provider AA0008 Healthcare Provider MID_BB0019 Medication Start Date 2003-05-19T00:00:00-05:00 Medication Proventil HFA 90mcg/1actuation Oral Inhaler Inhale 2 puff(s) q4-6h #1 6.7 gm inhaler Active Healthcare Provider AA0008 Healthcare Provider Albuterol Sulfate Proventil HFA 90 mcg 1 actuation 6.7 gm inhaler 1 6.7 gm inhaler Inhale 2 puff(s) q 4 to 6 hr Inhalation Asthma Healthcare Provider AA0008 Healthcare Provider MID_BB0021 Medication Start Date 2002-09-09T00:00:00-05:00 Medication Albuterol 2mg/5ml Syrup Take 1 tsp by mouth tid QS for 10 day(s) Active Healthcare Provider AA0007 Healthcare Provider Albuterol Sulfate Albuterol 2 mg 5 ml ml 0 ml Take 1 teaspoon by mouth tid Oral Asthma Healthcare Provider AA0007 Healthcare Provider MID_BB0023 Medication Start Date 2001-06-20T00:00:00-05:00 Medication Allegra 30mg Capsule 1 capsule(s) po bid #60 Capsules Active Healthcare Provider AA0007 Healthcare Provider PID_BB0016 Fexofenadine HCl Allegra 60 mg <none> 0 <none> Take 1 capsule(s) by mouth bid Oral Allergies Healthcare Provider AA0007 Healthcare Provider MID_BB0025 Medication Start Date 2005-04-24T00:00:00-05:00 Medication Accu-Chek Advantage Care Kit Kit use as directed QS for 7 day(s) Active Healthcare Provider Glucose Monitoring Care Kit Accu-Chek Advantage Care Kit kit(s) 4 kit(s) use as directed <none> Healthcare Provider MID_BB0026 Medication Start Date 2003-05-19T00:00:00-05:00 Medication Advair Diskus 100/50 Inhalation Powder Inhale 1 puff(s) bid #1 28 blister package Active Healthcare Provider AA0008 Healthcare Provider Fluticasone/Salmeterol Advair Diskus 100 mcg 50 mcg 28 blister package 1 28 blister package Inhale 1 puff(s) bid Inhalation Asthma Healthcare Provider AA0008 Healthcare Provider MID_BB0028 Medication Start Date 2003-05-19T00:00:00-05:00 Medication Zyrtec 10mg Tablet Take 1 tab(s) by mouth qd prn allergies. #30 tablet(s) Active Healthcare Provider AA0008 Healthcare Provider Cetirizine HCl Zyrtec 10 mg tablet(s) 30 tablet(s) Take 1 tab(s) by mouth qd prn allergies. Oral Allergies Healthcare Provider AA0008 Healthcare Provider MID_BB0030 Medication Start Date 2002-09-09T00:00:00-05:00 Medication Allegra 30mg Tablets 1 tab(s) po bid #60 tablet(s) Active Healthcare Provider AA0007 Healthcare Provider Fexofenadine HCl Allegra 30 mg tablet(s) 60 tablet(s) Take 1 tablet(s) by mouth bid Oral Allergic rhinitis, pollen-induced Healthcare Provider AA0007 Healthcare Provider MID_BB0032 Medication Start Date 2002-09-09T00:00:00-05:00 Medication Albuterol 0.5% Nebulizer Solution ½ ml nebulizer qid as directed #1 20 ml bottle Active Healthcare Provider AA0007 Healthcare Provider Albuterol Sulfate Albuterol 0.5 % 20 ml bottle 1 20 ml bottle 0.5 ml by nebulizer qid as directed Nebulization Asthma Healthcare Provider AA0007 Healthcare Provider as directed; as directed MID_BB0034 Medication Start Date 2002-08-13T00:00:00-05:00 Medication Allegra 30mg Tablet 1 tab(s) po bid #60 tablet(s) Active Healthcare Provider AA0009 Healthcare Provider Fexofenadine HCl Allegra 30 mg tablet(s) 60 tablet(s) Take 1 tablet(s) by mouth bid Oral Allergies Healthcare Provider AA0009 Healthcare Provider MID_BB0036 Medication Start Date 2002-07-12T00:00:00-05:00 Medication Allegra 180mg Tablet 1 tab(s) po qd #30 tablet(s) Active Healthcare Provider AA0007 Healthcare Provider PID_BB0016 Fexofenadine HCl Allegra 180 mg tablet(s) 30 tablet(s) 1 tab(s) po qd Oral Allergies Healthcare Provider AA0007 Healthcare Provider MID_BB0038 Medication Start Date 2002-03-18T00:00:00-06:00 Medication Allegra 30mg Tablets 1 tab(s) po bid #60 tablet(s) Active Healthcare Provider Fexofenadine HCl Allegra 30 mg tablet(s) 60 tablet(s) Take 1 tablet(s) by mouth bid Oral Healthcare Provider VID_BB0046 Assessment Time 2005-05-10T16:46:15-05:00 Due Date Current AA0002 Primary Provider BB0047 Result Due Date AA0002 Primary Provider 0 date VID_BB0048 Assessment Time 2003-05-19T15:43:13-05:00 Height Current AA0002 Primary Provider BB0049 Observation Height AA0002 Primary Provider 51 inch(es) VID_BB0050 Assessment Time 2002-09-09T16:00:48-05:00 Peak Expiratory Flow Rate Current AA0002 Primary Provider BB0051 Result Peak Expiratory Flow Rate AA0002 Primary Provider 175 L/min VID_BB0052 Assessment Time 2003-05-19T15:43:13-05:00 Pulse Current AA0002 Primary Provider BB0053 Result Pulse AA0002 Primary Provider 96 bpm VID_BB0054 Assessment Time 2003-05-19T15:43:14-05:00 Respiration Current AA0002 Primary Provider BB0055 Result Respiration AA0002 Primary Provider 13 bpm VID_BB0056 Assessment Time 2003-05-19T15:43:14-05:00 Temperature Current AA0002 Primary Provider BB0057 Result Temperature AA0002 Primary Provider 98.8 F VID_BB0058 Assessment Time 2005-05-10T00:00:00-05:00 Weight Current AA0002 Primary Provider BB0059 Observation Weight AA0002 Primary Provider 62 lbs AA0001 Alexander T Alexander T Acuna Alexander T Acuna Date of Birth 5/23/1995 12:00:00 AM male patient

Home 146 Valley Boulevard Cedar Park TX 78613 Active

(834)272-5969 Home 1 Active AA0002 Primary Medical Facility AA0002 Timmy B Timmy B Trauterman M.D. Timmy B Trauterman male Primary Physician

Billing Address 74432 Limerick Cedar Park TX 78613 Active

Business 54943 Trail Ridge Dr Cedar Park TX 78613 Active

(059)526-8232 Home 1 Active AA0002 Primary Medical Facility AA0003 AAPG Insurance Program Insurance

Business 429 Rocky Mound Ln Phoneix AZ 85068-9060 Active

AA0002 Primary Medical Facility AA0004 Arthur S Arthur S Torrance Arthur S Torrance male Child

Home 97241 Sanders Road Cedar Park TX 78613 Active

(963)772-4978 Home 1 Active AA0002 Primary Medical Facility AA0005 Cigna Insurance

Business 25 Live Oak Trl Sherman TX 75091-9310 Active

AA0002 Primary Medical Facility AA0006 Patty Pen Stealer Patty Pen Stealer Beardslee MD Patty Pen Stealer Beardslee male Healthcare Provider

Business 123 Main Street Fond du Lac WI 54935 Active

AA0002 Primary Medical Facility AA0007 Andrea Andrea Parker P.A. Andrea Parker female Healthcare Provider

Billing Address 8763 W Whitestone Blvd Cedar Park TX 78613 Active

Business 9834 Circle Oaks Cv Cedar Park TX 78613 Active

AA0002 Primary Medical Facility AA0008 Carter M Carter M Edwards MD Carter M Edwards male Healthcare Provider

Business 140 Veronica Ave Cedar Park TX 78613 Active

AA0002 Primary Medical Facility AA0009 Jackie Jackie Enders P.A. Jackie Enders female Healthcare Provider

Business 425 North Route 303 Cedar Park TX 78613 Active

AA0002 Primary Medical Facility eMDs_BB0060 e-MDs Solution Series Electronic Medical Database Record System 1.7.0.0

Physical Address 500 West Whitestone ste. 200 Cedar Park Texas 78613

Billing Address P.O. Box 2889 Cedar Park Texas 78630

888-344-9836 Sales 800-565-5564 Support 512-335-4375 Fax www.e-mds.com eMDs Main Website Active AA0002 Primary Medical Facility