632826949866917505 English V1.0 2006-04-10T10:35:06Z AA0001 AA0002 Other AA0003 AA0004 AA0005 Primary Care Provider 2006-04-10 Lab Results BB0001 Effective Date 1988-01-01T05:00:00Z Termination Date 2006-12-31T05:00:00Z Plan Code 925 AA0002 Policy Number 2888251 AA0002 Group Number HD028 AA0002 Group Name NCMC AA0002 Patient ID HCID123456789 AA0002 Primary Health Insurance AA0002 AA0006 Payer AA0007 BB0002 Onset Jan 1995 Problem Diabetes mellitus, type I [insulin dependent type] [IDDM] [juvenile type], not stated as uncontrolled


										250.31
										ICD-9 CM
										2005


										C0375127
										UMLS Concept
										2005

Chronic AA0005 BB0009 Prescription Date 2006-03-21T09:10:00Z Medication Active AA0005 insulin isophane-insulin regular Humulin 70/30 Pen


											00002877059
											NDC
											2005

human recombinant 70 units 30 units/mL 30 ml subcut As directed subcut AA0005 BB0002 0 BB0012 Assessment Time 2006-05-10T10:10:00Z Electrolyte panel This panel must include the following: Carbon dioxide (82374) Chloride (82435) Potassium (84132) Sodium (84295)


										80051
										CPT
										2005


										C0519824
										UMLS Concept
										2005

AA0002 BB0013 Result Sodium; serum


											84295
											CPT
											2005

AA0002 135 MMOL/L BB0014 Result Potassium; serum


											84132
											CPT
											2005

AA0002 3.6 MMOL/L BB0015 Result Chloride; blood


											82435
											CPT
											2005

AA0002 102 MMOL/L BB0016 Result Carbon dioxide (bicarbonate)


											82374
											CPT
											2005

AA0002 19 MMOL/L Low BB0010 Assessment Time 2006-04-10T10:05:00Z Glucose; quantitative, blood (except reagent strip)


										82947
										CPT
										2005


										C0523658
										UMLS Concept
										2005

AA0002 BB0011 Result Glucose; quantitative, blood (except reagent strip)


											82947
											CPT
											2005

AA0002 125 mg/dL High BB0012 Assessment Time 2006-04-10T10:10:00Z Hemoglobin; glycated


										83036
										CPT
										2005


										C0373638
										UMLS Concept
										2005

AA0002 BB0013 Result Hemoglobin; glycated


											83036
											CPT
											2005

AA0002 6.6 % High BB0008 Assessment Time 2006-04-10T10:05:00Z Urea nitrogen; quantitative


										84520
										CPT
										2005


										C0202238
										UMLS Concept
										2005

AA0002 BB0009 Result Urea nitrogen; quantitative


											84520
											CPT
											2005

AA0002 21 mg/dL High BB0010 Assessment Time 2006-04-10T10:05:00Z Creatinine; blood


										82565
										CPT
										2005


										C0373593
										UMLS Concept
										2005

AA0002 BB0011 Result Creatinine; blood


											82565
											CPT
											2005

AA0002 2.6 mg/dL High AA0001 Robert Terence Labonte 1968-11-05T05:00:00Z Male MRN 00-12-23 AA0002 SSN 987-65-4321 AA0002 HICN HCID123456789 AA0002

Home 325 Tanglewood Terrace Knoxville TN 65135

555-777-8899 Home 505-135-4689 Alternate rtlab@home.net AA0002 AA0002 Doctor's Medical Lab Doctor's Medical Lab

Home 7458 W Middlesex Rd Knoxville TN 64135

515-777-1212 Home support@doctorsmedlab.com AA0002 AA0003 Doctor's Medical Lab

Main 7458 W Middlesex Rd Knoxville TN 64135

515-777-1212 Main support@doctorsmedlab.com AA0002 AA0004 Solventus CCR ViewPort V1.0 AA0002 AA0005 Robert Allen Frost Dr. Robert Frost Internal Medicine

Work 11398 Marker Rd Knoxville TN 64135

515-777-9865 Office 515-777-5000 Emergency rafrost@office.com AA0004 AA0006 Mutual Medical Plans, Inc. AA0002 AA0008 Home Depot

Main 987 Kentucky Blvd Knoxville TN 64135

505-135-4689 Main AA0002 S0001 2006-01-15T14:23:06Z AA0002 QG7nfFPW26ZGrneo0cLwZzcSKtsrMfPbBpKNGSsT9JwbiPVXpZcXWTNtyjEV2m+O/XHXKd2s6IU4bSDrg1QMOYotD/Y+3v8+44wAedbnOi4Le3ermYaVT3G9xiaJYHY3WrZ1EZbVBkv62lUm51isu7k8jAM1TJOqYDsoHYR9px8= RSA Key wzJS0XGQNp32Vxu4eUeNHIIwlbShcVR8HagN0g/wQlq3bFoFLmASPAgZLuqqmJ2IPHorgsYRPK0wmm1xmSRcsa2/tW+d7Q+QctKQ6tyDJHmGxPqehtovp8jiI/nuN4gd8mLsSdTXmXfn1Veh87MK/Pvn2BdrASq+ESC3eidmuKs= AQAB