From 44315e8cc6a5b9a1a6349e64b7514a6e0f8b2e85 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Feb 2015 02:07:37 -0500 Subject: [PATCH 01/15] Added Medicare.xml for Medicare PHI information --- claims-working.json | 8 +- claims.json | 20 +- claims.xml | 8 +- sample/medicare.txt | 2117 +++++++++++++++++++++++++++++++++++++++++++ sample/medicare.xml | 344 +++++++ 5 files changed, 2483 insertions(+), 14 deletions(-) create mode 100644 sample/medicare.txt create mode 100644 sample/medicare.xml diff --git a/claims-working.json b/claims-working.json index 8c47d48..657c443 100644 --- a/claims-working.json +++ b/claims-working.json @@ -3,16 +3,18 @@ "name": "Ellen Harrison Lu", "first_name":"Ellen", "middle_name": "Harrison", - "last_name": "Lu" + "last_name": "Lu", + "patient_identifier":"W1234123456" }, "payer":{ "name":"Name of Insurance", "payer_id":123456, "payer_id_type":"National Payer ID", - "plan_name":"Name of Policy", - "plan_id":123456, + "policy_name":"Name of Policy", + "policy_id":123456, "member_id":"W1234123456", "member_name":"Name of Plan Member", + "plan_name":"Name of Plan", "url":"http://yourinsurer.org" }, "claims":[ diff --git a/claims.json b/claims.json index 1206883..fb45300 100644 --- a/claims.json +++ b/claims.json @@ -1,6 +1,9 @@ { "patient":{ - "name":"Ellen Lu", + "name":"Ellen Harrison Lu", + "first_name":"Ellen", + "middle_name":"Harrison", + "last_name":"Lu", "patient_identifier":"W1234123456" }, "insurance":{ @@ -8,10 +11,11 @@ "payer_id":123456, "payer_id_type":"National Payer ID", "policy_name":"Name of Policy", - "policy_information":123456, + "policy_id":123456, "member_id":"W1234123456", "member_name":"Name of Plan Member", - "plan_name":"Name of Plan" + "plan_name":"Name of Plan", + "url":"http://yourinsurer.org" }, "claims":[ { @@ -29,7 +33,7 @@ }, "charges":{ "price_billed":1022.50, - "negotiated_price":782.33, + "procedure_price":782.33, "insurance_paid":625.86, "patient_responsibility":156.47 }, @@ -53,7 +57,7 @@ "code":5854 } ], - "lines":[ + "details":[ { "start_date":20101102, "end_date":20101102, @@ -66,7 +70,7 @@ ], "quantity":1, "price_billed":275.00, - "negotiated_price":208.99, + "procedure_price":208.99, "patient_responsibility":66.01, "place_of_service_code":41, "place_of_service:":"Ambulance - Land", @@ -87,7 +91,7 @@ ], "quantity":1, "price_billed":275.00, - "negotiated_price":208.99, + "procedure_price":208.99, "patient_responsibility":66.01, "place_of_service_code":41, "place_of_service:":"Ambulance - Land", @@ -108,7 +112,7 @@ ], "quantity":44, "price_billed":472.50, - "negotiated_price":364.35, + "procedure_price":364.35, "patient_responsibility":108.15, "place_of_service_code":41, "place_of_service:":"Ambulance - Land", diff --git a/claims.xml b/claims.xml index 0bf33ef..1d63236 100644 --- a/claims.xml +++ b/claims.xml @@ -5,17 +5,19 @@ Ellen Harrison Lu + W1234123456 - + Name of Insurance 123456 National Payer ID - Name of Policy + Name of Policy 123456 W1234123456 Name of Plan Member + Name of Plan http://yourinsurer.org - + 0210336239290 Part B diff --git a/sample/medicare.txt b/sample/medicare.txt new file mode 100644 index 0000000..4426c8b --- /dev/null +++ b/sample/medicare.txt @@ -0,0 +1,2117 @@ +-------------------------------- +MYMEDICARE.GOV PERSONAL HEALTH INFORMATION + +-------------------------------- +**********CONFIDENTIAL*********** + +Produced by the Blue Button (v2.0) + +02/04/2015 9:18 AM + + + + +-------------------------------- +Demographic + +-------------------------------- + +Source: MyMedicare.gov + + + +Name: JOHN DOE + +Date of Birth: 1/1/1910 + +Address Line 1: 123 ANY ROAD + +Address Line 2: + +City: ANYTOWN + +State: IN + +Zip: 46250 + +Phone Number: 215-248-0684 + +Email: + +Part A Effective Date: 2/1/2014 + +Part B Effective Date: 2/1/2014 + + + +-------------------------------- +Emergency Contact + +-------------------------------- + +Source: Self-Entered + + + +Contact Name: Billy Bigelow2 + +Address Type:Home + +Address Line 1: 1234 Carnival Lane + +Address Line 2: Lobster Bay, ME 11112 + +City: + +State: + +Zip: 11111 + +Relationship: Friend + +Home Phone: + +Work Phone: + +Mobile Phone: + +Email Address: + + + +Contact Name: Enoch Snow + +Address Type:Home + +Address Line 1: 2345 Fish Head Cove + +Address Line 2: Lobster Bay, ME 11112 + +City: + +State: + +Zip: + +Relationship: Friend + +Home Phone: + +Work Phone: + +Mobile Phone: + +Email Address: + + + +-------------------------------- +Self Reported Medical Conditions + +-------------------------------- + +Source: Self-Entered + + + +Condition Name: Allergies + +Medical Condition Start Date: 1/29/2013 + +Medical Condition End Date: + + + +Condition Name: Arthritis + +Medical Condition Start Date: 8/1/1960 + +Medical Condition End Date: 12/31/1980 + + + +Condition Name: Broken Wrist + +Medical Condition Start Date: 2/6/1910 + +Medical Condition End Date: 2/6/2013 + + + +Condition Name: Other + +Medical Condition Start Date: 2/1/2011 + +Medical Condition End Date: + + + +Condition Name: Other + +Medical Condition Start Date: 2/28/2012 + +Medical Condition End Date: + + + +-------------------------------- +Self Reported Allergies + +-------------------------------- + +Source: Self-Entered + + + +Allergy Name: Antibotic + +Type: Drugs + +Reaction: + +Severity: + +Diagnosed: + +Treatment: + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +Allergy Name: Corn + +Type: Food + +Reaction: Blisters + +Severity: Mild + +Diagnosed: Yes + +Treatment: Other + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +Allergy Name: Milk + +Type: Food + +Reaction: Anaphylaxis + +Severity: Severe + +Diagnosed: Yes + +Treatment: Epinephrine (Epi-Pen) + +First Episode Date: 3/21/1985 + +Last Episode Date: 3/31/2012 + +Last Treatment Date: 3/31/2012 + +Comments: + + + +Allergy Name: Other - other + +Type: Other - other + +Reaction: + +Severity: + +Diagnosed: + +Treatment: + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +-------------------------------- +Self Reported Implantable Device + +-------------------------------- + +Source: Self-Entered + + + +Device Name: COronary stent + +Date Implanted: 11/27/2005 + + + +Device Name: Knee replacement + +Date Implanted: 2/2/2014 + + + +Device Name: Pace maker + +Date Implanted: 2/28/2012 + + + +Device Name: foot + +Date Implanted: 9/9/1984 + + + +Device Name: hearing aid + +Date Implanted: 1/1/2013 + + + +Device Name: nov20 + +Date Implanted: 12/15/2007 + + + +-------------------------------- +Self Reported Immunizations + +-------------------------------- + +Source: Self-Entered + + + +Immunization Name: shingles + +Date Administered:2/3/2010 + +Method: Injection + +Were you vaccinated in the US: Yes + +Comments: + +Booster 1 Date: 2/4/2011 + +Booster 2 Date: 4/6/2012 + +Booster 3 Date: + + + +-------------------------------- +Self Reported Labs and Tests + +-------------------------------- + +Source: Self-Entered + + + +Test/Lab Type: Test + +Date Taken: 1/2/2013 + +Administered by: Inova + +Requesting Doctor: Dr. John Doe + +Reason Test/Lab Requested: + +Results: + +Comments: + + + +-------------------------------- +Self Reported Vital Statistics + +-------------------------------- + +Source: Self-Entered + + + +Vital Statistic Type: Glucose + +Date: 2/7/2008 + +Time: 12:00 AM + +Reading/Value: 322 + +Comments: + + + +Vital Statistic Type: Glucose + +Date: 4/3/2009 + +Time: 12:02 PM + +Reading/Value: 24 + +Comments: fwrqwrgreg + + + +Vital Statistic Type: Glucose + +Date: 5/14/2009 + +Time: 12:17 PM + +Reading/Value: 134 + +Comments: rwrtrt + + + +Vital Statistic Type: Otro - other + +Date: 1/1/1939 + +Time: 12:00 AM + +Reading/Value: other + +Comments: + + + +Vital Statistic Type: Pulse + +Date: 4/6/2013 + +Time: 12:00 AM + +Reading/Value: 333 + +Comments: + + + +Vital Statistic Type: Pulse + +Date: 3/2/2011 + +Time: 12:09 AM + +Reading/Value: 80 + +Comments: wwqrgtrt + + + +Vital Statistic Type: Temperature + +Date: 6/5/2009 + +Time: 8:06 AM + +Reading/Value: 100 + +Comments: fwqerqwr + + + +Vital Statistic Type: Temperature + +Date: 4/4/2008 + +Time: 9:02 AM + +Reading/Value: 99 + +Comments: + + + +-------------------------------- +Family Medical History + +-------------------------------- + +Source: Self-Entered + + + +Family Member: Daughter + +Type: Maternal + +DOB:1/1/1994 + +DOD: + +Age: 31 + +Type: Allergy + +Description: Dyes + +Type: Condition + +Description: Diabetes, Type 2 + +Description: Skin Cancer + + +Family Member: Brother + +Type: + +DOB:4/4/2012 + +DOD: + +Age: + +Type: Allergy + +Description: Chemotherapy + +Type: Condition + +Description: Alzheimer's Disease + + +-------------------------------- +Drugs + +-------------------------------- + +Source: Self-Entered + + + +Drug Name: Abacavir TAB 300MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Abacavir + + + +Drug Name: Abilify Maintena INJ 300MG + +Supply: 1 X Vial Every 1 Month + +Orig Drug Entry: Abilify Maintena + + + +Drug Name: Amlodipine Besylate TAB 10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate TAB 2.5MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate TAB 5MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Caduet + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Androgel Pump GEL 1.62% + +Supply: 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month + +Orig Drug Entry: Androgel Pump + + + +Drug Name: Drospirenone/Ethinyl Estradiol TAB 3-0.03MG + +Supply: 28 Every 1 Month + +Orig Drug Entry: Yasmin 28 + + + +Drug Name: Gabapentin CAP 100MG + +Supply: 90 Every 1 Month + +Orig Drug Entry: Gabapentin + + + +Drug Name: Gabapentin SOL 250/5ML + +Supply: 1 X 470ML Bottle Every 1 Month + +Orig Drug Entry: Gabapentin + + + +Drug Name: Jakafi TAB 10MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Jakafi + + + +Drug Name: Losartan Potassium/Hydrochlorothiazide TAB 100-25 + +Supply: 30 Every 1 Month + +Orig Drug Entry: Losartan Potassium/Hydrochlorothiazide + + + +Drug Name: Montelukast Sodium TAB 10MG + +Supply: 90 Every 3 Month + +Orig Drug Entry: Montelukast Sodium + + + +Drug Name: Omeprazole CAP 20MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Omeprazole + + + +Drug Name: Rabavert INJ + +Supply: 2 X Vial (sold in a package of 2) Every 12 Month + +Orig Drug Entry: Rabavert + + + +Drug Name: Tabloid TAB 40MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Tabloid + + + +Drug Name: Vagifem TAB 10MCG + +Supply: 8 Every 1 Month + +Orig Drug Entry: Vagifem + + + +Drug Name: Zafirlukast TAB 20MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Zafirlukast + + + +Drug Name: Zaleplon CAP 10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Zaleplon + + + +Drug Name: Zaltrap INJ 100/4ML + +Supply: 1 X 4ML Vial Every 1 Month + +Orig Drug Entry: Zaltrap + + + +-------------------------------- +Preventive Services + +-------------------------------- + +Source: MyMedicare.gov + + + +Description: ABDOMINAL AORTIC ANEURYSM + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: CARDIOVASCULAR + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: PPV + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: PROSTATE + +Next Eligible Date: 2/1/2014 + +Last Date of Service: 3/26/2012 + + + +Description: PSA + +Next Eligible Date: 2/1/2014 + +Last Date of Service: 3/26/2012 + + + +Description: ANNUAL WELLNESS VISIT + +Next Eligible Date: 2/1/2015 + +Last Date of Service: + + + +Description: ALCOHOL MISUSE SCREENING + +Next Eligible Date: + +Last Date of Service: + + + +Description: CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) + +Next Eligible Date: + +Last Date of Service: + + + +Description: COLORECTAL + +Next Eligible Date: + +Last Date of Service: 4/21/2011 + + + +Description: DEPRESSION SCREENING + +Next Eligible Date: + +Last Date of Service: + + + +Description: DIABETES + +Next Eligible Date: + +Last Date of Service: 5/21/2012 + + + +Description: HIGH INTENSITY BEHAVIORAL COUNSELING + +Next Eligible Date: + +Last Date of Service: + + + +Description: OBESITY COUNSELING + +Next Eligible Date: + +Last Date of Service: + + + +Description: PHYSICAL + +Next Eligible Date: + +Last Date of Service: + + + +Description: SMOKING CESSATION (counseling to stop smoking) + +Next Eligible Date: + +Last Date of Service: + + + +-------------------------------- +Providers + +-------------------------------- + +Source: Self-Entered + + + +Provider Name: ANGELO SCOTTI + +Provider Address: 180 WHITE RD LITTLE SILVER, NJ 07739 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: DOUGLAS KNOX + +Provider Address: 1104 E 23RD ST LAWRENCE, KS 66046 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: SIAMAK RASSADI + +Provider Address: 1331 N 7TH ST PHOENIX, AZ 85006 + +Type: Physician & Other Healthcare Professional + +Specialty: Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) + +Medicare Provider: May Accept Medicare + + + +Provider Name: PETER LEAVITT + +Provider Address: 2965 NECONNERS AVE BEND, OR 97701 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: JOHN KENNEDY + +Provider Address: 8888 KEYSTONE XING INDIANAPOLIS, IN 46240 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: REBECCA KELLY + +Provider Address: 7250 CLEARVISTA DR INDIANAPOLIS, IN 46256 + +Type: Physician & Other Healthcare Professional + +Specialty: Addiction Medicine + +Medicare Provider: Yes + + + +Provider Name: RILEY HOSPITAL - PEDS DIALYSIS + +Provider Address: 705 RILEY HOSPITAL DRIVE INDIANAPOLIS, IN 46202 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC - SHADELAND STATION + +Provider Address: 7155 SHADELAND STATION STE 130 INDIANAPOLIS, IN 46256 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: IU HEALTH - HOME DIALYSIS + +Provider Address: 8803 N. MERIDIAN ST., STE 150 INDIANAPOLIS, IN 46260 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: MESA VISTA OF BOULDER + +Provider Address: 2121 MESA DRIVE BOULDER, CO 80304 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: FAIRBANKS + +Provider Address: 8102 CLEARVISTA PARKWAY INDIANAPOLIS, IN 46256 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: ALLIANCE HOME HEALTH SERVICES INC + +Provider Address: 9615 N COLLEGE AVE INDIANAPOLIS, IN 46280 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: THE VIRGINIAN + +Provider Address: 9229 ARLINGTON BLVD FAIRFAX, VA 22031 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: KINDRED TRANSITIONAL CARE & REHAB-ALLISON POINTE + +Provider Address: 5226 E 82ND ST INDIANAPOLIS, IN 46250 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: INDIANA HEART HOSPITAL THE + +Provider Address: 8075 N SHADELAND AVE INDIANAPOLIS, IN 46250 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: COMMUNITY HOSPITAL NORTH + +Provider Address: 7150 CLEARVISTA DR INDIANAPOLIS, IN 46256 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FORUM AT THE CROSSING + +Provider Address: 8505 WOODFIELD CROSSING BLVD INDIANAPOLIS, IN 46240 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: BEAUMONT HOSPITAL, TROY + +Provider Address: 44201 DEQUINDRE ROAD TROY, MI 48085 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DAVITA - EAGLE HIGHLANDS + +Provider Address: 6925 SHORE TERRACE INDIANAPOLIS, IN 46254 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC - CARMEL + +Provider Address: 12400 NORTH MERIDIAN ST., STE 200 CARMEL, IN 46032 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DSI - NW INDIANAPOLIS RENAL CENTER + +Provider Address: 6488 CORPORATE DRIVE INDIANAPOLIS, IN 46268 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: GEORGE WASHINGTON UNIV HOSPITAL + +Provider Address: 900 23RD ST NW WASHINGTON, DC 20037 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DAVITA - CARMEL HEALTH AND LIVING + +Provider Address: 118 MEDICAL DRIVE, SUITE 114 CARMEL, IN 46032 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC-INDIANAPOLIS MIDTOWN + +Provider Address: 3007 DR ANDREW J BROWN AVENUE INDIANAPOLIS, IN 46205 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: MILLER'S SENIOR LIVING COMMUNITY + +Provider Address: 8400 CLEARVISTA PL INDIANAPOLIS, IN 46256 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: TEST QT + +Provider Address: COEBURN, VA 24230 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: ADVANCED HOME CARE, INC + +Provider Address: 165 PLAZA ROAD, SUITE 20 WISE, VA 24293 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: TEST NHC QT + +Provider Address: 0 24230 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: HERITAGE HALL WISE + +Provider Address: 9434 COEBURN MOUNTAIN ROAD WISE, VA 24293 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: QT JAN 15 TEST + +Provider Address: 121 HOME STREET COEBURN, VA 24230 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: NORTON COMMUNITY HOSPITAL + +Provider Address: 100 15TH ST NW NORTON, VA 24273 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +-------------------------------- +Pharmacies + +-------------------------------- + +Source: Self-Entered + + + +Pharmacy Name: Castleton Integrative Health 8208 Allisonville Rd Indianapolis, IN 46250 + +Pharmacy Phone: 317-849-1222 + + + +Pharmacy Name: Costco Pharmacy Indianapolis, IN 462506110 East 86th Street Castleton, IN 46250 + +Pharmacy Phone: 317-558-1452 + + + +-------------------------------- +Plans + +-------------------------------- + +Source: MyMedicare.gov + + + +Contract ID/Plan ID: S1111/801 + +Plan Period: 12/01/2012 - current + +Plan Name: + +Marketing Name: + +Plan Address: + +Plan Type: 11 - Medicare Prescription Drug Plan + + + +-------------------------------- +Employer Subsidy + +-------------------------------- + +Source: MyMedicare.gov + + + + +-------------------------------- +Primary Insurance + +-------------------------------- + +Source: MyMedicare.gov + + + + +-------------------------------- +Other Insurance + +-------------------------------- + +Source: MyMedicare.gov + + + +MSP Type: + +Policy Number: 30002 + +Insurer Name: UNITEDHEALTH GROUP + +Insurer Address: 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 + +Effective Date: 10/01/1984 + +Termination Date: + + + +-------------------------------- +Claim Summary + +-------------------------------- + +Source: MyMedicare.gov + + + +Claim Number: 11122233330000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $92.53 + +Provider Paid: $74.02 + +You May be Billed: $18.51 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233330000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $92.53 + +Non-Covered: $42.47 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 11122233320000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $90.45 + +Provider Paid: $72.36 + +You May be Billed: $18.09 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233320000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $90.45 + +Non-Covered: $44.55 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555100 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 7392 +Diagnosis Code 2: 7241 +Diagnosis Code 3: 7393 +Diagnosis Code 4: 7391 + +-------------------------------- +Claim Lines for Claim Number: 2333444555100 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 98941 - Chiropractic Manipulative Treatment, 3 To 4 Spinal Regions + +Modifier 1/Description: GA - Waiver Of Liability Statement Issued As Required By Payer Policy, Individual Case + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: G0283 - Electrical Stimulation (Unattended), To One Or More Areas For Indication(S) Other Than Wound + +Modifier 1/Description: GY - Item Or Service Statutorily Excluded, Does Not Meet The Definition Of Any Medicare Benefit Or, + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555500 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $1,022.50 + +Medicare Approved: $782.33 + +Provider Paid: $625.86 + +You May be Billed: $156.47 + +Claim Type: PartB + +Diagnosis Code 1: 70700 + +-------------------------------- +Claim Lines for Claim Number: 2333444555500 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + +Modifier 1/Description: RH + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $275.00 + +Allowed Amount: $208.99 + +Non-Covered: $66.01 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + +Modifier 1/Description: HR - Family/Couple With Client Present + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $275.00 + +Allowed Amount: $208.99 + +Non-Covered: $66.01 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 3 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0425 - Ground Mileage, Per Statute Mile + +Modifier 1/Description: RH + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 44 + +Submitted Amount/Charges: $472.50 + +Allowed Amount: $364.35 + +Non-Covered: $108.15 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555200 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 2163 + +-------------------------------- +Claim Lines for Claim Number: 2333444555200 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 99213 - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 22 - Outpatient Hospital + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555300 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 28521 +Diagnosis Code 2: 5854 + +-------------------------------- +Claim Lines for Claim Number: 2333444555300 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: J2916 - Injection, Sodium Ferric Gluconate Complex In Sucrose Injection, 12.5 Mg + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 10 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 36000 - Insertion Of Needle Or Catheter Into A Vein + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 2 - Surgery + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 3 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 90765 - Intravenous Infusion, For Therapy, Prophylaxis, Or Diagnosis (Specify Substance Or Drug); In + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 4 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 90775 - Therapeutic, Prophylactic Or Diagnostic Injection (Specify Substance Or Drug); Each Addition + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 5 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 99211 - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes + +Modifier 1/Description: 25 - Significant, Separately Identifiable Evaluation And Management Service By The Same Physician On + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555400 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $38.00 + +Medicare Approved: $9.38 + +Provider Paid: $7.50 + +You May be Billed: $1.88 + +Claim Type: PartB + +Diagnosis Code 1: 9593 +Diagnosis Code 2: E8889 + +-------------------------------- +Claim Lines for Claim Number: 2333444555400 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 73110 - X-Ray Of Wrist, Minimum Of 3 Views + +Modifier 1/Description: 26 - Professional Component: Certain Procedures Are A Combination Of A Physician Component And A Tec + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $38.00 + +Allowed Amount: $9.38 + +Non-Covered: $28.62 + +Place of Service/Description: 22 - Outpatient Hospital + +Type of Service/Description: 4 - Diagnostic x-ray + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Claim Number: 11122233310000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $90.45 + +Provider Paid: $72.36 + +You May be Billed: $18.09 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233310000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $90.45 + +Non-Covered: $44.55 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + + diff --git a/sample/medicare.xml b/sample/medicare.xml new file mode 100644 index 0000000..e050a03 --- /dev/null +++ b/sample/medicare.xml @@ -0,0 +1,344 @@ + + + +MyMedicare.gov Personal Health Information +code="US" + + + + + + + Ellen Harrison Lu + Ellen + Harrison + Lu + 19100101 +
+ 8115 Knuee Road + Mailpoint INA1-AF-16 + Indianapolis + IN + 46250 +
+ W1234123456 + + 215-555-0684 + + test_user_fh@gmail.com + + 19850103 + 19850104 + + medicare.gov + + + + Billy B Bigelow + Billy + B + Bigelow +
+ Home + 1234 Carnival Lane + Apt B + Lobster Bay + ME + 11112 +
+ Friend + + 123-456-7890 + 123-456-7891 + 123-456-7892 + + billy.bigelow@example.com + patient + + + Enoch C Snow + Enoch + C + Snow +
+ Home + 2345 Fish Head Cove + C + Lobster Bay + ME + 11112 +
+ Friend + + 123-456-7890 + 123-456-7891 + 123-456-7892 + + esnoww@example.com + patient + + + + + Allergies + 20130129 + + patient + + + Arthritis + 19600108 + 19801231 + patient + + + Broken Wrist + 19100602 + 19101202 + patient + + + Other + 20110102 + + patient + + + Other + 20120228 + + patient + + + + + Antibiotic + drugs + + + + + + + + + patient + + + Corn + Food + Blisters + Mild + Yes + Other + + + + + patient + + + Milk + Food + Anaphylaxis + Severe + Yes + Epinephrine (Epi-Pen) + 19850321 + 20120331 + 20120331 + + patient + + + Other - other + Other - other + + + + + + + + + patient + + + + + Coronary Stent + 20051127 + patient + + + Knee replacement + 20140202 + patient + + + Pace maker + 20120228 + patient + + + Foot + 19840909 + patient + + + Hearing aid + 20130101 + patient + + + Nov20 + 20071215 + patient + + + + + Shingles + 20100302 + Injection + Yes + + + + 20110402 + + + 20120604 + + + + + + patient + + + + + Test + 20130102 + Inova + Dr. John Doe + + + + patient + + + + + Glucose + 20080702 + + 322 + + patient + + + Glucose + 20090403 + + 24 + a comment + patient + + + Glucose + 20090514 + + 134 + another comment + patient + + + Otro - other + 19390101 + + other + + patient + + + Pulse + 20130613 + + 333 + + patient + + + Pulse + 20110302 + + 80 + commenting + patient + + + Temperature + 20090605 + + 100 + commenting again + patient + + + Temperature + 20080404 + + 99 + comments + patient + + + + + Daughter + Maternal + 19940101 + + 31 + + Allergy + Dyes + + + Condition + Diabetes, Type 2 + + + Skin Cancer + + + patient + + + Brother + Paternal + 20120404 + + + + Allergy + Chemotherapy + + + Condition + Alzheimer's Disease + + patient + + + + \ No newline at end of file From ae4067422ef270549be6f09342d73e03c51b09ab Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Feb 2015 10:31:23 -0500 Subject: [PATCH 02/15] BlueButtonPlus XML Data file Updated medicare.xml to add PHR sections from sample text file. --- sample/medicare.xml | 578 ++++++++++++++++++++++++++++++++++++++++++++ 1 file changed, 578 insertions(+) diff --git a/sample/medicare.xml b/sample/medicare.xml index e050a03..401da55 100644 --- a/sample/medicare.xml +++ b/sample/medicare.xml @@ -340,5 +340,583 @@ patient + + + Abacavir TAB 300MG + 60 Every 1 Month + Abacavir + patient + + + Abilify Maintena INJ 300MG + 1 X Vial Every 1 Month + Abilify Maintena + patient + + + Amlodipine Besylate TAB 10MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate TAB 2.5MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate TAB 5MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG + 30 Every 1 Month + Caduet + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Androgel Pump GEL 1.62% + 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month + Androgel Pump + patient + + + Drospirenone/Ethinyl Estradiol TAB 3-0.03MG + 28 Every 1 Month + Yasmin 28 + patient + + + Gabapentin CAP 100MG + 90 Every 1 Month + Gabapentin + patient + + + Gabapentin SOL 250/5ML + 1 X 470ML Bottle Every 1 Month + Gabapentin + patient + + + Jakafi TAB 10MG + 60 Every 1 Month + Jakafi + patient + + + Losartan Potassium/Hydrochlorothiazide TAB 100-25 + 30 Every 1 Month + Losartan Potassium/Hydrochlorothiazide + patient + + + Montelukast Sodium TAB 10MG + 90 Every 3 Month + Montelukast Sodium + patient + + + Omeprazole CAP 20MG + 30 Every 1 Month + Omeprazole + patient + + + Rabavert INJ + 2 X Vial (sold in a package of 2) Every 12 Month + Rabavert + patient + + + Tabloid TAB 40MG + 30 Every 1 Month + Tabloid + patient + + + Vagifem TAB 10MCG + 8 Every 1 Month + Vagifem + patient + + + Zafirlukast TAB 20MG + 60 Every 1 Month + Zafirlukast + patient + + + Zaleplon CAP 10MG + 30 Every 1 Month + Zaleplon + patient + + + Zaltrap INJ 100/4ML + 1 X 4ML Vial Every 1 Month + Zaltrap + patient + + + + + ABDOMINAL AORTIC ANEURYSM + 20140201 + + MyMedicare.gov + + + CARDIOVASCULAR + 20140201 + + MyMedicare.gov + + + PPV + 20140201 + + MyMedicare.gov + + + PROSTATE + 20140201 + 20120326 + MyMedicare.gov + + + PSA + 20140201 + 20120326 + MyMedicare.gov + + + ANNUAL WELLNESS VISIT + 20150201 + + MyMedicare.gov + + + ALCOHOL MISUSE SCREENING + + + MyMedicare.gov + + + CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) + + + MyMedicare.gov + + + COLORECTAL + + 20110421 + MyMedicare.gov + + + DEPRESSION SCREENING + + + MyMedicare.gov + + + DIABETES + + 20120521 + MyMedicare.gov + + + HIGH INTENSITY BEHAVIORAL COUNSELING + + + MyMedicare.gov + + + OBESITY COUNSELING + + + MyMedicare.gov + + + PHYSICAL + + + MyMedicare.gov + + + SMOKING CESSATION (counseling to stop smoking) + + + MyMedicare.gov + + + + + ANGELO SCOTTI +
+ 180 WHITE RD + + LITTLE SILVER + NJ + 07739 +
+ Physician & Other Healthcare Professional + + Yes + patient + + + DOUGLAS KNOX +
+ 1104 E 23RD ST + + LAWRENCE + KS + 66046 +
+ Physician & Other Healthcare Professional + + Yes + patient + + + SIAMAK RASSADI +
+ 1331 N 7TH ST + + PHOENIX + AZ + 85006 +
+ Physician & Other Healthcare Professional + Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) + May Accept Medicare + patient + + + PETER LEAVITT +
+ 2965 NECONNERS AVE + + BEND + OR + 97701 +
+ Physician & Other Healthcare Professional + + Yes + patient + + + JOHN KENNEDY +
+ 8888 KEYSTONE XING + + INDIANAPOLIS + IN + 46240 +
+ Physician & Other Healthcare Professional + + Yes + patient + + + REBECCA KELLY +
+ 7250 CLEARVISTA DR + + INDIANAPOLIS + IN + 46256 +
+ Physician & Other Healthcare Professional + Addiction Medicine + Yes + patient + + + RILEY HOSPITAL - PEDS DIALYSIS +
+ 705 RILEY HOSPITAL DRIVE + + INDIANAPOLIS + IN + 46202 +
+ Dialysis Facility + + Not Available + patient + + + FMC - SHADELAND STATION +
+ 7155 SHADELAND STATION + STE 130 + INDIANAPOLIS + IN + 46256 +
+ Dialysis Facility + Dialysis Facility + Not Available + patient + + + IU HEALTH - HOME DIALYSIS +
+ 8803 N. MERIDIAN ST. + STE 150 + INDIANAPOLIS + IN + 46260 +
+ Dialysis Facility + + Not Available + patient + + + MESA VISTA OF BOULDER +
+ 2121 MESA DRIVE + + BOULDER + CO + 80304 +
+ Nursing Home + + Yes + patient + + + FAIRBANKS +
+ 8102 CLEARVISTA PARKWAY + + INDIANAPOLis + IN + 46256 +
+ Hospital + + Not Available + patient + + + ALLIANCE HOME HEALTH SERVICES INC +
+ 9615 N COLLEGE AVE + + INDIANAPOLIS + IN + 46280 +
+ Home Health + + Not Available + patient + + + THE VIRGINIAN +
+ 9229 ARLINGTON BLVD + + FAIRFAX + VA + 22031 +
+ Nursing Home + + Yes + patient + + + KINDRED TRANSITIONAL CARE & REHAB-ALLISON POINTE +
+ 5226 E 82ND ST + + INDIANAPOLIS + IN + 46250 +
+ Nursing Home + + Yes + patient + + + INDIANA HEART HOSPITAL THE +
+ 8075 N SHADELAND AVE + + INDIANAPOLIS + IN + 46250 +
+ Hospital + + Not Available + patient + + + COMMUNITY HOSPITAL NORTH +
+ 7150 CLEARVISTA DR + + INDIANAPOLIS + IN + 46256 +
+ Hospital + + Not Available + patient + + + FORUM AT THE CROSSING +
+ 8505 WOODFIELD CROSSING BLVD + + INDIANAPOLIS + IN + 46240 +
+ Nursing Home + + Not Available + patient + + + +
+ + + + + +
+ Physician & Other Healthcare Professional + + Not Available + patient + + + + + Castleton Integrative Health +
+ 8208 Allisonville Rd + + INDIANAPOLIS + IN + 46250 +
+ 317-849-1222 + patient + + + Costco Pharmacy Indianapolis, IN 462506110 +
+ East 86th Street + + Castleton + IN + 46250 +
+ 317-558-1452 + patient + + + + + Medicare + + S1111/801 + 20120112 + + Medicare + + +
+ 11 - Medicare Prescription Drug Plan + MyMedicare.gov + + + Employer Subsidy + + + + + + + +
+ + MyMedicare.gov + + + Primary Insurance + + + + + + + +
+ + MyMedicare.gov + + + Other Insurance + + 30002 + 19841001 + + UNITEDHEALTH GROUP + + +
601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034
+ + MyMedicare.gov + + \ No newline at end of file From c9ed6b25844a9ec704b4261b055ba97444e70485 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Feb 2015 10:35:04 -0500 Subject: [PATCH 03/15] Updated ReadMe.md Identified ToDo activities. --- README.md | 10 +++++++++- 1 file changed, 9 insertions(+), 1 deletion(-) diff --git a/README.md b/README.md index bea37e4..7afdb40 100644 --- a/README.md +++ b/README.md @@ -1,4 +1,12 @@ claims ====== -Exploring JSON representation for claims data \ No newline at end of file +Exploring JSON representation for claims data. + +Took Sample BlueButton Test file from MyMedicare.gov and created a medicare.xml format. +This will combine with claims.xml to present the complete BlueButton Plus file. + +ToDo: +1. Combine medicare.xml and claims.xml +2. Create medicare.json from the combined medicare.xml and claims.xml. + From 93477f5d4bfa0d23996e8a87f077650ff5f748be Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Feb 2015 12:18:08 -0500 Subject: [PATCH 04/15] Added claims.xml to medicare.xml Incorporated Claims.xml in to the medicare.xml file. --- README.md | 4 +- sample/medicare.xml | 123 +++++++++++++++++++++++++++++++++++++++++++- 2 files changed, 124 insertions(+), 3 deletions(-) diff --git a/README.md b/README.md index 7afdb40..63c8d8d 100644 --- a/README.md +++ b/README.md @@ -7,6 +7,6 @@ Took Sample BlueButton Test file from MyMedicare.gov and created a medicare.xml This will combine with claims.xml to present the complete BlueButton Plus file. ToDo: -1. Combine medicare.xml and claims.xml -2. Create medicare.json from the combined medicare.xml and claims.xml. + +1. Create medicare.json from the combined medicare.xml and claims.xml. diff --git a/sample/medicare.xml b/sample/medicare.xml index 401da55..60de518 100644 --- a/sample/medicare.xml +++ b/sample/medicare.xml @@ -918,5 +918,126 @@ MyMedicare.gov - + + + 0210336239290 + MyMedicare.gov + Part B + + Inova Health Services + 123456789 + National Provider ID + 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 + + + 20101102 + 20101102 + + + 1022.5 + 782.33 + 625.86 + 156.47 + + + Name of Service Provided + CPT + 2.16.840.1.113883.6.96 + 28521 + + + Name of Condition + CPT + 2.16.840.1.113883.6.96 + 28521 + + + Name of Condition + CPT + 2.16.840.1.113883.6.96 + 5854 + +
+ 20101102 + 20101102 + A0428 + Description of Procedure + + Additional details + more information + + 1 + 275.00 + 208.99 + 66.01 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544 +
+
+ 20101102 + 20101102 + A0428 + Description of Procedure + + Additional details + + 1 + 275 + 208.99 + 66.01 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544 +
+
+ 20101102 + 20101102 + A0425 + Description of Procedure + + Additional details + + 44 + 472.5 + 364.35 + 108.15 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544 +
+ + + 000000123456 + MyMedicare.gov + Part D + + Costco Pharmacy + 1234567891 + National Provider ID + 601 FIRST STREET, FORT WASHINGTON, PA 19034 + + 20071002 + + OXISTAT + RxNorm + 00462035860 + 0 + 30 + + + 1111111111 + Harvey, A. McGehee + + + \ No newline at end of file From 0fef47483b6396d0bacf26746cf14a369062dd6d Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Feb 2015 12:57:48 -0500 Subject: [PATCH 05/15] Generate medicar.json Generate medicare.json from medicare.xml --- sample/medicare.xml | 35 ++++++++++++++++++----------------- 1 file changed, 18 insertions(+), 17 deletions(-) diff --git a/sample/medicare.xml b/sample/medicare.xml index 60de518..82a3d75 100644 --- a/sample/medicare.xml +++ b/sample/medicare.xml @@ -1,6 +1,6 @@ - - -MyMedicare.gov Personal Health Information -code="US" - - - - +
+ MyMedicare.gov Personal Health Information + code="en-US" + + + +
Ellen Harrison Lu Ellen @@ -22,7 +23,7 @@ Lu 19100101
- 8115 Knuee Road + 8115 Knuee Road Mailpoint INA1-AF-16 Indianapolis IN @@ -594,7 +595,7 @@ NJ 07739
- Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Yes patient @@ -608,7 +609,7 @@ KS 66046 - Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Yes patient @@ -622,7 +623,7 @@ AZ 85006 - Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) May Accept Medicare patient @@ -636,7 +637,7 @@ OR 97701 - Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Yes patient @@ -650,7 +651,7 @@ IN 46240 - Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Yes patient @@ -664,7 +665,7 @@ IN 46256 - Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Addiction Medicine Yes patient @@ -768,7 +769,7 @@ patient - KINDRED TRANSITIONAL CARE & REHAB-ALLISON POINTE + KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE
5226 E 82ND ST @@ -832,7 +833,7 @@
- Physician & Other Healthcare Professional + Physician and Other Healthcare Professional Not Available patient From 6de2e72fbf5b55116b99b65140a9a56c87d2ef95 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Wed, 11 Feb 2015 09:52:11 -0500 Subject: [PATCH 06/15] Updated with Originator value Renamed sample to medicare. Created payer folder for sample payer blue button plus files. renamed medicare files to medicare_bbp.* (bbp = BlueButton Plus). Added Originator field to Header section. Added more information to README.md --- .gitignore | 2 +- Medicare/medicare_bbp.json | 1049 +++++++++++++++++ .../medicare.txt => Medicare/medicare_bbp.txt | 0 .../medicare.xml => Medicare/medicare_bbp.xml | 1 + README.md | 50 +- sample/medicare.json | 294 ----- 6 files changed, 1097 insertions(+), 299 deletions(-) create mode 100644 Medicare/medicare_bbp.json rename sample/medicare.txt => Medicare/medicare_bbp.txt (100%) rename sample/medicare.xml => Medicare/medicare_bbp.xml (99%) delete mode 100644 sample/medicare.json diff --git a/.gitignore b/.gitignore index 171318e..1f94645 100644 --- a/.gitignore +++ b/.gitignore @@ -1,4 +1,4 @@ -sample/.DS_Store +medicare/.DS_Store .DS_Store diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json new file mode 100644 index 0000000..e088fa8 --- /dev/null +++ b/Medicare/medicare_bbp.json @@ -0,0 +1,1049 @@ +{ + "header":{"title": "MyMedicare.gov Personal Health Information", +      "languageCode": "code=\"en-US\"", +      "versionNumber": { +         "value": "3" +      }, +      "effectiveTime": { +         "value": "20150210171504+0500" +      }, +      "confidentialityCode": { +         "code": "N", +         "codeSystem": "2.16.840.1.113883.5.25" +      }, + "originator": "MyMedicare.gov" +   }, +   "patient": { +      "name": "Ellen Harrison Lu", +      "first_name": "Ellen", +      "middle_name": "Harrison", +      "last_name": "Lu", +      "birthday": "19100101", +      "address": { +         "line_1": "8115 Knuee Road", +         "line_2": "Mailpoint INA1-AF-16", +         "city": "Indianapolis", +         "state": "IN", +         "zip": "46250" +      }, +      "patient_identifier": "W1234123456", +      "phone": [ +         "215-555-0684" +      ], +      "email_address": "test_user_fh@gmail.com", +      "medicare": { +         "part_a_effective_date": "19850103", +         "part_b_effective_date": "19850104" +      }, +      "source": "medicare.gov" +   }, +   "emergency_contact": [ +      { +         "name": "Billy B Bigelow", +         "first_name": "Billy", +         "middle_name": "B", +         "last_name": "Bigelow", +         "address": { +            "type": "Home", +            "line_1": "1234 Carnival Lane", +            "line_2": "Apt B", +            "city": "Lobster Bay", +            "state": "ME", +            "zip": "11112" +         }, +         "relationship": "Friend", +         "phone": { +            "home": "123-456-7890", +            "work": "123-456-7891", +            "mobile": "123-456-7892" +         }, +         "email": "billy.bigelow@example.com", +         "source": "patient" +      }, +      { +         "name": "Enoch C Snow", +         "first_name": "Enoch", +         "middle_name": "C", +         "last_name": "Snow", +         "address": { +            "type": "Home", +            "line_1": "2345 Fish Head Cove", +            "line_2": "C", +            "city": "Lobster Bay", +            "state": "ME", +            "zip": "11112" +         }, +         "relationship": "Friend", +         "phone": { +            "home": "123-456-7890", +            "work": "123-456-7891", +            "mobile": "123-456-7892" +         }, +         "email": "esnoww@example.com", +         "source": "patient" +      } +   ], +   "medical_conditions": [ +      { +         "name": "Allergies", +         "start": "20130129", +         "end": [], +         "source": "patient" +      }, +      { +         "name": "Arthritis", +         "start": "19600108", +         "end": "19801231", +         "source": "patient" +      }, +      { +         "name": "Broken Wrist", +         "start": "19100602", +         "end": "19101202", +         "source": "patient" +      }, +      { +         "name": "Other", +         "start": "20110102", +         "end": [], +         "source": "patient" +      }, +      { +         "name": "Other", +         "start": "20120228", +         "end": [], +         "source": "patient" +      } +   ], +   "allergies": [ +      { +         "name": "Antibiotic", +         "type": "drugs", +         "reaction": [], +         "severity": [], +         "diagnosed": [], +         "treatment": [], +         "first_episode_date": [], +         "last_episode_date": [], +         "last_treatment_date": [], +         "comments": [], +         "source": "patient" +      }, +      { +         "name": "Corn", +         "type": "Food", +         "reaction": "Blisters", +         "severity": "Mild", +         "diagnosed": "Yes", +         "treatment": "Other", +         "first_episode_date": [], +         "last_episode_date": [], +         "last_treatment_date": [], +         "comments": [], +         "source": "patient" +      }, +      { +         "name": "Milk", +         "type": "Food", +         "reaction": "Anaphylaxis", +         "severity": "Severe", +         "diagnosed": "Yes", +         "treatment": "Epinephrine (Epi-Pen)", +         "first_episode_date": "19850321", +         "last_episode_date": "20120331", +         "last_treatment_date": "20120331", +         "comments": [], +         "source": "patient" +      }, +      { +         "name": "Other - other", +         "type": "Other - other", +         "reaction": [], +         "severity": [], +         "diagnosed": [], +         "treatment": [], +         "first_episode_date": [], +         "last_episode_date": [], +         "last_treatment_date": [], +         "comments": [], +         "source": "patient" +      } +   ], +   "implantable_devices": [ +      { +         "name": "Coronary Stent", +         "implanted_date": "20051127", +         "source": "patient" +      }, +      { +         "name": "Knee replacement", +         "implanted_date": "20140202", +         "source": "patient" +      }, +      { +         "name": "Pace maker", +         "implanted_date": "20120228", +         "source": "patient" +      }, +      { +         "name": "Foot", +         "implanted_date": "19840909", +         "source": "patient" +      }, +      { +         "name": "Hearing aid", +         "implanted_date": "20130101", +         "source": "patient" +      }, +      { +         "name": "Nov20", +         "implanted_date": "20071215", +         "source": "patient" +      } +   ], +   "immunizations": [ +      { +         "name": "Shingles", +         "administered_date": "20100302", +         "method": "Injection", +         "vaccination_in_usa": "Yes", +         "Comments": [], +         "boosters": [ +            [ +               "20110402" +            ], +            [ +               "20120604" +            ], +            [ +               [] +            ] +         ], +         "source": "patient" +      } +   ], +   "labs": [ +      { +         "type": "Test", +         "date": "20130102", +         "administered_by": "Inova", +         "requesting_doctor": "Dr. John Doe", +         "reason_requested": [], +         "results": [], +         "comments": [], +         "source": "patient" +      } +   ], +   "vitals": [ +      { +         "type": "Glucose", +         "date": "20080702", +         "time": "12:00 AM", +         "reading_value": "322", +         "comments": [], +         "source": "patient" +      }, +      { +         "type": "Glucose", +         "date": "20090403", +         "time": "12:02 PM", +         "reading_value": "24", +         "comments": "a comment", +         "source": "patient" +      }, +      { +         "type": "Glucose", +         "date": "20090514", +         "time": "12:17 PM", +         "reading_value": "134", +         "comments": "another comment", +         "source": "patient" +      }, +      { +         "type": "Otro - other", +         "date": "19390101", +         "time": "12:00 AM", +         "reading_value": "other", +         "comments": [], +         "source": "patient" +      }, +      { +         "type": "Pulse", +         "date": "20130613", +         "time": "12:00 AM", +         "reading_value": "333", +         "comments": [], +         "source": "patient" +      }, +      { +         "type": "Pulse", +         "date": "20110302", +         "time": "12:00 AM", +         "reading_value": "80", +         "comments": "commenting", +         "source": "patient" +      }, +      { +         "type": "Temperature", +         "date": "20090605", +         "time": "8:06 AM", +         "reading_value": "100", +         "comments": "commenting again", +         "source": "patient" +      }, +      { +         "type": "Temperature", +         "date": "20080404", +         "time": "9:02 AM", +         "reading_value": "99", +         "comments": "comments", +         "source": "patient" +      } +   ], +   "family_history": [ +      { +         "relationship": "Daughter", +         "type": "Maternal", +         "date_of_birth": "19940101", +         "date_of_death": [], +         "age": "31", +         "condition": [ +            { +               "type": "Allergy", +               "description": "Dyes" +            }, +            { +               "type": "Condition", +               "description": "Diabetes, Type 2" +            }, +            { +               "type": "Skin Cancer", +               "description": [] +            } +         ], +         "source": "patient" +      }, +      { +         "relationship": "Brother", +         "type": "Paternal", +         "date_of_birth": "20120404", +         "date_of_death": [], +         "age": [], +         "condition": [ +            { +               "type": "Allergy", +               "description": "Chemotherapy" +            }, +            { +               "type": "Condition", +               "description": "Alzheimer's Disease" +            } +         ], +         "source": "patient" +      } +   ], +   "medications": [ +      { +         "name": "Abacavir TAB 300MG", +         "supply": "60 Every 1 Month", +         "original_drug": "Abacavir", +         "source": "patient" +      }, +      { +         "name": "Abilify Maintena INJ 300MG", +         "supply": "1 X Vial Every 1 Month", +         "original_drug": "Abilify Maintena", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate TAB 10MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate TAB 2.5MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate TAB 5MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Caduet", +         "source": "patient" +      }, +      { +         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", +         "source": "patient" +      }, +      { +         "name": "Androgel Pump GEL 1.62%", +         "supply": "2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month", +         "original_drug": "Androgel Pump", +         "source": "patient" +      }, +      { +         "name": "Drospirenone/Ethinyl Estradiol TAB 3-0.03MG", +         "supply": "28 Every 1 Month", +         "original_drug": "Yasmin 28", +         "source": "patient" +      }, +      { +         "name": "Gabapentin CAP 100MG", +         "supply": "90 Every 1 Month", +         "original_drug": "Gabapentin", +         "source": "patient" +      }, +      { +         "name": "Gabapentin SOL 250/5ML", +         "supply": "1 X 470ML Bottle Every 1 Month", +         "original_drug": "Gabapentin", +         "source": "patient" +      }, +      { +         "name": "Jakafi TAB 10MG", +         "supply": "60 Every 1 Month", +         "original_drug": "Jakafi", +         "source": "patient" +      }, +      { +         "name": "Losartan Potassium/Hydrochlorothiazide TAB 100-25", +         "supply": "30 Every 1 Month", +         "original_drug": "Losartan Potassium/Hydrochlorothiazide", +         "source": "patient" +      }, +      { +         "name": "Montelukast Sodium TAB 10MG", +         "supply": "90 Every 3 Month", +         "original_drug": "Montelukast Sodium", +         "source": "patient" +      }, +      { +         "name": "Omeprazole CAP 20MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Omeprazole", +         "source": "patient" +      }, +      { +         "name": "Rabavert INJ", +         "supply": "2 X Vial (sold in a package of 2) Every 12 Month", +         "original_drug": "Rabavert", +         "source": "patient" +      }, +      { +         "name": "Tabloid TAB 40MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Tabloid", +         "source": "patient" +      }, +      { +         "name": "Vagifem TAB 10MCG", +         "supply": "8 Every 1 Month", +         "original_drug": "Vagifem", +         "source": "patient" +      }, +      { +         "name": "Zafirlukast TAB 20MG", +         "supply": "60 Every 1 Month", +         "original_drug": "Zafirlukast", +         "source": "patient" +      }, +      { +         "name": "Zaleplon CAP 10MG", +         "supply": "30 Every 1 Month", +         "original_drug": "Zaleplon", +         "source": "patient" +      }, +      { +         "name": "Zaltrap INJ 100/4ML", +         "supply": "1 X 4ML Vial Every 1 Month", +         "original_drug": "Zaltrap", +         "source": "patient" +      } +   ], +   "preventive_services": [ +      { +         "description": "ABDOMINAL AORTIC ANEURYSM", +         "next_eligible_date": "20140201", +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "CARDIOVASCULAR", +         "next_eligible_date": "20140201", +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "PPV", +         "next_eligible_date": "20140201", +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "PROSTATE", +         "next_eligible_date": "20140201", +         "last_date_of_service": "20120326", +         "source": "MyMedicare.gov" +      }, +      { +         "description": "PSA", +         "next_eligible_date": "20140201", +         "last_date_of_service": "20120326", +         "source": "MyMedicare.gov" +      }, +      { +         "description": "ANNUAL WELLNESS VISIT", +         "next_eligible_date": "20150201", +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "ALCOHOL MISUSE SCREENING", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "COLORECTAL", +         "next_eligible_date": [], +         "last_date_of_service": "20110421", +         "source": "MyMedicare.gov" +      }, +      { +         "description": "DEPRESSION SCREENING", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "DIABETES", +         "next_eligible_date": [], +         "last_date_of_service": "20120521", +         "source": "MyMedicare.gov" +      }, +      { +         "description": "HIGH INTENSITY BEHAVIORAL COUNSELING", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "OBESITY COUNSELING", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "PHYSICAL", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      }, +      { +         "description": "SMOKING CESSATION (counseling to stop smoking)", +         "next_eligible_date": [], +         "last_date_of_service": [], +         "source": "MyMedicare.gov" +      } +   ], +   "providers": [ +      { +         "name": "ANGELO SCOTTI", +         "address": { +            "line_1": "180 WHITE RD", +            "line_2": [], +            "city": "LITTLE SILVER", +            "state": "NJ", +            "zip": "07739" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "DOUGLAS KNOX", +         "address": { +            "line_1": "1104 E 23RD ST", +            "line_2": [], +            "city": "LAWRENCE", +            "state": "KS", +            "zip": "66046" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "SIAMAK RASSADI", +         "address": { +            "line_1": "1331 N 7TH ST", +            "line_2": [], +            "city": "PHOENIX", +            "state": "AZ", +            "zip": "85006" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": "Cardiac Electrophysiology,Cardiovascular Disease (Cardiology)", +         "medicare_provider": "May Accept Medicare", +         "source": "patient" +      }, +      { +         "name": "PETER LEAVITT", +         "address": { +            "line_1": "2965 NECONNERS AVE", +            "line_2": [], +            "city": "BEND", +            "state": "OR", +            "zip": "97701" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "JOHN KENNEDY", +         "address": { +            "line_1": "8888 KEYSTONE XING", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46240" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "REBECCA KELLY", +         "address": { +            "line_1": "7250 CLEARVISTA DR", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46256" +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": "Addiction Medicine", +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "RILEY HOSPITAL - PEDS DIALYSIS", +         "address": { +            "line_1": "705 RILEY HOSPITAL DRIVE", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46202" +         }, +         "type": "Dialysis Facility", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "FMC - SHADELAND STATION", +         "address": { +            "line_1": "7155 SHADELAND STATION", +            "line_2": "STE 130", +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46256" +         }, +         "type": "Dialysis Facility", +         "specialty": "Dialysis Facility", +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "IU HEALTH - HOME DIALYSIS", +         "address": { +            "line_1": "8803 N. MERIDIAN ST.", +            "line_2": "STE 150", +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46260" +         }, +         "type": "Dialysis Facility", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "MESA VISTA OF BOULDER", +         "address": { +            "line_1": "2121 MESA DRIVE", +            "line_2": [], +            "city": "BOULDER", +            "state": "CO", +            "zip": "80304" +         }, +         "type": "Nursing Home", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "FAIRBANKS", +         "address": { +            "line_1": "8102 CLEARVISTA PARKWAY", +            "line_2": [], +            "city": "INDIANAPOLis", +            "state": "IN", +            "zip": "46256" +         }, +         "type": "Hospital", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "ALLIANCE HOME HEALTH SERVICES INC", +         "address": { +            "line_1": "9615 N COLLEGE AVE", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46280" +         }, +         "type": "Home Health", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "THE VIRGINIAN", +         "address": { +            "line_1": "9229 ARLINGTON BLVD", +            "line_2": [], +            "city": "FAIRFAX", +            "state": "VA", +            "zip": "22031" +         }, +         "type": "Nursing Home", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE", +         "address": { +            "line_1": "5226 E 82ND ST", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46250" +         }, +         "type": "Nursing Home", +         "specialty": [], +         "medicare_provider": "Yes", +         "source": "patient" +      }, +      { +         "name": "INDIANA HEART HOSPITAL THE", +         "address": { +            "line_1": "8075 N SHADELAND AVE", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46250" +         }, +         "type": "Hospital", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "COMMUNITY HOSPITAL NORTH", +         "address": { +            "line_1": "7150 CLEARVISTA DR", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46256" +         }, +         "type": "Hospital", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": "FORUM AT THE CROSSING", +         "address": { +            "line_1": "8505 WOODFIELD CROSSING BLVD", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46240" +         }, +         "type": "Nursing Home", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      }, +      { +         "name": [], +         "address": { +            "line_1": [], +            "line_2": [], +            "city": [], +            "state": [], +            "zip": [] +         }, +         "type": "Physician and Other Healthcare Professional", +         "specialty": [], +         "medicare_provider": "Not Available", +         "source": "patient" +      } +   ], +   "pharmacies": [ +      { +         "name": "Castleton Integrative Health", +         "address": { +            "line_1": "8208 Allisonville Rd", +            "line_2": [], +            "city": "INDIANAPOLIS", +            "state": "IN", +            "zip": "46250" +         }, +         "phone": "317-849-1222", +         "source": "patient" +      }, +      { +         "name": "Costco Pharmacy Indianapolis, IN 462506110", +         "address": { +            "line_1": "East 86th Street", +            "line_2": [], +            "city": "Castleton", +            "state": "IN", +            "zip": "46250" +         }, +         "phone": "317-558-1452", +         "source": "patient" +      } +   ], +   "insurance": [ +      { +         "category": "Medicare", +         "msp_type": [], +         "contract_id_plan_id": "S1111/801", +         "start_date": "20120112", +         "end_date": [], +         "insurer": "Medicare", +         "name": [], +         "marketing_name": [], +         "address": [], +         "type": "11 - Medicare Prescription Drug Plan", +         "source": "MyMedicare.gov" +      }, +      { +         "category": "Employer Subsidy", +         "msp_type": [], +         "contract_id_plan_id": [], +         "start_date": [], +         "end_date": [], +         "insurer": [], +         "name": [], +         "marketing_name": [], +         "address": [], +         "type": [], +         "source": "MyMedicare.gov" +      }, +      { +         "category": "Primary Insurance", +         "msp_type": [], +         "contract_id_plan_id": [], +         "start_date": [], +         "end_date": [], +         "insurer": [], +         "name": [], +         "marketing_name": [], +         "address": [], +         "type": [], +         "source": "MyMedicare.gov" +      }, +      { +         "category": "Other Insurance", +         "msp_type": [], +         "contract_id_plan_id": "30002", +         "start_date": "19841001", +         "end_date": [], +         "insurer": "UNITEDHEALTH GROUP", +         "name": [], +         "marketing_name": [], +         "address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034", +         "type": [], +         "source": "MyMedicare.gov" +      } +   ], +   "claims": [ +      { +         "claim_number": "0210336239290", +         "source": "MyMedicare.gov", +         "type": "Part B", +         "provider": { +            "name": "Inova Health Services", +            "provider_id": "123456789", +            "provider_id_type": "National Provider ID", +            "provider_billing_address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034" +         }, +         "date": { +            "start_date": "20101102", +            "end_date": "20101102" +         }, +         "charges": { +            "price_billed": "1022.5", +            "negotiated_price": "782.33", +            "insurance_paid": "625.86", +            "patient_responsibility": "156.47" +         }, +         "service": { +            "name": "Name of Service Provided", +            "code_system_name": "CPT", +            "code_system": "2.16.840.1.113883.6.96", +            "code": "28521" +         }, +         "diagnoses": [ +            { +               "name": "Name of Condition", +               "code_system_name": "CPT", +               "code_system": "2.16.840.1.113883.6.96", +               "code": "28521" +            }, +            { +               "name": "Name of Condition", +               "code_system_name": "CPT", +               "code_system": "2.16.840.1.113883.6.96", +               "code": "5854" +            } +         ], +         "details": [ +            { +               "start_date": "20101102", +               "end_date": "20101102", +               "procedure_code": "A0428", +               "procedure_description": "Description of Procedure", +               "modifiers": [ +                  "Additional details", +                  "more information" +               ], +               "quantity": "1", +               "price_billed": "275.00", +               "negotiated_price": "208.99", +               "patient_responsibility": "66.01", +               "place_of_service_code": "41", +               "place_of_service": "Ambulance - Land", +               "type_of_service_code": "9", +               "type_of_service": "Other Medical Services", +               "rendering_provider_number": "Q335520003", +               "rendering_provider_npi": "1023062544" +            }, +            { +               "start_date": "20101102", +               "end_date": "20101102", +               "procedure_code": "A0428", +               "procedure_description": "Description of Procedure", +               "modifiers": [ +                  "Additional details" +               ], +               "quantity": "1", +               "price_billed": "275", +               "negotiated_price": "208.99", +               "patient_responsibility": "66.01", +               "place_of_service_code": "41", +               "place_of_service": "Ambulance - Land", +               "type_of_service_code": "9", +               "type_of_service": "Other Medical Services", +               "rendering_provider_number": "Q335520003", +               "rendering_provider_npi": "1023062544" +            }, +            { +               "start_date": "20101102", +               "end_date": "20101102", +               "procedure_code": "A0425", +               "procedure_description": "Description of Procedure", +               "modifiers": [ +                  "Additional details" +               ], +               "quantity": "44", +               "price_billed": "472.5", +               "negotiated_price": "364.35", +               "patient_responsibility": "108.15", +               "place_of_service_code": "41", +               "place_of_service": "Ambulance - Land", +               "type_of_service_code": "9", +               "type_of_service": "Other Medical Services", +               "rendering_provider_number": "Q335520003", +               "rendering_provider_npi": "1023062544" +            } +         ] +      }, +      { +         "claim_number": "000000123456", +         "source": "MyMedicare.gov", +         "type": "Part D", +         "pharmacy": { +            "name": "Costco Pharmacy", +            "provider_id": "1234567891", +            "provider_id_type": "National Provider ID", +            "provider_billing_address": "601 FIRST STREET, FORT WASHINGTON, PA 19034" +         }, +         "date": "20071002", +         "drug": { +            "name": "OXISTAT", +            "code_system_name": "RxNorm", +            "code": "00462035860", +            "fill_number": "0", +            "days_supply": "30" +         }, +         "prescriber": { +            "identifier": "1111111111", +            "name": "Harvey, A. McGehee" +         } +      } +   ] +} \ No newline at end of file diff --git a/sample/medicare.txt b/Medicare/medicare_bbp.txt similarity index 100% rename from sample/medicare.txt rename to Medicare/medicare_bbp.txt diff --git a/sample/medicare.xml b/Medicare/medicare_bbp.xml similarity index 99% rename from sample/medicare.xml rename to Medicare/medicare_bbp.xml index 82a3d75..543dc93 100644 --- a/sample/medicare.xml +++ b/Medicare/medicare_bbp.xml @@ -15,6 +15,7 @@ + MyMedicare.gov Ellen Harrison Lu diff --git a/README.md b/README.md index 63c8d8d..7749271 100644 --- a/README.md +++ b/README.md @@ -3,10 +3,52 @@ claims Exploring JSON representation for claims data. -Took Sample BlueButton Test file from MyMedicare.gov and created a medicare.xml format. -This will combine with claims.xml to present the complete BlueButton Plus file. +A sample BlueButton Test file (medicare/medicare_bbp.txt) from MyMedicare.gov has been used to create a medicare_bbp.xml and medicare_bbp.json format. +This has been based on the claims.xml file that was initially created by Ryan Panchadsaram. -ToDo: +Objective +--------- -1. Create medicare.json from the combined medicare.xml and claims.xml. +The objective of this work is to: + +1. Create structured file formats in XML and JSON that can be used for the CMS BlueButton Plus data-as-a-service project. +2. Create claims summary and claim detail sections that will also satisfy the needs of the payer community for BlueButton +claims output for beneficiaries of Medicare, Medicaid and private insurance plans. + +Design Principles +----------------- + +The following design principles have been adopted in creating these file formats: + +1. Keep it simple +2. Develop a single file format with the necessary sections incorporated within the file +in order to avoid the challenges that can come with packaging multiple sets of files. + + +# Files in medicare folder: + +## medicare_bbp.txt + +This is a medicare bluebutton test file in simple ASCII format + +## medicare_bbp.xml + +This is an xml version based on the fields in the medicare_bbp.txt file + +## medicare_bbp.json + +This is a json format file that has been generated from the medicare_bbp.xml using an xml to JSON converter at +http://www.freeformatter.com/xml-to-json-converter.html + + +TODO-ekivemark +-------------- + +1. Create a generic BlueButtonPlus.xml and BlueButtonPlus.json that covers medicare and non-medicare payers. +2. Confirm approach in using field within data segments to identify source of data. + +Current Source field Values: + ++ patient ++ mymedicare.gov diff --git a/sample/medicare.json b/sample/medicare.json deleted file mode 100644 index ada63c9..0000000 --- a/sample/medicare.json +++ /dev/null @@ -1,294 +0,0 @@ -{ - "patient":{ - "name":"John Doe", - "birthday":19100101, - "address":{ - "line1": "8115 Knue Road", - "line2": "Mailpoint INA1-AF-16", - "city": "Indianapolis", - "state": "IN", - "zip": 46250 - }, - "homePhone":"215-555-0684", - "emailAddress": "test_user_fh@gmail.com" - }, - "medicare":{ - "partAEffectiveDate": 19850103, - "partBEffectiveDate": 19850104 - }, - "claims":[ - { - "claim":"0210336239290", - "type":"PartB", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101102, - "highValue":20101102 - }, - "charges":{ - "priceBilled":1022.50, - "negotiatedPrice":782.33, - "insurancePaid":625.86, - "patientResponsibility":156.47 - }, - "diagnosis":[ - { - "name":"Pressure ulcer, unspecified site (Pressure ulcer, site NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"70700" - } - ] - }, - { - "claim":"1410019001810", - "type":"PartB", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":354.25, - "negotiatedPrice":0.00, - "insurancePaid":0.00, - "patientResponsibility":0.00 - }, - "diagnosis":[ - { - "name":"Anemia in chronic kidney disease (Anemia in chr kidney dis)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"28521" - }, - { - "name":"Chronic kidney disease, Stage IV (severe) (Chr kidney dis stage IV)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"5854" - } - ] - }, - { - "claim":"0210020056080", - "type":"PartB", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":38.00, - "negotiatedPrice":9.38, - "insurancePaid":7.50, - "patientResponsibility":1.88 - }, - "diagnosis":[ - { - "name":"Elbow, forearm, and wrist injury (Elb/forearm/wrst inj NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"9593" - }, - { - "name":"Unspecified fall (Fall NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"E8889" - } - ] - }, - { - "claim":"1110008250730", - "type":"PartB", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":42.00, - "negotiatedPrice":0.00, - "insurancePaid":0.00, - "patientResponsibility":0.00 - }, - "diagnosis":[ - { - "name":"Nonallopathic lesions, thoracic region (Somat dysfunc thorac reg)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"7392" - }, - { - "name":"Pain in thoracic spine", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"7241" - }, - { - "name":"Nonallopathic lesions, lumbar region (Somat dysfunc lumbar reg)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"7393" - }, - { - "name":"Nonallopathic lesions, cervical region (Somat dysfunc cervic reg)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"7391" - } - ] - }, - { - "claim":"21001100130504VAA", - "type":"Outpatient", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":232.00, - "negotiatedPrice":232.00, - "insurancePaid":0.00, - "patientResponsibility":46.98 - }, - "diagnosis":[ - { - "name":"Calculus of kidney", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"5920" - }, - { - "name":"Aftercare for healing traumatic fracture of hip (Aftrcre traumatic fx hip)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"V5413" - }, - { - "name":"Alzheimer's disease", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"3310" - }, - { - "name":"Care involving other physical therapy (Physical therapy NEC)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"V571" - }, - { - "name":"Encounter for occupational therapy (Encntr occupatnal thrpy)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"V5721" - }, - { - "name":"Ulcerative colitis, unspecified (Ulceratve colitis unspcf)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"5569" - }, - { - "name":"Unspecified glaucoma (Glaucoma NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"3659" - } - ] - }, - { - "claim":"21001400340202MAA", - "type":"Inpatient", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":456.00, - "negotiatedPrice":456.00, - "insurancePaid":0.00, - "patientResponsibility":0.00 - }, - "diagnosis":[ - { - "name":"Aftercare following surgery for neoplasm (Aftercare neoplasm surg)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"V5842" - }, - { - "name":"Malignant neoplasm of colon, unspecified site (Malignant neo colon NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"1539" - }, - { - "name":"Congestive heart failure, unspecified (CHF NOS)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"4280" - }, - { - "name":"Coronary atherosclerosis of unspecified type of vessel, native or graft (Cor ath unsp vsl ntv/gft)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"41400" - } - ] - }, - { - "claim":"2210019297820", - "type":"PartB", - "provider":{ - "name":"Inova Health Services", - "providerID":123456789, - "providerIDType":"National Provider ID" - }, - "date":{ - "lowValue":20101001, - "highValue":20101001 - }, - "charges":{ - "priceBilled":133.00, - "negotiatedPrice":0.00, - "insurancePaid":0.00, - "patientResponsibility":0.00 - }, - "diagnosis":[ - { - "name":"Benign neoplasm of skin of other and unspecified parts of face (Benign neo skin face NEC)", - "codeSystemName":"ICD-9", - "codeSystem":"2.16.840.1.113883.6.104", - "code":"2163" - } - ] - } - ] -} \ No newline at end of file From f0ed69f200b0b5a31a1b0b93a79f386e8a29025b Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 17 Feb 2015 13:33:48 -0500 Subject: [PATCH 07/15] minor tweaks to JSON format Changed layout to remove PyCharm Error of unexpected space character. --- Medicare/medicare_bbp.json | 1976 +++++++++++++++++------------------- 1 file changed, 930 insertions(+), 1046 deletions(-) diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index e088fa8..23de449 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -1,1049 +1,933 @@ { "header":{"title": "MyMedicare.gov Personal Health Information", -      "languageCode": "code=\"en-US\"", -      "versionNumber": { -         "value": "3" -      }, -      "effectiveTime": { -         "value": "20150210171504+0500" -      }, -      "confidentialityCode": { -         "code": "N", -         "codeSystem": "2.16.840.1.113883.5.25" -      }, - "originator": "MyMedicare.gov" -   }, -   "patient": { -      "name": "Ellen Harrison Lu", -      "first_name": "Ellen", -      "middle_name": "Harrison", -      "last_name": "Lu", -      "birthday": "19100101", -      "address": { -         "line_1": "8115 Knuee Road", -         "line_2": "Mailpoint INA1-AF-16", -         "city": "Indianapolis", -         "state": "IN", -         "zip": "46250" -      }, -      "patient_identifier": "W1234123456", -      "phone": [ -         "215-555-0684" -      ], -      "email_address": "test_user_fh@gmail.com", -      "medicare": { -         "part_a_effective_date": "19850103", -         "part_b_effective_date": "19850104" -      }, -      "source": "medicare.gov" -   }, -   "emergency_contact": [ -      { -         "name": "Billy B Bigelow", -         "first_name": "Billy", -         "middle_name": "B", -         "last_name": "Bigelow", -         "address": { -            "type": "Home", -            "line_1": "1234 Carnival Lane", -            "line_2": "Apt B", -            "city": "Lobster Bay", -            "state": "ME", -            "zip": "11112" -         }, -         "relationship": "Friend", -         "phone": { -            "home": "123-456-7890", -            "work": "123-456-7891", -            "mobile": "123-456-7892" -         }, -         "email": "billy.bigelow@example.com", -         "source": "patient" -      }, -      { -         "name": "Enoch C Snow", -         "first_name": "Enoch", -         "middle_name": "C", -         "last_name": "Snow", -         "address": { -            "type": "Home", -            "line_1": "2345 Fish Head Cove", -            "line_2": "C", -            "city": "Lobster Bay", -            "state": "ME", -            "zip": "11112" -         }, -         "relationship": "Friend", -         "phone": { -            "home": "123-456-7890", -            "work": "123-456-7891", -            "mobile": "123-456-7892" -         }, -         "email": "esnoww@example.com", -         "source": "patient" -      } -   ], -   "medical_conditions": [ -      { -         "name": "Allergies", -         "start": "20130129", -         "end": [], -         "source": "patient" -      }, -      { -         "name": "Arthritis", -         "start": "19600108", -         "end": "19801231", -         "source": "patient" -      }, -      { -         "name": "Broken Wrist", -         "start": "19100602", -         "end": "19101202", -         "source": "patient" -      }, -      { -         "name": "Other", -         "start": "20110102", -         "end": [], -         "source": "patient" -      }, -      { -         "name": "Other", -         "start": "20120228", -         "end": [], -         "source": "patient" -      } -   ], -   "allergies": [ -      { -         "name": "Antibiotic", -         "type": "drugs", -         "reaction": [], -         "severity": [], -         "diagnosed": [], -         "treatment": [], -         "first_episode_date": [], -         "last_episode_date": [], -         "last_treatment_date": [], -         "comments": [], -         "source": "patient" -      }, -      { -         "name": "Corn", -         "type": "Food", -         "reaction": "Blisters", -         "severity": "Mild", -         "diagnosed": "Yes", -         "treatment": "Other", -         "first_episode_date": [], -         "last_episode_date": [], -         "last_treatment_date": [], -         "comments": [], -         "source": "patient" -      }, -      { -         "name": "Milk", -         "type": "Food", -         "reaction": "Anaphylaxis", -         "severity": "Severe", -         "diagnosed": "Yes", -         "treatment": "Epinephrine (Epi-Pen)", -         "first_episode_date": "19850321", -         "last_episode_date": "20120331", -         "last_treatment_date": "20120331", -         "comments": [], -         "source": "patient" -      }, -      { -         "name": "Other - other", -         "type": "Other - other", -         "reaction": [], -         "severity": [], -         "diagnosed": [], -         "treatment": [], -         "first_episode_date": [], -         "last_episode_date": [], -         "last_treatment_date": [], -         "comments": [], -         "source": "patient" -      } -   ], -   "implantable_devices": [ -      { -         "name": "Coronary Stent", -         "implanted_date": "20051127", -         "source": "patient" -      }, -      { -         "name": "Knee replacement", -         "implanted_date": "20140202", -         "source": "patient" -      }, -      { -         "name": "Pace maker", -         "implanted_date": "20120228", -         "source": "patient" -      }, -      { -         "name": "Foot", -         "implanted_date": "19840909", -         "source": "patient" -      }, -      { -         "name": "Hearing aid", -         "implanted_date": "20130101", -         "source": "patient" -      }, -      { -         "name": "Nov20", -         "implanted_date": "20071215", -         "source": "patient" -      } -   ], -   "immunizations": [ -      { -         "name": "Shingles", -         "administered_date": "20100302", -         "method": "Injection", -         "vaccination_in_usa": "Yes", -         "Comments": [], -         "boosters": [ -            [ -               "20110402" -            ], -            [ -               "20120604" -            ], -            [ -               [] -            ] -         ], -         "source": "patient" -      } -   ], -   "labs": [ -      { -         "type": "Test", -         "date": "20130102", -         "administered_by": "Inova", -         "requesting_doctor": "Dr. John Doe", -         "reason_requested": [], -         "results": [], -         "comments": [], -         "source": "patient" -      } -   ], -   "vitals": [ -      { -         "type": "Glucose", -         "date": "20080702", -         "time": "12:00 AM", -         "reading_value": "322", -         "comments": [], -         "source": "patient" -      }, -      { -         "type": "Glucose", -         "date": "20090403", -         "time": "12:02 PM", -         "reading_value": "24", -         "comments": "a comment", -         "source": "patient" -      }, -      { -         "type": "Glucose", -         "date": "20090514", -         "time": "12:17 PM", -         "reading_value": "134", -         "comments": "another comment", -         "source": "patient" -      }, -      { -         "type": "Otro - other", -         "date": "19390101", -         "time": "12:00 AM", -         "reading_value": "other", -         "comments": [], -         "source": "patient" -      }, -      { -         "type": "Pulse", -         "date": "20130613", -         "time": "12:00 AM", -         "reading_value": "333", -         "comments": [], -         "source": "patient" -      }, -      { -         "type": "Pulse", -         "date": "20110302", -         "time": "12:00 AM", -         "reading_value": "80", -         "comments": "commenting", -         "source": "patient" -      }, -      { -         "type": "Temperature", -         "date": "20090605", -         "time": "8:06 AM", -         "reading_value": "100", -         "comments": "commenting again", -         "source": "patient" -      }, -      { -         "type": "Temperature", -         "date": "20080404", -         "time": "9:02 AM", -         "reading_value": "99", -         "comments": "comments", -         "source": "patient" -      } -   ], -   "family_history": [ -      { -         "relationship": "Daughter", -         "type": "Maternal", -         "date_of_birth": "19940101", -         "date_of_death": [], -         "age": "31", -         "condition": [ -            { -               "type": "Allergy", -               "description": "Dyes" -            }, -            { -               "type": "Condition", -               "description": "Diabetes, Type 2" -            }, -            { -               "type": "Skin Cancer", -               "description": [] -            } -         ], -         "source": "patient" -      }, -      { -         "relationship": "Brother", -         "type": "Paternal", -         "date_of_birth": "20120404", -         "date_of_death": [], -         "age": [], -         "condition": [ -            { -               "type": "Allergy", -               "description": "Chemotherapy" -            }, -            { -               "type": "Condition", -               "description": "Alzheimer's Disease" -            } -         ], -         "source": "patient" -      } -   ], -   "medications": [ -      { -         "name": "Abacavir TAB 300MG", -         "supply": "60 Every 1 Month", -         "original_drug": "Abacavir", -         "source": "patient" -      }, -      { -         "name": "Abilify Maintena INJ 300MG", -         "supply": "1 X Vial Every 1 Month", -         "original_drug": "Abilify Maintena", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate TAB 10MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate TAB 2.5MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate TAB 5MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Caduet", -         "source": "patient" -      }, -      { -         "name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", -         "source": "patient" -      }, -      { -         "name": "Androgel Pump GEL 1.62%", -         "supply": "2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month", -         "original_drug": "Androgel Pump", -         "source": "patient" -      }, -      { -         "name": "Drospirenone/Ethinyl Estradiol TAB 3-0.03MG", -         "supply": "28 Every 1 Month", -         "original_drug": "Yasmin 28", -         "source": "patient" -      }, -      { -         "name": "Gabapentin CAP 100MG", -         "supply": "90 Every 1 Month", -         "original_drug": "Gabapentin", -         "source": "patient" -      }, -      { -         "name": "Gabapentin SOL 250/5ML", -         "supply": "1 X 470ML Bottle Every 1 Month", -         "original_drug": "Gabapentin", -         "source": "patient" -      }, -      { -         "name": "Jakafi TAB 10MG", -         "supply": "60 Every 1 Month", -         "original_drug": "Jakafi", -         "source": "patient" -      }, -      { -         "name": "Losartan Potassium/Hydrochlorothiazide TAB 100-25", -         "supply": "30 Every 1 Month", -         "original_drug": "Losartan Potassium/Hydrochlorothiazide", -         "source": "patient" -      }, -      { -         "name": "Montelukast Sodium TAB 10MG", -         "supply": "90 Every 3 Month", -         "original_drug": "Montelukast Sodium", -         "source": "patient" -      }, -      { -         "name": "Omeprazole CAP 20MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Omeprazole", -         "source": "patient" -      }, -      { -         "name": "Rabavert INJ", -         "supply": "2 X Vial (sold in a package of 2) Every 12 Month", -         "original_drug": "Rabavert", -         "source": "patient" -      }, -      { -         "name": "Tabloid TAB 40MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Tabloid", -         "source": "patient" -      }, -      { -         "name": "Vagifem TAB 10MCG", -         "supply": "8 Every 1 Month", -         "original_drug": "Vagifem", -         "source": "patient" -      }, -      { -         "name": "Zafirlukast TAB 20MG", -         "supply": "60 Every 1 Month", -         "original_drug": "Zafirlukast", -         "source": "patient" -      }, -      { -         "name": "Zaleplon CAP 10MG", -         "supply": "30 Every 1 Month", -         "original_drug": "Zaleplon", -         "source": "patient" -      }, -      { -         "name": "Zaltrap INJ 100/4ML", -         "supply": "1 X 4ML Vial Every 1 Month", -         "original_drug": "Zaltrap", -         "source": "patient" -      } -   ], -   "preventive_services": [ -      { -         "description": "ABDOMINAL AORTIC ANEURYSM", -         "next_eligible_date": "20140201", -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "CARDIOVASCULAR", -         "next_eligible_date": "20140201", -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "PPV", -         "next_eligible_date": "20140201", -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "PROSTATE", -         "next_eligible_date": "20140201", -         "last_date_of_service": "20120326", -         "source": "MyMedicare.gov" -      }, -      { -         "description": "PSA", -         "next_eligible_date": "20140201", -         "last_date_of_service": "20120326", -         "source": "MyMedicare.gov" -      }, -      { -         "description": "ANNUAL WELLNESS VISIT", -         "next_eligible_date": "20150201", -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "ALCOHOL MISUSE SCREENING", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "COLORECTAL", -         "next_eligible_date": [], -         "last_date_of_service": "20110421", -         "source": "MyMedicare.gov" -      }, -      { -         "description": "DEPRESSION SCREENING", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "DIABETES", -         "next_eligible_date": [], -         "last_date_of_service": "20120521", -         "source": "MyMedicare.gov" -      }, -      { -         "description": "HIGH INTENSITY BEHAVIORAL COUNSELING", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "OBESITY COUNSELING", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "PHYSICAL", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      }, -      { -         "description": "SMOKING CESSATION (counseling to stop smoking)", -         "next_eligible_date": [], -         "last_date_of_service": [], -         "source": "MyMedicare.gov" -      } -   ], -   "providers": [ -      { -         "name": "ANGELO SCOTTI", -         "address": { -            "line_1": "180 WHITE RD", -            "line_2": [], -            "city": "LITTLE SILVER", -            "state": "NJ", -            "zip": "07739" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "DOUGLAS KNOX", -         "address": { -            "line_1": "1104 E 23RD ST", -            "line_2": [], -            "city": "LAWRENCE", -            "state": "KS", -            "zip": "66046" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "SIAMAK RASSADI", -         "address": { -            "line_1": "1331 N 7TH ST", -            "line_2": [], -            "city": "PHOENIX", -            "state": "AZ", -            "zip": "85006" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": "Cardiac Electrophysiology,Cardiovascular Disease (Cardiology)", -         "medicare_provider": "May Accept Medicare", -         "source": "patient" -      }, -      { -         "name": "PETER LEAVITT", -         "address": { -            "line_1": "2965 NECONNERS AVE", -            "line_2": [], -            "city": "BEND", -            "state": "OR", -            "zip": "97701" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "JOHN KENNEDY", -         "address": { -            "line_1": "8888 KEYSTONE XING", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46240" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "REBECCA KELLY", -         "address": { -            "line_1": "7250 CLEARVISTA DR", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46256" -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": "Addiction Medicine", -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "RILEY HOSPITAL - PEDS DIALYSIS", -         "address": { -            "line_1": "705 RILEY HOSPITAL DRIVE", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46202" -         }, -         "type": "Dialysis Facility", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "FMC - SHADELAND STATION", -         "address": { -            "line_1": "7155 SHADELAND STATION", -            "line_2": "STE 130", -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46256" -         }, -         "type": "Dialysis Facility", -         "specialty": "Dialysis Facility", -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "IU HEALTH - HOME DIALYSIS", -         "address": { -            "line_1": "8803 N. MERIDIAN ST.", -            "line_2": "STE 150", -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46260" -         }, -         "type": "Dialysis Facility", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "MESA VISTA OF BOULDER", -         "address": { -            "line_1": "2121 MESA DRIVE", -            "line_2": [], -            "city": "BOULDER", -            "state": "CO", -            "zip": "80304" -         }, -         "type": "Nursing Home", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "FAIRBANKS", -         "address": { -            "line_1": "8102 CLEARVISTA PARKWAY", -            "line_2": [], -            "city": "INDIANAPOLis", -            "state": "IN", -            "zip": "46256" -         }, -         "type": "Hospital", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "ALLIANCE HOME HEALTH SERVICES INC", -         "address": { -            "line_1": "9615 N COLLEGE AVE", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46280" -         }, -         "type": "Home Health", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "THE VIRGINIAN", -         "address": { -            "line_1": "9229 ARLINGTON BLVD", -            "line_2": [], -            "city": "FAIRFAX", -            "state": "VA", -            "zip": "22031" -         }, -         "type": "Nursing Home", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE", -         "address": { -            "line_1": "5226 E 82ND ST", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46250" -         }, -         "type": "Nursing Home", -         "specialty": [], -         "medicare_provider": "Yes", -         "source": "patient" -      }, -      { -         "name": "INDIANA HEART HOSPITAL THE", -         "address": { -            "line_1": "8075 N SHADELAND AVE", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46250" -         }, -         "type": "Hospital", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "COMMUNITY HOSPITAL NORTH", -         "address": { -            "line_1": "7150 CLEARVISTA DR", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46256" -         }, -         "type": "Hospital", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": "FORUM AT THE CROSSING", -         "address": { -            "line_1": "8505 WOODFIELD CROSSING BLVD", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46240" -         }, -         "type": "Nursing Home", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      }, -      { -         "name": [], -         "address": { -            "line_1": [], -            "line_2": [], -            "city": [], -            "state": [], -            "zip": [] -         }, -         "type": "Physician and Other Healthcare Professional", -         "specialty": [], -         "medicare_provider": "Not Available", -         "source": "patient" -      } -   ], -   "pharmacies": [ -      { -         "name": "Castleton Integrative Health", -         "address": { -            "line_1": "8208 Allisonville Rd", -            "line_2": [], -            "city": "INDIANAPOLIS", -            "state": "IN", -            "zip": "46250" -         }, -         "phone": "317-849-1222", -         "source": "patient" -      }, -      { -         "name": "Costco Pharmacy Indianapolis, IN 462506110", -         "address": { -            "line_1": "East 86th Street", -            "line_2": [], -            "city": "Castleton", -            "state": "IN", -            "zip": "46250" -         }, -         "phone": "317-558-1452", -         "source": "patient" -      } -   ], -   "insurance": [ -      { -         "category": "Medicare", -         "msp_type": [], -         "contract_id_plan_id": "S1111/801", -         "start_date": "20120112", -         "end_date": [], -         "insurer": "Medicare", -         "name": [], -         "marketing_name": [], -         "address": [], -         "type": "11 - Medicare Prescription Drug Plan", -         "source": "MyMedicare.gov" -      }, -      { -         "category": "Employer Subsidy", -         "msp_type": [], -         "contract_id_plan_id": [], -         "start_date": [], -         "end_date": [], -         "insurer": [], -         "name": [], -         "marketing_name": [], -         "address": [], -         "type": [], -         "source": "MyMedicare.gov" -      }, -      { -         "category": "Primary Insurance", -         "msp_type": [], -         "contract_id_plan_id": [], -         "start_date": [], -         "end_date": [], -         "insurer": [], -         "name": [], -         "marketing_name": [], -         "address": [], -         "type": [], -         "source": "MyMedicare.gov" -      }, -      { -         "category": "Other Insurance", -         "msp_type": [], -         "contract_id_plan_id": "30002", -         "start_date": "19841001", -         "end_date": [], -         "insurer": "UNITEDHEALTH GROUP", -         "name": [], -         "marketing_name": [], -         "address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034", -         "type": [], -         "source": "MyMedicare.gov" -      } -   ], -   "claims": [ -      { -         "claim_number": "0210336239290", -         "source": "MyMedicare.gov", -         "type": "Part B", -         "provider": { -            "name": "Inova Health Services", -            "provider_id": "123456789", -            "provider_id_type": "National Provider ID", -            "provider_billing_address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034" -         }, -         "date": { -            "start_date": "20101102", -            "end_date": "20101102" -         }, -         "charges": { -            "price_billed": "1022.5", -            "negotiated_price": "782.33", -            "insurance_paid": "625.86", -            "patient_responsibility": "156.47" -         }, -         "service": { -            "name": "Name of Service Provided", -            "code_system_name": "CPT", -            "code_system": "2.16.840.1.113883.6.96", -            "code": "28521" -         }, -         "diagnoses": [ -            { -               "name": "Name of Condition", -               "code_system_name": "CPT", -               "code_system": "2.16.840.1.113883.6.96", -               "code": "28521" -            }, -            { -               "name": "Name of Condition", -               "code_system_name": "CPT", -               "code_system": "2.16.840.1.113883.6.96", -               "code": "5854" -            } -         ], -         "details": [ -            { -               "start_date": "20101102", -               "end_date": "20101102", -               "procedure_code": "A0428", -               "procedure_description": "Description of Procedure", -               "modifiers": [ -                  "Additional details", -                  "more information" -               ], -               "quantity": "1", -               "price_billed": "275.00", -               "negotiated_price": "208.99", -               "patient_responsibility": "66.01", -               "place_of_service_code": "41", -               "place_of_service": "Ambulance - Land", -               "type_of_service_code": "9", -               "type_of_service": "Other Medical Services", -               "rendering_provider_number": "Q335520003", -               "rendering_provider_npi": "1023062544" -            }, -            { -               "start_date": "20101102", -               "end_date": "20101102", -               "procedure_code": "A0428", -               "procedure_description": "Description of Procedure", -               "modifiers": [ -                  "Additional details" -               ], -               "quantity": "1", -               "price_billed": "275", -               "negotiated_price": "208.99", -               "patient_responsibility": "66.01", -               "place_of_service_code": "41", -               "place_of_service": "Ambulance - Land", -               "type_of_service_code": "9", -               "type_of_service": "Other Medical Services", -               "rendering_provider_number": "Q335520003", -               "rendering_provider_npi": "1023062544" -            }, -            { -               "start_date": "20101102", -               "end_date": "20101102", -               "procedure_code": "A0425", -               "procedure_description": "Description of Procedure", -               "modifiers": [ -                  "Additional details" -               ], -               "quantity": "44", -               "price_billed": "472.5", -               "negotiated_price": "364.35", -               "patient_responsibility": "108.15", -               "place_of_service_code": "41", -               "place_of_service": "Ambulance - Land", -               "type_of_service_code": "9", -               "type_of_service": "Other Medical Services", -               "rendering_provider_number": "Q335520003", -               "rendering_provider_npi": "1023062544" -            } -         ] -      }, -      { -         "claim_number": "000000123456", -         "source": "MyMedicare.gov", -         "type": "Part D", -         "pharmacy": { -            "name": "Costco Pharmacy", -            "provider_id": "1234567891", -            "provider_id_type": "National Provider ID", -            "provider_billing_address": "601 FIRST STREET, FORT WASHINGTON, PA 19034" -         }, -         "date": "20071002", -         "drug": { -            "name": "OXISTAT", -            "code_system_name": "RxNorm", -            "code": "00462035860", -            "fill_number": "0", -            "days_supply": "30" -         }, -         "prescriber": { -            "identifier": "1111111111", -            "name": "Harvey, A. McGehee" -         } -      } -   ] + "languageCode": "code=\"en-US\"", + "versionNumber": {"value": "3"}, + "effectiveTime": {"value": "20150210171504+0500"}, + "confidentialityCode": {"code": "N", + "codeSystem": "2.16.840.1.113883.5.25"}, + "originator": "MyMedicare.gov" + }, + "patient": {"name": "Ellen Harrison Lu", + "first_name": "Ellen", + "middle_name": "Harrison", + "last_name": "Lu", + "birthday": "19100101", + "address":{"line_1": "8115 Knuee Road", + "line_2": "Mailpoint INA1-AF-16", + "city": "Indianapolis", + "state": "IN", + "zip": "46250" + }, + "patient_identifier": "W1234123456", + "phone": [ + "215-555-0684"], + "email_address": "test_user_fh@gmail.com", + + "medicare": { + "part_a_effective_date": "19850103", + "part_b_effective_date": "19850104" + }, + "source": "medicare.gov" + }, + "emergency_contact": [ + {"name": "Billy B Bigelow", + "first_name": "Billy", + "middle_name": "B", + "last_name": "Bigelow", + "address": { + "type": "Home", + "line_1": "1234 Carnival Lane", + "line_2": "Apt B", + "city": "Lobster Bay", + "state": "ME", + "zip": "11112" + }, + "relationship": "Friend", + "phone": { + "home": "123-456-7890", + "work": "123-456-7891", + "mobile": "123-456-7892" + }, + "email": "billy.bigelow@example.com", + "source": "patient" + }, + {"name": "Enoch C Snow", + "first_name": "Enoch", + "middle_name": "C", + "last_name": "Snow", + "address": { + "type": "Home", + "line_1": "2345 Fish Head Cove", + "line_2": "C", + "city": "Lobster Bay", + "state": "ME", + "zip": "11112" + }, + "relationship": "Friend", + "phone": { + "home": "123-456-7890", + "work": "123-456-7891", + "mobile": "123-456-7892" + }, + "email": "esnoww@example.com", + "source": "patient" + } + ], + "medical_conditions": [ + {"name": "Allergies", + "start": "20130129", + "end": [], + "source": "patient" + }, + {"name": "Arthritis", + "start": "19600108", + "end": "19801231", + "source": "patient" + }, + {"name": "Broken Wrist", + + "start": "19100602", + "end": "19101202", + "source": "patient" + }, + {"name": "Other", + "start": "20110102", + "end": [], + "source": "patient" + }, + {"name": "Other", + "start": "20120228", + "end": [], + "source": "patient" + } + ], + "allergies": [ + {"name": "Antibiotic", + "type": "drugs", + "reaction": [], + "severity": [], + "diagnosed": [], + "treatment": [], + "first_episode_date": [], + "last_episode_date": [], + "last_treatment_date": [], + "comments": [], + "source": "patient" + }, + {"name": "Corn", + "type": "Food", + "reaction": "Blisters", + "severity": "Mild", + "diagnosed": "Yes", + "treatment": "Other", + "first_episode_date": [], + "last_episode_date": [], + "last_treatment_date": [], + "comments": [], + "source": "patient" + }, + {"name": "Milk", + "type": "Food", + "reaction": "Anaphylaxis", + "severity": "Severe", + "diagnosed": "Yes", + "treatment": "Epinephrine (Epi-Pen)", + "first_episode_date": "19850321", + "last_episode_date": "20120331", + "last_treatment_date": "20120331", + "comments": [], + "source": "patient" + }, + {"name": "Other - other", + "type": "Other - other", + "reaction": [], + "severity": [], + "diagnosed": [], + "treatment": [], + "first_episode_date": [], + "last_episode_date": [], + "last_treatment_date": [], + "comments": [], + "source": "patient" + } + ], + "implantable_devices": [ + {"name": "Coronary Stent", + "implanted_date": "20051127", + "source": "patient" + }, + {"name": "Knee replacement", + "implanted_date": "20140202", + "source": "patient" + }, + {"name": "Pace maker", + "implanted_date": "20120228", + "source": "patient" + }, + {"name": "Foot", + "implanted_date": "19840909", + "source": "patient" + }, + {"name": "Hearing aid", + "implanted_date": "20130101", + "source": "patient" + }, + {"name": "Nov20", + "implanted_date": "20071215", + "source": "patient" + } + ], + "immunizations": [ + {"name": "Shingles", + "administered_date": "20100302", + "method": "Injection", + "vaccination_in_usa": "Yes", + "Comments": [], + "boosters": [ + ["20110402"], + ["20120604"], + [ + [] + ] + ], + "source": "patient" + } + ], + "labs": [ + {"type": "Test", + "date": "20130102", + "administered_by": "Inova", + "requesting_doctor": "Dr. John Doe", + "reason_requested": [], + "results": [], + "comments": [], + "source": "patient" + } + ], + "vitals": [ + {"type": "Glucose", + "date": "20080702", + "time": "12:00 AM", + "reading_value": "322", + "comments": [], + "source": "patient" + }, + {"type": "Glucose", + "date": "20090403", + "time": "12:02 PM", + "reading_value": "24", + "comments": "a comment", + "source": "patient" + }, + {"type": "Glucose", + "date": "20090514", + "time": "12:17 PM", + "reading_value": "134", + "comments": "another comment", + "source": "patient" + }, + {"type": "Otro - other", + "date": "19390101", + "time": "12:00 AM", + "reading_value": "other", + "comments": [], + "source": "patient" + }, + {"type": "Pulse", + "date": "20130613", + "time": "12:00 AM", + "reading_value": "333", + "comments": [], + "source": "patient" + }, + {"type": "Pulse", + "date": "20110302", + "time": "12:00 AM", + "reading_value": "80", + "comments": "commenting", + "source": "patient" + }, + {"type": "Temperature", + "date": "20090605", + "time": "8:06 AM", + "reading_value": "100", + "comments": "commenting again", + "source": "patient" + }, + {"type": "Temperature", + "date": "20080404", + "time": "9:02 AM", + "reading_value": "99", + "comments": "comments", + "source": "patient" + } + ], + "family_history": [ + {"relationship": "Daughter", + "type": "Maternal", + "date_of_birth": "19940101", + "date_of_death": [], + "age": "31", + "condition": [ + {"type": "Allergy", + "description": "Dyes" + }, + {"type": "Condition", + "description": "Diabetes, Type 2" + }, + {"type": "Skin Cancer", + "description": [] + } + ], + "source": "patient" + }, + {"relationship": "Brother", + "type": "Paternal", + "date_of_birth": "20120404", + "date_of_death": [], + "age": [], + "condition": [ + {"type": "Allergy", + "description": "Chemotherapy" + }, + {"type": "Condition", + "description": "Alzheimer's Disease" + } + ], + "source": "patient" + } + ], + "medications": [ + {"name": "Abacavir TAB 300MG", + "supply": "60 Every 1 Month", + "original_drug": "Abacavir", + "source": "patient" + }, + {"name": "Abilify Maintena INJ 300MG", + "supply": "1 X Vial Every 1 Month", + "original_drug": "Abilify Maintena", + "source": "patient" + }, + {"name": "Amlodipine Besylate TAB 10MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate", + "source": "patient" + }, + {"name": "Amlodipine Besylate TAB 2.5MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate", + "source": "patient" + }, + {"name": "Amlodipine Besylate TAB 5MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG", + "supply": "30 Every 1 Month", + "original_drug": "Caduet", + "source": "patient" + }, + {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG", + "supply": "30 Every 1 Month", + "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "source": "patient" + }, + {"name": "Androgel Pump GEL 1.62%", + "supply": "2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month", + "original_drug": "Androgel Pump", + "source": "patient" + }, + {"name": "Drospirenone/Ethinyl Estradiol TAB 3-0.03MG", + "supply": "28 Every 1 Month", + "original_drug": "Yasmin 28", + "source": "patient" + }, + {"name": "Gabapentin CAP 100MG", + "supply": "90 Every 1 Month", + "original_drug": "Gabapentin", + "source": "patient" + }, + {"name": "Gabapentin SOL 250/5ML", + "supply": "1 X 470ML Bottle Every 1 Month", + "original_drug": "Gabapentin", + "source": "patient" + }, + {"name": "Jakafi TAB 10MG", + "supply": "60 Every 1 Month", + "original_drug": "Jakafi", + "source": "patient" + }, + {"name": "Losartan Potassium/Hydrochlorothiazide TAB 100-25", + "supply": "30 Every 1 Month", + "original_drug": "Losartan Potassium/Hydrochlorothiazide", + "source": "patient" + }, + {"name": "Montelukast Sodium TAB 10MG", + "supply": "90 Every 3 Month", + "original_drug": "Montelukast Sodium", + "source": "patient" + }, + {"name": "Omeprazole CAP 20MG", + "supply": "30 Every 1 Month", + "original_drug": "Omeprazole", + "source": "patient" + }, + {"name": "Rabavert INJ", + "supply": "2 X Vial (sold in a package of 2) Every 12 Month", + "original_drug": "Rabavert", + "source": "patient" + }, + {"name": "Tabloid TAB 40MG", + "supply": "30 Every 1 Month", + "original_drug": "Tabloid", + "source": "patient" + }, + {"name": "Vagifem TAB 10MCG", + "supply": "8 Every 1 Month", + "original_drug": "Vagifem", + "source": "patient" + }, + {"name": "Zafirlukast TAB 20MG", + "supply": "60 Every 1 Month", + "original_drug": "Zafirlukast", + "source": "patient" + }, + {"name": "Zaleplon CAP 10MG", + "supply": "30 Every 1 Month", + "original_drug": "Zaleplon", + "source": "patient" + }, + {"name": "Zaltrap INJ 100/4ML", + "supply": "1 X 4ML Vial Every 1 Month", + "original_drug": "Zaltrap", + "source": "patient" + } + ], + "preventive_services": [ + {"description": "ABDOMINAL AORTIC ANEURYSM", + "next_eligible_date": "20140201", + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "CARDIOVASCULAR", + "next_eligible_date": "20140201", + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "PPV", + "next_eligible_date": "20140201", + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "PROSTATE", + "next_eligible_date": "20140201", + "last_date_of_service": "20120326", + "source": "MyMedicare.gov" + }, + {"description": "PSA", + "next_eligible_date": "20140201", + "last_date_of_service": "20120326", + "source": "MyMedicare.gov" + }, + {"description": "ANNUAL WELLNESS VISIT", + "next_eligible_date": "20150201", + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "ALCOHOL MISUSE SCREENING", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "COLORECTAL", + "next_eligible_date": [], + "last_date_of_service": "20110421", + "source": "MyMedicare.gov" + }, + {"description": "DEPRESSION SCREENING", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "DIABETES", + "next_eligible_date": [], + "last_date_of_service": "20120521", + "source": "MyMedicare.gov" + }, + {"description": "HIGH INTENSITY BEHAVIORAL COUNSELING", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "OBESITY COUNSELING", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "PHYSICAL", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + }, + {"description": "SMOKING CESSATION (counseling to stop smoking)", + "next_eligible_date": [], + "last_date_of_service": [], + "source": "MyMedicare.gov" + } + ], + "providers": [ + {"name": "ANGELO SCOTTI", + "address": { + "line_1": "180 WHITE RD", + "line_2": [], + "city": "LITTLE SILVER", + "state": "NJ", + "zip": "07739" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "DOUGLAS KNOX", + "address": { + "line_1": "1104 E 23RD ST", + "line_2": [], + "city": "LAWRENCE", + "state": "KS", + "zip": "66046" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "SIAMAK RASSADI", + "address": { + "line_1": "1331 N 7TH ST", + "line_2": [], + "city": "PHOENIX", + "state": "AZ", + "zip": "85006" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": "Cardiac Electrophysiology,Cardiovascular Disease (Cardiology)", + "medicare_provider": "May Accept Medicare", + "source": "patient" + }, + {"name": "PETER LEAVITT", + "address": { + "line_1": "2965 NECONNERS AVE", + "line_2": [], + "city": "BEND", + "state": "OR", + "zip": "97701" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "JOHN KENNEDY", + "address": { + "line_1": "8888 KEYSTONE XING", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46240" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "REBECCA KELLY", + "address": { + "line_1": "7250 CLEARVISTA DR", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46256" + }, + "type": "Physician and Other Healthcare Professional", + "specialty": "Addiction Medicine", + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "RILEY HOSPITAL - PEDS DIALYSIS", + "address": { + "line_1": "705 RILEY HOSPITAL DRIVE", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46202" + }, + "type": "Dialysis Facility", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "FMC - SHADELAND STATION", + "address": { + "line_1": "7155 SHADELAND STATION", + "line_2": "STE 130", + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46256" + }, + "type": "Dialysis Facility", + "specialty": "Dialysis Facility", + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "IU HEALTH - HOME DIALYSIS", + "address": { + "line_1": "8803 N. MERIDIAN ST.", + "line_2": "STE 150", + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46260" + }, + "type": "Dialysis Facility", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "MESA VISTA OF BOULDER", + "address": { + "line_1": "2121 MESA DRIVE", + "line_2": [], + "city": "BOULDER", + "state": "CO", + "zip": "80304" + }, + "type": "Nursing Home", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "FAIRBANKS", + "address": { + "line_1": "8102 CLEARVISTA PARKWAY", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46256" + }, + "type": "Hospital", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "ALLIANCE HOME HEALTH SERVICES INC", + "address": { + "line_1": "9615 N COLLEGE AVE", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46280" + }, + "type": "Home Health", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "THE VIRGINIAN", + "address": { + "line_1": "9229 ARLINGTON BLVD", + "line_2": [], + "city": "FAIRFAX", + "state": "VA", + "zip": "22031" + }, + "type": "Nursing Home", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE", + "address": { + "line_1": "5226 E 82ND ST", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46250" + }, + "type": "Nursing Home", + "specialty": [], + "medicare_provider": "Yes", + "source": "patient" + }, + {"name": "INDIANA HEART HOSPITAL THE", + "address": { + "line_1": "8075 N SHADELAND AVE", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46250" + }, + "type": "Hospital", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "COMMUNITY HOSPITAL NORTH", + "address": { + "line_1": "7150 CLEARVISTA DR", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46256" + }, + "type": "Hospital", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": "FORUM AT THE CROSSING", + "address": { + "line_1": "8505 WOODFIELD CROSSING BLVD", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46240" + }, + "type": "Nursing Home", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + }, + {"name": [], + "address": { + "line_1": [], + "line_2": [], + "city": [], + "state": [], + "zip": [] + }, + "type": "Physician and Other Healthcare Professional", + "specialty": [], + "medicare_provider": "Not Available", + "source": "patient" + } + ], + "pharmacies": [ + {"name": "Castleton Integrative Health", + "address": { + "line_1": "8208 Allisonville Rd", + "line_2": [], + "city": "INDIANAPOLIS", + "state": "IN", + "zip": "46250" + }, + "phone": "317-849-1222", + "source": "patient" + }, + {"name": "Costco Pharmacy Indianapolis, IN 462506110", + "address": { + "line_1": "East 86th Street", + "line_2": [], + "city": "Castleton", + "state": "IN", + "zip": "46250" + }, + "phone": "317-558-1452", + "source": "patient" + } + ], + "insurance": [ + {"category": "Medicare", + "msp_type": [], + "contract_id_plan_id": "S1111/801", + "start_date": "20120112", + "end_date": [], + "insurer": "Medicare", + "name": [], + "marketing_name": [], + "address": [], + "type": "11 - Medicare Prescription Drug Plan", + "source": "MyMedicare.gov" + }, + {"category": "Employer Subsidy", + "msp_type": [], + "contract_id_plan_id": [], + "start_date": [], + "end_date": [], + "insurer": [], + "name": [], + "marketing_name": [], + "address": [], + "type": [], + "source": "MyMedicare.gov" + }, + {"category": "Primary Insurance", + "msp_type": [], + "contract_id_plan_id": [], + "start_date": [], + "end_date": [], + "insurer": [], + "name": [], + "marketing_name": [], + "address": [], + "type": [], + "source": "MyMedicare.gov" + }, + {"category": "Other Insurance", + "msp_type": [], + "contract_id_plan_id": "30002", + "start_date": "19841001", + "end_date": [], + "insurer": "UNITEDHEALTH GROUP", + "name": [], + "marketing_name": [], + "address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034", + "type": [], + "source": "MyMedicare.gov" + } + ], + "claims": [ + {"claim_number": "0210336239290", + "source": "MyMedicare.gov", + "type": "Part B", + "provider": { + "name": "Inova Health Services", + "provider_id": "123456789", + "provider_id_type": "National Provider ID", + "provider_billing_address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034" + }, + "date": { + "start_date": "20101102", + "end_date": "20101102" + }, + "charges": { + "price_billed": "1022.5", + "negotiated_price": "782.33", + "insurance_paid": "625.86", + "patient_responsibility": "156.47" + }, + "service": { + "name": "Name of Service Provided", + "code_system_name": "CPT", + "code_system": "2.16.840.1.113883.6.96", + "code": "28521" + }, + "diagnoses": [ + {"name": "Name of Condition", + "code_system_name": "CPT", + "code_system": "2.16.840.1.113883.6.96", + "code": "28521" + }, + {"name": "Name of Condition", + "code_system_name": "CPT", + "code_system": "2.16.840.1.113883.6.96", + "code": "5854" + } + ], + "details": [ + {"start_date": "20101102", + "end_date": "20101102", + "procedure_code": "A0428", + "procedure_description": "Description of Procedure", + "modifiers": [ + "Additional details", + "more information" + ], + "quantity": "1", + "price_billed": "275.00", + "negotiated_price": "208.99", + "patient_responsibility": "66.01", + "place_of_service_code": "41", + "place_of_service": "Ambulance - Land", + "type_of_service_code": "9", + "type_of_service": "Other Medical Services", + "rendering_provider_number": "Q335520003", + "rendering_provider_npi": "1023062544" + }, + {"start_date": "20101102", + "end_date": "20101102", + "procedure_code": "A0428", + "procedure_description": "Description of Procedure", + "modifiers": [ + "Additional details" + ], + "quantity": "1", + "price_billed": "275", + "negotiated_price": "208.99", + "patient_responsibility": "66.01", + "place_of_service_code": "41", + "place_of_service": "Ambulance - Land", + "type_of_service_code": "9", + "type_of_service": "Other Medical Services", + "rendering_provider_number": "Q335520003", + "rendering_provider_npi": "1023062544" + }, + {"start_date": "20101102", + "end_date": "20101102", + "procedure_code": "A0425", + "procedure_description": "Description of Procedure", + "modifiers": [ + "Additional details" + ], + "quantity": "44", + "price_billed": "472.5", + "negotiated_price": "364.35", + "patient_responsibility": "108.15", + "place_of_service_code": "41", + "place_of_service": "Ambulance - Land", + "type_of_service_code": "9", + "type_of_service": "Other Medical Services", + "rendering_provider_number": "Q335520003", + "rendering_provider_npi": "1023062544" + } + ] + }, + {"claim_number": "000000123456", + "source": "MyMedicare.gov", + "type": "Part D", + "pharmacy": { + "name": "Costco Pharmacy", + "provider_id": "1234567891", + "provider_id_type": "National Provider ID", + "provider_billing_address": "601 FIRST STREET, FORT WASHINGTON, PA 19034" + }, + "date": "20071002", + "drug": { + "name": "OXISTAT", + "code_system_name": "RxNorm", + "code": "00462035860", + "fill_number": "0", + "days_supply": "30" + }, + "prescriber": { + "identifier": "1111111111", + "name": "Harvey, A. McGehee" + } + } + ] } \ No newline at end of file From 8a3f7155fed87e53a8362c857d540495c6a73c1e Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Wed, 4 Mar 2015 14:38:13 -0500 Subject: [PATCH 08/15] Applied headlessCamelCase to field names MIME-Version: 1.0 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: 8bit Amended XML and JSON to use headlessCamelCase. Removed Underscores and Spaces, capitalized words and set first character of field name to lower case. ie. “Medicare Part B Effective Date” becomes medicarePartBEffectiveData” --- Medicare/medicare_bbp.json | 512 +++++++++++++++++------------------ Medicare/medicare_bbp.xml | 537 +++++++++++++++++++------------------ 2 files changed, 525 insertions(+), 524 deletions(-) diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index 23de449..ba0b92e 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -8,36 +8,36 @@ "originator": "MyMedicare.gov" }, "patient": {"name": "Ellen Harrison Lu", - "first_name": "Ellen", - "middle_name": "Harrison", - "last_name": "Lu", + "firstName": "Ellen", + "middleName": "Harrison", + "lastName": "Lu", "birthday": "19100101", - "address":{"line_1": "8115 Knuee Road", - "line_2": "Mailpoint INA1-AF-16", + "address":{"line1": "8115 Knuee Road", + "line2": "Mailpoint INA1-AF-16", "city": "Indianapolis", "state": "IN", "zip": "46250" }, - "patient_identifier": "W1234123456", + "patientIdentifier": "W1234123456", "phone": [ "215-555-0684"], - "email_address": "test_user_fh@gmail.com", + "emailAddress": "testUserFh@gmail.com", "medicare": { - "part_a_effective_date": "19850103", - "part_b_effective_date": "19850104" + "partAEffectiveDate": "19850103", + "partBEffectiveDate": "19850104" }, "source": "medicare.gov" }, - "emergency_contact": [ + "emergencyContact": [ {"name": "Billy B Bigelow", - "first_name": "Billy", - "middle_name": "B", - "last_name": "Bigelow", + "firstName": "Billy", + "middleName": "B", + "lastName": "Bigelow", "address": { "type": "Home", - "line_1": "1234 Carnival Lane", - "line_2": "Apt B", + "line1": "1234 Carnival Lane", + "line2": "Apt B", "city": "Lobster Bay", "state": "ME", "zip": "11112" @@ -52,13 +52,13 @@ "source": "patient" }, {"name": "Enoch C Snow", - "first_name": "Enoch", - "middle_name": "C", - "last_name": "Snow", + "firstName": "Enoch", + "middleName": "C", + "lastName": "Snow", "address": { "type": "Home", - "line_1": "2345 Fish Head Cove", - "line_2": "C", + "line1": "2345 Fish Head Cove", + "line2": "C", "city": "Lobster Bay", "state": "ME", "zip": "11112" @@ -73,7 +73,7 @@ "source": "patient" } ], - "medical_conditions": [ + "medicalConditions": [ {"name": "Allergies", "start": "20130129", "end": [], @@ -108,9 +108,9 @@ "severity": [], "diagnosed": [], "treatment": [], - "first_episode_date": [], - "last_episode_date": [], - "last_treatment_date": [], + "firstEpisodeDate": [], + "lastEpisodeDate": [], + "lastTreatmentDate": [], "comments": [], "source": "patient" }, @@ -120,9 +120,9 @@ "severity": "Mild", "diagnosed": "Yes", "treatment": "Other", - "first_episode_date": [], - "last_episode_date": [], - "last_treatment_date": [], + "firstEpisodeDate": [], + "lastEpisodeDate": [], + "lastTreatmentDate": [], "comments": [], "source": "patient" }, @@ -132,9 +132,9 @@ "severity": "Severe", "diagnosed": "Yes", "treatment": "Epinephrine (Epi-Pen)", - "first_episode_date": "19850321", - "last_episode_date": "20120331", - "last_treatment_date": "20120331", + "firstEpisodeDate": "19850321", + "lastEpisodeDate": "20120331", + "lastTreatmentDate": "20120331", "comments": [], "source": "patient" }, @@ -144,44 +144,44 @@ "severity": [], "diagnosed": [], "treatment": [], - "first_episode_date": [], - "last_episode_date": [], - "last_treatment_date": [], + "firstEpisodeDate": [], + "lastEpisodeDate": [], + "lastTreatmentDate": [], "comments": [], "source": "patient" } ], - "implantable_devices": [ + "implantableDevices": [ {"name": "Coronary Stent", - "implanted_date": "20051127", + "implantedDate": "20051127", "source": "patient" }, {"name": "Knee replacement", - "implanted_date": "20140202", + "implantedDate": "20140202", "source": "patient" }, {"name": "Pace maker", - "implanted_date": "20120228", + "implantedDate": "20120228", "source": "patient" }, {"name": "Foot", - "implanted_date": "19840909", + "implantedDate": "19840909", "source": "patient" }, {"name": "Hearing aid", - "implanted_date": "20130101", + "implantedDate": "20130101", "source": "patient" }, {"name": "Nov20", - "implanted_date": "20071215", + "implantedDate": "20071215", "source": "patient" } ], "immunizations": [ {"name": "Shingles", - "administered_date": "20100302", + "administeredDate": "20100302", "method": "Injection", - "vaccination_in_usa": "Yes", + "vaccinationInUsa": "Yes", "Comments": [], "boosters": [ ["20110402"], @@ -196,9 +196,9 @@ "labs": [ {"type": "Test", "date": "20130102", - "administered_by": "Inova", - "requesting_doctor": "Dr. John Doe", - "reason_requested": [], + "administeredBy": "Inova", + "requestingDoctor": "Dr. John Doe", + "reasonRequested": [], "results": [], "comments": [], "source": "patient" @@ -208,65 +208,65 @@ {"type": "Glucose", "date": "20080702", "time": "12:00 AM", - "reading_value": "322", + "readingValue": "322", "comments": [], "source": "patient" }, {"type": "Glucose", "date": "20090403", "time": "12:02 PM", - "reading_value": "24", + "readingValue": "24", "comments": "a comment", "source": "patient" }, {"type": "Glucose", "date": "20090514", "time": "12:17 PM", - "reading_value": "134", + "readingValue": "134", "comments": "another comment", "source": "patient" }, {"type": "Otro - other", "date": "19390101", "time": "12:00 AM", - "reading_value": "other", + "readingValue": "other", "comments": [], "source": "patient" }, {"type": "Pulse", "date": "20130613", "time": "12:00 AM", - "reading_value": "333", + "readingValue": "333", "comments": [], "source": "patient" }, {"type": "Pulse", "date": "20110302", "time": "12:00 AM", - "reading_value": "80", + "readingValue": "80", "comments": "commenting", "source": "patient" }, {"type": "Temperature", "date": "20090605", "time": "8:06 AM", - "reading_value": "100", + "readingValue": "100", "comments": "commenting again", "source": "patient" }, {"type": "Temperature", "date": "20080404", "time": "9:02 AM", - "reading_value": "99", + "readingValue": "99", "comments": "comments", "source": "patient" } ], - "family_history": [ + "familyHistory": [ {"relationship": "Daughter", "type": "Maternal", - "date_of_birth": "19940101", - "date_of_death": [], + "dateOfBirth": "19940101", + "dateOfDeath": [], "age": "31", "condition": [ {"type": "Allergy", @@ -283,8 +283,8 @@ }, {"relationship": "Brother", "type": "Paternal", - "date_of_birth": "20120404", - "date_of_death": [], + "dateOfBirth": "20120404", + "dateOfDeath": [], "age": [], "condition": [ {"type": "Allergy", @@ -300,448 +300,448 @@ "medications": [ {"name": "Abacavir TAB 300MG", "supply": "60 Every 1 Month", - "original_drug": "Abacavir", + "originalDrug": "Abacavir", "source": "patient" }, {"name": "Abilify Maintena INJ 300MG", "supply": "1 X Vial Every 1 Month", - "original_drug": "Abilify Maintena", + "originalDrug": "Abilify Maintena", "source": "patient" }, {"name": "Amlodipine Besylate TAB 10MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate", + "originalDrug": "Amlodipine Besylate", "source": "patient" }, {"name": "Amlodipine Besylate TAB 2.5MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate", + "originalDrug": "Amlodipine Besylate", "source": "patient" }, {"name": "Amlodipine Besylate TAB 5MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate", + "originalDrug": "Amlodipine Besylate", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "originalDrug": "Amlodipine Besylate/Atorvastatin Calcium", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "originalDrug": "Amlodipine Besylate/Atorvastatin Calcium", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "originalDrug": "Amlodipine Besylate/Atorvastatin Calcium", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "originalDrug": "Amlodipine Besylate/Atorvastatin Calcium", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG", "supply": "30 Every 1 Month", - "original_drug": "Caduet", + "originalDrug": "Caduet", "source": "patient" }, {"name": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG", "supply": "30 Every 1 Month", - "original_drug": "Amlodipine Besylate/Atorvastatin Calcium", + "originalDrug": "Amlodipine Besylate/Atorvastatin Calcium", "source": "patient" }, {"name": "Androgel Pump GEL 1.62%", "supply": "2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month", - "original_drug": "Androgel Pump", + "originalDrug": "Androgel Pump", "source": "patient" }, {"name": "Drospirenone/Ethinyl Estradiol TAB 3-0.03MG", "supply": "28 Every 1 Month", - "original_drug": "Yasmin 28", + "originalDrug": "Yasmin 28", "source": "patient" }, {"name": "Gabapentin CAP 100MG", "supply": "90 Every 1 Month", - "original_drug": "Gabapentin", + "originalDrug": "Gabapentin", "source": "patient" }, {"name": "Gabapentin SOL 250/5ML", "supply": "1 X 470ML Bottle Every 1 Month", - "original_drug": "Gabapentin", + "originalDrug": "Gabapentin", "source": "patient" }, {"name": "Jakafi TAB 10MG", "supply": "60 Every 1 Month", - "original_drug": "Jakafi", + "originalDrug": "Jakafi", "source": "patient" }, {"name": "Losartan Potassium/Hydrochlorothiazide TAB 100-25", "supply": "30 Every 1 Month", - "original_drug": "Losartan Potassium/Hydrochlorothiazide", + "originalDrug": "Losartan Potassium/Hydrochlorothiazide", "source": "patient" }, {"name": "Montelukast Sodium TAB 10MG", "supply": "90 Every 3 Month", - "original_drug": "Montelukast Sodium", + "originalDrug": "Montelukast Sodium", "source": "patient" }, {"name": "Omeprazole CAP 20MG", "supply": "30 Every 1 Month", - "original_drug": "Omeprazole", + "originalDrug": "Omeprazole", "source": "patient" }, {"name": "Rabavert INJ", "supply": "2 X Vial (sold in a package of 2) Every 12 Month", - "original_drug": "Rabavert", + "originalDrug": "Rabavert", "source": "patient" }, {"name": "Tabloid TAB 40MG", "supply": "30 Every 1 Month", - "original_drug": "Tabloid", + "originalDrug": "Tabloid", "source": "patient" }, {"name": "Vagifem TAB 10MCG", "supply": "8 Every 1 Month", - "original_drug": "Vagifem", + "originalDrug": "Vagifem", "source": "patient" }, {"name": "Zafirlukast TAB 20MG", "supply": "60 Every 1 Month", - "original_drug": "Zafirlukast", + "originalDrug": "Zafirlukast", "source": "patient" }, {"name": "Zaleplon CAP 10MG", "supply": "30 Every 1 Month", - "original_drug": "Zaleplon", + "originalDrug": "Zaleplon", "source": "patient" }, {"name": "Zaltrap INJ 100/4ML", "supply": "1 X 4ML Vial Every 1 Month", - "original_drug": "Zaltrap", + "originalDrug": "Zaltrap", "source": "patient" } ], - "preventive_services": [ + "preventiveServices": [ {"description": "ABDOMINAL AORTIC ANEURYSM", - "next_eligible_date": "20140201", - "last_date_of_service": [], + "nextEligibleDate": "20140201", + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "CARDIOVASCULAR", - "next_eligible_date": "20140201", - "last_date_of_service": [], + "nextEligibleDate": "20140201", + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "PPV", - "next_eligible_date": "20140201", - "last_date_of_service": [], + "nextEligibleDate": "20140201", + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "PROSTATE", - "next_eligible_date": "20140201", - "last_date_of_service": "20120326", + "nextEligibleDate": "20140201", + "lastDateOfService": "20120326", "source": "MyMedicare.gov" }, {"description": "PSA", - "next_eligible_date": "20140201", - "last_date_of_service": "20120326", + "nextEligibleDate": "20140201", + "lastDateOfService": "20120326", "source": "MyMedicare.gov" }, {"description": "ANNUAL WELLNESS VISIT", - "next_eligible_date": "20150201", - "last_date_of_service": [], + "nextEligibleDate": "20150201", + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "ALCOHOL MISUSE SCREENING", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "COLORECTAL", - "next_eligible_date": [], - "last_date_of_service": "20110421", + "nextEligibleDate": [], + "lastDateOfService": "20110421", "source": "MyMedicare.gov" }, {"description": "DEPRESSION SCREENING", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "DIABETES", - "next_eligible_date": [], - "last_date_of_service": "20120521", + "nextEligibleDate": [], + "lastDateOfService": "20120521", "source": "MyMedicare.gov" }, {"description": "HIGH INTENSITY BEHAVIORAL COUNSELING", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "OBESITY COUNSELING", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "PHYSICAL", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" }, {"description": "SMOKING CESSATION (counseling to stop smoking)", - "next_eligible_date": [], - "last_date_of_service": [], + "nextEligibleDate": [], + "lastDateOfService": [], "source": "MyMedicare.gov" } ], "providers": [ {"name": "ANGELO SCOTTI", "address": { - "line_1": "180 WHITE RD", - "line_2": [], + "line1": "180 WHITE RD", + "line2": [], "city": "LITTLE SILVER", "state": "NJ", "zip": "07739" }, "type": "Physician and Other Healthcare Professional", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "DOUGLAS KNOX", "address": { - "line_1": "1104 E 23RD ST", - "line_2": [], + "line1": "1104 E 23RD ST", + "line2": [], "city": "LAWRENCE", "state": "KS", "zip": "66046" }, "type": "Physician and Other Healthcare Professional", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "SIAMAK RASSADI", "address": { - "line_1": "1331 N 7TH ST", - "line_2": [], + "line1": "1331 N 7TH ST", + "line2": [], "city": "PHOENIX", "state": "AZ", "zip": "85006" }, "type": "Physician and Other Healthcare Professional", "specialty": "Cardiac Electrophysiology,Cardiovascular Disease (Cardiology)", - "medicare_provider": "May Accept Medicare", + "medicareProvider": "May Accept Medicare", "source": "patient" }, {"name": "PETER LEAVITT", "address": { - "line_1": "2965 NECONNERS AVE", - "line_2": [], + "line1": "2965 NECONNERS AVE", + "line2": [], "city": "BEND", "state": "OR", "zip": "97701" }, "type": "Physician and Other Healthcare Professional", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "JOHN KENNEDY", "address": { - "line_1": "8888 KEYSTONE XING", - "line_2": [], + "line1": "8888 KEYSTONE XING", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46240" }, "type": "Physician and Other Healthcare Professional", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "REBECCA KELLY", "address": { - "line_1": "7250 CLEARVISTA DR", - "line_2": [], + "line1": "7250 CLEARVISTA DR", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" }, "type": "Physician and Other Healthcare Professional", "specialty": "Addiction Medicine", - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "RILEY HOSPITAL - PEDS DIALYSIS", "address": { - "line_1": "705 RILEY HOSPITAL DRIVE", - "line_2": [], + "line1": "705 RILEY HOSPITAL DRIVE", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46202" }, "type": "Dialysis Facility", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "FMC - SHADELAND STATION", "address": { - "line_1": "7155 SHADELAND STATION", - "line_2": "STE 130", + "line1": "7155 SHADELAND STATION", + "line2": "STE 130", "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" }, "type": "Dialysis Facility", "specialty": "Dialysis Facility", - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "IU HEALTH - HOME DIALYSIS", "address": { - "line_1": "8803 N. MERIDIAN ST.", - "line_2": "STE 150", + "line1": "8803 N. MERIDIAN ST.", + "line2": "STE 150", "city": "INDIANAPOLIS", "state": "IN", "zip": "46260" }, "type": "Dialysis Facility", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "MESA VISTA OF BOULDER", "address": { - "line_1": "2121 MESA DRIVE", - "line_2": [], + "line1": "2121 MESA DRIVE", + "line2": [], "city": "BOULDER", "state": "CO", "zip": "80304" }, "type": "Nursing Home", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "FAIRBANKS", "address": { - "line_1": "8102 CLEARVISTA PARKWAY", - "line_2": [], + "line1": "8102 CLEARVISTA PARKWAY", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" }, "type": "Hospital", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "ALLIANCE HOME HEALTH SERVICES INC", "address": { - "line_1": "9615 N COLLEGE AVE", - "line_2": [], + "line1": "9615 N COLLEGE AVE", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46280" }, "type": "Home Health", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "THE VIRGINIAN", "address": { - "line_1": "9229 ARLINGTON BLVD", - "line_2": [], + "line1": "9229 ARLINGTON BLVD", + "line2": [], "city": "FAIRFAX", "state": "VA", "zip": "22031" }, "type": "Nursing Home", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE", "address": { - "line_1": "5226 E 82ND ST", - "line_2": [], + "line1": "5226 E 82ND ST", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" }, "type": "Nursing Home", "specialty": [], - "medicare_provider": "Yes", + "medicareProvider": "Yes", "source": "patient" }, {"name": "INDIANA HEART HOSPITAL THE", "address": { - "line_1": "8075 N SHADELAND AVE", - "line_2": [], + "line1": "8075 N SHADELAND AVE", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" }, "type": "Hospital", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "COMMUNITY HOSPITAL NORTH", "address": { - "line_1": "7150 CLEARVISTA DR", - "line_2": [], + "line1": "7150 CLEARVISTA DR", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" }, "type": "Hospital", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": "FORUM AT THE CROSSING", "address": { - "line_1": "8505 WOODFIELD CROSSING BLVD", - "line_2": [], + "line1": "8505 WOODFIELD CROSSING BLVD", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46240" }, "type": "Nursing Home", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" }, {"name": [], "address": { - "line_1": [], - "line_2": [], + "line1": [], + "line2": [], "city": [], "state": [], "zip": [] }, "type": "Physician and Other Healthcare Professional", "specialty": [], - "medicare_provider": "Not Available", + "medicareProvider": "Not Available", "source": "patient" } ], "pharmacies": [ {"name": "Castleton Integrative Health", "address": { - "line_1": "8208 Allisonville Rd", - "line_2": [], + "line1": "8208 Allisonville Rd", + "line2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" @@ -751,8 +751,8 @@ }, {"name": "Costco Pharmacy Indianapolis, IN 462506110", "address": { - "line_1": "East 86th Street", - "line_2": [], + "line1": "East 86th Street", + "line2": [], "city": "Castleton", "state": "IN", "zip": "46250" @@ -763,166 +763,166 @@ ], "insurance": [ {"category": "Medicare", - "msp_type": [], - "contract_id_plan_id": "S1111/801", - "start_date": "20120112", - "end_date": [], + "mspType": [], + "contractIdPlanId": "S1111/801", + "startDate": "20120112", + "endDate": [], "insurer": "Medicare", "name": [], - "marketing_name": [], + "marketingName": [], "address": [], "type": "11 - Medicare Prescription Drug Plan", "source": "MyMedicare.gov" }, {"category": "Employer Subsidy", - "msp_type": [], - "contract_id_plan_id": [], - "start_date": [], - "end_date": [], + "mspType": [], + "contractIdPlanId": [], + "startDate": [], + "endDate": [], "insurer": [], "name": [], - "marketing_name": [], + "marketingName": [], "address": [], "type": [], "source": "MyMedicare.gov" }, {"category": "Primary Insurance", - "msp_type": [], - "contract_id_plan_id": [], - "start_date": [], - "end_date": [], + "mspType": [], + "contractIdPlanId": [], + "startDate": [], + "endDate": [], "insurer": [], "name": [], - "marketing_name": [], + "marketingName": [], "address": [], "type": [], "source": "MyMedicare.gov" }, {"category": "Other Insurance", - "msp_type": [], - "contract_id_plan_id": "30002", - "start_date": "19841001", - "end_date": [], + "mspType": [], + "contractIdPlanId": "30002", + "startDate": "19841001", + "endDate": [], "insurer": "UNITEDHEALTH GROUP", "name": [], - "marketing_name": [], + "marketingName": [], "address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034", "type": [], "source": "MyMedicare.gov" } ], "claims": [ - {"claim_number": "0210336239290", + {"claimNumber": "0210336239290", "source": "MyMedicare.gov", "type": "Part B", "provider": { "name": "Inova Health Services", - "provider_id": "123456789", - "provider_id_type": "National Provider ID", - "provider_billing_address": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034" + "providerId": "123456789", + "providerIdType": "National Provider ID", + "providerBillingAddress": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034" }, "date": { - "start_date": "20101102", - "end_date": "20101102" + "startDate": "20101102", + "endDate": "20101102" }, "charges": { - "price_billed": "1022.5", - "negotiated_price": "782.33", - "insurance_paid": "625.86", - "patient_responsibility": "156.47" + "priceBilled": "1022.5", + "negotiatedPrice": "782.33", + "insurancePaid": "625.86", + "patientResponsibility": "156.47" }, "service": { "name": "Name of Service Provided", - "code_system_name": "CPT", - "code_system": "2.16.840.1.113883.6.96", + "codeSystemName": "CPT", + "codeSystem": "2.16.840.1.113883.6.96", "code": "28521" }, "diagnoses": [ {"name": "Name of Condition", - "code_system_name": "CPT", - "code_system": "2.16.840.1.113883.6.96", + "codeSystemName": "CPT", + "codeSystem": "2.16.840.1.113883.6.96", "code": "28521" }, {"name": "Name of Condition", - "code_system_name": "CPT", - "code_system": "2.16.840.1.113883.6.96", + "codeSystemName": "CPT", + "codeSystem": "2.16.840.1.113883.6.96", "code": "5854" } ], "details": [ - {"start_date": "20101102", - "end_date": "20101102", - "procedure_code": "A0428", - "procedure_description": "Description of Procedure", + {"startDate": "20101102", + "endDate": "20101102", + "procedureCode": "A0428", + "procedureDescription": "Description of Procedure", "modifiers": [ "Additional details", "more information" ], "quantity": "1", - "price_billed": "275.00", - "negotiated_price": "208.99", - "patient_responsibility": "66.01", - "place_of_service_code": "41", - "place_of_service": "Ambulance - Land", - "type_of_service_code": "9", - "type_of_service": "Other Medical Services", - "rendering_provider_number": "Q335520003", - "rendering_provider_npi": "1023062544" - }, - {"start_date": "20101102", - "end_date": "20101102", - "procedure_code": "A0428", - "procedure_description": "Description of Procedure", + "priceBilled": "275.00", + "negotiatedPrice": "208.99", + "patientResponsibility": "66.01", + "placeOfServiceCode": "41", + "placeOfService": "Ambulance - Land", + "typeOfServiceCode": "9", + "typeOfService": "Other Medical Services", + "renderingProviderNumber": "Q335520003", + "renderingProviderNpi": "1023062544" + }, + {"startDate": "20101102", + "endDate": "20101102", + "procedureCode": "A0428", + "procedureDescription": "Description of Procedure", "modifiers": [ "Additional details" ], "quantity": "1", - "price_billed": "275", - "negotiated_price": "208.99", - "patient_responsibility": "66.01", - "place_of_service_code": "41", - "place_of_service": "Ambulance - Land", - "type_of_service_code": "9", - "type_of_service": "Other Medical Services", - "rendering_provider_number": "Q335520003", - "rendering_provider_npi": "1023062544" - }, - {"start_date": "20101102", - "end_date": "20101102", - "procedure_code": "A0425", - "procedure_description": "Description of Procedure", + "priceBilled": "275", + "negotiatedPrice": "208.99", + "patientResponsibility": "66.01", + "placeOfServiceCode": "41", + "placeOfService": "Ambulance - Land", + "typeOfServiceCode": "9", + "typeOfService": "Other Medical Services", + "renderingProviderNumber": "Q335520003", + "renderingProviderNpi": "1023062544" + }, + {"startDate": "20101102", + "endDate": "20101102", + "procedureCode": "A0425", + "procedureDescription": "Description of Procedure", "modifiers": [ "Additional details" ], "quantity": "44", - "price_billed": "472.5", - "negotiated_price": "364.35", - "patient_responsibility": "108.15", - "place_of_service_code": "41", - "place_of_service": "Ambulance - Land", - "type_of_service_code": "9", - "type_of_service": "Other Medical Services", - "rendering_provider_number": "Q335520003", - "rendering_provider_npi": "1023062544" + "priceBilled": "472.5", + "negotiatedPrice": "364.35", + "patientResponsibility": "108.15", + "placeOfServiceCode": "41", + "placeOfService": "Ambulance - Land", + "typeOfServiceCode": "9", + "typeOfService": "Other Medical Services", + "renderingProviderNumber": "Q335520003", + "renderingProviderNpi": "1023062544" } ] }, - {"claim_number": "000000123456", + {"claimNumber": "000000123456", "source": "MyMedicare.gov", "type": "Part D", "pharmacy": { "name": "Costco Pharmacy", - "provider_id": "1234567891", - "provider_id_type": "National Provider ID", - "provider_billing_address": "601 FIRST STREET, FORT WASHINGTON, PA 19034" + "providerId": "1234567891", + "providerIdType": "National Provider ID", + "providerBillingAddress": "601 FIRST STREET, FORT WASHINGTON, PA 19034" }, "date": "20071002", "drug": { "name": "OXISTAT", - "code_system_name": "RxNorm", + "codeSystemName": "RxNorm", "code": "00462035860", - "fill_number": "0", - "days_supply": "30" + "fillNumber": "0", + "daysSupply": "30" }, "prescriber": { "identifier": "1111111111", diff --git a/Medicare/medicare_bbp.xml b/Medicare/medicare_bbp.xml index 543dc93..2352d19 100644 --- a/Medicare/medicare_bbp.xml +++ b/Medicare/medicare_bbp.xml @@ -1,14 +1,15 @@ - +
MyMedicare.gov Personal Health Information code="en-US" @@ -19,38 +20,38 @@
Ellen Harrison Lu - Ellen - Harrison - Lu + Ellen + Harrison + Lu 19100101
- 8115 Knuee Road - Mailpoint INA1-AF-16 + 8115 Knuee Road + Mailpoint INA1-AF-16 Indianapolis IN 46250
- W1234123456 + W1234123456 215-555-0684 - test_user_fh@gmail.com + testUser_fh@gmail.com - 19850103 - 19850104 + 19850103 + 19850104 medicare.gov - + Billy B Bigelow - Billy - B - Bigelow + Billy + B + Bigelow
Home - 1234 Carnival Lane - Apt B + 1234 Carnival Lane + Apt B Lobster Bay ME 11112 @@ -61,18 +62,18 @@ 123-456-7891 123-456-7892 - billy.bigelow@example.com + billy.bigelow@example.com patient Enoch C Snow - Enoch - C - Snow + Enoch + C + Snow
Home - 2345 Fish Head Cove - C + 2345 Fish Head Cove + C Lobster Bay ME 11112 @@ -83,11 +84,11 @@ 123-456-7891 123-456-7892 - esnoww@example.com + esnoww@example.com patient - - + + Allergies 20130129 @@ -118,7 +119,7 @@ patient - + Antibiotic @@ -127,9 +128,9 @@ - - - + + + patient @@ -140,9 +141,9 @@ Mild Yes Other - - - + + + patient @@ -153,9 +154,9 @@ Severe Yes Epinephrine (Epi-Pen) - 19850321 - 20120331 - 20120331 + 19850321 + 20120331 + 20120331 patient @@ -166,51 +167,51 @@ - - - + + + patient - + Coronary Stent - 20051127 + 20051127 patient Knee replacement - 20140202 + 20140202 patient Pace maker - 20120228 + 20120228 patient Foot - 19840909 + 19840909 patient Hearing aid - 20130101 + 20130101 patient Nov20 - 20071215 + 20071215 patient - + Shingles - 20100302 + 20100302 Injection - Yes + Yes @@ -227,23 +228,23 @@ - + Test 20130102 - Inova - Dr. John Doe - + Inova + Dr. John Doe + patient - + Glucose 20080702 - 322 + 322 patient @@ -251,7 +252,7 @@ Glucose 20090403 - 24 + 24 a comment patient @@ -259,7 +260,7 @@ Glucose 20090514 - 134 + 134 another comment patient @@ -267,7 +268,7 @@ Otro - other 19390101 - other + other patient @@ -275,7 +276,7 @@ Pulse 20130613 - 333 + 333 patient @@ -283,7 +284,7 @@ Pulse 20110302 - 80 + 80 commenting patient @@ -291,7 +292,7 @@ Temperature 20090605 - 100 + 100 commenting again patient @@ -299,17 +300,17 @@ Temperature 20080404 - 99 + 99 comments patient - + Daughter Maternal - 19940101 - + 19940101 + 31 Allergy @@ -324,12 +325,12 @@ patient - - + + Brother Paternal - 20120404 - + 20120404 + Allergy @@ -340,503 +341,503 @@ Alzheimer's Disease patient - + Abacavir TAB 300MG 60 Every 1 Month - Abacavir + Abacavir patient Abilify Maintena INJ 300MG 1 X Vial Every 1 Month - Abilify Maintena + Abilify Maintena patient Amlodipine Besylate TAB 10MG 30 Every 1 Month - Amlodipine Besylate + Amlodipine Besylate patient Amlodipine Besylate TAB 2.5MG 30 Every 1 Month - Amlodipine Besylate + Amlodipine Besylate patient Amlodipine Besylate TAB 5MG 30 Every 1 Month - Amlodipine Besylate + Amlodipine Besylate patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG 30 Every 1 Month - Amlodipine Besylate/Atorvastatin Calcium + Amlodipine Besylate/Atorvastatin Calcium patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG 30 Every 1 Month - Amlodipine Besylate/Atorvastatin Calcium + Amlodipine Besylate/Atorvastatin Calcium patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG 30 Every 1 Month - Amlodipine Besylate/Atorvastatin Calcium + Amlodipine Besylate/Atorvastatin Calcium patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG 30 Every 1 Month - Amlodipine Besylate/Atorvastatin Calcium + Amlodipine Besylate/Atorvastatin Calcium patient Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG 30 Every 1 Month - Caduet + Caduet patient Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG 30 Every 1 Month - Amlodipine Besylate/Atorvastatin Calcium + Amlodipine Besylate/Atorvastatin Calcium patient Androgel Pump GEL 1.62% 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month - Androgel Pump + Androgel Pump patient Drospirenone/Ethinyl Estradiol TAB 3-0.03MG 28 Every 1 Month - Yasmin 28 + Yasmin 28 patient Gabapentin CAP 100MG 90 Every 1 Month - Gabapentin + Gabapentin patient Gabapentin SOL 250/5ML 1 X 470ML Bottle Every 1 Month - Gabapentin + Gabapentin patient Jakafi TAB 10MG 60 Every 1 Month - Jakafi + Jakafi patient Losartan Potassium/Hydrochlorothiazide TAB 100-25 30 Every 1 Month - Losartan Potassium/Hydrochlorothiazide + Losartan Potassium/Hydrochlorothiazide patient Montelukast Sodium TAB 10MG 90 Every 3 Month - Montelukast Sodium + Montelukast Sodium patient Omeprazole CAP 20MG 30 Every 1 Month - Omeprazole + Omeprazole patient Rabavert INJ 2 X Vial (sold in a package of 2) Every 12 Month - Rabavert + Rabavert patient Tabloid TAB 40MG 30 Every 1 Month - Tabloid + Tabloid patient Vagifem TAB 10MCG 8 Every 1 Month - Vagifem + Vagifem patient Zafirlukast TAB 20MG 60 Every 1 Month - Zafirlukast + Zafirlukast patient Zaleplon CAP 10MG 30 Every 1 Month - Zaleplon + Zaleplon patient Zaltrap INJ 100/4ML 1 X 4ML Vial Every 1 Month - Zaltrap + Zaltrap patient - + ABDOMINAL AORTIC ANEURYSM - 20140201 - + 20140201 + MyMedicare.gov CARDIOVASCULAR - 20140201 - + 20140201 + MyMedicare.gov PPV - 20140201 - + 20140201 + MyMedicare.gov PROSTATE - 20140201 - 20120326 + 20140201 + 20120326 MyMedicare.gov PSA - 20140201 - 20120326 + 20140201 + 20120326 MyMedicare.gov ANNUAL WELLNESS VISIT - 20150201 - + 20150201 + MyMedicare.gov ALCOHOL MISUSE SCREENING - - + + MyMedicare.gov CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) - - + + MyMedicare.gov COLORECTAL - - 20110421 + + 20110421 MyMedicare.gov DEPRESSION SCREENING - - + + MyMedicare.gov DIABETES - - 20120521 + + 20120521 MyMedicare.gov HIGH INTENSITY BEHAVIORAL COUNSELING - - + + MyMedicare.gov OBESITY COUNSELING - - + + MyMedicare.gov PHYSICAL - - + + MyMedicare.gov SMOKING CESSATION (counseling to stop smoking) - - + + MyMedicare.gov - + ANGELO SCOTTI
- 180 WHITE RD - + 180 WHITE RD + LITTLE SILVER NJ 07739
Physician and Other Healthcare Professional - Yes + Yes patient DOUGLAS KNOX
- 1104 E 23RD ST - + 1104 E 23RD ST + LAWRENCE KS 66046
Physician and Other Healthcare Professional - Yes + Yes patient SIAMAK RASSADI
- 1331 N 7TH ST - + 1331 N 7TH ST + PHOENIX AZ 85006
Physician and Other Healthcare Professional Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) - May Accept Medicare + May Accept Medicare patient PETER LEAVITT
- 2965 NECONNERS AVE - + 2965 NECONNERS AVE + BEND OR 97701
Physician and Other Healthcare Professional - Yes + Yes patient JOHN KENNEDY
- 8888 KEYSTONE XING - + 8888 KEYSTONE XING + INDIANAPOLIS IN 46240
Physician and Other Healthcare Professional - Yes + Yes patient REBECCA KELLY
- 7250 CLEARVISTA DR - + 7250 CLEARVISTA DR + INDIANAPOLIS IN 46256
Physician and Other Healthcare Professional Addiction Medicine - Yes + Yes patient RILEY HOSPITAL - PEDS DIALYSIS
- 705 RILEY HOSPITAL DRIVE - + 705 RILEY HOSPITAL DRIVE + INDIANAPOLIS IN 46202
Dialysis Facility - Not Available + Not Available patient FMC - SHADELAND STATION
- 7155 SHADELAND STATION - STE 130 + 7155 SHADELAND STATION + STE 130 INDIANAPOLIS IN 46256
Dialysis Facility Dialysis Facility - Not Available + Not Available patient IU HEALTH - HOME DIALYSIS
- 8803 N. MERIDIAN ST. - STE 150 + 8803 N. MERIDIAN ST. + STE 150 INDIANAPOLIS IN 46260
Dialysis Facility - Not Available + Not Available patient MESA VISTA OF BOULDER
- 2121 MESA DRIVE - + 2121 MESA DRIVE + BOULDER CO 80304
Nursing Home - Yes + Yes patient FAIRBANKS
- 8102 CLEARVISTA PARKWAY - + 8102 CLEARVISTA PARKWAY + INDIANAPOLis IN 46256
Hospital - Not Available + Not Available patient ALLIANCE HOME HEALTH SERVICES INC
- 9615 N COLLEGE AVE - + 9615 N COLLEGE AVE + INDIANAPOLIS IN 46280
Home Health - Not Available + Not Available patient THE VIRGINIAN
- 9229 ARLINGTON BLVD - + 9229 ARLINGTON BLVD + FAIRFAX VA 22031
Nursing Home - Yes + Yes patient KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE
- 5226 E 82ND ST - + 5226 E 82ND ST + INDIANAPOLIS IN 46250
Nursing Home - Yes + Yes patient INDIANA HEART HOSPITAL THE
- 8075 N SHADELAND AVE - + 8075 N SHADELAND AVE + INDIANAPOLIS IN 46250
Hospital - Not Available + Not Available patient COMMUNITY HOSPITAL NORTH
- 7150 CLEARVISTA DR - + 7150 CLEARVISTA DR + INDIANAPOLIS IN 46256
Hospital - Not Available + Not Available patient FORUM AT THE CROSSING
- 8505 WOODFIELD CROSSING BLVD - + 8505 WOODFIELD CROSSING BLVD + INDIANAPOLIS IN 46240
Nursing Home - Not Available + Not Available patient
- - + +
Physician and Other Healthcare Professional - Not Available + Not Available patient @@ -844,8 +845,8 @@ Castleton Integrative Health
- 8208 Allisonville Rd - + 8208 Allisonville Rd + INDIANAPOLIS IN 46250 @@ -856,8 +857,8 @@ Costco Pharmacy Indianapolis, IN 462506110
- East 86th Street - + East 86th Street + Castleton IN 46250 @@ -869,52 +870,52 @@ Medicare - - S1111/801 - 20120112 - + + S1111/801 + 20120112 + Medicare - +
11 - Medicare Prescription Drug Plan MyMedicare.gov Employer Subsidy - - - - + + + + - +
MyMedicare.gov Primary Insurance - - - - + + + + - +
MyMedicare.gov Other Insurance - - 30002 - 19841001 - + + 30002 + 19841001 + UNITEDHEALTH GROUP - +
601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034
MyMedicare.gov @@ -922,119 +923,119 @@ - 0210336239290 + 0210336239290 MyMedicare.gov Part B Inova Health Services - 123456789 - National Provider ID - 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 + 123456789 + National Provider ID + 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 - 20101102 - 20101102 + 20101102 + 20101102 - 1022.5 - 782.33 - 625.86 - 156.47 + 1022.5 + 782.33 + 625.86 + 156.47 Name of Service Provided - CPT - 2.16.840.1.113883.6.96 + CPT + 2.16.840.1.113883.6.96 28521 Name of Condition - CPT - 2.16.840.1.113883.6.96 + CPT + 2.16.840.1.113883.6.96 28521 Name of Condition - CPT - 2.16.840.1.113883.6.96 + CPT + 2.16.840.1.113883.6.96 5854
- 20101102 - 20101102 - A0428 - Description of Procedure + 20101102 + 20101102 + A0428 + Description of Procedure Additional details more information 1 - 275.00 - 208.99 - 66.01 - 41 - Ambulance - Land - 9 - Other Medical Services - Q335520003 - 1023062544 + 275.00 + 208.99 + 66.01 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544
- 20101102 - 20101102 - A0428 - Description of Procedure + 20101102 + 20101102 + A0428 + Description of Procedure Additional details 1 - 275 - 208.99 - 66.01 - 41 - Ambulance - Land - 9 - Other Medical Services - Q335520003 - 1023062544 + 275 + 208.99 + 66.01 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544
- 20101102 - 20101102 - A0425 - Description of Procedure + 20101102 + 20101102 + A0425 + Description of Procedure Additional details 44 - 472.5 - 364.35 - 108.15 - 41 - Ambulance - Land - 9 - Other Medical Services - Q335520003 - 1023062544 + 472.5 + 364.35 + 108.15 + 41 + Ambulance - Land + 9 + Other Medical Services + Q335520003 + 1023062544
- 000000123456 + 000000123456 MyMedicare.gov Part D Costco Pharmacy - 1234567891 - National Provider ID - 601 FIRST STREET, FORT WASHINGTON, PA 19034 + 1234567891 + National Provider ID + 601 FIRST STREET, FORT WASHINGTON, PA 19034 20071002 OXISTAT - RxNorm + RxNorm 00462035860 - 0 - 30 + 0 + 30 1111111111 @@ -1042,4 +1043,4 @@ - \ No newline at end of file + \ No newline at end of file From b20af522c4ab5f0457eeb47212491d133b111bbd Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Wed, 4 Mar 2015 14:47:28 -0500 Subject: [PATCH 09/15] Updated README.md noted use of headlessCamelCase --- README.md | 3 +++ 1 file changed, 3 insertions(+) diff --git a/README.md b/README.md index 7749271..44fb264 100644 --- a/README.md +++ b/README.md @@ -6,6 +6,9 @@ Exploring JSON representation for claims data. A sample BlueButton Test file (medicare/medicare_bbp.txt) from MyMedicare.gov has been used to create a medicare_bbp.xml and medicare_bbp.json format. This has been based on the claims.xml file that was initially created by Ryan Panchadsaram. +Latest change is to change field names to headlessCamelCase. ie. "Medicare Part B Effective Date" becomes "medicarePartBEffectiveDate". + + Objective --------- From 8b35084e325ac0dc423f9f70eeb50fffc4a8daea Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Mar 2015 11:50:45 -0400 Subject: [PATCH 10/15] Change Birthday to dateOfBirth Changing birthday in Patient segment to dateOfBirth for easier translation --- Medicare/medicare_bbp.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index ba0b92e..873c05c 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -11,7 +11,7 @@ "firstName": "Ellen", "middleName": "Harrison", "lastName": "Lu", - "birthday": "19100101", + "dateOfBirth": "19100101", "address":{"line1": "8115 Knuee Road", "line2": "Mailpoint INA1-AF-16", "city": "Indianapolis", From 27cd990c99579d7effb1e7f05c9b12d675d84540 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Mar 2015 12:00:12 -0400 Subject: [PATCH 11/15] Update Address Format Changing line1 / line2 to addressLine1 / addressLine2 for simplified translation. --- Medicare/medicare_bbp.json | 8 ++++---- 1 file changed, 4 insertions(+), 4 deletions(-) diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index 873c05c..4ee3964 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -12,8 +12,8 @@ "middleName": "Harrison", "lastName": "Lu", "dateOfBirth": "19100101", - "address":{"line1": "8115 Knuee Road", - "line2": "Mailpoint INA1-AF-16", + "address":{"addressLine1": "8115 Knuee Road", + "addressLine2": "Mailpoint INA1-AF-16", "city": "Indianapolis", "state": "IN", "zip": "46250" @@ -36,8 +36,8 @@ "lastName": "Bigelow", "address": { "type": "Home", - "line1": "1234 Carnival Lane", - "line2": "Apt B", + "AddressLine1": "1234 Carnival Lane", + "AddressLine2": "Apt B", "city": "Lobster Bay", "state": "ME", "zip": "11112" From 51b538f214fa64b5833375d13af8f5f943de9736 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 10 Mar 2015 18:57:23 -0400 Subject: [PATCH 12/15] Minor changes to field names Simplifying translation from CMS Medicare v2.0 text file --- Medicare/medicare_bbp.json | 24 ++++++++++++------------ 1 file changed, 12 insertions(+), 12 deletions(-) diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index 4ee3964..39cd906 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -30,14 +30,14 @@ "source": "medicare.gov" }, "emergencyContact": [ - {"name": "Billy B Bigelow", + {"contactName": "Billy B Bigelow", "firstName": "Billy", "middleName": "B", "lastName": "Bigelow", "address": { - "type": "Home", - "AddressLine1": "1234 Carnival Lane", - "AddressLine2": "Apt B", + "addressType": "Home", + "addressLine1": "1234 Carnival Lane", + "addressLine2": "Apt B", "city": "Lobster Bay", "state": "ME", "zip": "11112" @@ -51,14 +51,14 @@ "email": "billy.bigelow@example.com", "source": "patient" }, - {"name": "Enoch C Snow", + {"contactName": "Enoch C Snow", "firstName": "Enoch", "middleName": "C", "lastName": "Snow", "address": { - "type": "Home", - "line1": "2345 Fish Head Cove", - "line2": "C", + "addressType": "Home", + "addressLine1": "2345 Fish Head Cove", + "addressLine2": "C", "city": "Lobster Bay", "state": "ME", "zip": "11112" @@ -738,10 +738,10 @@ } ], "pharmacies": [ - {"name": "Castleton Integrative Health", + {"pharmacyName": "Castleton Integrative Health", "address": { "line1": "8208 Allisonville Rd", - "line2": [], + "line2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" @@ -749,10 +749,10 @@ "phone": "317-849-1222", "source": "patient" }, - {"name": "Costco Pharmacy Indianapolis, IN 462506110", + {"pharmacyName": "Costco Pharmacy Indianapolis, IN 462506110", "address": { "line1": "East 86th Street", - "line2": [], + "line2":"", "city": "Castleton", "state": "IN", "zip": "46250" From 240b14a6ddb117f6def2983d74b3c1be357d63e6 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Sat, 28 Mar 2015 17:47:25 -0400 Subject: [PATCH 13/15] =?UTF-8?q?Updated=20medicare=20formats=20with=20v2?= =?UTF-8?q?=20versions.=20Also=20removed=20=E2=80=9C/=E2=80=9C=20from=20fi?= =?UTF-8?q?eld=20names?= MIME-Version: 1.0 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: 8bit --- Medicare/medicare_bbp.json | 172 ++--- Medicare/medicare_bbp.xml | 92 +-- Medicare/medicare_bbp_v2.json | 1365 +++++++++++++++++++++++++++++++++ Medicare/medicare_bbp_v2.xml | 1251 ++++++++++++++++++++++++++++++ README.md | 9 +- 5 files changed, 2755 insertions(+), 134 deletions(-) create mode 100644 Medicare/medicare_bbp_v2.json create mode 100644 Medicare/medicare_bbp_v2.xml diff --git a/Medicare/medicare_bbp.json b/Medicare/medicare_bbp.json index 39cd906..dea1b34 100644 --- a/Medicare/medicare_bbp.json +++ b/Medicare/medicare_bbp.json @@ -21,7 +21,7 @@ "patientIdentifier": "W1234123456", "phone": [ "215-555-0684"], - "emailAddress": "testUserFh@gmail.com", + "email": "testUserFh@gmail.com", "medicare": { "partAEffectiveDate": "19850103", @@ -48,7 +48,7 @@ "work": "123-456-7891", "mobile": "123-456-7892" }, - "email": "billy.bigelow@example.com", + "emailAddress": "billy.bigelow@example.com", "source": "patient" }, {"contactName": "Enoch C Snow", @@ -69,14 +69,14 @@ "work": "123-456-7891", "mobile": "123-456-7892" }, - "email": "esnoww@example.com", + "emailAddress": "esnoww@example.com", "source": "patient" } ], "medicalConditions": [ {"name": "Allergies", "start": "20130129", - "end": [], + "end": "", "source": "patient" }, {"name": "Arthritis", @@ -92,12 +92,12 @@ }, {"name": "Other", "start": "20110102", - "end": [], + "end": "", "source": "patient" }, {"name": "Other", "start": "20120228", - "end": [], + "end": "", "source": "patient" } ], @@ -108,9 +108,9 @@ "severity": [], "diagnosed": [], "treatment": [], - "firstEpisodeDate": [], - "lastEpisodeDate": [], - "lastTreatmentDate": [], + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", "comments": [], "source": "patient" }, @@ -120,9 +120,9 @@ "severity": "Mild", "diagnosed": "Yes", "treatment": "Other", - "firstEpisodeDate": [], - "lastEpisodeDate": [], - "lastTreatmentDate": [], + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", "comments": [], "source": "patient" }, @@ -144,9 +144,9 @@ "severity": [], "diagnosed": [], "treatment": [], - "firstEpisodeDate": [], - "lastEpisodeDate": [], - "lastTreatmentDate": [], + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", "comments": [], "source": "patient" } @@ -186,9 +186,7 @@ "boosters": [ ["20110402"], ["20120604"], - [ - [] - ] + [""] ], "source": "patient" } @@ -266,7 +264,7 @@ {"relationship": "Daughter", "type": "Maternal", "dateOfBirth": "19940101", - "dateOfDeath": [], + "dateOfDeath": "", "age": "31", "condition": [ {"type": "Allergy", @@ -284,7 +282,7 @@ {"relationship": "Brother", "type": "Paternal", "dateOfBirth": "20120404", - "dateOfDeath": [], + "dateOfDeath": "", "age": [], "condition": [ {"type": "Allergy", @@ -427,17 +425,17 @@ "preventiveServices": [ {"description": "ABDOMINAL AORTIC ANEURYSM", "nextEligibleDate": "20140201", - "lastDateOfService": [], + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "CARDIOVASCULAR", "nextEligibleDate": "20140201", - "lastDateOfService": [], + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "PPV", "nextEligibleDate": "20140201", - "lastDateOfService": [], + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "PROSTATE", @@ -452,60 +450,60 @@ }, {"description": "ANNUAL WELLNESS VISIT", "nextEligibleDate": "20150201", - "lastDateOfService": [], + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "ALCOHOL MISUSE SCREENING", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "COLORECTAL", - "nextEligibleDate": [], + "nextEligibleDate": "", "lastDateOfService": "20110421", "source": "MyMedicare.gov" }, {"description": "DEPRESSION SCREENING", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "DIABETES", - "nextEligibleDate": [], + "nextEligibleDate": "", "lastDateOfService": "20120521", "source": "MyMedicare.gov" }, {"description": "HIGH INTENSITY BEHAVIORAL COUNSELING", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "OBESITY COUNSELING", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "PHYSICAL", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" }, {"description": "SMOKING CESSATION (counseling to stop smoking)", - "nextEligibleDate": [], - "lastDateOfService": [], + "nextEligibleDate": "", + "lastDateOfService": "", "source": "MyMedicare.gov" } ], "providers": [ {"name": "ANGELO SCOTTI", "address": { - "line1": "180 WHITE RD", - "line2": [], + "addressLine1": "180 WHITE RD", + "addressLine2": "", "city": "LITTLE SILVER", "state": "NJ", "zip": "07739" @@ -517,8 +515,8 @@ }, {"name": "DOUGLAS KNOX", "address": { - "line1": "1104 E 23RD ST", - "line2": [], + "addressLine1": "1104 E 23RD ST", + "addressLine2": "", "city": "LAWRENCE", "state": "KS", "zip": "66046" @@ -530,8 +528,8 @@ }, {"name": "SIAMAK RASSADI", "address": { - "line1": "1331 N 7TH ST", - "line2": [], + "addressLine1": "1331 N 7TH ST", + "addressLine2": "", "city": "PHOENIX", "state": "AZ", "zip": "85006" @@ -543,21 +541,21 @@ }, {"name": "PETER LEAVITT", "address": { - "line1": "2965 NECONNERS AVE", - "line2": [], + "addressLine1": "2965 NECONNERS AVE", + "addressLine2": "", "city": "BEND", "state": "OR", "zip": "97701" }, "type": "Physician and Other Healthcare Professional", - "specialty": [], + "specialty": "", "medicareProvider": "Yes", "source": "patient" }, {"name": "JOHN KENNEDY", "address": { - "line1": "8888 KEYSTONE XING", - "line2": [], + "addressLine1": "8888 KEYSTONE XING", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46240" @@ -569,8 +567,8 @@ }, {"name": "REBECCA KELLY", "address": { - "line1": "7250 CLEARVISTA DR", - "line2": [], + "addressLine1": "7250 CLEARVISTA DR", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" @@ -582,8 +580,8 @@ }, {"name": "RILEY HOSPITAL - PEDS DIALYSIS", "address": { - "line1": "705 RILEY HOSPITAL DRIVE", - "line2": [], + "addressLine1": "705 RILEY HOSPITAL DRIVE", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46202" @@ -595,8 +593,8 @@ }, {"name": "FMC - SHADELAND STATION", "address": { - "line1": "7155 SHADELAND STATION", - "line2": "STE 130", + "addressLine1": "7155 SHADELAND STATION", + "addressLine2": "STE 130", "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" @@ -608,8 +606,8 @@ }, {"name": "IU HEALTH - HOME DIALYSIS", "address": { - "line1": "8803 N. MERIDIAN ST.", - "line2": "STE 150", + "addressLine1": "8803 N. MERIDIAN ST.", + "addressLine2": "STE 150", "city": "INDIANAPOLIS", "state": "IN", "zip": "46260" @@ -621,8 +619,8 @@ }, {"name": "MESA VISTA OF BOULDER", "address": { - "line1": "2121 MESA DRIVE", - "line2": [], + "addressLine1": "2121 MESA DRIVE", + "addressLine2": "", "city": "BOULDER", "state": "CO", "zip": "80304" @@ -634,8 +632,8 @@ }, {"name": "FAIRBANKS", "address": { - "line1": "8102 CLEARVISTA PARKWAY", - "line2": [], + "addressLine1": "8102 CLEARVISTA PARKWAY", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" @@ -647,8 +645,8 @@ }, {"name": "ALLIANCE HOME HEALTH SERVICES INC", "address": { - "line1": "9615 N COLLEGE AVE", - "line2": [], + "addressLine1": "9615 N COLLEGE AVE", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46280" @@ -660,8 +658,8 @@ }, {"name": "THE VIRGINIAN", "address": { - "line1": "9229 ARLINGTON BLVD", - "line2": [], + "addressLine1": "9229 ARLINGTON BLVD", + "addressLine2": "", "city": "FAIRFAX", "state": "VA", "zip": "22031" @@ -673,8 +671,8 @@ }, {"name": "KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE", "address": { - "line1": "5226 E 82ND ST", - "line2": [], + "addressLine1": "5226 E 82ND ST", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" @@ -686,8 +684,8 @@ }, {"name": "INDIANA HEART HOSPITAL THE", "address": { - "line1": "8075 N SHADELAND AVE", - "line2": [], + "addressLine1": "8075 N SHADELAND AVE", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" @@ -699,8 +697,8 @@ }, {"name": "COMMUNITY HOSPITAL NORTH", "address": { - "line1": "7150 CLEARVISTA DR", - "line2": [], + "addressLine1": "7150 CLEARVISTA DR", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46256" @@ -712,8 +710,8 @@ }, {"name": "FORUM AT THE CROSSING", "address": { - "line1": "8505 WOODFIELD CROSSING BLVD", - "line2": [], + "addressLine1": "8505 WOODFIELD CROSSING BLVD", + "addressLine2": [], "city": "INDIANAPOLIS", "state": "IN", "zip": "46240" @@ -725,11 +723,11 @@ }, {"name": [], "address": { - "line1": [], - "line2": [], - "city": [], - "state": [], - "zip": [] + "addressLine1": "", + "addressLine2": "", + "city": "", + "state": "", + "zip": "" }, "type": "Physician and Other Healthcare Professional", "specialty": [], @@ -740,8 +738,8 @@ "pharmacies": [ {"pharmacyName": "Castleton Integrative Health", "address": { - "line1": "8208 Allisonville Rd", - "line2": "", + "addressLine1": "8208 Allisonville Rd", + "addressLine2": "", "city": "INDIANAPOLIS", "state": "IN", "zip": "46250" @@ -751,8 +749,8 @@ }, {"pharmacyName": "Costco Pharmacy Indianapolis, IN 462506110", "address": { - "line1": "East 86th Street", - "line2":"", + "addressLine1": "East 86th Street", + "addressLine2":"", "city": "Castleton", "state": "IN", "zip": "46250" @@ -764,13 +762,13 @@ "insurance": [ {"category": "Medicare", "mspType": [], - "contractIdPlanId": "S1111/801", + "contractId/PlanId": "S1111/801", "startDate": "20120112", "endDate": [], "insurer": "Medicare", - "name": [], + "planName": [], "marketingName": [], - "address": [], + "planAddress": [], "type": "11 - Medicare Prescription Drug Plan", "source": "MyMedicare.gov" }, diff --git a/Medicare/medicare_bbp.xml b/Medicare/medicare_bbp.xml index 2352d19..80d845f 100644 --- a/Medicare/medicare_bbp.xml +++ b/Medicare/medicare_bbp.xml @@ -25,8 +25,8 @@ Lu 19100101
- 8115 Knuee Road - Mailpoint INA1-AF-16 + 8115 Knuee Road + Mailpoint INA1-AF-16 Indianapolis IN 46250 @@ -50,8 +50,8 @@ Bigelow
Home - 1234 Carnival Lane - Apt B + 1234 Carnival Lane + Apt B Lobster Bay ME 11112 @@ -72,8 +72,8 @@ Snow
Home - 2345 Fish Head Cove - C + 2345 Fish Head Cove + C Lobster Bay ME 11112 @@ -591,8 +591,8 @@ ANGELO SCOTTI
- 180 WHITE RD - + 180 WHITE RD + LITTLE SILVER NJ 07739 @@ -605,8 +605,8 @@ DOUGLAS KNOX
- 1104 E 23RD ST - + 1104 E 23RD ST + LAWRENCE KS 66046 @@ -619,8 +619,8 @@ SIAMAK RASSADI
- 1331 N 7TH ST - + 1331 N 7TH ST + PHOENIX AZ 85006 @@ -633,8 +633,8 @@ PETER LEAVITT
- 2965 NECONNERS AVE - + 2965 NECONNERS AVE + BEND OR 97701 @@ -647,8 +647,8 @@ JOHN KENNEDY
- 8888 KEYSTONE XING - + 8888 KEYSTONE XING + INDIANAPOLIS IN 46240 @@ -661,8 +661,8 @@ REBECCA KELLY
- 7250 CLEARVISTA DR - + 7250 CLEARVISTA DR + INDIANAPOLIS IN 46256 @@ -675,8 +675,8 @@ RILEY HOSPITAL - PEDS DIALYSIS
- 705 RILEY HOSPITAL DRIVE - + 705 RILEY HOSPITAL DRIVE + INDIANAPOLIS IN 46202 @@ -689,8 +689,8 @@ FMC - SHADELAND STATION
- 7155 SHADELAND STATION - STE 130 + 7155 SHADELAND STATION + STE 130 INDIANAPOLIS IN 46256 @@ -703,8 +703,8 @@ IU HEALTH - HOME DIALYSIS
- 8803 N. MERIDIAN ST. - STE 150 + 8803 N. MERIDIAN ST. + STE 150 INDIANAPOLIS IN 46260 @@ -717,8 +717,8 @@ MESA VISTA OF BOULDER
- 2121 MESA DRIVE - + 2121 MESA DRIVE + BOULDER CO 80304 @@ -731,8 +731,8 @@ FAIRBANKS
- 8102 CLEARVISTA PARKWAY - + 8102 CLEARVISTA PARKWAY + INDIANAPOLis IN 46256 @@ -745,8 +745,8 @@ ALLIANCE HOME HEALTH SERVICES INC
- 9615 N COLLEGE AVE - + 9615 N COLLEGE AVE + INDIANAPOLIS IN 46280 @@ -759,8 +759,8 @@ THE VIRGINIAN
- 9229 ARLINGTON BLVD - + 9229 ARLINGTON BLVD + FAIRFAX VA 22031 @@ -773,8 +773,8 @@ KINDRED TRANSITIONAL CARE AND REHAB-ALLISON POINTE
- 5226 E 82ND ST - + 5226 E 82ND ST + INDIANAPOLIS IN 46250 @@ -787,8 +787,8 @@ INDIANA HEART HOSPITAL THE
- 8075 N SHADELAND AVE - + 8075 N SHADELAND AVE + INDIANAPOLIS IN 46250 @@ -801,8 +801,8 @@ COMMUNITY HOSPITAL NORTH
- 7150 CLEARVISTA DR - + 7150 CLEARVISTA DR + INDIANAPOLIS IN 46256 @@ -815,8 +815,8 @@ FORUM AT THE CROSSING
- 8505 WOODFIELD CROSSING BLVD - + 8505 WOODFIELD CROSSING BLVD + INDIANAPOLIS IN 46240 @@ -829,8 +829,8 @@
- - + + @@ -845,8 +845,8 @@ Castleton Integrative Health
- 8208 Allisonville Rd - + 8208 Allisonville Rd + INDIANAPOLIS IN 46250 @@ -857,8 +857,8 @@ Costco Pharmacy Indianapolis, IN 462506110
- East 86th Street - + East 86th Street + Castleton IN 46250 diff --git a/Medicare/medicare_bbp_v2.json b/Medicare/medicare_bbp_v2.json new file mode 100644 index 0000000..e8fb427 --- /dev/null +++ b/Medicare/medicare_bbp_v2.json @@ -0,0 +1,1365 @@ +{ + "header": { + "originator": "MyMedicare.gov", + "languageCode": "code=\"en-US\"", + "versionNumber": { + "value": "2" + }, + "source": "MyMedicare.gov", + "title": "MyMedicare.gov Personal Health Information", + "effectiveTime": { + "value": "20150204091800+0500" + }, + "confidentialityCode": { + "code": "N", + "codeSystem": "2.16.840.1.113883.5.25" + }, + "comments": [ + "generated by python-bluebutton utility", + "http://github.com/ekivemark/python-bluebutton", + "using text file downloaded from", + "https://myMedicare.gov", + "**********CONFIDENTIAL***********", + "Produced by the Blue Button (v2.0)" + ] + }, + "patient": { + "source": "MyMedicare.gov", + "name": "JOHN DOE", + "dateOfBirth": "19100101", + "address": { + "addressType": "", + "addressLine1": "123 ANY ROAD", + "addressLine2": "", + "city": "ANYTOWN", + "state": "IN", + "zip": "46250" + }, + "phoneNumber": [ + "215-248-0684" + ], + "email": "", + "medicare": { + "partAEffectiveDate": "20140201", + "partBEffectiveDate": "20140201" + } + }, + "emergencyContact": [ + { + "source": "patient", + "contactName": { + "contactName": "Billy Bigelow2" + }, + "address": { + "addressType": "Home", + "addressLine1": "1234 Carnival Lane", + "addressLine2": "Lobster Bay, ME 11112", + "city": "", + "state": "", + "zip": "11111" + }, + "relationship": "Friend", + "phone": { + "mobile": "", + "home": "", + "work": "" + }, + "emailAddress": "" + }, + { + "contactName": "Enoch Snow", + "address": { + "addressType": "Home", + "addressLine1": "2345 Fish Head Cove", + "addressLine2": "Lobster Bay,", + "city": "", + "state": "ME", + "zip": "11112" + }, + "relationship": "Friend", + "phone": { + "mobile": "", + "home": "", + "work": "" + }, + "emailAddress": "", + "source": "patient" + } + ], + "medicalConditions": [ + { + "source": "patient", + "conditionName": "Allergies", + "medicalConditionStartDate": "20130129", + "medicalConditionEndDate": "" + }, + { + "conditionName": "Arthritis", + "medicalConditionStartDate": "19600801", + "medicalConditionEndDate": "19801231", + "source": "patient" + }, + { + "conditionName": "Broken Wrist", + "medicalConditionStartDate": "19100206", + "medicalConditionEndDate": "20130206", + "source": "patient" + }, + { + "conditionName": "Other", + "medicalConditionStartDate": "20110201", + "medicalConditionEndDate": "", + "source": "patient" + }, + { + "conditionName": "Other", + "medicalConditionStartDate": "20120228", + "medicalConditionEndDate": "", + "source": "patient" + } + ], + "Allergies": [ + { + "source": "patient", + "allergyName": "Antibotic", + "type": "Drugs", + "reaction": "", + "severity": "", + "diagnosed": "", + "treatment": "", + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", + "comments": [ + "" + ] + }, + { + "allergyName": "Corn", + "type": "Food", + "reaction": "Blisters", + "severity": "Mild", + "diagnosed": "Yes", + "treatment": "Other", + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", + "comments": [ + "" + ], + "source": "patient" + }, + { + "allergyName": "Milk", + "type": "Food", + "reaction": "Anaphylaxis", + "severity": "Severe", + "diagnosed": "Yes", + "treatment": "Epinephrine (Epi-Pen)", + "firstEpisodeDate": "19850321", + "lastEpisodeDate": "20120331", + "lastTreatmentDate": "20120331", + "comments": [ + "" + ], + "source": "patient" + }, + { + "allergyName": "Other - other", + "type": "Other - other", + "reaction": "", + "severity": "", + "diagnosed": "", + "treatment": "", + "firstEpisodeDate": "", + "lastEpisodeDate": "", + "lastTreatmentDate": "", + "comments": [ + "" + ], + "source": "patient" + } + ], + "ImplantableDevices": [ + { + "source": "patient", + "deviceName": "COronary 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+ Friend + + + + + + + + + Enoch Snow +
+ Home + 2345 Fish Head Cove + Lobster Bay, + + ME + 11112 +
+ Friend + + + + + + + patient + + + patient + Allergies + 20130129 + + + + Arthritis + 19600801 + 19801231 + patient + + + Broken Wrist + 19100206 + 20130206 + patient + + + Other + 20110201 + + patient + + + Other + 20120228 + + patient + + + patient + Antibotic + Drugs + + + + + + + + + + + Corn + Food + Blisters + Mild + Yes + Other + + + + + patient + + + Milk + Food + Anaphylaxis + Severe + Yes + Epinephrine (Epi-Pen) + 19850321 + 20120331 + 20120331 + + patient + + + Other - other + Other - other + + + + + + + + + patient + + + patient + COronary stent + 20051127 + + + Knee replacement + 20140202 + patient + + + Pace maker + 20120228 + patient + + + foot + 19840909 + patient + + + hearing aid + 20130101 + patient + + + nov20 + 20071215 + patient + + + patient + shingles + 20100203 + Injection + Yes + + + + 20110204 + 20120406 + + patient + + + patient + Test + 20130102 + Inova + Dr. John Doe + + + + + + patient + Glucose + 20080207 + + 322 + + + + Glucose + 20090403 + + 24 + fwrqwrgreg + patient + + + Glucose + 20090514 + + 134 + rwrtrt + patient + + + Otro - other + 19390101 + + other + + patient + + + Pulse + 20130406 + + 333 + + patient + + + Pulse + 20110302 + + 80 + wwqrgtrt + patient + + + Temperature + 20090605 + + 100 + fwqerqwr + patient + + + Temperature + 20080404 + + 99 + + patient + + + patient + Daughter + Maternal + 19940101 + + 31 + + type + description + patient + + + type + description + patient + + + description + + + + Brother + + 20120404 + + + + type + description + patient + + + type + description + + patient + + + patient + Abacavir TAB 300MG + 60 Every 1 Month + Abacavir + + + Abilify Maintena INJ 300MG + 1 X Vial Every 1 Month + Abilify Maintena + patient + + + Amlodipine Besylate TAB 10MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate TAB 2.5MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate TAB 5MG + 30 Every 1 Month + Amlodipine Besylate + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG + 30 Every 1 Month + Caduet + patient + + + Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG + 30 Every 1 Month + Amlodipine Besylate/Atorvastatin Calcium + patient + + + Androgel Pump GEL 1.62% + 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month + Androgel Pump + patient + + + Drospirenone/Ethinyl Estradiol TAB 3-0.03MG + 28 Every 1 Month + Yasmin 28 + patient + + + Gabapentin CAP 100MG + 90 Every 1 Month + Gabapentin + patient + + + Gabapentin SOL 250/5ML + 1 X 470ML Bottle Every 1 Month + Gabapentin + patient + + + Jakafi TAB 10MG + 60 Every 1 Month + Jakafi + patient + + + Losartan Potassium/Hydrochlorothiazide TAB 100-25 + 30 Every 1 Month + Losartan Potassium/Hydrochlorothiazide + patient + + + Montelukast Sodium TAB 10MG + 90 Every 3 Month + Montelukast Sodium + patient + + + Omeprazole CAP 20MG + 30 Every 1 Month + Omeprazole + patient + + + Rabavert INJ + 2 X Vial (sold in a package of 2) Every 12 Month + Rabavert + patient + + + Tabloid TAB 40MG + 30 Every 1 Month + Tabloid + patient + + + Vagifem TAB 10MCG + 8 Every 1 Month + Vagifem + patient + + + Zafirlukast TAB 20MG + 60 Every 1 Month + Zafirlukast + patient + + + Zaleplon CAP 10MG + 30 Every 1 Month + Zaleplon + patient + + + Zaltrap INJ 100/4ML + 1 X 4ML Vial Every 1 Month + Zaltrap + patient + + + MyMedicare.gov + ABDOMINAL AORTIC ANEURYSM + 20140201 + + + + CARDIOVASCULAR + 20140201 + + MyMedicare.gov + + + PPV + 20140201 + + MyMedicare.gov + + + PROSTATE + 20140201 + 20120326 + MyMedicare.gov + + + PSA + 20140201 + 20120326 + MyMedicare.gov + + + ANNUAL WELLNESS VISIT + 20150201 + + MyMedicare.gov + + + ALCOHOL MISUSE SCREENING + + + MyMedicare.gov + + + CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) + + + MyMedicare.gov + + + COLORECTAL + + 20110421 + MyMedicare.gov + + + DEPRESSION SCREENING + + + MyMedicare.gov + + + DIABETES + + 20120521 + MyMedicare.gov + + + HIGH INTENSITY BEHAVIORAL COUNSELING + + + MyMedicare.gov + + + OBESITY COUNSELING + + + MyMedicare.gov + + + PHYSICAL + + + MyMedicare.gov + + + SMOKING CESSATION (counseling to stop smoking) + + + MyMedicare.gov + + + patient + ANGELO SCOTTI + 180 WHITE RD LITTLE SILVER, NJ 07739 + Physician & Other Healthcare Professional + + Yes + + + DOUGLAS KNOX + 1104 E 23RD ST LAWRENCE, KS 66046 + Physician & Other Healthcare Professional + + Yes + patient + + + SIAMAK RASSADI + 1331 N 7TH ST PHOENIX, AZ 85006 + Physician & Other Healthcare Professional + Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) + May Accept Medicare + patient + + + PETER LEAVITT + 2965 NECONNERS AVE BEND, OR 97701 + Physician & Other Healthcare Professional + + Yes + patient + + + JOHN KENNEDY + 8888 KEYSTONE XING INDIANAPOLIS, IN 46240 + Physician & Other Healthcare Professional + + Yes + patient + + + REBECCA KELLY + 7250 CLEARVISTA DR INDIANAPOLIS, IN 46256 + Physician & Other Healthcare Professional + Addiction Medicine + Yes + patient + + + RILEY HOSPITAL - PEDS DIALYSIS + 705 RILEY HOSPITAL DRIVE INDIANAPOLIS, IN 46202 + Dialysis Facility + + Not Available + patient + + + FMC - SHADELAND STATION + 7155 SHADELAND STATION STE 130 INDIANAPOLIS, IN 46256 + Dialysis Facility + + Not Available + patient + + + IU HEALTH - HOME DIALYSIS + 8803 N. MERIDIAN ST., STE 150 INDIANAPOLIS, IN 46260 + Dialysis Facility + + Not Available + patient + + + MESA VISTA OF BOULDER + 2121 MESA DRIVE BOULDER, CO 80304 + Nursing Home + + Yes + patient + + + FAIRBANKS + 8102 CLEARVISTA PARKWAY INDIANAPOLIS, IN 46256 + Hospital + + Not Available + patient + + + ALLIANCE HOME HEALTH SERVICES INC + 9615 N COLLEGE AVE INDIANAPOLIS, IN 46280 + Home Health + + Not Available + patient + + + THE VIRGINIAN + 9229 ARLINGTON BLVD FAIRFAX, VA 22031 + Nursing Home + + Yes + patient + + + KINDRED TRANSITIONAL CARE & REHAB-ALLISON POINTE + 5226 E 82ND ST INDIANAPOLIS, IN 46250 + Nursing Home + + Yes + patient + + + INDIANA HEART HOSPITAL THE + 8075 N SHADELAND AVE INDIANAPOLIS, IN 46250 + Hospital + + Not Available + patient + + + COMMUNITY HOSPITAL NORTH + 7150 CLEARVISTA DR INDIANAPOLIS, IN 46256 + Hospital + + Not Available + patient + + + FORUM AT THE CROSSING + 8505 WOODFIELD CROSSING BLVD INDIANAPOLIS, IN 46240 + Nursing Home + + Not Available + patient + + + BEAUMONT HOSPITAL, TROY + 44201 DEQUINDRE ROAD TROY, MI 48085 + Hospital + + Not Available + patient + + + DAVITA - EAGLE HIGHLANDS + 6925 SHORE TERRACE INDIANAPOLIS, IN 46254 + Dialysis Facility + + Not Available + patient + + + FMC - CARMEL + 12400 NORTH MERIDIAN ST., STE 200 CARMEL, IN 46032 + Dialysis Facility + + Not Available + patient + + + DSI - NW INDIANAPOLIS RENAL CENTER + 6488 CORPORATE DRIVE INDIANAPOLIS, IN 46268 + Dialysis Facility + + Not Available + patient + + + GEORGE WASHINGTON UNIV HOSPITAL + 900 23RD ST NW WASHINGTON, DC 20037 + Hospital + + Not Available + patient + + + DAVITA - CARMEL HEALTH AND LIVING + 118 MEDICAL DRIVE, SUITE 114 CARMEL, IN 46032 + Dialysis Facility + + Not Available + patient + + + FMC-INDIANAPOLIS MIDTOWN + 3007 DR ANDREW J BROWN AVENUE INDIANAPOLIS, IN 46205 + Dialysis Facility + + Not Available + patient + + + MILLER'S SENIOR LIVING COMMUNITY + 8400 CLEARVISTA PL INDIANAPOLIS, IN 46256 + Nursing Home + + Yes + patient + + + TEST QT + COEBURN, VA 24230 + Home Health + + Not Available + patient + + + ADVANCED HOME CARE, INC + 165 PLAZA ROAD, SUITE 20 WISE, VA 24293 + Home Health + + Not Available + patient + + + TEST NHC QT + 0 24230 + Nursing Home + + Not Available + patient + + + HERITAGE HALL WISE + 9434 COEBURN MOUNTAIN ROAD WISE, VA 24293 + Nursing Home + + Yes + patient + + + QT JAN 15 TEST + 121 HOME STREET COEBURN, VA 24230 + Hospital + + Not Available + patient + + + NORTON COMMUNITY HOSPITAL + 100 15TH ST NW NORTON, VA 24273 + Hospital + + Not Available + patient + + + patient + Castleton Integrative Health 8208 Allisonville Rd Indianapolis, IN 46250 + 317-849-1222 + + + Costco Pharmacy Indianapolis, IN 462506110 East 86th Street Castleton, IN 46250 + 317-558-1452 + patient + + + MyMedicare.gov + S1111801 + 12012012 - current + + + + 11 - Medicare Prescription Drug Plan + + + + 11 - Medicare Prescription Drug Plan + + MyMedicare.gov + + + + MyMedicare.gov + + MyMedicare.gov + + + + MyMedicare.gov + + + 30002 + UNITEDHEALTH GROUP + 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 + 19841001 + + MyMedicare.gov + + + MyMedicare.gov + 11122233330000 + No Information Available + + + 20140105 + 20140105 + + + $135.00 + $92.53 + $74.02 + $18.51 + + DME + 32723 + 78051 +
+ 1 + 20140105 + 20140105 + E0601 - Continuous Positive Airway Pressure (Cpap) Device + MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + KX - Requirements Specified In The Medical Policy Have Been Met + + + 1 + $135.00 + $92.53 + $42.47 + 12 - Home + R - Rental of DME + DMEPROVIDR + + MyMedicare.gov +
+ + + 11122233320000 + No Information Available + + + 20140105 + 20140105 + + + $135.00 + $90.45 + $72.36 + $18.09 + + DME + 32723 + 78051 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + E0601 - Continuous Positive Airway Pressure (Cpap) Device + MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + KX - Requirements Specified In The Medical Policy Have Been Met + + + 1 + $135.00 + $90.45 + $44.55 + 12 - Home + R - Rental of DME + DMEPROVIDR + + MyMedicare.gov +
+ + + 2333444555100 + No Information Available + + + 20140105 + 20140105 + + + * Not Available * + * Not Available * + * Not Available * + * Not Available * + + PartB + 7392 + 7241 + 7393 + 7391 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + 98941 - Chiropractic Manipulative Treatment, 3 To 4 Spinal Regions + GA - Waiver Of Liability Statement Issued As Required By Payer Policy, Individual Case + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+
+ 2 + 20140105 + 20140105 + G0283 - Electrical Stimulation (Unattended), To One Or More Areas For Indication(S) Other Than Wound + GY - Item Or Service Statutorily Excluded, Does Not Meet The Definition Of Any Medicare Benefit Or, + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+ + + 2333444555500 + No Information Available + + + 20140105 + 20140105 + + + $1,022.50 + $782.33 + $625.86 + $156.47 + + PartB + 70700 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + RH + + + + 1 + $275.00 + $208.99 + $66.01 + 41 - Ambulance - Land + 9 - Other Medical Services + PARTBPROV + + MyMedicare.gov +
+
+ 2 + 20140105 + 20140105 + A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + HR - FamilyCouple With Client Present + + + + 1 + $275.00 + $208.99 + $66.01 + 41 - Ambulance - Land + 9 - Other Medical Services + PARTBPROV + + MyMedicare.gov +
+
+ 3 + 20140105 + 20140105 + A0425 - Ground Mileage, Per Statute Mile + RH + + + + 44 + $472.50 + $364.35 + $108.15 + 41 - Ambulance - Land + 9 - Other Medical Services + PARTBPROV + + MyMedicare.gov +
+ + + 2333444555200 + No Information Available + + + 20140105 + 20140105 + + + * Not Available * + * Not Available * + * Not Available * + * Not Available * + + PartB + 2163 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + 99213 - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes + + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 22 - Outpatient Hospital + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+ + + 2333444555300 + No Information Available + + + 20140105 + 20140105 + + + * Not Available * + * Not Available * + * Not Available * + * Not Available * + + PartB + 28521 + 5854 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + J2916 - Injection, Sodium Ferric Gluconate Complex In Sucrose Injection, 12.5 Mg + + + + + 10 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+
+ 2 + 20140105 + 20140105 + 36000 - Insertion Of Needle Or Catheter Into A Vein + + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 2 - Surgery + PARTBPROV + + MyMedicare.gov +
+
+ 3 + 20140105 + 20140105 + 90765 - Intravenous Infusion, For Therapy, Prophylaxis, Or Diagnosis (Specify Substance Or Drug); In + + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+
+ 4 + 20140105 + 20140105 + 90775 - Therapeutic, Prophylactic Or Diagnostic Injection (Specify Substance Or Drug); Each Addition + + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+
+ 5 + 20140105 + 20140105 + 99211 - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes + 25 - Significant, Separately Identifiable Evaluation And Management Service By The Same Physician On + + + + 1 + * Not Available * + * Not Available * + * Not Available * + 11 - Office + 1 - Medical Care + PARTBPROV + + MyMedicare.gov +
+ + + 2333444555400 + No Information Available + + + 20140105 + 20140105 + + + $38.00 + $9.38 + $7.50 + $1.88 + + PartB + 9593 + E8889 + MyMedicare.gov +
+ 1 + 20140105 + 20140105 + E0601 - Continuous Positive Airway Pressure (Cpap) Device + MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + KX - Requirements Specified In The Medical Policy Have Been Met + + + 1 + $135.00 + $90.45 + $44.55 + 12 - Home + R - Rental of DME + DMEPROVIDR + MyMedicare.gov +
+ + \ No newline at end of file diff --git a/README.md b/README.md index 44fb264..4eea641 100644 --- a/README.md +++ b/README.md @@ -44,12 +44,19 @@ This is a json format file that has been generated from the medicare_bbp.xml usi http://www.freeformatter.com/xml-to-json-converter.html +Code conversion from medicare_bbp_v2.txt to medicare_bbp_v2.json by python-bluebutton +(see https://github.com/ekivemark/python-bluebutton + +Code conversion from medicare_bbp_v2.json to medicar_bbp_v2.xml by +http://codebeautify.org/jsontoxml + + TODO-ekivemark -------------- 1. Create a generic BlueButtonPlus.xml and BlueButtonPlus.json that covers medicare and non-medicare payers. 2. Confirm approach in using field within data segments to identify source of data. - +3. change field names to remove / Current Source field Values: + patient From 9213e08bd116364bf70f112c40d35ad9a2c15a8e Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Sat, 28 Mar 2015 17:48:44 -0400 Subject: [PATCH 14/15] added v2 files --- Medicare/medicare_bbp_v2.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/Medicare/medicare_bbp_v2.json b/Medicare/medicare_bbp_v2.json index e8fb427..9ce9d7e 100644 --- a/Medicare/medicare_bbp_v2.json +++ b/Medicare/medicare_bbp_v2.json @@ -1326,7 +1326,7 @@ "provider": "No Information Available", "providerBillingAddress": "", "date": { - "serviceStartDate": "20140105", + "serviceStartDate": "20140105", "serviceEndDate": "20140105" }, "charges": { From 4e367b7207af75156f73fd40087465794001a526 Mon Sep 17 00:00:00 2001 From: Mark Scrimshire Date: Tue, 7 Apr 2015 14:07:37 -0400 Subject: [PATCH 15/15] Updated JSON and XML v2 files Update JSON and XML v2 files based on output generated using http://github.com/ekivemark/python-bluebutton utility. --- Medicare/medicare_bbp_v2.json | 312 +++-- Medicare/medicare_bbp_v2.xml | 229 +++- medicare/medicare_bbp_v2.txt | 2117 +++++++++++++++++++++++++++++++++ 3 files changed, 2528 insertions(+), 130 deletions(-) create mode 100644 medicare/medicare_bbp_v2.txt diff --git a/Medicare/medicare_bbp_v2.json b/Medicare/medicare_bbp_v2.json index 9ce9d7e..74d47a4 100644 --- a/Medicare/medicare_bbp_v2.json +++ b/Medicare/medicare_bbp_v2.json @@ -21,9 +21,15 @@ "https://myMedicare.gov", "**********CONFIDENTIAL***********", "Produced by the Blue Button (v2.0)" - ] + ], + "header": { + "header": "MYMEDICARE.GOV PERSONAL HEALTH INFORMATION" + } }, "patient": { + "patient": { + "patient": "Demographic" + }, "source": "MyMedicare.gov", "name": "JOHN DOE", "dateOfBirth": "19100101", @@ -46,10 +52,8 @@ }, "emergencyContact": [ { - "source": "patient", - "contactName": { - "contactName": "Billy Bigelow2" - }, + "emergencyContact": "Emergency Contact", + "contactName": "Billy Bigelow2", "address": { "addressType": "Home", "addressLine1": "1234 Carnival Lane", @@ -64,7 +68,9 @@ "home": "", "work": "" }, - "emailAddress": "" + "emailAddress": "", + "category": "Emergency Contact", + "source": "patient" }, { "contactName": "Enoch Snow", @@ -83,44 +89,51 @@ "work": "" }, "emailAddress": "", + "category": "Emergency Contact", "source": "patient" } ], "medicalConditions": [ { - "source": "patient", + "medicalConditions": "Self Reported Medical Conditions", "conditionName": "Allergies", "medicalConditionStartDate": "20130129", - "medicalConditionEndDate": "" + "medicalConditionEndDate": "", + "category": "Self Reported Medical Conditions", + "source": "patient" }, { "conditionName": "Arthritis", "medicalConditionStartDate": "19600801", "medicalConditionEndDate": "19801231", + "category": "Self Reported Medical Conditions", "source": "patient" }, { "conditionName": "Broken Wrist", "medicalConditionStartDate": "19100206", "medicalConditionEndDate": "20130206", + "category": "Self Reported Medical Conditions", "source": "patient" }, { "conditionName": "Other", "medicalConditionStartDate": "20110201", "medicalConditionEndDate": "", + "category": "Self Reported Medical Conditions", "source": "patient" }, { "conditionName": "Other", "medicalConditionStartDate": "20120228", "medicalConditionEndDate": "", + "category": "Self Reported Medical Conditions", "source": "patient" } ], "Allergies": [ { - "source": "patient", + "Allergies": "Self Reported Allergies", "allergyName": "Antibotic", "type": "Drugs", "reaction": "", @@ -132,7 +145,9 @@ "lastTreatmentDate": "", "comments": [ "" - ] + ], + "category": "Self Reported Allergies", + "source": "patient" }, { "allergyName": "Corn", @@ -147,6 +162,7 @@ "comments": [ "" ], + "category": "Self Reported Allergies", "source": "patient" }, { @@ -162,6 +178,7 @@ "comments": [ "" ], + "category": "Self Reported Allergies", "source": "patient" }, { @@ -177,62 +194,73 @@ "comments": [ "" ], + "category": "Self Reported Allergies", "source": "patient" } ], "ImplantableDevices": [ { - "source": "patient", + "ImplantableDevices": "Self Reported Implantable Device", "deviceName": "COronary stent", - "dateImplanted": "20051127" + "dateImplanted": "20051127", + "category": "Self Reported Implantable Device", + "source": "patient" }, { "deviceName": "Knee replacement", "dateImplanted": "20140202", + "category": "Self Reported Implantable Device", "source": "patient" }, { "deviceName": "Pace maker", "dateImplanted": "20120228", + "category": "Self Reported Implantable Device", "source": "patient" }, { "deviceName": "foot", "dateImplanted": "19840909", + "category": "Self Reported Implantable Device", "source": "patient" }, { "deviceName": "hearing aid", "dateImplanted": "20130101", + "category": "Self Reported Implantable Device", "source": "patient" }, { "deviceName": "nov20", "dateImplanted": "20071215", + "category": "Self Reported Implantable Device", "source": "patient" } ], "Immunizations": [ { - "source": "patient", + "Immunizations": "Self Reported Immunizations", "immunizationName": "shingles", "dateAdministered": "20100203", "method": "Injection", "wereYouVaccinatedInTheUs": "Yes", "comments": [ "" - ] + ], + "category": "Self Reported Immunizations", + "source": "patient" }, { "booster1Date": "20110204", "booster2Date": "20120406", "booster3Date": "", + "category": "Self Reported Immunizations", "source": "patient" } ], "Labs": [ { - "source": "patient", + "Labs": "Self Reported Labs and Tests", "testLabType": "Test", "dateTaken": "20130102", "administeredBy": "Inova", @@ -241,19 +269,23 @@ "results": "", "comments": [ "" - ] + ], + "category": "Self Reported Labs and Tests", + "source": "patient" } ], "vitals": [ { - "source": "patient", + "vitals": "Self Reported Vital Statistics", "vitalStatisticType": "Glucose", "date": "20080207", "time": "12:00 AM", "readingValue": "322", "comments": [ "" - ] + ], + "category": "Self Reported Vital Statistics", + "source": "patient" }, { "vitalStatisticType": "Glucose", @@ -263,6 +295,7 @@ "comments": [ "fwrqwrgreg" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -273,6 +306,7 @@ "comments": [ "rwrtrt" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -283,6 +317,7 @@ "comments": [ "" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -293,6 +328,7 @@ "comments": [ "" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -303,6 +339,7 @@ "comments": [ "wwqrgtrt" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -313,6 +350,7 @@ "comments": [ "fwqerqwr" ], + "category": "Self Reported Vital Statistics", "source": "patient" }, { @@ -323,11 +361,13 @@ "comments": [ "" ], + "category": "Self Reported Vital Statistics", "source": "patient" } ], "familyHistory": [ { + "familyHistory": "Family Medical History", "source": "patient", "familyMember": "Daughter", "type": "Maternal", @@ -338,17 +378,20 @@ { "type": "type", "description": "description", + "category": "Family Medical History", "source": "patient" }, { "type": "type", "description": "description", + "category": "Family Medical History", "source": "patient" }, { "description": "description" } - ] + ], + "category": "Family Medical History" }, { "familyMember": "Brother", @@ -360,6 +403,7 @@ { "type": "type", "description": "description", + "category": "Family Medical History", "source": "patient" }, { @@ -372,256 +416,300 @@ ], "medications": [ { - "source": "patient", + "medications": "Drugs", "drugName": "Abacavir TAB 300MG", "supply": "60 Every 1 Month", - "origDrugEntry": "Abacavir" + "origDrugEntry": "Abacavir", + "category": "Drugs", + "source": "patient" }, { "drugName": "Abilify Maintena INJ 300MG", "supply": "1 X Vial Every 1 Month", "origDrugEntry": "Abilify Maintena", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate TAB 10MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate TAB 2.5MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate TAB 5MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate/Atorvastatin Calcium", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate/Atorvastatin Calcium", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate/Atorvastatin Calcium", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate/Atorvastatin Calcium", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG", "supply": "30 Every 1 Month", "origDrugEntry": "Caduet", + "category": "Drugs", "source": "patient" }, { "drugName": "Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG", "supply": "30 Every 1 Month", "origDrugEntry": "Amlodipine Besylate/Atorvastatin Calcium", + "category": "Drugs", "source": "patient" }, { "drugName": "Androgel Pump GEL 1.62%", "supply": "2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month", "origDrugEntry": "Androgel Pump", + "category": "Drugs", "source": "patient" }, { "drugName": "Drospirenone/Ethinyl Estradiol TAB 3-0.03MG", "supply": "28 Every 1 Month", "origDrugEntry": "Yasmin 28", + "category": "Drugs", "source": "patient" }, { "drugName": "Gabapentin CAP 100MG", "supply": "90 Every 1 Month", "origDrugEntry": "Gabapentin", + "category": "Drugs", "source": "patient" }, { "drugName": "Gabapentin SOL 250/5ML", "supply": "1 X 470ML Bottle Every 1 Month", "origDrugEntry": "Gabapentin", + "category": "Drugs", "source": "patient" }, { "drugName": "Jakafi TAB 10MG", "supply": "60 Every 1 Month", "origDrugEntry": "Jakafi", + "category": "Drugs", "source": "patient" }, { "drugName": "Losartan Potassium/Hydrochlorothiazide TAB 100-25", "supply": "30 Every 1 Month", "origDrugEntry": "Losartan Potassium/Hydrochlorothiazide", + "category": "Drugs", "source": "patient" }, { "drugName": "Montelukast Sodium TAB 10MG", "supply": "90 Every 3 Month", "origDrugEntry": "Montelukast Sodium", + "category": "Drugs", "source": "patient" }, { "drugName": "Omeprazole CAP 20MG", "supply": "30 Every 1 Month", "origDrugEntry": "Omeprazole", + "category": "Drugs", "source": "patient" }, { "drugName": "Rabavert INJ", "supply": "2 X Vial (sold in a package of 2) Every 12 Month", "origDrugEntry": "Rabavert", + "category": "Drugs", "source": "patient" }, { "drugName": "Tabloid TAB 40MG", "supply": "30 Every 1 Month", "origDrugEntry": "Tabloid", + "category": "Drugs", "source": "patient" }, { "drugName": "Vagifem TAB 10MCG", "supply": "8 Every 1 Month", "origDrugEntry": "Vagifem", + "category": "Drugs", "source": "patient" }, { "drugName": "Zafirlukast TAB 20MG", "supply": "60 Every 1 Month", "origDrugEntry": "Zafirlukast", + "category": "Drugs", "source": "patient" }, { "drugName": "Zaleplon CAP 10MG", "supply": "30 Every 1 Month", "origDrugEntry": "Zaleplon", + "category": "Drugs", "source": "patient" }, { "drugName": "Zaltrap INJ 100/4ML", "supply": "1 X 4ML Vial Every 1 Month", "origDrugEntry": "Zaltrap", + "category": "Drugs", "source": "patient" } ], "preventiveServices": [ { - "source": "MyMedicare.gov", + "preventiveServices": "Preventive Services", "description": "ABDOMINAL AORTIC ANEURYSM", "nextEligibleDate": "20140201", - "lastDateOfService": "" + "lastDateOfService": "", + "category": "Preventive Services", + "source": "MyMedicare.gov" }, { "description": "CARDIOVASCULAR", "nextEligibleDate": "20140201", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "PPV", "nextEligibleDate": "20140201", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "PROSTATE", "nextEligibleDate": "20140201", "lastDateOfService": "20120326", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "PSA", "nextEligibleDate": "20140201", "lastDateOfService": "20120326", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "ANNUAL WELLNESS VISIT", "nextEligibleDate": "20150201", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "ALCOHOL MISUSE SCREENING", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY)", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "COLORECTAL", "nextEligibleDate": "", "lastDateOfService": "20110421", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "DEPRESSION SCREENING", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "DIABETES", "nextEligibleDate": "", "lastDateOfService": "20120521", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "HIGH INTENSITY BEHAVIORAL COUNSELING", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "OBESITY COUNSELING", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "PHYSICAL", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" }, { "description": "SMOKING CESSATION (counseling to stop smoking)", "nextEligibleDate": "", "lastDateOfService": "", + "category": "Preventive Services", "source": "MyMedicare.gov" } ], "providers": [ { - "source": "patient", + "providers": "Providers", "providerName": "ANGELO SCOTTI", "providerAddress": "180 WHITE RD LITTLE SILVER, NJ 07739", "type": "Physician & Other Healthcare Professional", "specialty": "", - "medicareProvider": "Yes" + "medicareProvider": "Yes", + "category": "Providers", + "source": "patient" }, { "providerName": "DOUGLAS KNOX", @@ -629,6 +717,7 @@ "type": "Physician & Other Healthcare Professional", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -637,6 +726,7 @@ "type": "Physician & Other Healthcare Professional", "specialty": "Cardiac Electrophysiology,Cardiovascular Disease (Cardiology)", "medicareProvider": "May Accept Medicare", + "category": "Providers", "source": "patient" }, { @@ -645,6 +735,7 @@ "type": "Physician & Other Healthcare Professional", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -653,6 +744,7 @@ "type": "Physician & Other Healthcare Professional", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -661,6 +753,7 @@ "type": "Physician & Other Healthcare Professional", "specialty": "Addiction Medicine", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -669,6 +762,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -677,6 +771,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -685,6 +780,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -693,6 +789,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -701,6 +798,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -709,6 +807,7 @@ "type": "Home Health", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -717,6 +816,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -725,6 +825,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -733,6 +834,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -741,6 +843,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -749,6 +852,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -757,6 +861,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -765,6 +870,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -773,6 +879,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -781,6 +888,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -789,6 +897,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -797,6 +906,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -805,6 +915,7 @@ "type": "Dialysis Facility", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -813,6 +924,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -821,6 +933,7 @@ "type": "Home Health", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -829,6 +942,7 @@ "type": "Home Health", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -837,6 +951,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -845,6 +960,7 @@ "type": "Nursing Home", "specialty": "", "medicareProvider": "Yes", + "category": "Providers", "source": "patient" }, { @@ -853,6 +969,7 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" }, { @@ -861,83 +978,51 @@ "type": "Hospital", "specialty": "", "medicareProvider": "Not Available", + "category": "Providers", "source": "patient" } ], "pharmacies": [ { - "source": "patient", + "pharmacies": "Pharmacies", "pharmacyName": "Castleton Integrative Health 8208 Allisonville Rd Indianapolis, IN 46250", - "pharmacyPhone": "317-849-1222" + "pharmacyPhone": "317-849-1222", + "category": "Pharmacies", + "source": "patient" }, { "pharmacyName": "Costco Pharmacy Indianapolis, IN 462506110 East 86th Street Castleton, IN 46250", "pharmacyPhone": "317-558-1452", + "category": "Pharmacies", "source": "patient" } ], "insurance": [ { - "source": "MyMedicare.gov", + "insurance": "Plans", "contractIdPlanId": "S1111/801", "planPeriod": "12/01/2012 - current", "planName": "", "marketingName": "", "planAddress": "", - "planType": "11 - Medicare Prescription Drug Plan" - }, - { - "category": { - "category": "11 - Medicare Prescription Drug Plan" - }, - "startDate": [], - "endDate": [], - "name": [], - "contractIdPlanId": [], - "type": [], - "insurer": [], - "marketingName": [], - "address": [], + "planType": "11 - Medicare Prescription Drug Plan", + "category": "Plans", "source": "MyMedicare.gov" }, { - "category": { - "category": "MyMedicare.gov" - }, - "startDate": [], - "mspType": [], - "endDate": [], - "name": [], - "contractIdPlanId": [], - "type": [], - "insurer": [], - "marketingName": [], - "address": [], - "source": "MyMedicare.gov" - }, - { - "category": { - "category": "MyMedicare.gov" - }, - "startDate": [], - "endDate": [], - "name": [], - "contractIdPlanId": [], - "type": [], - "address": [], - "marketingName": [], "mspType": "", "policyNumber": "30002", "insurerName": "UNITEDHEALTH GROUP", "insurerAddress": "601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034", "effectiveDate": "19841001", "terminationDate": "", + "category": "Other Insurance", "source": "MyMedicare.gov" } ], "claims": [ { - "source": "MyMedicare.gov", + "claims": "Claim Summary", "claimNumber": "11122233330000", "provider": "No Information Available", "providerBillingAddress": "", @@ -954,9 +1039,11 @@ "claimType": "DME", "diagnosisCode1": "32723", "diagnosisCode2": "78051", + "category": "Claim Summary", + "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -973,12 +1060,14 @@ "typeOfServiceDescription": "R - Rental of DME", "renderingProviderNo": "DMEPROVIDR", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "11122233330000" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "11122233320000", "provider": "No Information Available", "providerBillingAddress": "", @@ -995,10 +1084,11 @@ "claimType": "DME", "diagnosisCode1": "32723", "diagnosisCode2": "78051", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1015,12 +1105,14 @@ "typeOfServiceDescription": "R - Rental of DME", "renderingProviderNo": "DMEPROVIDR", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "11122233320000" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "2333444555100", "provider": "No Information Available", "providerBillingAddress": "", @@ -1039,10 +1131,11 @@ "diagnosisCode2": "7241", "diagnosisCode3": "7393", "diagnosisCode4": "7391", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1059,7 +1152,9 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555100" }, { "lineNumber": "2", @@ -1078,12 +1173,14 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555100" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "2333444555500", "provider": "No Information Available", "providerBillingAddress": "", @@ -1099,10 +1196,11 @@ }, "claimType": "PartB", "diagnosisCode1": "70700", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1119,7 +1217,9 @@ "typeOfServiceDescription": "9 - Other Medical Services", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555500" }, { "lineNumber": "2", @@ -1138,7 +1238,9 @@ "typeOfServiceDescription": "9 - Other Medical Services", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555500" }, { "lineNumber": "3", @@ -1157,12 +1259,14 @@ "typeOfServiceDescription": "9 - Other Medical Services", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555500" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "2333444555200", "provider": "No Information Available", "providerBillingAddress": "", @@ -1178,10 +1282,11 @@ }, "claimType": "PartB", "diagnosisCode1": "2163", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1198,12 +1303,14 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555200" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "2333444555300", "provider": "No Information Available", "providerBillingAddress": "", @@ -1220,10 +1327,11 @@ "claimType": "PartB", "diagnosisCode1": "28521", "diagnosisCode2": "5854", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1240,7 +1348,9 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555300" }, { "lineNumber": "2", @@ -1259,7 +1369,9 @@ "typeOfServiceDescription": "2 - Surgery", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555300" }, { "lineNumber": "3", @@ -1278,7 +1390,9 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555300" }, { "lineNumber": "4", @@ -1297,7 +1411,9 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555300" }, { "lineNumber": "5", @@ -1316,12 +1432,14 @@ "typeOfServiceDescription": "1 - Medical Care", "renderingProviderNo": "PARTBPROV", "renderingProviderNpi": "", - "source": "MyMedicare.gov" + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "2333444555300" } ] }, { - "claim": [], + "claim": "claim Header", "claimNumber": "2333444555400", "provider": "No Information Available", "providerBillingAddress": "", @@ -1338,10 +1456,11 @@ "claimType": "PartB", "diagnosisCode1": "9593", "diagnosisCode2": "E8889", + "category": "claim Header", "source": "MyMedicare.gov", "details": [ { - "details": [], + "details": "Claim Lines for Claim Number", "lineNumber": "1", "dateOfServiceFrom": "20140105", "dateOfServiceTo": "20140105", @@ -1357,7 +1476,10 @@ "placeOfServiceDescription": "12 - Home", "typeOfServiceDescription": "R - Rental of DME", "renderingProviderNo": "DMEPROVIDR", - "source": "MyMedicare.gov" + "renderingProviderNpi": "", + "category": "Claim Lines for Claim Number", + "source": "MyMedicare.gov", + "claimNumber": "11122233310000" } ] } diff --git a/Medicare/medicare_bbp_v2.xml b/Medicare/medicare_bbp_v2.xml index 3cc0429..6c88a27 100644 --- a/Medicare/medicare_bbp_v2.xml +++ b/Medicare/medicare_bbp_v2.xml @@ -1,5 +1,5 @@ - +
MyMedicare.gov code="en-US" @@ -21,8 +21,14 @@ https://myMedicare.gov **********CONFIDENTIAL*********** Produced by the Blue Button (v2.0) +
+
MYMEDICARE.GOV PERSONAL HEALTH INFORMATION
+
+ + Demographic + MyMedicare.gov JOHN DOE 19100101 @@ -42,10 +48,8 @@ - patient - - Billy Bigelow2 - + Emergency Contact + Billy Bigelow2
Home 1234 Carnival Lane @@ -61,6 +65,8 @@ + Emergency Contact + patient Enoch Snow @@ -79,40 +85,47 @@ + Emergency Contact patient - patient + Self Reported Medical Conditions Allergies 20130129 + Self Reported Medical Conditions + patient Arthritis 19600801 19801231 + Self Reported Medical Conditions patient Broken Wrist 19100206 20130206 + Self Reported Medical Conditions patient Other 20110201 + Self Reported Medical Conditions patient Other 20120228 + Self Reported Medical Conditions patient - patient + Self Reported Allergies Antibotic Drugs @@ -123,6 +136,8 @@ + Self Reported Allergies + patient Corn @@ -135,6 +150,7 @@ + Self Reported Allergies patient @@ -148,6 +164,7 @@ 20120331 20120331 + Self Reported Allergies patient @@ -161,54 +178,65 @@ + Self Reported Allergies patient - patient + Self Reported Implantable Device COronary stent 20051127 + Self Reported Implantable Device + patient Knee replacement 20140202 + Self Reported Implantable Device patient Pace maker 20120228 + Self Reported Implantable Device patient foot 19840909 + Self Reported Implantable Device patient hearing aid 20130101 + Self Reported Implantable Device patient nov20 20071215 + Self Reported Implantable Device patient - patient + Self Reported Immunizations shingles 20100203 Injection Yes + Self Reported Immunizations + patient 20110204 20120406 + Self Reported Immunizations patient - patient + Self Reported Labs and Tests Test 20130102 Inova @@ -216,14 +244,18 @@ + Self Reported Labs and Tests + patient - patient + Self Reported Vital Statistics Glucose 20080207 322 + Self Reported Vital Statistics + patient Glucose @@ -231,6 +263,7 @@ 24 fwrqwrgreg + Self Reported Vital Statistics patient @@ -239,6 +272,7 @@ 134 rwrtrt + Self Reported Vital Statistics patient @@ -247,6 +281,7 @@ other + Self Reported Vital Statistics patient @@ -255,6 +290,7 @@ 333 + Self Reported Vital Statistics patient @@ -263,6 +299,7 @@ 80 wwqrgtrt + Self Reported Vital Statistics patient @@ -271,6 +308,7 @@ 100 fwqerqwr + Self Reported Vital Statistics patient @@ -279,9 +317,11 @@ 99 + Self Reported Vital Statistics patient + Family Medical History patient Daughter Maternal @@ -291,16 +331,19 @@ type description + Family Medical History patient type description + Family Medical History patient description + Family Medical History Brother @@ -311,6 +354,7 @@ type description + Family Medical History patient @@ -320,252 +364,296 @@ patient - patient + Drugs Abacavir TAB 300MG 60 Every 1 Month Abacavir + Drugs + patient Abilify Maintena INJ 300MG 1 X Vial Every 1 Month Abilify Maintena + Drugs patient Amlodipine Besylate TAB 10MG 30 Every 1 Month Amlodipine Besylate + Drugs patient Amlodipine Besylate TAB 2.5MG 30 Every 1 Month Amlodipine Besylate + Drugs patient Amlodipine Besylate TAB 5MG 30 Every 1 Month Amlodipine Besylate + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG 30 Every 1 Month Amlodipine Besylate/Atorvastatin Calcium + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG 30 Every 1 Month Amlodipine Besylate/Atorvastatin Calcium + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG 30 Every 1 Month Amlodipine Besylate/Atorvastatin Calcium + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG 30 Every 1 Month Amlodipine Besylate/Atorvastatin Calcium + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG 30 Every 1 Month Caduet + Drugs patient Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG 30 Every 1 Month Amlodipine Besylate/Atorvastatin Calcium + Drugs patient Androgel Pump GEL 1.62% 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month Androgel Pump + Drugs patient Drospirenone/Ethinyl Estradiol TAB 3-0.03MG 28 Every 1 Month Yasmin 28 + Drugs patient Gabapentin CAP 100MG 90 Every 1 Month Gabapentin + Drugs patient Gabapentin SOL 250/5ML 1 X 470ML Bottle Every 1 Month Gabapentin + Drugs patient Jakafi TAB 10MG 60 Every 1 Month Jakafi + Drugs patient Losartan Potassium/Hydrochlorothiazide TAB 100-25 30 Every 1 Month Losartan Potassium/Hydrochlorothiazide + Drugs patient Montelukast Sodium TAB 10MG 90 Every 3 Month Montelukast Sodium + Drugs patient Omeprazole CAP 20MG 30 Every 1 Month Omeprazole + Drugs patient Rabavert INJ 2 X Vial (sold in a package of 2) Every 12 Month Rabavert + Drugs patient Tabloid TAB 40MG 30 Every 1 Month Tabloid + Drugs patient Vagifem TAB 10MCG 8 Every 1 Month Vagifem + Drugs patient Zafirlukast TAB 20MG 60 Every 1 Month Zafirlukast + Drugs patient Zaleplon CAP 10MG 30 Every 1 Month Zaleplon + Drugs patient Zaltrap INJ 100/4ML 1 X 4ML Vial Every 1 Month Zaltrap + Drugs patient - MyMedicare.gov + Preventive Services ABDOMINAL AORTIC ANEURYSM 20140201 + Preventive Services + MyMedicare.gov CARDIOVASCULAR 20140201 + Preventive Services MyMedicare.gov PPV 20140201 + Preventive Services MyMedicare.gov PROSTATE 20140201 20120326 + Preventive Services MyMedicare.gov PSA 20140201 20120326 + Preventive Services MyMedicare.gov ANNUAL WELLNESS VISIT 20150201 + Preventive Services MyMedicare.gov ALCOHOL MISUSE SCREENING + Preventive Services MyMedicare.gov CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) + Preventive Services MyMedicare.gov COLORECTAL 20110421 + Preventive Services MyMedicare.gov DEPRESSION SCREENING + Preventive Services MyMedicare.gov DIABETES 20120521 + Preventive Services MyMedicare.gov HIGH INTENSITY BEHAVIORAL COUNSELING + Preventive Services MyMedicare.gov OBESITY COUNSELING + Preventive Services MyMedicare.gov PHYSICAL + Preventive Services MyMedicare.gov SMOKING CESSATION (counseling to stop smoking) + Preventive Services MyMedicare.gov - patient + Providers ANGELO SCOTTI 180 WHITE RD LITTLE SILVER, NJ 07739 Physician & Other Healthcare Professional Yes + Providers + patient DOUGLAS KNOX @@ -573,6 +661,7 @@ Physician & Other Healthcare Professional Yes + Providers patient @@ -581,6 +670,7 @@ Physician & Other Healthcare Professional Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) May Accept Medicare + Providers patient @@ -589,6 +679,7 @@ Physician & Other Healthcare Professional Yes + Providers patient @@ -597,6 +688,7 @@ Physician & Other Healthcare Professional Yes + Providers patient @@ -605,6 +697,7 @@ Physician & Other Healthcare Professional Addiction Medicine Yes + Providers patient @@ -613,6 +706,7 @@ Dialysis Facility Not Available + Providers patient @@ -621,6 +715,7 @@ Dialysis Facility Not Available + Providers patient @@ -629,6 +724,7 @@ Dialysis Facility Not Available + Providers patient @@ -637,6 +733,7 @@ Nursing Home Yes + Providers patient @@ -645,6 +742,7 @@ Hospital Not Available + Providers patient @@ -653,6 +751,7 @@ Home Health Not Available + Providers patient @@ -661,6 +760,7 @@ Nursing Home Yes + Providers patient @@ -669,6 +769,7 @@ Nursing Home Yes + Providers patient @@ -677,6 +778,7 @@ Hospital Not Available + Providers patient @@ -685,6 +787,7 @@ Hospital Not Available + Providers patient @@ -693,6 +796,7 @@ Nursing Home Not Available + Providers patient @@ -701,6 +805,7 @@ Hospital Not Available + Providers patient @@ -709,6 +814,7 @@ Dialysis Facility Not Available + Providers patient @@ -717,6 +823,7 @@ Dialysis Facility Not Available + Providers patient @@ -725,6 +832,7 @@ Dialysis Facility Not Available + Providers patient @@ -733,6 +841,7 @@ Hospital Not Available + Providers patient @@ -741,6 +850,7 @@ Dialysis Facility Not Available + Providers patient @@ -749,6 +859,7 @@ Dialysis Facility Not Available + Providers patient @@ -757,6 +868,7 @@ Nursing Home Yes + Providers patient @@ -765,6 +877,7 @@ Home Health Not Available + Providers patient @@ -773,6 +886,7 @@ Home Health Not Available + Providers patient @@ -781,6 +895,7 @@ Nursing Home Not Available + Providers patient @@ -789,6 +904,7 @@ Nursing Home Yes + Providers patient @@ -797,6 +913,7 @@ Hospital Not Available + Providers patient @@ -805,53 +922,45 @@ Hospital Not Available + Providers patient - patient + Pharmacies Castleton Integrative Health 8208 Allisonville Rd Indianapolis, IN 46250 317-849-1222 + Pharmacies + patient Costco Pharmacy Indianapolis, IN 462506110 East 86th Street Castleton, IN 46250 317-558-1452 + Pharmacies patient - MyMedicare.gov - S1111801 - 12012012 - current + Plans + S1111/801 + 12/01/2012 - current 11 - Medicare Prescription Drug Plan - - - - 11 - Medicare Prescription Drug Plan - - MyMedicare.gov - - - - MyMedicare.gov - + Plans MyMedicare.gov - - MyMedicare.gov - 30002 UNITEDHEALTH GROUP 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 19841001 + Other Insurance MyMedicare.gov - MyMedicare.gov + Claim Summary 11122233330000 No Information Available @@ -868,7 +977,10 @@ DME 32723 78051 + Claim Summary + MyMedicare.gov
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Claim Lines for Claim Number
1 20140105 20140105 @@ -885,10 +997,13 @@ R - Rental of DME DMEPROVIDR + Claim Lines for Claim Number MyMedicare.gov + 11122233330000
+ claim Header 11122233320000 No Information Available @@ -905,8 +1020,10 @@ DME 32723 78051 + claim Header MyMedicare.gov
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Claim Lines for Claim Number
1 20140105 20140105 @@ -923,10 +1040,13 @@ R - Rental of DME DMEPROVIDR + Claim Lines for Claim Number MyMedicare.gov + 11122233320000
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Claim Lines for Claim Number
1 20140105 20140105 @@ -963,7 +1085,9 @@ 1 - Medical Care PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555100
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Claim Lines for Claim Number
1 20140105 20140105 @@ -1019,14 +1148,16 @@ 9 - Other Medical Services PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555500
2 20140105 20140105 A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) - HR - FamilyCouple With Client Present + HR - Family/Couple With Client Present @@ -1038,7 +1169,9 @@ 9 - Other Medical Services PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555500
3 @@ -1057,10 +1190,13 @@ 9 - Other Medical Services PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555500
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Claim Lines for Claim Number
1 20140105 20140105 @@ -1094,10 +1232,13 @@ 1 - Medical Care PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555200
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Claim Lines for Claim Number
1 20140105 20140105 @@ -1132,7 +1275,9 @@ 1 - Medical Care PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555300
2 @@ -1151,7 +1296,9 @@ 2 - Surgery PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555300
3 @@ -1170,7 +1317,9 @@ 1 - Medical Care PARTBPROV + Claim Lines for Claim Number MyMedicare.gov + 2333444555300
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Claim Lines for Claim Number
1 20140105 20140105 @@ -1245,7 +1401,10 @@ 12 - Home R - Rental of DME DMEPROVIDR + + Claim Lines for Claim Number MyMedicare.gov + 11122233310000
- \ No newline at end of file + \ No newline at end of file diff --git a/medicare/medicare_bbp_v2.txt b/medicare/medicare_bbp_v2.txt new file mode 100644 index 0000000..4426c8b --- /dev/null +++ b/medicare/medicare_bbp_v2.txt @@ -0,0 +1,2117 @@ +-------------------------------- +MYMEDICARE.GOV PERSONAL HEALTH INFORMATION + +-------------------------------- +**********CONFIDENTIAL*********** + +Produced by the Blue Button (v2.0) + +02/04/2015 9:18 AM + + + + +-------------------------------- +Demographic + +-------------------------------- + +Source: MyMedicare.gov + + + +Name: JOHN DOE + +Date of Birth: 1/1/1910 + +Address Line 1: 123 ANY ROAD + +Address Line 2: + +City: ANYTOWN + +State: IN + +Zip: 46250 + +Phone Number: 215-248-0684 + +Email: + +Part A Effective Date: 2/1/2014 + +Part B Effective Date: 2/1/2014 + + + +-------------------------------- +Emergency Contact + +-------------------------------- + +Source: Self-Entered + + + +Contact Name: Billy Bigelow2 + +Address Type:Home + +Address Line 1: 1234 Carnival Lane + +Address Line 2: Lobster Bay, ME 11112 + +City: + +State: + +Zip: 11111 + +Relationship: Friend + +Home Phone: + +Work Phone: + +Mobile Phone: + +Email Address: + + + +Contact Name: Enoch Snow + +Address Type:Home + +Address Line 1: 2345 Fish Head Cove + +Address Line 2: Lobster Bay, ME 11112 + +City: + +State: + +Zip: + +Relationship: Friend + +Home Phone: + +Work Phone: + +Mobile Phone: + +Email Address: + + + +-------------------------------- +Self Reported Medical Conditions + +-------------------------------- + +Source: Self-Entered + + + +Condition Name: Allergies + +Medical Condition Start Date: 1/29/2013 + +Medical Condition End Date: + + + +Condition Name: Arthritis + +Medical Condition Start Date: 8/1/1960 + +Medical Condition End Date: 12/31/1980 + + + +Condition Name: Broken Wrist + +Medical Condition Start Date: 2/6/1910 + +Medical Condition End Date: 2/6/2013 + + + +Condition Name: Other + +Medical Condition Start Date: 2/1/2011 + +Medical Condition End Date: + + + +Condition Name: Other + +Medical Condition Start Date: 2/28/2012 + +Medical Condition End Date: + + + +-------------------------------- +Self Reported Allergies + +-------------------------------- + +Source: Self-Entered + + + +Allergy Name: Antibotic + +Type: Drugs + +Reaction: + +Severity: + +Diagnosed: + +Treatment: + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +Allergy Name: Corn + +Type: Food + +Reaction: Blisters + +Severity: Mild + +Diagnosed: Yes + +Treatment: Other + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +Allergy Name: Milk + +Type: Food + +Reaction: Anaphylaxis + +Severity: Severe + +Diagnosed: Yes + +Treatment: Epinephrine (Epi-Pen) + +First Episode Date: 3/21/1985 + +Last Episode Date: 3/31/2012 + +Last Treatment Date: 3/31/2012 + +Comments: + + + +Allergy Name: Other - other + +Type: Other - other + +Reaction: + +Severity: + +Diagnosed: + +Treatment: + +First Episode Date: + +Last Episode Date: + +Last Treatment Date: + +Comments: + + + +-------------------------------- +Self Reported Implantable Device + +-------------------------------- + +Source: Self-Entered + + + +Device Name: COronary stent + +Date Implanted: 11/27/2005 + + + +Device Name: Knee replacement + +Date Implanted: 2/2/2014 + + + +Device Name: Pace maker + +Date Implanted: 2/28/2012 + + + +Device Name: foot + +Date Implanted: 9/9/1984 + + + +Device Name: hearing aid + +Date Implanted: 1/1/2013 + + + +Device Name: nov20 + +Date Implanted: 12/15/2007 + + + +-------------------------------- +Self Reported Immunizations + +-------------------------------- + +Source: Self-Entered + + + +Immunization Name: shingles + +Date Administered:2/3/2010 + +Method: Injection + +Were you vaccinated in the US: Yes + +Comments: + +Booster 1 Date: 2/4/2011 + +Booster 2 Date: 4/6/2012 + +Booster 3 Date: + + + +-------------------------------- +Self Reported Labs and Tests + +-------------------------------- + +Source: Self-Entered + + + +Test/Lab Type: Test + +Date Taken: 1/2/2013 + +Administered by: Inova + +Requesting Doctor: Dr. John Doe + +Reason Test/Lab Requested: + +Results: + +Comments: + + + +-------------------------------- +Self Reported Vital Statistics + +-------------------------------- + +Source: Self-Entered + + + +Vital Statistic Type: Glucose + +Date: 2/7/2008 + +Time: 12:00 AM + +Reading/Value: 322 + +Comments: + + + +Vital Statistic Type: Glucose + +Date: 4/3/2009 + +Time: 12:02 PM + +Reading/Value: 24 + +Comments: fwrqwrgreg + + + +Vital Statistic Type: Glucose + +Date: 5/14/2009 + +Time: 12:17 PM + +Reading/Value: 134 + +Comments: rwrtrt + + + +Vital Statistic Type: Otro - other + +Date: 1/1/1939 + +Time: 12:00 AM + +Reading/Value: other + +Comments: + + + +Vital Statistic Type: Pulse + +Date: 4/6/2013 + +Time: 12:00 AM + +Reading/Value: 333 + +Comments: + + + +Vital Statistic Type: Pulse + +Date: 3/2/2011 + +Time: 12:09 AM + +Reading/Value: 80 + +Comments: wwqrgtrt + + + +Vital Statistic Type: Temperature + +Date: 6/5/2009 + +Time: 8:06 AM + +Reading/Value: 100 + +Comments: fwqerqwr + + + +Vital Statistic Type: Temperature + +Date: 4/4/2008 + +Time: 9:02 AM + +Reading/Value: 99 + +Comments: + + + +-------------------------------- +Family Medical History + +-------------------------------- + +Source: Self-Entered + + + +Family Member: Daughter + +Type: Maternal + +DOB:1/1/1994 + +DOD: + +Age: 31 + +Type: Allergy + +Description: Dyes + +Type: Condition + +Description: Diabetes, Type 2 + +Description: Skin Cancer + + +Family Member: Brother + +Type: + +DOB:4/4/2012 + +DOD: + +Age: + +Type: Allergy + +Description: Chemotherapy + +Type: Condition + +Description: Alzheimer's Disease + + +-------------------------------- +Drugs + +-------------------------------- + +Source: Self-Entered + + + +Drug Name: Abacavir TAB 300MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Abacavir + + + +Drug Name: Abilify Maintena INJ 300MG + +Supply: 1 X Vial Every 1 Month + +Orig Drug Entry: Abilify Maintena + + + +Drug Name: Amlodipine Besylate TAB 10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate TAB 2.5MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate TAB 5MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-20MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-40MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 10-80MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 5-10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Caduet + + + +Drug Name: Amlodipine Besylate/Atorvastatin Calcium TAB 5-80MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Amlodipine Besylate/Atorvastatin Calcium + + + +Drug Name: Androgel Pump GEL 1.62% + +Supply: 2 X 75GM Pump Bottle (sold in a package of 1 pump bottle) Every 1 Month + +Orig Drug Entry: Androgel Pump + + + +Drug Name: Drospirenone/Ethinyl Estradiol TAB 3-0.03MG + +Supply: 28 Every 1 Month + +Orig Drug Entry: Yasmin 28 + + + +Drug Name: Gabapentin CAP 100MG + +Supply: 90 Every 1 Month + +Orig Drug Entry: Gabapentin + + + +Drug Name: Gabapentin SOL 250/5ML + +Supply: 1 X 470ML Bottle Every 1 Month + +Orig Drug Entry: Gabapentin + + + +Drug Name: Jakafi TAB 10MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Jakafi + + + +Drug Name: Losartan Potassium/Hydrochlorothiazide TAB 100-25 + +Supply: 30 Every 1 Month + +Orig Drug Entry: Losartan Potassium/Hydrochlorothiazide + + + +Drug Name: Montelukast Sodium TAB 10MG + +Supply: 90 Every 3 Month + +Orig Drug Entry: Montelukast Sodium + + + +Drug Name: Omeprazole CAP 20MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Omeprazole + + + +Drug Name: Rabavert INJ + +Supply: 2 X Vial (sold in a package of 2) Every 12 Month + +Orig Drug Entry: Rabavert + + + +Drug Name: Tabloid TAB 40MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Tabloid + + + +Drug Name: Vagifem TAB 10MCG + +Supply: 8 Every 1 Month + +Orig Drug Entry: Vagifem + + + +Drug Name: Zafirlukast TAB 20MG + +Supply: 60 Every 1 Month + +Orig Drug Entry: Zafirlukast + + + +Drug Name: Zaleplon CAP 10MG + +Supply: 30 Every 1 Month + +Orig Drug Entry: Zaleplon + + + +Drug Name: Zaltrap INJ 100/4ML + +Supply: 1 X 4ML Vial Every 1 Month + +Orig Drug Entry: Zaltrap + + + +-------------------------------- +Preventive Services + +-------------------------------- + +Source: MyMedicare.gov + + + +Description: ABDOMINAL AORTIC ANEURYSM + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: CARDIOVASCULAR + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: PPV + +Next Eligible Date: 2/1/2014 + +Last Date of Service: + + + +Description: PROSTATE + +Next Eligible Date: 2/1/2014 + +Last Date of Service: 3/26/2012 + + + +Description: PSA + +Next Eligible Date: 2/1/2014 + +Last Date of Service: 3/26/2012 + + + +Description: ANNUAL WELLNESS VISIT + +Next Eligible Date: 2/1/2015 + +Last Date of Service: + + + +Description: ALCOHOL MISUSE SCREENING + +Next Eligible Date: + +Last Date of Service: + + + +Description: CARDIOVASCULAR DISEASE (BEHAVIORAL THERAPY) + +Next Eligible Date: + +Last Date of Service: + + + +Description: COLORECTAL + +Next Eligible Date: + +Last Date of Service: 4/21/2011 + + + +Description: DEPRESSION SCREENING + +Next Eligible Date: + +Last Date of Service: + + + +Description: DIABETES + +Next Eligible Date: + +Last Date of Service: 5/21/2012 + + + +Description: HIGH INTENSITY BEHAVIORAL COUNSELING + +Next Eligible Date: + +Last Date of Service: + + + +Description: OBESITY COUNSELING + +Next Eligible Date: + +Last Date of Service: + + + +Description: PHYSICAL + +Next Eligible Date: + +Last Date of Service: + + + +Description: SMOKING CESSATION (counseling to stop smoking) + +Next Eligible Date: + +Last Date of Service: + + + +-------------------------------- +Providers + +-------------------------------- + +Source: Self-Entered + + + +Provider Name: ANGELO SCOTTI + +Provider Address: 180 WHITE RD LITTLE SILVER, NJ 07739 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: DOUGLAS KNOX + +Provider Address: 1104 E 23RD ST LAWRENCE, KS 66046 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: SIAMAK RASSADI + +Provider Address: 1331 N 7TH ST PHOENIX, AZ 85006 + +Type: Physician & Other Healthcare Professional + +Specialty: Cardiac Electrophysiology,Cardiovascular Disease (Cardiology) + +Medicare Provider: May Accept Medicare + + + +Provider Name: PETER LEAVITT + +Provider Address: 2965 NECONNERS AVE BEND, OR 97701 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: JOHN KENNEDY + +Provider Address: 8888 KEYSTONE XING INDIANAPOLIS, IN 46240 + +Type: Physician & Other Healthcare Professional + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: REBECCA KELLY + +Provider Address: 7250 CLEARVISTA DR INDIANAPOLIS, IN 46256 + +Type: Physician & Other Healthcare Professional + +Specialty: Addiction Medicine + +Medicare Provider: Yes + + + +Provider Name: RILEY HOSPITAL - PEDS DIALYSIS + +Provider Address: 705 RILEY HOSPITAL DRIVE INDIANAPOLIS, IN 46202 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC - SHADELAND STATION + +Provider Address: 7155 SHADELAND STATION STE 130 INDIANAPOLIS, IN 46256 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: IU HEALTH - HOME DIALYSIS + +Provider Address: 8803 N. MERIDIAN ST., STE 150 INDIANAPOLIS, IN 46260 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: MESA VISTA OF BOULDER + +Provider Address: 2121 MESA DRIVE BOULDER, CO 80304 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: FAIRBANKS + +Provider Address: 8102 CLEARVISTA PARKWAY INDIANAPOLIS, IN 46256 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: ALLIANCE HOME HEALTH SERVICES INC + +Provider Address: 9615 N COLLEGE AVE INDIANAPOLIS, IN 46280 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: THE VIRGINIAN + +Provider Address: 9229 ARLINGTON BLVD FAIRFAX, VA 22031 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: KINDRED TRANSITIONAL CARE & REHAB-ALLISON POINTE + +Provider Address: 5226 E 82ND ST INDIANAPOLIS, IN 46250 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: INDIANA HEART HOSPITAL THE + +Provider Address: 8075 N SHADELAND AVE INDIANAPOLIS, IN 46250 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: COMMUNITY HOSPITAL NORTH + +Provider Address: 7150 CLEARVISTA DR INDIANAPOLIS, IN 46256 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FORUM AT THE CROSSING + +Provider Address: 8505 WOODFIELD CROSSING BLVD INDIANAPOLIS, IN 46240 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: BEAUMONT HOSPITAL, TROY + +Provider Address: 44201 DEQUINDRE ROAD TROY, MI 48085 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DAVITA - EAGLE HIGHLANDS + +Provider Address: 6925 SHORE TERRACE INDIANAPOLIS, IN 46254 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC - CARMEL + +Provider Address: 12400 NORTH MERIDIAN ST., STE 200 CARMEL, IN 46032 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DSI - NW INDIANAPOLIS RENAL CENTER + +Provider Address: 6488 CORPORATE DRIVE INDIANAPOLIS, IN 46268 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: GEORGE WASHINGTON UNIV HOSPITAL + +Provider Address: 900 23RD ST NW WASHINGTON, DC 20037 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: DAVITA - CARMEL HEALTH AND LIVING + +Provider Address: 118 MEDICAL DRIVE, SUITE 114 CARMEL, IN 46032 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: FMC-INDIANAPOLIS MIDTOWN + +Provider Address: 3007 DR ANDREW J BROWN AVENUE INDIANAPOLIS, IN 46205 + +Type: Dialysis Facility + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: MILLER'S SENIOR LIVING COMMUNITY + +Provider Address: 8400 CLEARVISTA PL INDIANAPOLIS, IN 46256 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: TEST QT + +Provider Address: COEBURN, VA 24230 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: ADVANCED HOME CARE, INC + +Provider Address: 165 PLAZA ROAD, SUITE 20 WISE, VA 24293 + +Type: Home Health + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: TEST NHC QT + +Provider Address: 0 24230 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: HERITAGE HALL WISE + +Provider Address: 9434 COEBURN MOUNTAIN ROAD WISE, VA 24293 + +Type: Nursing Home + +Specialty: + +Medicare Provider: Yes + + + +Provider Name: QT JAN 15 TEST + +Provider Address: 121 HOME STREET COEBURN, VA 24230 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +Provider Name: NORTON COMMUNITY HOSPITAL + +Provider Address: 100 15TH ST NW NORTON, VA 24273 + +Type: Hospital + +Specialty: + +Medicare Provider: Not Available + + + +-------------------------------- +Pharmacies + +-------------------------------- + +Source: Self-Entered + + + +Pharmacy Name: Castleton Integrative Health 8208 Allisonville Rd Indianapolis, IN 46250 + +Pharmacy Phone: 317-849-1222 + + + +Pharmacy Name: Costco Pharmacy Indianapolis, IN 462506110 East 86th Street Castleton, IN 46250 + +Pharmacy Phone: 317-558-1452 + + + +-------------------------------- +Plans + +-------------------------------- + +Source: MyMedicare.gov + + + +Contract ID/Plan ID: S1111/801 + +Plan Period: 12/01/2012 - current + +Plan Name: + +Marketing Name: + +Plan Address: + +Plan Type: 11 - Medicare Prescription Drug Plan + + + +-------------------------------- +Employer Subsidy + +-------------------------------- + +Source: MyMedicare.gov + + + + +-------------------------------- +Primary Insurance + +-------------------------------- + +Source: MyMedicare.gov + + + + +-------------------------------- +Other Insurance + +-------------------------------- + +Source: MyMedicare.gov + + + +MSP Type: + +Policy Number: 30002 + +Insurer Name: UNITEDHEALTH GROUP + +Insurer Address: 601 OFFICE CENTER DRIVE FORT WASHINGTON, PA 19034 + +Effective Date: 10/01/1984 + +Termination Date: + + + +-------------------------------- +Claim Summary + +-------------------------------- + +Source: MyMedicare.gov + + + +Claim Number: 11122233330000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $92.53 + +Provider Paid: $74.02 + +You May be Billed: $18.51 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233330000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $92.53 + +Non-Covered: $42.47 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 11122233320000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $90.45 + +Provider Paid: $72.36 + +You May be Billed: $18.09 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233320000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $90.45 + +Non-Covered: $44.55 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555100 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 7392 +Diagnosis Code 2: 7241 +Diagnosis Code 3: 7393 +Diagnosis Code 4: 7391 + +-------------------------------- +Claim Lines for Claim Number: 2333444555100 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 98941 - Chiropractic Manipulative Treatment, 3 To 4 Spinal Regions + +Modifier 1/Description: GA - Waiver Of Liability Statement Issued As Required By Payer Policy, Individual Case + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: G0283 - Electrical Stimulation (Unattended), To One Or More Areas For Indication(S) Other Than Wound + +Modifier 1/Description: GY - Item Or Service Statutorily Excluded, Does Not Meet The Definition Of Any Medicare Benefit Or, + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555500 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $1,022.50 + +Medicare Approved: $782.33 + +Provider Paid: $625.86 + +You May be Billed: $156.47 + +Claim Type: PartB + +Diagnosis Code 1: 70700 + +-------------------------------- +Claim Lines for Claim Number: 2333444555500 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + +Modifier 1/Description: RH + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $275.00 + +Allowed Amount: $208.99 + +Non-Covered: $66.01 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0428 - Ambulance Service, Basic Life Support, Non-Emergency Transport, (Bls) + +Modifier 1/Description: HR - Family/Couple With Client Present + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $275.00 + +Allowed Amount: $208.99 + +Non-Covered: $66.01 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 3 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: A0425 - Ground Mileage, Per Statute Mile + +Modifier 1/Description: RH + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 44 + +Submitted Amount/Charges: $472.50 + +Allowed Amount: $364.35 + +Non-Covered: $108.15 + +Place of Service/Description: 41 - Ambulance - Land + +Type of Service/Description: 9 - Other Medical Services + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555200 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 2163 + +-------------------------------- +Claim Lines for Claim Number: 2333444555200 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 99213 - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 22 - Outpatient Hospital + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555300 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: * Not Available * + +Medicare Approved: * Not Available * + +Provider Paid: * Not Available * + +You May be Billed: * Not Available * + +Claim Type: PartB + +Diagnosis Code 1: 28521 +Diagnosis Code 2: 5854 + +-------------------------------- +Claim Lines for Claim Number: 2333444555300 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: J2916 - Injection, Sodium Ferric Gluconate Complex In Sucrose Injection, 12.5 Mg + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 10 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 2 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 36000 - Insertion Of Needle Or Catheter Into A Vein + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 2 - Surgery + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 3 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 90765 - Intravenous Infusion, For Therapy, Prophylaxis, Or Diagnosis (Specify Substance Or Drug); In + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 4 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 90775 - Therapeutic, Prophylactic Or Diagnostic Injection (Specify Substance Or Drug); Each Addition + +Modifier 1/Description: + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Line number: 5 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 99211 - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes + +Modifier 1/Description: 25 - Significant, Separately Identifiable Evaluation And Management Service By The Same Physician On + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: * Not Available * + +Allowed Amount: * Not Available * + +Non-Covered: * Not Available * + +Place of Service/Description: 11 - Office + +Type of Service/Description: 1 - Medical Care + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +-------------------------------- + + + +-------------------------------- + + + +Claim Number: 2333444555400 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $38.00 + +Medicare Approved: $9.38 + +Provider Paid: $7.50 + +You May be Billed: $1.88 + +Claim Type: PartB + +Diagnosis Code 1: 9593 +Diagnosis Code 2: E8889 + +-------------------------------- +Claim Lines for Claim Number: 2333444555400 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: 73110 - X-Ray Of Wrist, Minimum Of 3 Views + +Modifier 1/Description: 26 - Professional Component: Certain Procedures Are A Combination Of A Physician Component And A Tec + +Modifier 2/Description: + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $38.00 + +Allowed Amount: $9.38 + +Non-Covered: $28.62 + +Place of Service/Description: 22 - Outpatient Hospital + +Type of Service/Description: 4 - Diagnostic x-ray + +Rendering Provider No: PARTBPROV + +Rendering Provider NPI: + + + +Claim Number: 11122233310000 + +Provider: No Information Available + +Provider Billing Address: + +Service Start Date: 01/05/2014 + +Service End Date: 01/05/2014 + +Amount Charged: $135.00 + +Medicare Approved: $90.45 + +Provider Paid: $72.36 + +You May be Billed: $18.09 + +Claim Type: DME + +Diagnosis Code 1: 32723 +Diagnosis Code 2: 78051 + +-------------------------------- +Claim Lines for Claim Number: 11122233310000 + +-------------------------------- + + + +Line number: 1 + +Date of Service From: 01/05/2014 + +Date of Service To: 01/05/2014 + +Procedure Code/Description: E0601 - Continuous Positive Airway Pressure (Cpap) Device + +Modifier 1/Description: MS - Six Month Maintenance And Servicing Fee For Reasonable And Necessary Parts And Labor Which Are + +Modifier 2/Description: KX - Requirements Specified In The Medical Policy Have Been Met + +Modifier 3/Description: + +Modifier 4/Description: + +Quantity Billed/Units: 1 + +Submitted Amount/Charges: $135.00 + +Allowed Amount: $90.45 + +Non-Covered: $44.55 + +Place of Service/Description: 12 - Home + +Type of Service/Description: R - Rental of DME + +Rendering Provider No: DMEPROVIDR + +Rendering Provider NPI: + + +