aeroreyna
5.4 KiB
5.4 KiB
Date, Author, Tags
| Date | Author | Tags | |||||
|---|---|---|---|---|---|---|---|
| 2026-05-26 | Pi-Brain |
|
Medical Appointments
Adolfo - Radiology
- Exam: CT Temporal Bones Without Contrast
- Prep: No prep necessary
- Date: Thursday, June 4, 2026
- Time: 4:55 PM
- Confirmation Number: 4323239
- Facility: Radiology Imaging Associates — FT Pierce Imaging Center
- Address: 2306 Nebraska Ave, Fort Pierce, FL 34950
- Phone: (772) 464-1650
Adolfo - ENT Audiology (Completed)
- Visit date: 2026-05-21
- Report: Audiologic Report (3 pages) — ENT Hearing Associates of Florida
- Facility: ENT Hearing Associates of Florida / ENT & Allergy Associates of Florida
- Address: 1401 N Lawnwood Circle, Fort Pierce, FL 34950
- Phone: (772) 464-6055
- Audiologist: Michele Phillips, Au.D.
- Referring physician: Timothy S. Tudor, DO
Key findings (from report)
- Mild mixed sloping hearing loss in right ear.
- Normal hearing in left ear.
- Asymmetrical hearing loss noted.
- Tinnitus reported: "crackling electrical noise" in left ear around loud sounds (longstanding).
- Word recognition:
- Right ear: 84% at 75 dBHL
- Left ear: 96% at 55 dBHL
- Diagnosis code listed: H90.71
Recommendations (from report)
- Medical management per physician recommendations.
- Repeat audiogram per otologic plan of care, or sooner if hearing changes.
- Results and recommendations discussed with patient.
Grace and Elias - Pediatric Dental / Rachelle A. Dermody, D.M.D. (June 2026)
- Source: WhatsApp screenshots processed on 2026-06-04; documents dated 2026-06-03.
- Provider: Rachelle A. Dermody, D.M.D., P.A., 441 SW Bethany Drive, Port St. Lucie, FL 34986; phone (772) 879-1879.
- Mailing guarantor on statement: Alicia Reyna, 220 Emerald Ave, Ft. Pierce, FL 34945.
- Statement chart number: REG312; treatment-plan chart number for Grace: REG315.
- Insurance shown: Primary Delta Dental.
Statement of Services Rendered - 2026-06-03
- Current charges: $1,114.00.
- Current credits: $212.70 credit card payment.
- Prior balance: $0.00.
- New balance: $901.30.
- Dental insurance estimate: $910.00.
- Please pay shown: -$8.70, likely an estimated credit after insurance; confirm with dental office if needed.
Elias services
- Periodic oral evaluation: $88.00.
- Prophylaxis - child: $120.00.
- Topical application fluoride varnish: $68.00.
- Sealants: teeth 3, 14, 19, 30 at $104.00 each.
- Elias subtotal: $692.00.
Grace services
- Periodic oral evaluation: $86.00.
- Bitewing two image: $80.00.
- Prophylaxis - child: $120.00.
- Topical application fluoride varnish: $68.00.
- Tooth E intraoral occlusal image: $70.00.
- Grace subtotal: $424.00.
Grace Treatment Plan - 2026-06-03
- Treatment plan total: $5,622.00.
- Estimated deductible to be applied: $50.00.
- Estimated insurance payment: $1,393.00.
- Estimated patient portion: $4,229.00.
- Plain-English summary: Grace has proposed fillings on teeth A, B, I, J, K, L, S, and T, plus a stainless steel crown and pulpotomy on tooth L; treatment is split across 4 visits, each including nitrous oxide.
Visit 1 - total $1,171.00 / estimated patient portion $425.40
- 2026-06-03 line items: d00001 oral exam/reversal $41.00 patient $41.00; D9230 nitrous oxide $148.00 patient $148.00; tooth S DO D2392 resin composite 2 surfaces posterior $491.00 patient $98.20; tooth T MO D2392 resin composite 2 surfaces posterior $491.00 patient $138.20.
Visit 2 - total $1,961.00 / estimated patient portion $1,313.60
- 2026-06-03 line items: d00001 oral exam/reversal $41.00 patient $41.00; D9230 nitrous oxide $148.00 patient $148.00; tooth K MO D2392 resin composite 2 surfaces posterior $491.00 patient $236.40; tooth L DO D2392 resin composite 2 surfaces posterior $491.00 patient $98.20; tooth L D2930 prefabricated stainless steel crown primary $438.00 patient $438.00; tooth L D3220 therapeutic pulpotomy excluding final restoration $352.00 patient $352.00.
Visit 3 - total $1,245.00 / estimated patient portion $1,245.00
- 2026-06-03 line items: d00001 oral exam/reversal $41.00 patient $41.00; D9230 nitrous oxide $148.00 patient $148.00; tooth I DO D2392 resin composite 2 surfaces posterior $491.00 patient $491.00; tooth J MOL D2393 resin composite 3 surfaces posterior $565.00 patient $565.00.
Visit 4 - total $1,245.00 / estimated patient portion $1,245.00
- 2026-06-03 line items: d00001 oral exam/reversal $41.00 patient $41.00; D9230 nitrous oxide $148.00 patient $148.00; tooth A MOL D2393 resin composite 3 surfaces posterior $565.00 patient $565.00; tooth B DO D2392 resin composite 2 surfaces posterior $491.00 patient $491.00.
Upcoming dental appointments from statement
- Grace: Monday, June 15, 2026 at 11:00 AM. Reason shown: ResCmp2s#S, ResCmp2s#T, AnlgNitOx, Orv; likely composite fillings on teeth S and T, nitrous oxide, and Oraverse/reversal.
- Elias: Wednesday, December 2, 2026 at 10:20 AM. Reason shown: Ex, FLV, ProC; likely exam, fluoride varnish, child cleaning.
- Grace: Wednesday, December 2, 2026 at 10:20 AM. Reason shown: Ex, FLV, ProC; likely exam, fluoride varnish, child cleaning.
OCR uncertainty notes
d00001may be an internal office code rather than a standard CDT code.- "Oral exam / reversal" and "Orv" were somewhat unclear; may refer to Oraverse/reversal.
- Financial totals and procedure codes appeared readable with good confidence, but should be verified against the original screenshots/documents before payment or medical decisions.