The patient, providers, and dates here are all made up, and there's no real health information anywhere in it. This is an example of the work Penna produces, kept clearly labeled so it's never mistaken for a real file.
Example output
A clear, dated timeline of one patient's care after a collision, pulled together from 847 pages across five providers into a single record you can read at a glance. Every entry cites the page it came from. We organize the facts; we don't draw legal conclusions, weigh in on causation, or track deadlines.
| Date | Provider | Visit type | Key findings | Diagnosis (as written) | Treatment & next steps | Billing | Pg |
|---|---|---|---|---|---|---|---|
| 03/02/2026 | Metro General ER | Emergency | Rear-end collision; neck and low-back pain, no loss of consciousness; CT head normal; lumbar X-ray no acute fracture | "Cervical strain; lumbar strain" | NSAIDs, methocarbamol, 3-day work note, follow up with PCP | $3,180 | 1–58 |
| 03/05/2026 | Valley Primary Care | Office follow-up | Persistent low-back pain radiating to left leg; paraspinal spasm; reduced lumbar range of motion | "Lumbago with left-sided sciatica" | Referrals to orthopedics and physical therapy; continue medications | $210 | 59–71 |
| 03/14/2026 | Summit Orthopaedics | Orthopedic eval | Positive left straight-leg raise; decreased sensation L5 distribution | "Lumbar radiculopathy, rule out disc herniation" | Lumbar MRI ordered; activity modification | $365 | 93–116 |
| 03/28/2026 | Mercy Imaging | Lumbar MRI | "L4–L5 disc protrusion with left neural foraminal narrowing; mild facet arthrosis" | "L4–L5 disc protrusion" | Return to orthopedics for review | $1,420 | 169–198 |
| 04/10/2026 | Active Physical Therapy | Physical therapy eval | Pain 7/10; antalgic gait; lumbar flexion limited | "Lumbar radiculopathy" | Physical therapy 3x/week for 8 weeks | $245 | 215–242 |
| 04/10–06/05 | Active Physical Therapy | Physical therapy, 24 visits | Pain 7→4/10; improved range of motion and activity tolerance | – | Continued therapy; home exercise program | $5,760 | 243–560 |
| 04/22/2026 | Summit Orthopaedics | Orthopedic follow-up | Persistent radicular pain despite therapy; straight-leg raise still positive | "Lumbar radiculopathy, L4–L5" | Recommend lumbar epidural steroid injection | $310 | 117–140 |
| 05/06/2026 | Summit Orthopaedics | Injection | Fluoroscopy-guided left L4–L5 transforaminal epidural steroid injection | "Status post L4–L5 ESI" | Follow up 4 weeks; continue therapy | $2,950 | 141–168 |
| 05/22/2026 | Mercy Imaging | Lumbar X-ray | "No acute change; alignment preserved" (post-procedure) | "L4–L5 disc protrusion" | Clinical correlation | $360 | 199–214 |
| 06/05/2026 | Active Physical Therapy | Physical therapy discharge | Pain 4/10; functional gains met; home program issued | "Resolving lumbar radiculopathy" | Discharge to home exercise program | incl. | 561–612 |
| 06/12/2026 | Valley Primary Care | Office follow-up | ~50% relief after injection; residual intermittent left-leg pain | "Improved lumbar radiculopathy" | Continue home program; orthopedics as needed | $210 | 72–92 |
The patient was rear-ended on 03/02/2026 and went to the Metro General ER the same day with neck and low-back pain. A head CT and a lumbar X-ray both came back clear of any acute injury, and the ER chart recorded "cervical strain; lumbar strain" (pp. 1–58). Three days later, a primary-care visit on 03/05/2026 noted low-back pain spreading down into the left leg, written up as "lumbago with left-sided sciatica," and set up referrals to orthopedics and physical therapy (pp. 59–71). Orthopedics saw the patient on 03/14/2026, found exam signs pointing to an irritated nerve in the lower back, and ordered an MRI (pp. 93–116).
The MRI on 03/28/2026 confirmed a disc problem at the L4–L5 level, reported as an "L4–L5 disc protrusion with left neural foraminal narrowing" (pp. 169–198). The patient started physical therapy on 04/10/2026 and finished 24 visits by 06/05/2026, with pain easing from 7/10 down to 4/10 (pp. 215–560). When the leg pain kept up despite therapy, orthopedics gave a steroid injection at the L4–L5 level on 05/06/2026 (pp. 117–168). At the last visit in this set, on 06/12/2026, the patient reported about 50% relief with some on-and-off left-leg pain still remaining (pp. 72–92).
A gap is a period of more than 30 days with no treatment record in this set. Each one is listed with its dates, its length, and the page cited on either side. We flag gaps in the records, with citations, so the attorney can decide what they mean.
| Period | Length | Before the gap | After the gap |
|---|---|---|---|
| 2024 to 03/02/2026 Before the collision | Over 14 months | A 2024 lumbar X-ray at an outside facility, mentioned in the ER note (p. 41). The X-ray itself is not in this set. | Metro General ER visit, 03/02/2026 (pp. 1–58) |
After the collision, no period between treatment dates is longer than 30 days. The last treatment record in this set is dated 06/12/2026 (pp. 72–92); the set holds none after it.
We check that every billed code is supported by the record for that date of service. Each charge is matched to the visit, procedure or report dated that day, with the page it comes from, and shown with the codes the provider billed. Supported means the record for that date documents the service billed. Flagged means it does not, or it documents something different; the reason is in the Record column, for the attorney to review.
| Date of service | Provider | CPT | Service billed | ICD-10-CM | Record for that date | Billed | Pg | Status |
|---|---|---|---|---|---|---|---|---|
| 03/02/2026 | Metro General ER | 99284 | Emergency room visit | S16.1XXA S39.012A | ER report documents the visit | $1,450 | 1–58 | Supported |
| 03/02/2026 | Metro General ER | 70450 | Head CT scan, no contrast | S16.1XXA S39.012A | ER report: head CT done, read as normal | $1,100 | 1–58 | Supported |
| 03/02/2026 | Metro General ER | 72100 | Lower-spine X-ray, 2 or 3 views | S16.1XXA S39.012A | ER report: lumbar X-ray done, no acute fracture | $480 | 1–58 | Supported |
| 03/02/2026 | Metro General ER | 85025 | Complete blood count | S16.1XXA S39.012A | ER chart includes the lab results | $150 | 1–58 | Supported |
| 03/05/2026 | Valley Primary Care | 99213 | Office visit, established patient | M54.42 | Office note for this date | $210 | 59–71 | Supported |
| 03/14/2026 | Summit Orthopaedics | 99204 | Office visit, new patient | M54.16 | Evaluation note for this date | $365 | 93–116 | Supported |
| 03/28/2026 | Mercy Imaging | 72148 | Lower-spine MRI, no contrast | M51.26 | MRI report for this date | $1,420 | 169–198 | Supported |
| 04/10/2026 | Active Physical Therapy | 97162 | Physical therapy evaluation | M54.16 | Evaluation note for this date | $245 | 215–242 | Supported |
| 04/10–06/05 | Active Physical Therapy | Not itemized | 24 therapy visit totals | Not stated | 24 visit notes found. Line-item codes are missing on several dates; an itemized ledger was requested (p. 601). | $5,760 | 243–560 | Flagged |
| Date of service | Provider | CPT | Service billed | ICD-10-CM | Record for that date | Billed | Pg | Status |
|---|---|---|---|---|---|---|---|---|
| 04/22/2026 | Summit Orthopaedics | 99214 | Office visit, established patient | M54.16 | Follow-up note for this date | $310 | 117–140 | Supported |
| 05/06/2026 | Summit Orthopaedics | 64483 | Lower-back steroid injection, X-ray guided | M54.16 | Procedure note: left L4–L5 injection under fluoroscopy | $2,700 | 141–168 | Supported |
| 05/06/2026 | Summit Orthopaedics | 99213 | Office visit, established patient | M54.16 | No visit note on this date. The only record for 05/06/2026 is the procedure note. | $250 | 141–168 | Flagged |
| 05/22/2026 | Mercy Imaging | 72110 | Lower-spine X-ray, 4 or more views | M51.26 | The report lists 2 views. The code billed is for 4 or more views (p. 205). | $360 | 199–214 | Flagged |
| 06/12/2026 | Valley Primary Care | 99213 | Office visit, established patient | M54.16 | Office note for this date | $210 | 72–92 | Supported |
We do not assign, change or certify codes, and we do not judge whether a charge was reasonable or necessary.
ICD-10-CM codes above: S16.1XXA neck muscle strain, initial encounter; S39.012A lower-back muscle strain, initial encounter; M54.42 lower-back pain with left-leg sciatica; M54.16 irritated lower-back nerve root (radiculopathy); M51.26 displaced disc in the lower back.
| Provider | Billed, as written |
|---|---|
| Active Physical Therapy | $6,005 |
| Summit Orthopaedics | $3,625 |
| Metro General ER | $3,180 |
| Mercy Imaging | $1,780 |
| Valley Primary Care | $420 |
Transcribed from the providers’ own statements, not adjusted or audited. The physical-therapy discharge visit is included in that provider’s course-of-care total.
| Source pp. | Provider | Document type | Date span |
|---|---|---|---|
| 1–58 | Metro General ER | ER report, CT head, lumbar X-ray, labs | 03/02/2026 |
| 59–92 | Valley Primary Care | Office notes (2 visits) | 03/05–06/12/2026 |
| 93–168 | Summit Orthopaedics | Evaluations, follow-ups, ESI procedure note | 03/14–05/06/2026 |
| 169–214 | Mercy Imaging | MRI report, post-procedure X-ray | 03/28–05/22/2026 |
| 215–612 | Active Physical Therapy | Evaluation, 24 visit notes, discharge | 04/10–06/05/2026 |
| 613–847 | All sources | Itemized billing ledgers and statements | 03/2026–06/2026 |