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 is checked against 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).
| 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 |