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[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/01/2025\"\n },\n \"people\": {\n \"patient_name\": \"Rewa, Joanngela\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"404.9\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Payment a CK ICA. CC ih ort PU Appiee eat el) hs Est) New Fol Mohs Surg BL Cos TH Patient: Rewa, Joanngela DOB: 12/10/1972 Pt's Residence: Battle Creek Appt Date: 10/01/2025 Provider: TT Insurance: Humana Gold Plus MRN: BC7074377 Location of Appt: ADR ANG (8 HIL JXN KZO- STU ST) Ordering D\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_0.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"(\\u20acz/og/01) 7d 184 om VN Wl dN dd ds SIME 9 s v ozs Vojoadsy aed xq $ 8rd $'8ra 8rd s'8rd S8ra 80rd S'8ra S8rd $'8ra S'8ra S'8ra $'8ra 3rd S'8ra s'srd s'8ra $8 S'8ra S8ra S8ra S8ra ssra $8ra S'8ra ssra s8ra s8ra $8ra ssra $'8rd $3ra 6\\u20acca cL \\u20ac7a 1Le7a tL'\\u20accd. 1L\\u00a27a 067d seca seca co ez7a 1\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_1.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/11/25\"\n },\n \"people\": {\n \"patient_name\": \"has an\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \" oy ce Age OZ pie (ONS Patient #1 \\u2014 Patients age 12 and older - Are you currently a tobacco user (any form of tobacco)? Yes (G9902) No (G9903) Patient counseled, 3 minutes or less (provider initial) J #2 \\u2014 Patients age 65 and older - Do you have an advance care plan or do you wan\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_2.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"02/24/2012\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"404.9\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"| Payment [Z CK CA CC Initials F/U Appt rae tox ee | ee Est New & Mohs Surg BL Cos TH DOB: 02/24/2012 Pt's Residence: EATON RAPIDS Appt Date: 10.1.25 Provider: KH Insurance: McLaren Health Plan MRN: MM0000080191 Location of Appt: ADR ANG e HIL JXN KZO S\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_3.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"ee = eS = one (\\u20acz/oE/o1) cd L8d ort VW Wl JIN dd dS SIME 9 s v azig ojo eds aed Xd 6'cd tL\\u20act. leed tL eta IL\\u00a27d 067d seca sca wc 19\\u00b0\\u20acta co eta I9'\\u20acta ceca 19 ta z9'\\u20acta 19'\\u00a2ta seca std recd oe oleca tl etd ramxces tIleza Iiveza weed Iveea reed sca 6\\u00a3 \\u00a27a 6\\u00a3eca worse] 80rd S 8rd s8r\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_4.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/11/25\"\n },\n \"people\": {\n \"patient_name\": \"QUESTIONNAIRE\\n\\n \\n \\n \\n\\nPatient\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \" . . Fy ict SK PATIENT QUESTIONNAIRE Patient Age |3 Date (ol (/2. #1 \\u2014 Patients age 12 and older - Are you currently a tobacco user (any form of tobacco)? Yes (G9902) .~_No (G9903) Patient counseled, 3 minutes or less (provider initial) #2 \\u2014 Patients age 65 and older - Do you have an a\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_5.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"03/04/1974\"\n },\n \"people\": {\n \"patient_name\": \"BEMUS, PAUL\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"404.9\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Payment Initials F/U Appt Patient: BEMUS, PAUL Appt Date: 10.1.25 MRN: MM0000082011 CK CA CC Provider: KH Insurance: ~ Est New or.) Mots Surg BL Cos TH DOB: 03/04/1974 Pt's Residence: DELTON Location of Appt: ADR ANG (BC (1.8 cADR ANG (ee) Community Plan (GLHP) HIL JXN KZO STU ST) \\u00a9 \"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_6.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"ee eee Oo ats (\\u20acz/oE/o1) zd 184 ott VN W7I wo Wr WE We WI JN dd dS IME AMT MAT de dz ai :Nanlad 9 \\u20ac s z + 1 SHOW 2Z1S ojo adh aed xa ezis Vo jo odkL aed XG sera 6\\u00a2cd 677d ; lero cod 6th 8rd cLeta wed 6IL' bho t'0a (ams 8) 1004 YT o 8rd lLeza Ltd T\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_7.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/11/25\"\n },\n \"people\": {\n \"patient_name\": \"QUESTIONNAIRE\\n\\nAge\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"ESS ES_\\u2014C sd nl eye oS PATIENT QUESTIONNAIRE Age Si Date lof | 1a Patient #1 \\u2014 Patients age 12 and older - Are you currently a tobacco user (any form of tobacco)? Yes (G9902) / No (G9903) Patient counseled, 3 minutes or less (provider initial) #2 \\u2014 Patients age 65 and older - Do you have an \"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_8.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/01/2025\"\n },\n \"people\": {\n \"patient_name\": \"Wheeler, Yolonda\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"404.9\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Payment 5 CK CA. CC ane) Initials F/U Appt Est (New_/ Fol Mohs Surg BL Cos TH SH lap fae Patient: Wheeler, Yolonda DOB: 08/11/1981 Pt's Residence: Quincy Appt Date: 10/01/2025 Provider: TT Insurance: UnitedHealthcea Community Plan (GLHP) MRN: MM0000083723 Location of Appt:ADR ANG (6c _\\u201cHIL JXN KZO S\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_9.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"TT ee, Ce ese ee (ez/oe/o1) zd 8d out WIN Wel SIN sda dS AME 9 s v azig Woo adky awa xq 8rd s8ra s8ra s3rd S8ra sora ssrd 8rd ssra $ 8rd ssra ssa 8rd s8rd $ 3rd s'8rd 3rd S8ra ssra \\u00a2'8ra 8rd S8ra s'8ra ssra ssra ose 8rd ssrd 8rd s8rd S8ra JOIARYOg 67d w'\\u20ac7a ILeta tet ILeca o'6ca s\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_10.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/11/25\"\n },\n \"people\": {\n \"patient_name\": \"has an\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \" PATIENT QUESTIONNAIRE N\\u00a2 | Age U4 Date (yidehzs Patient #1 \\u2014 Patients age 12 and older - Are you currently a tobacco user (any form of tobacco)? Yes (G9902) o No (G9903) Patient counseled, 3 minutes or less (provider initial) #2 \\u2014 Patients age 65 and older - Do you have an advance care\"\n}"
}
] |
[
"datasets_images/Done - bc misc fee tx 10-1-25_page_11.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"DOB Perm\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Department Appointments Report: Woofter Family Med-CC - Combined Departments - 10/31/2025 Color F... Time Arrived... VisitDate MRN Patient DOB Perm Comments Appt Notes *Provider/Resource Phone Type @ 8:15 AM | 8:10AM 10/31/202| E2042838\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_0.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"DOB Perm\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \" Department Appointments Report: Woofter Family Med-CC - Combined Departments - 10/31/2025 Color F... Time Arrived... Visit Date MRN Patient DOB Perm Comments Appt Notes *Provider/Resource Phone Type e@ 9:00 AM | 8:43 AM iz | 10\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_1.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"DOB Perm\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Department Appointments Report: Woofter Family Med-CC - Combined Departments - 10/31/2025 Color F... Time Arrived ... Visit Date MRN Patient DOB Perm Comments Appt Notes *Provider/Resource Phone Type T @ 8:00\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_2.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"9/13/1972\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"212.11\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: REED,RONALD A [MRN: E1582071 SSN Masked #3..: xxx-xx-6772 Date of birth..: 9/13/1972 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD, BLUE CROSS BLUE SHIELD/WV HIGHMARK BCBS PPO Plan Address: PO BOX 7026, PO Box 7026, WHEELING, Wheeling, WV, WVZIP: 26003, 26003 Sub ID: R58134833 \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_3.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/13/1966\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"200.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: FOBARE,MICHAEL L [MRN: E1769209 SSN Masked #3..: xxx-xx-0889 Date of birth..: 11/13/1966 Coverages: FO | Payer/Plan: HEALTH PLAN, HEALTH PLAN PEIA/HEALTH PLAN (PPO- NON PEIA) Plan Address: 1110 MAIN STREET, 1110 MAIN STREET, WHEELING, WHEELING, WV, WVZIP: 26003, 26003 Sub ID: Sub Na\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_4.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/10/1998\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"0.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: LOUGH,BROOKE D [MRN: E2343555 SSN Masked #3..: xxx-xx-4998 Date of birth..: 6/10/1998 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD/FEDERAL BLUE CROSS Plan Address: PO Box 7026, Wheeling, WVZIP: 26003 Sub ID: R61768088 Sub Name: LOUGH,BROOKE D FO 2 FO 3 Encounter Information\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_5.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/9/2005\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"78.4\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: WALLACE,NEVADA [MRN: E1901186 SSN Masked #3..: xxx-xx-2234 Date of birth..: 6/9/2005 Coverages: FO 1 Payer/Plan: PROGRESSIVE AUTO, BLUE CROSS BLUE SHIELD, HEALTH PLAN MEDICAID/WV HIGHMARK BCRS PPO Plan Address: PO BOX 2930, PO BOX 7026, 1110 MAIN STREET, CLINTON, WHEELING, WHEELING,\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_6.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/27/1942\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: STUBBS,JIMMIE L [MRN: E1506263 SSN Masked #3..: xxx-xx-7497 Date of birth..: 11/27/1942 Coverages: FO 1 Payer/Plan: HUMANA MEDICARE/HUMANA MEDICARE ADV PEIA Plan Address: PO BOX 14601, LEXINGTON, KYZIP: 40512-4601 Sub ID: H54994758 Sub Name: STUBBS,JIMMIE L FO2 FO 3 Encounter Inf\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_7.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/19/1970\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: MCMUNN,DEENA R [MRN: E352636 SSN Masked #3..: xxx-xx-2926 Date of birth..: 6/19/1970 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD/FEDERAL BLUE CROSS Plan Address: PO Box 7026, Wheeling, WVZIP: 26003 Sub ID: R61399909 Sub Name: MCMUNN,DEENA R FO2 FO 3 Encounter Information \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_8.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Billing provider: | Woofter, Dominick, MD Printed on: 11/1/2025 Primary Account: MCMUNN.DEENA R [100093458] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_9.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"4/1/2003\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"40.9\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: GREGG,BRANDON [MRN: E391216 SSN Masked #3..: xxx-xx-1900 Date of birth..: 4/1/2003 Coverages: FO 1 Payer/Plan: WELLPOINT WV/WELLPOINT WV MEDICAID Plan Address: PO Box 91, Charleston, WVZIP: 25321-0091 Sub ID: 00101630699 Sub Name: GREGG,BRANDON FO 2 FO 3 Encounter Information En\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_10.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"7/16/1997\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"43.1\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: ALLMAN,HALEY M [MRN: E249652 SSN Masked #3..: xxx-xx-4953 Date of birth..: 7/16/1997 Coverages: FO 1 Payer/Plan: AETNA BETTER HEALTH - WV/AETNA BETTER HEALTH - WV Plan Address: PO BOX 982965, EL PASO, TXZIP: 79998-2965 Sub ID: 00300461272 Sub Name: ALLMAN,HALEY M FO2 FO 3 Encount\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_11.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Printed on: 11/1/2025 Primary Account: ALLMAN,HALEY M [101674644] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_12.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"7/9/1939\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"125.1\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: LAFFERTY,CLARENCE [MRN: E30955 SSN Masked #3..: xxx-xx-0901 Date of birth..: 7/9/1939 Coverages: FO 1 Payer/Plan: MEDICARE, AARP HEALTH CARE OPTIONS/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 1878, COLUMBIA, SOUTHHAMPTON, SC, PAZIP: 29202-3190, 18966-9998 Sub ID: 9P64\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_13.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Primary Account: LAFFERTY,CLARENCE [100963995] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_14.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/1/1974\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"78.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: WARE,DANIEL L [MRN: E448199 SSN Masked #3..: xxx-xx-7223 Date of birth..: 10/1/1974 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD/FEDERAL BLUE CROSS Plan Address: PO Box 7026, Wheeling, WVZIP: 26003 Sub ID: R58908958 Sub Name: WARE,JESSICA FO 2 FO 3 Encounter Information Dat\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_15.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"0.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"3080F - PB DIAST BP = 90 MM HG 10/31/2025 1 Z00.00 Service provider: Woofter, Dominick, MD Place of service: WOOFTER FAMILY MED- cc Billing provider: _ Woofter, Dominick, MD 3077F - PB SYST BP = 140 MMHG 10/31/2025 1 Z00.00 Service provider: Woofter, Dominick, MD Place of service: WOOFTER FAMILY ME\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_16.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"7/3/1960\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"200.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: BROWN,DAVID L [MRN: E179072 SSN Masked #3..: xxx-xx-8514 Date of birth..: 7/3/1960 Coverages: FO 1 Payer/Plan: MEDICARE/MEDICARE PART A AND B Plan Address: PO BOX 100190, COLUMBIA, SCZIP: 29202-3190 Sub ID: 4UDIHW3UC21 Sub Name: BROWN,DAVID L FO 2 FO 3 Encounter Information D\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_17.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Printed on: 11/1/2025 Primary Account: BROWN,DAVID L [102409861] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_18.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"4/3/1997\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"0.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: BARKER,JUILIA ANNE [MRN: E393436 SSN Masked #3..: xxx-xx-8836 Date of birth..: 4/3/1997 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD, BLUE CROSS BLUE SHIELD/ANTHEM BCBS PPO Plan Address: PO BOX 7026, PO BOX 105187, WHEELING, ATLANTA, WV, GAZIP: 26003, 30348-5187 Sub ID: FNE924\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_19.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"12/16/1927\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"125.1\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: SPATAFORE,JOSEPH [MRN: E195612 SSN Masked #3..: xxx-xx-6884 Date of birth..: 12/16/1927 Coverages: FO | Payer/Plan: RAILROAD MEDICARE, HH AND HOSPICE CGS MEDICARE, UNITED HEALTHCARE/RAILROAD MEDICARE Plan Address: PO BOX 10066, AG 600 PO BOX 100238, PO Box 30304, AUGUSTA, COLUMBIA, \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_20.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"90471 - PB IMMUNIZ ADMIN, 1 SINGLE/COMB 10/31/2025 1 VAC/TOXOID Service provider: Woofter, Dominick, MD Place of service: WOOFTER FAMILY MED- Billing provider: Woofter, Dominick, MD Printed on: 11/1/2025 Primary Account: SPATAFORE,JOSEPH [100493550] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_21.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"4/14/1989\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"53.83\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: PEYATT,CARL [MRN: E2904716 SSN Masked #3..: xxx-xx-0871 Date of birth..: 4/14/1989 Coverages: FO | Payer/Plan: PEIA, TRICARE/PEIA/UMR Plan Address: PO BOX 30541, PO BOX 202146, SALT LAKE CITY, FLORENCE, UT, SCZIP: 84130-0541, 29502-2146 Sub ID: 7700951405 Sub Name: PEYATT,CAMILLE L \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_22.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"9/28/1973\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: OILER,KEVIN E [MRN: E1485876 SSN Masked #3..: xxx-xx-0414 Date of birth..: 9/28/1973 Coverages: FO 1 Payer/Plan: PEAK MEDICARE ADVANTAGE/PEAK ADVANTAGE SUMMIT A Plan Address: 1085 VAN VOORHIS RD, SUITE 300, MORGANTOWN, MORGANTOWN, WV, WVZIP: 26505, 26505 Sub ID: 26500017601 Sub Name\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_23.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"1/30/1963\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"17.2\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: BRAKE,SHARRI L [MRN: E1967438 SSN Masked #3..: xxx-xx-3172 Date of birth..: 1/30/1963 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD/WV HIGHMARK BCBS PPO Plan Address: PO BOX 7026, WHEELING, WVZIP: 26003 Sub ID: OVW112666758001 Sub Name: BRAKE,SHARRI L FO 2 FO 3 Encounter Inf\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_24.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"3/17/1964\"\n },\n \"people\": {\n \"patient_name\": \"PINTILMARK\\n\\nFO\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: PINTI,KELLY L [MRN: E365114 SSN Masked #3..: xxx-xx-1910 Date of birth..: 3/17/1964 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD, ALLIED BENEFIT SYSTEMS, INC/WV HIGHMARK BCBS PPO Plan Address: PO BOX 7026, PO BOX 21 1651, WHEELING, EAGAN, WV, MNZIP: 26003, 55121 Sub ID: OVW106\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_25.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/2/1954\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: PORTARO,BARBARA J [MRN: E68491 SSN Masked #3..: xxx-xx-8482 Date of birth..: 6/2/1954 Coverages: FO 1 Payer/Plan: HUMANA MEDICARE/HUMANA CHOICE PPO Plan Address: PO Box 14601, Lexington, KYZIP: 40512-4601 Sub ID: H66735155 Sub Name: PORTARO,BARBARA J FO 2 FO 3 Encounter Informati\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_26.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"2/15/1955\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"17.2\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: HAIRSTON,MAVIS A [MRN: E97216 SSN Masked #3..: xxx-xx-2699 Date of birth..: 2/15/1955 Coverages: FO 1 Payer/Plan: MEDICARE, BLUE CROSS BLUE SHIELD, HH AND HOSPICE CGS MEDICARE/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 105187, AG 600 PO BOX 100238, COLUMBIA, ATLANTA, \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_27.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Billing provider: \\u2014 Woofter, Isha, MD Printed on: 11/1/2025 Primary Account: HAIRSTON,MAVIS A [100066234] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_28.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/20/1949\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: PATTON,MARTHA A [MRN: E1616241 SSN Masked #3..: xxx-xx-5452 Date of birth..: 10/20/1949 Coverages: FO 1 Payer/Plan: MEDICARE, CHAMPVA CTR, CHAMPVA CTR/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 30750, PO BOX 30750, COLUMBIA, TAMPA, TAMPA, SC, FL, FLZIP: 29202-3190, 33\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_29.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"9/5/1937\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: CARTER,JEWELL FRANCES [MRN: E2042838 SSN Masked #3..: xxx-xx-0354 Date of birth..: 9/5/1937 Coverages: FO 1 Payer/Plan: PEAK MEDICARE ADVANTAGE/PEAK ADVANTAGE SUMMIT A Plan Address: 1085 VAN VOORHIS RD, SUITE 300, MORGANTOWN, MORGANTOWN, WV, WVZIP: 26505, 26505 Sub ID: 26500407901 S\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_30.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Primary Account: CARTER,JEWELL FRANCES [100915690] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_31.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"2/25/1950\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"78.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: HUTSON,GARY A [MRN: E116350 SSN Masked #3..: xxx-xx-4992 Date of birth..: 2/25/1950 Coverages: FO 1 Payer/Plan: UHC MEDICARE/UHC MEDICARE ADVANTAGE PPO Plan Address: PO BOX 31362, SALT LAKE CITY, UTZIP: 84131-8362 Sub ID: 98201279200 Sub Name: HUTSON,GARY A FO 2 FO 3 Encounter In\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_32.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"PRSRV FREE IM Service provider: Nurse Visit, Woofter Family Place of service: WOOFTER FAMILY MED- Med-Cc. Billing provider: | Woofter, Dominick, MD NDC Amount 70461-655-03 -5 Milliliters 90471 - PB IMMUNIZ ADMIN, 1 SINGLE/COMB 10/31/2025 1 VAC/TOXOID Service provider: Nurse Visit, Woofter Family\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_33.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"4/25/1966\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: BEAM,MARCINE [MRN: E294550 SSN Masked #3..: xxx-xx-6405 Date of birth..: 4/25/1966 Coverages: FO 1 Payer/Plan: HIGHMARK MEDICARE ADVANTAGE, HIGHMARK MEDICARE ADVANTAGE/HIGHMARK MEDICARE ADVANTAGE PPO Plan Address: PO BOX 7004, PO BOX 7004, Wheeling, Wheeling, WV, WVZIP: 26003, 26003\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_34.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"7/19/1973\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"200.0\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: MURPHY,CHRISTINA L [MRN: E722828 SSN Masked #3..: xxx-xx-863 1 Date of birth..: 7/19/1973 Coverages: FO 1 Payer/Plan: PEIA, PEIA/PEIA/UMR Plan Address: PO BOX 30541, PO BOX 30541, SALT LAKE CITY, SALT LAKE CITY, UT, UTZIP: 84130-0541, 84130-0541 Sub ID: 7700308271 Sub Name: MURPHY,C\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_35.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/8/1952\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: CURRAN,JAMES M [MRN: E556998 SSN Masked #3..: xxx-xx-2106 Date of birth..: 6/8/1952 Coverages: FO 1 Payer/Plan: MEDICARE, AARP HEALTH CARE OPTIONS, AARP HEALTH CARE OPTIONS/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 1878, PO BOX 1878, COLUMBIA, SOUTHHAMPTON, SOUTHHAMP\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_36.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Printed on: 11/1/2025 Primary Account: CURRAN,JAMES M [101381204] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_37.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"12/11/1961\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"280.42\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: DOWLING,CHARLES [MRN: E1615260 SSN Masked #3..: xxx-xx-1160 Date of birth..: 12/11/1961 Coverages: FO 1 Payer/Plan: PEIA/PEIA/UMR Plan Address: PO BOX 30541, SALT LAKE CITY, UTZIP: 84130-0541 Sub ID: 7700803416 Sub Name: DOWLING,SHERYL FO2 FO 3 Encounter Information Date......: 10/31\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_38.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"cc Billing provider: \\u2014 Woofter, Isha, MD NDC Amount 70461-655-04 -5 Milliliters 90471 - PB IMMUNIZ ADMIN,1 SINGLE/COMB 10/31/2025 1 223 VAC/TOXOID Service provider: Woofter, Isha, MD Place of service: WOOFTER FAMILY MED- Billing provider: Woofter, Isha, MD Printed on: 11/1/2025 Primary Acco\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_39.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/3/1951\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: BRYANT,GARY A [MRN: E494423 SSN Masked #3..: xxx-xx-2258 Date of birth..: 6/3/1951 Coverages: FO 1 Payer/Plan: HIGHMARK MEDICARE ADVANTAGE, HIGHMARK MEDICARE ADVANTAGE/HIGHMARK MEDICARE ADVANTAGE PPO Plan Address: PO BOX 7004, PO BOX 7004, Wheeling, Wheeling, WV, WVZIP: 26003, 26003\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_40.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/1/1958\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: ELLIOTT,LINDA K [MRN: E765832 SSN Masked #3..: xxx-xx-8256 Date of birth..: 10/1/1958 Coverages: FO | Payer/Plan: MEDICARE, MEDICARE, BANKERS LIFE & CASUALTY CO/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 100190, PO BOX 1935, COLUMBIA, COLUMBIA, CARMEL, SC, SC, INZIP: \"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_41.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/31/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Billing provider: | Woofter, Isha, MD NDC Amount 70461-655-04 -5 Milliliters 90471 - PB IMMUNIZ ADMIN,1 SINGLE/COMB 10/31/2025 1 223 VAC/TOXOID Service provider: Woofter, Isha, MD Place of service: WOOFTER FAMILY MED- cc Billing provider: | Woofter, Isha, MD Printed on: 11/1/2025 Primary Ac\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_42.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"7/24/1948\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: DEMASTUS,CLAUDE D [MRN: E123130 SSN Masked #3..: xxx-xx-2869 Date of birth..: 7/24/1948 Coverages: FO | Payer/Plan: MEDICARE, BANKERS FIDELITY LIFE INS CO/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 211701, COLUMBIA, EAGAN, SC, MNZIP: 29202-3190, 55121 Sub ID: 3FR6YE9V\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_43.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Primary Account: DEMASTUS,CLAUDE D [100213804] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_44.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"8/28/1940\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: MILLER,DANA J [MRN: E20389 SSN Masked #3..: xxx-xx-9341 Date of birth..: 8/28/1940 Coverages: FO 1 Payer/Plan: HUMANA MEDICARE, HUMANA MEDICARE/HUMANA CHOICE PPO Plan Address: PO Box 14601, PO Box 14601, Lexington, Lexington, KY, KYZIP: 40512-4601, 40512-4601 Sub ID: H57496937 Sub N\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_45.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"12/19/1945\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: DOUGLAS,LINDA K [MRN: E1499265 SSN Masked #3..: xxx-xx-7205 Date of birth..: 12/19/1945 Coverages: FO | Payer/Plan: MEDICARE, AARP HEALTH CARE OPTIONS/MEDICARE PART A AND B Plan Address: PO BOX 100190, PO BOX 1878, COLUMBIA, SOUTHHAMPTON, SC, PAZIP: 29202-3190, 18966-9998 Sub ID: 7Q\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_46.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"6/14/1952\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: MCDONALD.JESSE J [MRN: E71605 SSN Masked #3..: xxx-xx-8410 Date of birth..: 6/14/1952 Coverages: FO | Payer/Plan: AETNA-MEDI-ADV, WV MEDICAID/AETNA MEDICARE ADVANTAGE (MC) Plan Address: PO BOX 981106, PO Box 3767, EI. PASO, Charleston, TX, WVZIP: 79998-1106, 25337 Sub ID: 1015107547\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_47.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Primary Account: MCDONALD,JESSE J [101344119] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_48.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"2/14/1947\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: NICHOLS,BRENICE I [MRN: E235290 SSN Masked #3..: xxx-xx-7348 Date of birth..: 2/14/1947 Coverages: FO 1 Payer/Plan: HIGHMARK MEDICARE ADVANTAGE/HIGHMARK MEDICARE ADVANTAGE PPO Plan Address: PO BOX 7004, Wheeling, WVZIP: 26003 Sub ID: HSR139765091001 Sub Name: Nichols,Brenice I FO 2\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_49.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"3/25/1947\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"271.89\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: STARKEY,NANCY L [MRN: E1389058 SSN Masked #3..: xxx-xx-4745 Date of birth..: 3/25/1947 Coverages: FO 1 Payer/Plan: MEDICARE, MEDICARE, AETNA MEDICARE SUPPLEMENT/MEDICARE PART A ANT B Plan Address: PO BOX 100190, PO BOX 100190, PO BOX 14770, COLUMBIA, COLUMBIA, LEXINGTON, SC, SC, KYZ\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_50.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Printed on: 11/1/2025 Primary Account: STARKEY.NANCY L [101480360] \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_51.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Medical Report\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"10/25/1984\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Patient Name: SICKLES,MATTHEW R [MRN: E443106 SSN Masked #3..: xxx-xx-4869 Date of birth..: 10/25/1984 Coverages: FO 1 Payer/Plan: BLUE CROSS BLUE SHIELD/OTHER BCBS OUT OF STATE PPO Plan Address: PO BOX 7026, WHEELING, WVZIP: 26003 Sub ID: BKRW01910246 Sub Name: SICKLES,MATTHEW R FO2 FO 3 Enco\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_52.jpg"
] |
[
{
"role": "user",
"content": "<image>Analyze this document. Extract the invoice number, patient/customer name, total price, tax, and any highlighted text into JSON format."
},
{
"role": "assistant",
"content": "{\n \"document_type\": \"Invoice\",\n \"identifiers\": {\n \"invoice_number\": \"\",\n \"date\": \"11/1/2025\"\n },\n \"people\": {\n \"patient_name\": \"\",\n \"customer_name\": \"\"\n },\n \"financials\": {\n \"total_price\": \"\",\n \"tax_amount\": \"\"\n },\n \"highlighted_text\": [],\n \"raw_text_snippet\": \"Med-Cc Billing provider: | Woofter, Dominick, MD Printed on: 11/1/2025 Primary Account: SICKLES,MATTHEW R [102044604] cc \\f\"\n}"
}
] |
[
"datasets_images/10-31-2025 Charge Sheets_page_53.jpg"
] |
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