Date/Time Patient PT Status Age Sex

Date/Time Patient Pt Status Age Sex
5/3/2023 10:15 ADAM BECK Active 24 M

5/3/2023 16:15 ADREANA VALDEZ Active 15 F
5/3/2023 13:45 ALBERTO MARTINEZ Active 32 M
5/3/2023 11:00 ALEEZA BUTLER Active 25 F
5/3/2023 11:15 ALEX URQUIDEZ Active 34 M
5/3/2023 16:15 ALEXANDRA VALDEZ Active 18 F
5/3/2023 12:30 ALEXIS NANNY Active 30 F
5/3/2023 10:00 ALICIA AGUILAR Active 31 F
5/3/2023 11:15 ALICIA HERNANDEZ Active 34 F
5/3/2023 16:00 ALIYAH PREMEAUX Active 11 F
5/3/2023 19:15 ALMADELIA JUAREZ Active 37 F
5/3/2023 14:00 ALVIN MORK P+Active 69 M
5/3/2023 17:45 ALYSSA CARRIZALES Active 16 F
5/3/2023 9:30 ALYSSA VELARDE Active 26 F
5/3/2023 18:30 AMANDA FAULKNER Active 31 F
5/3/2023 9:45 AMBER BREZNIK Active 34 F
5/3/2023 15:30 ANAS BAKEER Active 33 M
5/3/2023 18:00 ANAYDEE MORALES Active 35 F
5/3/2023 11:15 ANDERSON NUNEZ Active 40 M
5/3/2023 15:15 ANDREA BUSTAMANTE Active 31 F
5/3/2023 14:15 ANGELA WELCH Active 56 F
5/3/2023 13:30 ANTOINETTE MOSLEY Active 25 F
5/3/2023 13:00 ASHLIE HAWS P+Active 33 F
5/3/2023 11:30 AUDREY NKADI Active 47 F
5/3/2023 11:45 AUTUMN DAVISTEAGUE Active 49 F
5/3/2023 19:45 BAYLIAN ABRAHAM Active 11 M
5/3/2023 14:00 BEN ZARATE Active 39 M
5/3/2023 10:15 BETH CRAIG Active 54 F
5/3/2023 16:00 BRANDON IBARRA Active 28 M
5/3/2023 17:00 BRAYLEN WHITE Active 16 F
5/3/2023 12:15 BRIKAYLA HARDY Active 33 F
5/3/2023 16:45 BRITTANY MCDONALD Active 36 F
5/3/2023 13:45 BROOKE HARGIS Active 24 F
5/3/2023 14:00 BRYNNA FITZPATRICK Active 20 F
5/3/2023 14:00 CALEB CANALES Active 10 M
5/3/2023 16:00 CAMERON GRAHAM Active 18 M
5/3/2023 13:30 CAMILLE PUTNAM P+Active 16 F
5/3/2023 14:30 CATHERINE LOVELADY Active 46 F
5/3/2023 13:45 CHARLES ELERI Active 35 M
5/3/2023 14:30 CHARLI DEUTSCH Active 19 F
5/3/2023 16:30 CHERIE GOODE Active 40 F
5/3/2023 15:45 CHRISTOPHER ALLEN Active 52 M
5/3/2023 18:30 DAMIEN RANSOM Active 20 M
5/3/2023 9:15 DAN JENKINS Active 48 M
5/3/2023 11:00 DANGELIQUE TIERCE Active 52 F
5/3/2023 13:15 DANICE GONZALES Active 47 F
5/3/2023 13:00 DAVE GARZA Active 15 M
5/3/2023 12:00 DEBRA JONES-STEWART Active 56 F
5/3/2023 11:00 DESJARE HUMPHREY P+Active 39 F
5/3/2023 16:30 DESTINY MCCARTY Active 11 F
5/3/2023 16:15 DONTRAYVION ALLEN Active 11 M
5/3/2023 9:00 DWIGHT ALLEN Active 57 M
5/3/2023 18:00 DYLAN MORENO Active 7 M
5/3/2023 10:00 EDNA GUTIERREZ Active 37 F
5/3/2023 9:30 ELIZABETH LOWE Active 84 F
5/3/2023 8:45 ELIZABETH HATLEY Active 38 F
5/3/2023 16:30 EMILY STEWART Active 37 F
5/3/2023 12:30 ERILYN BLACK Active 17 U
5/3/2023 14:00 EZEQUIEL CANALES Active 7 M
5/3/2023 9:30 GENESIS CHOURIO Active 30 F
5/3/2023 16:45 GENESIS DYER Active 16 F
5/3/2023 14:15 GINA DAVIS Active 39 F
5/3/2023 10:30 GINA RAMSEY Active 58 F
5/3/2023 9:15 GREGORY BUCKHOUSE Active 11 M
5/3/2023 14:45 GWEN NELSON Active 72 F
5/3/2023 17:45 HAILEY HOLLIS Active 13 F
5/3/2023 15:30 HALEY BURNS Active 20 F
5/3/2023 14:45 HARRISON HIDALGO Active 21 M
5/3/2023 12:00 HAYLEE JEFCOAT Active 28 F
5/3/2023 15:15 IAN SPENCER Active 15 M
5/3/2023 17:15 ISAIAS RIVAS Active 37 M
5/3/2023 11:30 JACOB NELSON Active 27 M
5/3/2023 13:30 JALITHA BELL-KNOX Active 57 F
5/3/2023 10:45 JANE OSBORNE Active 66 F
5/3/2023 19:30 JAQUELINE FRANCO Active 26 F
5/3/2023 17:15 JASON STIGERS Active 37 M
5/3/2023 18:45 JAZMIN SANCHEZ Active 20 F
5/3/2023 8:30 JEFFREY SKELTON P+Active 50 M
5/3/2023 18:45 JENNIFER BRUECKNER Active 50 F
5/3/2023 13:45 JENNIFER DEVANE Active 29 F
5/3/2023 18:45 JENNIFER MCVEY Active 42 F
5/3/2023 17:15 JEREMY HOLMBERG Active 47 M
5/3/2023 10:15 JESSI GARCIA Active 33 F
5/3/2023 9:15 JESSICA GONZALEZ Active 48 F
5/3/2023 14:30 JESSICA KNIGHT Active 43 F
5/3/2023 14:45 JESSICA SERRANO Active 43 F
5/3/2023 13:30 JOHN SHUTE Active 56 M
5/3/2023 14:45 JORGE NUNEZ Active 33 M
5/3/2023 11:45 JOSEPH GALLISHAW Active 67 M
5/3/2023 17:00 JOSEPHINE STEVENSON Active 22 F
5/3/2023 18:15 JOSUE PUENTES ARRIOLA Active 26 M
5/3/2023 9:30 JOYCE SWARB Active 49 F
5/3/2023 14:30 KATE LEDWITH Active 21 F
5/3/2023 17:30 KATELYNN FOWLER-GARZA Active 20 F
5/3/2023 16:00 KATHRYN BIRD Active 75 F
5/3/2023 16:15 KELLY PAWELKA Active 17 F
5/3/2023 10:00 KENESHA LOTT Active 32 F
5/3/2023 10:00 KENNETH CATLETT Active 73 M
5/3/2023 9:00 KIMBERLEE RICKER Active 61 F
5/3/2023 10:00 KIMBERLY FONTES Active 47 F
5/3/2023 12:00 KIMBERLY LAWSON Active 62 F
5/3/2023 14:00 KING JONES Active 13 M
5/3/2023 12:45 KIRAN SIDHWANI Active 70 F
5/3/2023 15:15 KIYA COLTON Active 16 F
5/3/2023 12:15 KRISTEN SHORES Active 30 F
5/3/2023 12:00 KYLIE YOUNG Active 19 F
5/3/2023 15:45 KYRA HUCKABY Active 18 F
5/3/2023 16:45 LAISHANNA BLEDSOE Active 48 F
5/3/2023 13:15 LAURA LUECK P+Active 38 F
5/3/2023 9:00 LEONEL GODINEZ Active 21 M
5/3/2023 13:00 LINDA LOWRY Active 71 F
5/3/2023 17:30 LOGAN MOSLEY Active 6 M
5/3/2023 9:00 LUZ MURILLO Active 14 F
5/3/2023 16:15 MACI DAVENPORT Active 16 F
5/3/2023 17:00 MADISON OCONNOR Active 27 F
5/3/2023 19:45 MARCIA ABRAHAM Active 30 F
5/3/2023 18:15 MARCOS COLLAZO Active 44 M
5/3/2023 13:00 MARY ANDRADO Active 74 F
5/3/2023 20:00 MATHEW ABRAHAM Active 20 M
5/3/2023 18:30 MELISSA CSIKOS Active 32 F
5/3/2023 9:00 MICHAEL RAMIREZ Active 8 M
5/3/2023 9:15 MICHAELA OSBORNE Active 17 F
5/3/2023 14:15 MICHELLE MITCHAM Active 40 F
5/3/2023 13:30 MICHELLE SODERBERG Active 50 F
5/3/2023 15:00 NATASHA REYES Active 32 F
5/3/2023 10:15 NEVAEH BROWN Active 15 F
5/3/2023 18:45 OLIVIA DEUTSCH Active 10 F
5/3/2023 10:30 PATRICIA COTTER Active 25 F
5/3/2023 12:45 PEGGY STEVENS P+Active 73 F
5/3/2023 19:00 REED SVENSSON Active 10 M
5/3/2023 13:15 RICHARD HANSEN Active 72 M
5/3/2023 16:00 RICHARD PREMEAUX Active 7 M
5/3/2023 12:00 ROBERT MCKETHAN P+Active 37 M
5/3/2023 11:45 RODOLFO ADONAY HENRIQUEZ ORELLANA Active 17 M
5/3/2023 13:30 ROSA SANCHEZ Active 24 F
5/3/2023 14:00 SAMANTHA MARTINEZ Active 14 F
5/3/2023 12:15 SANDRA EDGERTON Active 74 F
5/3/2023 9:15 SARA OSBORNE Active 43 F
5/3/2023 16:00 SARRA GAUNTT Active 19 F
5/3/2023 10:00 SELIA RUIZ Active 53 F
5/3/2023 14:30 SEVEN HARRIS Active 14 M
5/3/2023 16:45 SHARJEEL KHAN Active 33 M
5/3/2023 17:15 SOLOMON COOK Active 36 M
5/3/2023 9:00 SOPHIA BAUGH Active 13 F
5/3/2023 11:30 SUMMER BAUCUM Active 17 F
5/3/2023 10:45 SUSHMA VISHNUBHOTLA Active 34 F
5/3/2023 15:30 TIFFANY HENRY Active 40 F
5/3/2023 14:45 TIM GOMEZ Active 73 M
5/3/2023 16:00 VANESSA MARTINEZ Active 21 F
5/3/2023 17:45 VICTORIA BRADY Active 53 F
5/3/2023 18:15 VIOLETA ARROYO Active 40 F
5/3/2023 17:15 VIRGINIA VALADEZ Active 46 F
5/3/2023 14:45 WENDI JOHNSON Active 37 F
5/3/2023 19:15 WILLIAM ADKINS Active 13 M
5/3/2023 14:00 XAVIER JAMSHED-KHAN Active 27 M
5/3/2023 11:00 YAMILET GARCIA Active 30 F
DOB Location Provider
3/9/1999 Memorial Clinic TAI JOHNSON, NP

10/12/2007 Willowbrook Clinic WILLICIA TORAN, NP
5/1/1993 Willowbrook Clinic AMANDA RAY, NP
10/26/1988 Kingwood Clinic OLUWAFERANMI AFOLABI, NP
6/26/1985 Willowbrook Clinic CASSANDRA BODUCH, MD
6/25/1996 Kingwood Clinic RANDI KATZ, NP
5/11/1992 Willowbrook Clinic CATHERINE CHANG, MD
5/13/1992 Willowbrook Clinic SHAMARUKH KABIR, PA
6/23/1975 Willowbrook Clinic MASOOD JILANI, MD
9/30/1987 Willowbrook Clinic MASOOD JILANI, MD
12/1/1983 Willowbrook Clinic APRIL LEWIS, LMFT
11/11/1964 Willowbrook TMS MASOOD JILANI, MD
10/6/1969 Willowbrook TMS MASOOD JILANI, MD
Visit Type Primary/Secondary Scheduling Status
T - Est Pt, Outpatient Office Visit Aetna-MedicarePPO / Checked-Out

Est Pt, Outpatient Office Visit BCBS-PPO / Checked-Out
T - Est Pt, Outpatient Office Visit BCBS-PPO / Checked-Out
T - Est Pt, Outpatient Office Visit Ambetter-Marketplace / Checked-Out
T - Est Pt, Outpatient Office Visit Beacon / Checked-Out
T - Est Pt, Outpatient Office Visit Amerigroup-Medicaid / Checked-Out
T - New Pt, Outpatient Office Visit CHC-Medicaid / Checked-Out
T - Est Pt, Outpatient Office Visit TXChildrenMedicaid / Checked-Out
T - Est Pt, Outpatient Office Visit OscarHealth / OscarHealth Checked-Out
T - Est Pt, Outpatient Office Visit Aetna-POS / MedicareA&B Checked-Out
New Pt, Outpatient Office Visit Cigna-OpenAccess / Checked-Out
T - Est Pt, Outpatient Office Visit Magellan / Checked-Out
T - Est Pt, Outpatient Office Visit CHC-Marketplace / Amerigroup-Medicaid Checked-Out
T - Est Pt, Outpatient Office Visit Humana-PPO / Checked-Out
Est Pt, Outpatient Office Visit CHC-Marketplace / Checked-Out
T - Est Pt, Outpatient Office Visit Amerigroup-Medicaid / Checked-Out
Est Pt, Outpatient Office Visit Beacon / Checked-Out
T - Est Pt, Outpatient Office Visit Meritain / Checked-Out
T - Est Pt, Outpatient Office Visit Cigna-OpenAccessPlus / Checked-Out
T - New Pt, Outpatient Office Visit Checked-Out
T - Est Pt, Outpatient Office Visit CHC-Marketplace / Checked-Out
T - Est Pt, Outpatient Office Visit Aetna-PPO / Checked-Out
T - Est Pt, Outpatient Office Visit BCBS-PPO / Select insurance plan Checked-Out
T - Est Pt, Outpatient Office Visit CHC-Medicaid / Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-ChoicePlus / Select insurance plan Checked-Out
T - Est Pt, Outpatient Office Visit Aetna-HMO / Checked-Out
T - Est Pt, Outpatient Office Visit BCBS-PPO / TexasMedicaid Checked-Out
Est Pt, Outpatient Office Visit MedicareA&B / BCBS-PPO Checked-Out
T - Est Pt, Outpatient Office Visit Cigna-OpenAccess / Checked-Out
Est Pt, Outpatient Office Visit Wellcare-UXR-Medicaid/Medicare / Checked-Out
T - Est Pt, PsyT BCBS-PPO / In Room
Est Pt, Outpatient Office Visit Amerigroup-Medicaid / Amerigroup-Medicaid Checked-Out
T - Est Pt, Outpatient Office Visit TXChildrenMedicaid / Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum / Amerigroup-MedicareAdvantage Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-ChoicePlus / Checked-Out
New Pt, Outpatient Office Visit Aetna-PPO / Checked-Out
New Pt, Outpatient Office Visit Ambetter-Marketplace / Checked-Out
T - Est Pt, Outpatient Office Visit CHC-Marketplace / Select insurance plan Checked-Out
TMS Visit Humana-MedicareHMO / Checked-In
T - Est Pt, Outpatient Office Visit Magellan / Checked-Out
New Pt, Outpatient Office Visit Cigna-OpenAccessPlus / Checked-Out
T - Est Pt, Outpatient Office Visit River Oaks Accident Comp / Checked-Out
T - Est Pt, Outpatient Office Visit Amerigroup-MedicareAdvantage / Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum / Checked-Out
T - Est Pt, Outpatient Office Visit MedicareA&B / Checked-Out
T - New Pt, Outpatient Office Visit BCBS-PPO / Checked-Out
T - Est Pt, Outpatient Office Visit Ambetter-Marketplace / Select insurance plan Checked-Out
T - Est Pt, Outpatient Office Visit BCBS-HMO / Checked-Out
T - Est Pt, Outpatient Office Visit MedicareA&B / TexasMedicaid Checked-Out
T - Est Pt, Outpatient Office Visit Devoted / Checked-Out
T - Est Pt, Outpatient Office Visit Cigna-OpenAccess / Scheduled
T - Est Pt, Outpatient Office VisitBCBS-BlueAdvantageHMO / Select insurance plan Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-Choice / Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-Medicare / Checked-Out
T - Est Pt, Outpatient Office Visit Cigna-OpenAccessPlus / Select insurance plan Checked-Out
T - Est Pt, PsyT MedicareA&B / Tricare Checked-Out
Est Pt, Outpatient Office Visit Magellan / Checked-Out
Est Pt, Outpatient Office Visit Ambetter-Marketplace / Select insurance plan Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-Wellmed / Aetna-PPO Checked-Out
T - Est Pt, Outpatient Office Visit UHC/Optum-Medicare / MedicareA&B Checked-Out
Est Pt, Outpatient Office Visit Cigna-OpenAccessPlus / Checked-Out
Est Pt, Outpatient Office Visit Tricare / Checked-Out
T - Est Pt, Outpatient Office Visit Cigna-Healthspring / Checked-Out
T - Est Pt, Outpatient Office Visit MedicareA&B / Checked-Out
T - Est Pt, Outpatient Office Visit Humana-MedicarePPO / Select insurance plan Checked-Out
T - Est Pt, Transitional Care Mngt CHC-Medicaid / Checked-Out
T - Est Pt, Outpatient Office Visit Humana-MedicareHMO / Checked-Out
T - Est Pt, Outpatient Office Visit TXChildrenMedicaid / Scheduled
T - Est Pt, PsyT TXChildrenMedicaid / Checked-Out
Est Pt, Outpatient Office Visit UHC/Optum-Medicare / Checked-Out
T - Est Pt, Outpatient Office Visit Allegieance / Checked-Out
Est Pt, Outpatient Office Visit TXChildrenMedicaid / Checked-Out
T - Est Pt, Outpatient Office Visit Molina-Marketplace / Checked-Out
Est Pt, Transitional Care Mngt TXChildrenMedicaid / Checked-Out
New Pt, Outpatient Office Visit Aetna-PPO / Checked-Out
T - Est Pt, Outpatient Office Wellcare-UXR-Medicaid/Medicare
Visit / Select insurance plan
Checked-Out
T - Est Pt, Outpatient Office Visit Aetna-PPO / Molina-Medicaid Checked-Out
Est Pt, Outpatient Office Visit All / Checked-Out
New Pt, Outpatient Office Visit BCBS-PPO / Checked-Out
T - Est Pt, PsyT Cigna-OpenAccess / Scheduled
T - Est Pt, Outpatient Office Visit Aetna-MedicarePPO / Checked-Out
Est Pt, Outpatient Office Visit UHC/Optum-Medicaid / Checked-Out
TMS Visit BCBS-PPO / Checked-In
T - Est Pt, Outpatient Office Visit UHC/Optum-Medicaid / Checked-Out
T - Est Pt, Outpatient Office Visit MedicareA&B / TexasMedicaid Checked-Out
Est Pt, Outpatient Office Visit Aetna-HMO / Checked-Out
Est Pt, Outpatient Office Visit TXChildrenMedicaid / Checked-Out
T - Est Pt, PsyT Molina-Marketplace / In Room
New Pt, Outpatient Office Visit UHC/Optum-Choice / Checked-Out
Status Time Room Apt Veri Copay CoIns Balance
Due Paid Due Paid Due Paid
5/3/2023 14:42 Yes $0.00 $0.00 $0.00 $0.00 $265.00
5/3/2023 16:45 Yes $30.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:42 Yes $15.00 $0.00 $0.00 $0.00 $30.00
5/3/2023 11:39 Yes $15.00 $0.00 $0.00 $0.00 $75.00
5/3/2023 11:46 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:42 Yes $30.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:47 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:38 Yes $20.00 $0.00 $0.00 $0.00 $385.00
5/3/2023 15:42 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:57 Auth Req $0.00 $0.00 $0.00 $0.00 $892.00
5/4/2023 8:25 Yes $75.00 $75.00 $0.00 $0.00 $75.00
5/3/2023 14:39 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/5/2023 8:48 Yes $0.00 $0.00 $23.00 $0.00 $414.00
5/3/2023 11:45 Yes $0.00 $0.00 $31.24 $0.00 $31.00
5/4/2023 9:52 Yes $0.00 $0.00 $34.50 $0.00 $35.00
5/3/2023 11:35 Yes $25.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:40 Yes $30.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 11:09 Yes $0.00 $0.00 $19.44 $0.00 $61.00
5/3/2023 14:03 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:32 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/5/2023 14:06 No $0.00 $0.00 $0.00 $0.00 ($40.00)
5/3/2023 14:33 Yes $30.00 $0.00 $0.00 $0.00 $110.00
5/3/2023 15:24 Yes $25.00 $0.00 $0.00 $0.00 ($25.00)
5/3/2023 11:54 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:28 Yes $0.00 $0.00 $0.00 $0.00 $210.00
5/4/2023 8:09 Pending $0.00 $0.00 $0.00 $0.00 $140.00
5/3/2023 16:28 Yes $0.00 $0.00 $0.00 $0.00 $368.00
5/3/2023 11:39 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:29 Pending $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 9:36 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:44 Pending $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:34 Yes $45.00 $0.00 $0.00 $0.00 $45.00
5/3/2023 14:36 Yes $40.00 $0.00 $0.00 $0.00 $120.00
5/3/2023 15:13 Yes $15.00 $0.00 $0.00 $0.00 $30.00
5/3/2023 15:57 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:18 Yes $0.00 $0.00 $48.15 $0.00 $96.00
5/3/2023 15:38 Yes $25.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:20 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:48 Pending $0.00 $0.00 $0.00 $0.00 $642.00
5/3/2023 15:53 Yes $0.00 $0.00 $0.00 $0.00 $230.00
5/3/2023 16:49 Yes $15.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:46 Yes $30.00 $0.00 $0.00 $0.00 $120.00
5/5/2023 15:37 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:14 Yes $30.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:26 Yes $60.00 $0.00 $0.00 $0.00 $120.00
5/3/2023 15:04 Yes $150.00 $0.00 $0.00 $0.00 $1,525.00
5/3/2023 15:17 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:58 Pending $0.00 $0.00 $0.00 $0.00 $25.00
5/3/2023 12:17 Yes $0.00 $0.00 $0.00 $0.00 $404.00
5/3/2023 17:09 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:55 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:30 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 11:17 Pending $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:19 Yes $60.00 $0.00 $0.00 $0.00 $60.00
5/3/2023 11:16 Yes $40.00 $0.00 $0.00 $0.00 $40.00
5/3/2023 11:29 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:16 Yes $30.00 $0.00 $0.00 $0.00 $30.00
5/3/2023 15:10 Yes $0.00 $0.00 $0.00 $0.00 $35.00
5/3/2023 15:51 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:26 Yes $10.00 $0.00 $0.00 $0.00 $10.00
5/3/2023 17:37 Yes $15.00 $0.00 $0.00 $0.00 $30.00
5/3/2023 16:01 Auth Req $30.00 $30.00 $0.00 $0.00 $60.00
5/3/2023 10:01 Yes $0.00 $0.00 $0.00 $0.00 ($10.00)
5/3/2023 11:32 Yes $30.00 $0.00 $0.00 $0.00 $860.00
5/3/2023 15:35 Yes $0.00 $0.00 $0.00 $0.00 ($190.00)
5/4/2023 11:24 Yes $30.00 $0.00 $0.00 $0.00 $30.00
5/3/2023 16:09 Yes $0.00 $0.00 $0.00 $0.00 $584.00
5/3/2023 15:56 Yes $50.00 $0.00 $0.00 $0.00 $50.00
5/3/2023 15:26 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:40 Yes $30.00 $0.00 $0.00 $0.00 ($10.00)
5/3/2023 18:31 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 13:37 Yes $50.00 $0.00 $0.00 $0.00 $150.00
5/3/2023 15:35 Yes $35.00 $0.00 $0.00 $0.00 $260.00
5/3/2023 11:24 Yes $0.00 $0.00 $0.00 $0.00 $143.00
5/4/2023 8:19 Yes $15.00 $0.00 $0.00 $0.00 $45.00
5/5/2023 8:41 Yes $20.05 $0.00 $0.00 $0.00 $60.00
5/4/2023 8:46 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 10:51 Yes $50.00 $0.00 $0.00 $0.00 $50.00
5/4/2023 8:39 Yes $0.00 $0.00 $34.80 $0.00 $35.00
5/3/2023 16:56 Auth Req $0.00 $0.00 $31.24 $0.00 $110.00
5/4/2023 8:51 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 9:39 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:48 Yes $0.00 $0.00 $0.00 $0.00 $176.00
5/3/2023 11:19 Yes $0.00 $0.00 $0.00 $0.00 ($20.00)
5/3/2023 16:07 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:21 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:43 Yes $0.00 $0.00 $0.00 $0.00 ($120.00)
5/3/2023 17:18 Yes $25.00 $25.00 $0.00 $0.00 $25.00
5/3/2023 14:50 Yes $15.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 18:26 Yes $0.00 $0.00 $0.00 $0.00 ($2.00)
2/8/2023 19:10 Yes $35.00 $0.00 $0.00 $0.00 $70.00
5/3/2023 11:23 Yes $0.00 $0.00 $0.00 $0.00 ($150.00)
5/3/2023 15:33 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 11:35 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:25 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:53 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:37 Yes $25.00 $0.00 $0.00 $0.00 $50.00
5/3/2023 12:17 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:07 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 12:49 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:05 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:58 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:51 Yes $0.00 $0.00 $0.00 $0.00 $160.00
5/3/2023 15:47 Yes $50.00 $0.00 $0.00 $0.00 $50.00
5/3/2023 15:06 Yes $0.00 $0.00 $0.00 $0.00 $209.00
5/3/2023 14:20 Yes $36.00 $0.00 $0.00 $0.00 $108.00
5/3/2023 15:42 Yes $0.00 $0.00 $0.00 $0.00 ($150.00)
5/3/2023 16:55 Yes $0.00 $0.00 $0.00 $0.00 $512.00
5/3/2023 15:27 Yes $35.00 $0.00 $0.00 $0.00 $70.00
5/3/2023 15:29 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:55 Yes $0.00 $0.00 $0.00 $0.00 ($70.00)
5/8/2023 18:05 No $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 12:17 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:30 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 18:23 Yes $15.00 $0.00 $0.00 $0.00 $15.00
5/4/2023 8:14 Yes $0.00 $0.00 $22.99 $0.00 $609.00
5/4/2023 10:30 Yes $25.00 $0.00 $0.00 $0.00 $25.00
5/3/2023 15:13 Yes $10.00 $0.00 $0.00 $0.00 $0.00
5/5/2023 9:02 Yes $0.00 $0.00 $23.00 $0.00 $348.00
5/4/2023 10:00 Yes $30.00 $0.00 $0.00 $0.00 $60.00
5/3/2023 11:05 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:25 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:16 Yes $50.00 $0.00 $0.00 $0.00 $150.00
5/3/2023 15:09 Yes $25.00 $0.00 $0.00 $0.00 $90.00
5/3/2023 15:37 Yes $20.00 $0.00 $0.00 $0.00 $20.00
5/3/2023 11:21 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 9:46 Yes $0.00 $0.00 $0.00 $0.00 $230.00
5/3/2023 14:43 Yes $0.00 $0.00 $17.02 $0.00 $17.00
5/3/2023 14:51 Yes $25.00 $0.00 $0.00 $0.00 $75.00
5/4/2023 8:35 Yes $25.00 $0.00 $0.00 $0.00 $20.00
5/3/2023 14:33 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:06 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:41 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:13 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 15:41 Yes $40.00 $0.00 $0.00 $0.00 $40.00
4/3/2023 13:43 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 14:31 Yes $15.00 $0.00 $0.00 $0.00 $120.00
5/3/2023 12:40 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:36 Yes $0.00 $0.00 $0.00 $0.00 $82.00
5/3/2023 9:05 Yes $0.00 $0.00 $0.00 $0.00 $15.00
5/3/2023 15:50 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 17:53 Yes $25.00 $0.00 $0.00 $0.00 $50.00
5/3/2023 17:17 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 11:16 Yes $0.00 $0.00 $0.00 $0.00 $119.00
5/3/2023 14:06 Yes $20.00 $0.00 $0.00 $0.00 $20.00
5/3/2023 14:01 Pending $0.00 $0.00 $0.00 $0.00 ($16.00)
5/3/2023 17:21 Yes $0.00 $0.00 $0.00 $0.00 ($50.00)
5/3/2023 16:46 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 16:39 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 11:26 Yes $70.00 $0.00 $0.00 $0.00 $558.00
5/4/2023 10:28 Auth Req $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 18:28 Yes $0.00 $0.00 $0.00 $0.00 $136.00
5/3/2023 15:28 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/4/2023 11:05 Yes $25.00 $0.00 $0.00 $0.00 $50.00
5/4/2023 9:49 Yes $0.00 $0.00 $0.00 $0.00 $0.00
5/3/2023 12:12 Pending $0.00 $0.00 $0.00 $0.00 $0.00
Sign
Action Balance in CMD
Signed $265.37
Signed ($30.00)
Signed $0.00
Signed $30.00
Signed $4.50
Signed ($30.00)
Signed $0.00
Signed $365.00
Signed $0.00
Signed $892.00
Signed $0.00
Signed $23.67
Signed $90.97
Signed ($79.24)
Signed ($52.00)
Signed ($25.00)
Signed ($30.00)
Signed $41.92
Signed $0.00
Signed $0.00
Signed ($40.00)
Signed $80.00
Signed ($75.00)
Signed $0.00
Signed $209.56
Signed $140.00
Signed $368.11
Signed $0.00
Signed $0.00
Signed $0.00
Signed $120.00
Signed $0.00
Signed $40.00
Signed $15.00
Signed $0.00
Signed $48.15
Signed ($50.00)
Signed $0.00
Signed $762.00
Signed ($115.02)
Signed ($15.00)
Signed $90.00
Signed $0.00
Signed ($60.00)
Signed $0.00
Signed $1,375.00
Signed $0.00
Signed $25.00
$518.97
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed ($80.00)
Signed $0.00
Signed $0.00
Signed $35.00
Signed $0.00
Signed ($10.00)
Signed $15.00
Signed ($90.00)
Signed ($40.00)
Signed $830.00
Signed ($190.43)
Signed $0.00
Signed $464.09
Signed ($50.00)
Signed $0.00
Signed ($40.00)
Signed $0.00
Signed ($50.00)
Signed $225.00
Signed $53.60
Signed $15.00
Signed $40.10
Signed $0.00
Signed ($50.00)
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed ($65.40)
Signed ($20.03)
Signed $0.00
Signed $0.00
Signed ($120.00)
Signed $0.00
Signed ($15.00)
Signed ($1.79)
Signed $35.00
Signed ($150.00)
Signed $72.00
Signed $0.00
Signed $0.00
Signed ($20.00)
Signed ($25.00)
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed $160.27
Signed ($50.00)
Signed $108.68
Signed $0.00
Signed ($150.00)
Signed $531.89
Signed ($35.00)
Signed $0.00
Signed ($70.00)
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed $585.56
Signed $0.00
Signed ($20.00)
Signed $325.00
Signed $30.00
Signed $0.00
Signed $0.00
Signed $100.00
Signed ($25.00)
Signed $0.00
Signed $0.00
Signed ($115.40)
Signed $0.00
Signed $0.00
Signed ($30.00)
Signed $0.00
Signed $100.00
Signed $0.00
Signed $0.00
Signed $0.00
$0.00
Signed $105.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed $0.00
Signed ($25.00)
Signed $0.00
Signed $118.52
Signed $0.00
Signed ($16.43)
Signed ($50.00)
Signed $0.00
Signed $0.00
Signed $418.26
Signed $0.00
Signed $135.99
Signed $0.00
Signed $25.00
$0.00
Signed $0.00
Resource Name Patient ID Appt Facility ID Appt Resource ID
AMANDA RAY 38277240 10254997 10181064
AMANDA RAY 38576259 10254997 10181064
AMANDA RAY 38911385 10254997 10181064
AMANDA RAY 39109964 10254997 10181064
AMANDA RAY 39301042 10254997 10181064
AMANDA RAY 39309999 10254997 10181064
AMANDA RAY 39869828 10254997 10181064
AMANDA RAY 39897532 10254997 10181064
AMANDA RAY 40403707 10254997 10181064
AMANDA RAY 40404251 10254997 10181064
AMANDA RAY 41159460 10254997 10181064
AMANDA RAY 41370877 10254997 10181064
AMANDA RAY 41607386 10254997 10181064
AMANDA RAY 41653068 10254997 10181064
AMANDA RAY 41742132 10254997 10181064
AMANDA RAY 42091613 10254997 10181064
AMANDA RAY 42091938 10254997 10181064
AMANDA RAY 42365755 10254997 10181064
AMANDA RAY 42706065 10254997 10181064
AMANDA RAY 43632591 10254997 10181064
AMANDA RAY 48247463 10254997 10181064
AMANDA RAY 49239608 10254997 10181064
AMANDA RAY 49508512 10254997 10181064
AMANDA RAY 49632367 10254997 10181064
AMANDA RAY 49701711 10254997 10181064
AMANDA RAY 52909024 10254997 10181064
AMANDA RAY 53597885 10254997 10181064
AMANDA RAY 53906782 10254997 10181064
AMANDA RAY 54049003 10254997 10181064
AMANDA RAY 54079182 10254997 10181064
AMANDA RAY Totals
AMY VARGHESE 51633880 10254997 10189435
AMY VARGHESE Totals
APRIL LEWIS 49304392 10254997 10189974
APRIL LEWIS 52627393 10254997 10189974
APRIL LEWIS 53297879 10254997 10189974
APRIL LEWIS 53543690 10254997 10189974
APRIL LEWIS 53572799 10254997 10189974
APRIL LEWIS 53771165 10254997 10189974
APRIL LEWIS 53882272 10254997 10189974
APRIL LEWIS Totals
CASSANDRA BODUCH 37887422 10254997 10189216
CASSANDRA BODUCH Totals
CATHERINE CHANG, MD 45564780 10254997 10189968
CATHERINE CHANG, MD Totals
DR. MASOOD JILANI 42633823 10254997 10189626
DR. MASOOD JILANI 48828097 10254997 10189626
DR. MASOOD JILANI 49963568 10254997 10189626
DR. MASOOD JILANI 51197625 10254997 10189626
DR. MASOOD JILANI 51254079 10254997 10189626
DR. MASOOD JILANI 51825203 10254997 10189626
DR. MASOOD JILANI 54277159 10254997 10189626
DR. MASOOD JILANI Totals
RANDI KATZ 42720912 10254997 10189766
RANDI KATZ 42985963 10254997 10189766
RANDI KATZ 43296403 10254997 10189766
RANDI KATZ 44187665 10254997 10189766
RANDI KATZ 46016966 10254997 10189766
RANDI KATZ 47854406 10254997 10189766
RANDI KATZ 48901659 10254997 10189766
RANDI KATZ 50323405 10254997 10189766
RANDI KATZ 50855331 10254997 10189766
RANDI KATZ 51102300 10254997 10189766
RANDI KATZ 52039342 10254997 10189766
RANDI KATZ 52403129 10254997 10189766
RANDI KATZ 52406929 10254997 10189766
RANDI KATZ 52573278 10254997 10189766
RANDI KATZ 52586686 10254997 10189766
RANDI KATZ 52944078 10254997 10189766
RANDI KATZ 52951216 10254997 10189766
RANDI KATZ 53767219 10254997 10189766
RANDI KATZ 53846516 10254997 10189766
RANDI KATZ 53907004 10254997 10189766
RANDI KATZ 53941135 10254997 10189766
RANDI KATZ 53959155 10254997 10189766
RANDI KATZ 54060951 10254997 10189766
RANDI KATZ 54064707 10254997 10189766
RANDI KATZ 54216071 10254997 10189766
RANDI KATZ Totals
SHAMARUKH KABIR 38927636 10254997 10189318
SHAMARUKH KABIR 43570341 10254997 10189318
SHAMARUKH KABIR 48737603 10254997 10189318
SHAMARUKH KABIR 48780873 10254997 10189318
SHAMARUKH KABIR 48935292 10254997 10189318
SHAMARUKH KABIR 49064919 10254997 10189318
SHAMARUKH KABIR 49238339 10254997 10189318
SHAMARUKH KABIR 49257066 10254997 10189318
SHAMARUKH KABIR 49557610 10254997 10189318
SHAMARUKH KABIR 49992236 10254997 10189318
SHAMARUKH KABIR 50390145 10254997 10189318
SHAMARUKH KABIR 50588444 10254997 10189318
SHAMARUKH KABIR 50809618 10254997 10189318
SHAMARUKH KABIR 50832060 10254997 10189318
SHAMARUKH KABIR 51399941 10254997 10189318
SHAMARUKH KABIR 51428060 10254997 10189318
SHAMARUKH KABIR 51491710 10254997 10189318
SHAMARUKH KABIR 51988157 10254997 10189318
SHAMARUKH KABIR 52470692 10254997 10189318
SHAMARUKH KABIR 53079684 10254997 10189318
SHAMARUKH KABIR 53385110 10254997 10189318
SHAMARUKH KABIR 53410959 10254997 10189318
SHAMARUKH KABIR 53582262 10254997 10189318
SHAMARUKH KABIR 53725446 10254997 10189318
SHAMARUKH KABIR 53734036 10254997 10189318
SHAMARUKH KABIR 53754675 10254997 10189318
SHAMARUKH KABIR 53866720 10254997 10189318
SHAMARUKH KABIR 53892154 10254997 10189318
SHAMARUKH KABIR 53943146 10254997 10189318
SHAMARUKH KABIR 54049014 10254997 10189318
SHAMARUKH KABIR 54238610 10254997 10189318
SHAMARUKH KABIR 54263619 10254997 10189318
SHAMARUKH KABIR 54282957 10254997 10189318
SHAMARUKH KABIR 54290483 10254997 10189318
SHAMARUKH KABIR Totals
TAI JOHNSON, NP 40029221 10254997 10189991
TAI JOHNSON, NP 42241575 10254997 10189991
TAI JOHNSON, NP 42865747 10254997 10189991
TAI JOHNSON, NP 48688523 10254997 10189991
TAI JOHNSON, NP 49711621 10254997 10189991
TAI JOHNSON, NP 49795760 10254997 10189991
TAI JOHNSON, NP 49825294 10254997 10189991
TAI JOHNSON, NP 50599302 10254997 10189991
TAI JOHNSON, NP 51119673 10254997 10189991
TAI JOHNSON, NP 51245702 10254997 10189991
TAI JOHNSON, NP 52939965 10254997 10189991
TAI JOHNSON, NP 53293704 10254997 10189991
TAI JOHNSON, NP 53348732 10254997 10189991
TAI JOHNSON, NP 53601921 10254997 10189991
TAI JOHNSON, NP 53725291 10254997 10189991
TAI JOHNSON, NP 53785702 10254997 10189991
TAI JOHNSON, NP 53846901 10254997 10189991
TAI JOHNSON, NP 54035125 10254997 10189991
TAI JOHNSON, NP 54081956 10254997 10189991
TAI JOHNSON, NP 54114202 10254997 10189991
TAI JOHNSON, NP 54273218 10254997 10189991
TAI JOHNSON, NP 54274485 10254997 10189991
TAI JOHNSON, NP 54283518 10254997 10189991
TAI JOHNSON, NP Totals
WILLICIA TORAN 41164243 10254997 10189767
WILLICIA TORAN 47068448 10254997 10189767
WILLICIA TORAN 47261773 10254997 10189767
WILLICIA TORAN 48702827 10254997 10189767
WILLICIA TORAN 50708243 10254997 10189767
WILLICIA TORAN 50849270 10254997 10189767
WILLICIA TORAN 51427717 10254997 10189767
WILLICIA TORAN 51757583 10254997 10189767
WILLICIA TORAN 51803334 10254997 10189767
WILLICIA TORAN 52252440 10254997 10189767
WILLICIA TORAN 52308431 10254997 10189767
WILLICIA TORAN 52417200 10254997 10189767
WILLICIA TORAN 52421078 10254997 10189767
WILLICIA TORAN 52426564 10254997 10189767
WILLICIA TORAN 52483572 10254997 10189767
WILLICIA TORAN 52872992 10254997 10189767
WILLICIA TORAN 52877286 10254997 10189767
WILLICIA TORAN 52923852 10254997 10189767
WILLICIA TORAN 53079798 10254997 10189767
WILLICIA TORAN 53604853 10254997 10189767
WILLICIA TORAN 53643936 10254997 10189767
WILLICIA TORAN 53714397 10254997 10189767
WILLICIA TORAN 53755545 10254997 10189767
WILLICIA TORAN 53755845 10254997 10189767
WILLICIA TORAN 53817844 10254997 10189767
WILLICIA TORAN 53851105 10254997 10189767
WILLICIA TORAN 53868617 10254997 10189767
WILLICIA TORAN 54018192 10254997 10189767
WILLICIA TORAN 54266862 10254997 10189767
WILLICIA TORAN 54273246 10254997 10189767
WILLICIA TORAN 54274208 10254997 10189767
WILLICIA TORAN 54277976 10254997 10189767
WILLICIA TORAN Totals
Resource Name Appointment Date Appointment Date Patient First Name
AMANDA RAY 05/03/2023 May 2023 CAMERON
AMANDA RAY 05/03/2023 May 2023 BRANDON
AMANDA RAY 05/03/2023 May 2023 DANICE
AMANDA RAY 05/03/2023 May 2023 GREGORY
AMANDA RAY 05/03/2023 May 2023 MICHELLE
AMANDA RAY 05/03/2023 May 2023 BETH
AMANDA RAY 05/03/2023 May 2023 ALEXIS
AMANDA RAY 05/03/2023 May 2023 HALEY
AMANDA RAY 05/03/2023 May 2023 LAISHANNA
AMANDA RAY 05/03/2023 May 2023 CHERIE
AMANDA RAY 05/03/2023 May 2023 JACKIE
AMANDA RAY 05/03/2023 May 2023 KENIA
AMANDA RAY 05/03/2023 May 2023 BRYNNA
AMANDA RAY 05/03/2023 May 2023 LINDA
AMANDA RAY 05/03/2023 May 2023 JUSTIN
AMANDA RAY 05/03/2023 May 2023 AMBER
AMANDA RAY 05/03/2023 May 2023 KYRA
AMANDA RAY 05/03/2023 May 2023 GWENDOLYN
AMANDA RAY 05/03/2023 May 2023 MICHELLE
AMANDA RAY 05/03/2023 May 2023 IAN
AMANDA RAY 05/03/2023 May 2023 NATASHA
AMANDA RAY 05/03/2023 May 2023 ELIZABETH
AMANDA RAY 05/03/2023 May 2023 ALICIA
AMANDA RAY 05/03/2023 May 2023 DWIGHT
AMANDA RAY 05/03/2023 May 2023 BRIKAYLA
AMANDA RAY 05/03/2023 May 2023 KELLY
AMANDA RAY 05/03/2023 May 2023 LUZ
AMANDA RAY 05/03/2023 May 2023 PEGGY
AMANDA RAY 05/03/2023 May 2023 ROBERT
AMANDA RAY 05/03/2023 May 2023 KATE
AMY VARGHESE 05/03/2023 May 2023 REBECCA
APRIL LEWIS 05/03/2023 May 2023 XAVIER

APRIL LEWIS 05/03/2023 May 2023 LUZ
APRIL LEWIS 05/03/2023 May 2023 KENNETH
APRIL LEWIS 05/03/2023 May 2023 SAMANTHA
APRIL LEWIS 05/03/2023 May 2023 DESJARE
APRIL LEWIS 05/03/2023 May 2023 MELISSA
APRIL LEWIS 05/03/2023 May 2023 BROOKE
CASSANDRA BODUCH 05/03/2023 May 2023 VIRGINIA

CASSANDRA BODUCH 05/03/2023 May 2023 ALMADELIA
CASSANDRA BODUCH 05/03/2023 May 2023 JACQUELINE
CASSANDRA BODUCH 05/03/2023 May 2023 MELISSA
CASSANDRA BODUCH 05/03/2023 May 2023 REED
CASSANDRA BODUCH 05/03/2023 May 2023 WILLIAM
CASSANDRA BODUCH 05/03/2023 May 2023 JOSUE
CASSANDRA BODUCH 05/03/2023 May 2023 JENNIFER
CASSANDRA BODUCH 05/03/2023 May 2023 HAILEY
CASSANDRA BODUCH 05/03/2023 May 2023 OLIVIA
CASSANDRA BODUCH 05/03/2023 May 2023 JASON
CASSANDRA BODUCH 05/03/2023 May 2023 MARCIA
CASSANDRA BODUCH 05/03/2023 May 2023 MATHEW
CASSANDRA BODUCH 05/03/2023 May 2023 BAYLIAN
CASSANDRA BODUCH 05/03/2023 May 2023 KATELYNN
CASSANDRA BODUCH 05/03/2023 May 2023 JAZMIN
CASSANDRA BODUCH 05/03/2023 May 2023 ALYSSA
CASSANDRA BODUCH 05/03/2023 May 2023 LEIA
CASSANDRA BODUCH 05/03/2023 May 2023 JOSEPHINE
CASSANDRA BODUCH 05/03/2023 May 2023 FELIX
CASSANDRA BODUCH 05/03/2023 May 2023 DYLAN
CASSANDRA BODUCH 05/03/2023 May 2023 DALLAS
CASSANDRA BODUCH 05/03/2023 May 2023 MADISON
CASSANDRA BODUCH 05/03/2023 May 2023 LOGAN
CASSANDRA BODUCH 05/03/2023 May 2023 DAMIEN
CASSANDRA BODUCH 05/03/2023 May 2023 VIOLETA
CATHERINE CHANG, MD 05/03/2023 May 2023 VICTORIA

CATHERINE CHANG, MD 05/03/2023 May 2023 ANAYDEE
CATHERINE CHANG, MD 05/03/2023 May 2023 BRITTANY
CATHERINE CHANG, MD 05/03/2023 May 2023 REBECCA
CATHERINE CHANG, MD 05/03/2023 May 2023 MARCOS
CATHERINE CHANG, MD 05/03/2023 May 2023 ISAIAS
CATHERINE CHANG, MD 05/03/2023 May 2023 AMANDA
CATHERINE CHANG, MD 05/03/2023 May 2023 JENNIFER
CATHERINE CHANG, MD 05/03/2023 May 2023 BRANDON
DR. MASOOD JILANI 05/03/2023 May 2023 SELIA

DR. MASOOD JILANI 05/03/2023 May 2023 GINA
DR. MASOOD JILANI 05/03/2023 May 2023 MIGUEL
DR. MASOOD JILANI 05/03/2023 May 2023 KRISTEN
DR. MASOOD JILANI 05/03/2023 May 2023 CHARLES
DR. MASOOD JILANI 05/03/2023 May 2023 AUDREY
DR. MASOOD JILANI 05/03/2023 May 2023 GABRIEL
RANDI KATZ 05/03/2023 May 2023 BRAYLEN

RANDI KATZ 05/03/2023 May 2023 SUSHMA
RANDI KATZ 05/03/2023 May 2023 ANGIE
RANDI KATZ 05/03/2023 May 2023 CHRISTOPHER
RANDI KATZ 05/03/2023 May 2023 RICHARD
RANDI KATZ 05/03/2023 May 2023 ANGELA
RANDI KATZ 05/03/2023 May 2023 MACI
RANDI KATZ 05/03/2023 May 2023 HAYLEE
RANDI KATZ 05/03/2023 May 2023 JESSI
RANDI KATZ 05/03/2023 May 2023 LINDSEY
RANDI KATZ 05/03/2023 May 2023 ANTONIA
RANDI KATZ 05/03/2023 May 2023 WENDI
RANDI KATZ 05/03/2023 May 2023 KATHRYN
RANDI KATZ 05/03/2023 May 2023 SARA
RANDI KATZ 05/03/2023 May 2023 TIFFANY
RANDI KATZ 05/03/2023 May 2023 RICKY
RANDI KATZ 05/03/2023 May 2023 VELINDA
RANDI KATZ 05/03/2023 May 2023 GENESIS
RANDI KATZ 05/03/2023 May 2023 KIMBERLY
RANDI KATZ 05/03/2023 May 2023 JASON
RANDI KATZ 05/03/2023 May 2023 MICHAELA
RANDI KATZ 05/03/2023 May 2023 JEREMY
RANDI KATZ 05/03/2023 May 2023 ALYSSA
RANDI KATZ 05/03/2023 May 2023 JENNIFER
RANDI KATZ 05/03/2023 May 2023 SUMMER
SHAMARUKH KABIR 05/03/2023 May 2023 JESSICA

SHAMARUKH KABIR 05/03/2023 May 2023 JALITHA
SHAMARUKH KABIR 05/03/2023 May 2023 DANIELA
SHAMARUKH KABIR 05/03/2023 May 2023 CHRISTINE
SHAMARUKH KABIR 05/03/2023 May 2023 EMILY
SHAMARUKH KABIR 05/03/2023 May 2023 SOPHIA
SHAMARUKH KABIR 05/03/2023 May 2023 MARY
SHAMARUKH KABIR 05/03/2023 May 2023 CARLIE
SHAMARUKH KABIR 05/03/2023 May 2023 ARON
SHAMARUKH KABIR 05/03/2023 May 2023 KIMBERLY
SHAMARUKH KABIR 05/03/2023 May 2023 LAL
SHAMARUKH KABIR 05/03/2023 May 2023 CALEB
SHAMARUKH KABIR 05/03/2023 May 2023 ERILYN
SHAMARUKH KABIR 05/03/2023 May 2023 MICHAEL
SHAMARUKH KABIR 05/03/2023 May 2023 EZEQUIEL
SHAMARUKH KABIR 05/03/2023 May 2023 ANGEL
SHAMARUKH KABIR 05/03/2023 May 2023 JACOB
SHAMARUKH KABIR 05/03/2023 May 2023 VIANEY
SHAMARUKH KABIR 05/03/2023 May 2023 VANESSA
SHAMARUKH KABIR 05/03/2023 May 2023 ANDREA
SHAMARUKH KABIR 05/03/2023 May 2023 TIM
SHAMARUKH KABIR 05/03/2023 May 2023 KRISTEN
SHAMARUKH KABIR 05/03/2023 May 2023 CHRISTOPHER
SHAMARUKH KABIR 05/03/2023 May 2023 CATHERINE
SHAMARUKH KABIR 05/03/2023 May 2023 YAZMIN
SHAMARUKH KABIR 05/03/2023 May 2023 JESUS
SHAMARUKH KABIR 05/03/2023 May 2023 DEBRA
SHAMARUKH KABIR 05/03/2023 May 2023 JOSE
SHAMARUKH KABIR 05/03/2023 May 2023 GENESIS
SHAMARUKH KABIR 05/03/2023 May 2023 ASHLIE
SHAMARUKH KABIR 05/03/2023 May 2023 YAMILET
SHAMARUKH KABIR 05/03/2023 May 2023 ROSA
TAI JOHNSON, NP 05/03/2023 May 2023 JOYCE

TAI JOHNSON, NP 05/03/2023 May 2023 GINA
TAI JOHNSON, NP 05/03/2023 May 2023 JOHN
TAI JOHNSON, NP 05/03/2023 May 2023 JOSEPH
TAI JOHNSON, NP 05/03/2023 May 2023 DAVE
TAI JOHNSON, NP 05/03/2023 May 2023 ALICIA
TAI JOHNSON, NP 05/03/2023 May 2023 ALEEZA
TAI JOHNSON, NP 05/03/2023 May 2023 KIRAN
TAI JOHNSON, NP 05/03/2023 May 2023 SOLOMON
TAI JOHNSON, NP 05/03/2023 May 2023 BENJAMIN R
TAI JOHNSON, NP 05/03/2023 May 2023 ALBERTO
TAI JOHNSON, NP 05/03/2023 May 2023 ADAM
TAI JOHNSON, NP 05/03/2023 May 2023 SHARJEEL
TAI JOHNSON, NP 05/03/2023 May 2023 SARRA
TAI JOHNSON, NP 05/03/2023 May 2023 KATHERINE
TAI JOHNSON, NP 05/03/2023 May 2023 KING
TAI JOHNSON, NP 05/03/2023 May 2023 LAURA
TAI JOHNSON, NP 05/03/2023 May 2023 KENESHA
TAI JOHNSON, NP 05/03/2023 May 2023 DONTRAYVION
TAI JOHNSON, NP 05/03/2023 May 2023 CAMILLE
TAI JOHNSON, NP 05/03/2023 May 2023 PATRICIA
TAI JOHNSON, NP 05/03/2023 May 2023 LEONEL
TAI JOHNSON, NP 05/03/2023 May 2023 JORGE
WILLICIA TORAN 05/03/2023 May 2023 CHARLI

WILLICIA TORAN 05/03/2023 May 2023 ADREANA
WILLICIA TORAN 05/03/2023 May 2023 ALEXANDRA
WILLICIA TORAN 05/03/2023 May 2023 DAN
WILLICIA TORAN 05/03/2023 May 2023 BELLA
WILLICIA TORAN 05/03/2023 May 2023 JEFFREY
WILLICIA TORAN 05/03/2023 May 2023 DEANDRE
WILLICIA TORAN 05/03/2023 May 2023 SHANEON
WILLICIA TORAN 05/03/2023 May 2023 SANDRA
WILLICIA TORAN 05/03/2023 May 2023 SEVEN
WILLICIA TORAN 05/03/2023 May 2023 D ANGELIQUE
WILLICIA TORAN 05/03/2023 May 2023 AUTUMN
WILLICIA TORAN 05/03/2023 May 2023 BROOKE
WILLICIA TORAN 05/03/2023 May 2023 RICHARD
WILLICIA TORAN 05/03/2023 May 2023 ANDERSON
WILLICIA TORAN 05/03/2023 May 2023 KIMBERLEE
WILLICIA TORAN 05/03/2023 May 2023 ALIYAH
WILLICIA TORAN 05/03/2023 May 2023 ALEX
WILLICIA TORAN 05/03/2023 May 2023 EDNA
WILLICIA TORAN 05/03/2023 May 2023 KIYA
WILLICIA TORAN 05/03/2023 May 2023 ANTOINETTE
WILLICIA TORAN 05/03/2023 May 2023 JANE
WILLICIA TORAN 05/03/2023 May 2023 KYLIE
WILLICIA TORAN 05/03/2023 May 2023 DESTINY
WILLICIA TORAN 05/03/2023 May 2023 ZOEY
WILLICIA TORAN 05/03/2023 May 2023 ALVIN
WILLICIA TORAN 05/03/2023 May 2023 ELIZABETH
WILLICIA TORAN 05/03/2023 May 2023 RODOLFO ADONAY
WILLICIA TORAN 05/03/2023 May 2023 ANAS
WILLICIA TORAN 05/03/2023 May 2023 NEVAEH
WILLICIA TORAN 05/03/2023 May 2023 BRANDON
WILLICIA TORAN 05/03/2023 May 2023 HARRISON
Patient Last Name Patient Full Name Patient Birthday Appt Status
GRAHAM GRAHAM, CAMERON L 12/25/2004 Checked-Out
MARTINEZ MARTINEZ, BRANDON M 02/06/2004 ins Verified
GONZALES GONZALES, DANICE 09/16/1975 Checked-Out
BUCKHOUSE BUCKHOUSE, GREGORY R 09/06/2011 Checked-Out
SODERBERG SODERBERG, MICHELLE A 10/31/1972 Checked-Out
CRAIG CRAIG, BETH 05/17/1969 Checked-Out
NANNY NANNY, ALEXIS B 05/01/1993 Checked-Out
BURNS BURNS, HALEY 02/02/2003 Checked-Out
BLEDSOE BLEDSOE, LAISHANNA R 01/14/1975 Checked-Out
GOODE GOODE, CHERIE L 02/03/1983 Checked-Out
BEISERT BEISERT, JACKIE R 06/08/1965 No Show
LOPEZ LOPEZ, KENIA W 01/19/1994 ins Verified
FITZPATRICK FITZPATRICK, BRYNNA 02/13/2003 Checked-Out
LOWRY LOWRY, LINDA 03/08/1952 Checked-Out
OSBOURN OSBOURN, JUSTIN 02/26/1990 No Show
BREZNIK BREZNIK, AMBER N 04/16/1989 Checked-Out
HUCKABY HUCKABY, KYRA M 01/03/2005 Checked-Out
NELSON NELSON, GWENDOLYN S 10/10/1950 Checked-Out
MITCHAM MITCHAM, MICHELLE T 04/06/1983 Checked-Out
SPENCER SPENCER, IAN S 05/22/2007 Checked-Out
REYES REYES, NATASHA G 11/19/1990 Checked-Out
HATLEY HATLEY, ELIZABETH R 05/04/1985 Checked-Out
AGUILAR AGUILAR, ALICIA 02/27/1992 Checked-Out
ALLEN ALLEN, DWIGHT D 12/14/1965 Checked-Out
HARDY HARDY, BRIKAYLA 05/14/1990 Checked-Out
PAWELKA PAWELKA, KELLY 11/29/2005 Checked-Out
TORO TORO, LUZ 12/27/1989 ins Verified
STEVENS STEVENS, PEGGY ANNE 12/11/1949 Checked-Out
MCKETHAN MCKETHAN, ROBERT ALEXANDER 01/15/1986 Checked-Out
LEDWITH LEDWITH, KATE 10/21/2001 Checked-Out
30
WILSON WILSON, REBECCA 02/26/1998 Canceled
1
JAMSHED KHAN JAMSHED KHAN, XAVIER 09/21/1995 In Room
MURILLO MURILLO, LUZ E 05/24/2008 Checked-Out
CATLETT CATLETT, KENNETH E 12/24/1949 In Room
MARTINEZ MARTINEZ, SAMANTHA 07/28/2008 ins Verified
HUMPHREY HUMPHREY, DESJARE 12/01/1983 In Room
JIMENEZ D SAHAGUN JIMENEZ D SAHAGUN, MELISSA 11/29/1986 No Show
VALDEZ VALDEZ, BROOKE 02/23/1971 No Show
7
VALADEZ VALADEZ, VIRGINIA 03/15/1977 Checked-Out
JUAREZ JUAREZ, ALMADELIA 06/26/1985 Checked-Out
FRANCO FRANCO, JACQUELINE 09/06/1996 Checked-Out
CSIKOS CSIKOS, MELISSA 04/03/1991 Checked-Out
SVENSSON SVENSSON, REED 02/14/2013 Checked-Out
ADKINS ADKINS, WILLIAM 11/14/2009 Checked-Out
CRUZ ARRIOLA CRUZ ARRIOLA, JOSUE 08/11/1996 ins Verified
MCVEY MCVEY, JENNIFER 09/20/1980 Checked-Out
HOLLIS HOLLIS, HAILEY 03/24/2010 Checked-Out
DEUTSCH DEUTSCH, OLIVIA L 04/11/2013 Checked-Out
STIGERS STIGERS, JASON P 08/13/1985 ins Verified
ABRAHAM ABRAHAM, MARCIA L 05/19/1992 Checked-Out
ABRAHAM ABRAHAM, MATHEW EUGENE 10/19/2002 Checked-Out
ABRAHAM ABRAHAM, BAYLIAN 12/02/2011 Checked-Out
FOWLER GARZA FOWLER GARZA, KATELYNN 09/19/2002 Checked-Out
SANCHEZ SANCHEZ, JAZMIN 10/18/2002 Checked-Out
CARRIZALES CARRIZALES, ALYSSA 02/15/2007 ins Verified
COOK COOK, LEIA 05/08/2011 ins Verified
STEVENSON STEVENSON, JOSEPHINE L 07/20/2000 Checked-Out
GARCIA GARCIA, FELIX 11/20/1969 ins Verified
MORENO MORENO, DYLAN 04/10/2016 Checked-Out
WEST WEST, DALLAS 11/09/1980 ins Verified
OCONNOR OCONNOR, MADISON 04/08/1996 Checked-Out
MOSLEY MOSLEY, LOGAN L 03/31/2017 ins Verified
RANSOM RANSOM, DAMIEN S 04/29/2003 ins Verified
ARROYO ARROYO, VIOLETA 05/31/1982 Checked-Out
26
BRADY BRADY, VICTORIA 07/03/1969 Checked-Out
MORALES MORALES, ANAYDEE 06/16/1987 Checked-Out
MCDONALD MCDONALD, BRITTANY MARIE 08/21/1986 Checked-Out
BUTCHER BUTCHER, REBECCA MICHELLE 04/20/1993 Rescheduled
COLLAZO COLLAZO, MARCOS 08/02/1978 Checked-Out
RIVAS RIVAS, ISAIAS FUENTES 10/11/1985 Checked-Out
FAULKNER FAULKNER, AMANDA 05/11/1992 Checked-Out
BRUECKNER BRUECKNER, JENNIFER 07/04/1972 Checked-Out
IBARRA IBARRA, BRANDON 07/14/1994 Checked-Out
9
RUIZ RUIZ, SELIA 10/06/1969 Checked-In
RAMSEY RAMSEY, GINA G 11/11/1964 Checked-In
VARELA VARELA, MIGUEL O 09/05/1958 Rescheduled
WELLS WELLS, KRISTEN L 01/15/1983 Rescheduled
ELERI ELERI, CHARLES 09/30/1987 Checked-Out
NKADI NKADI, AUDREY M 06/23/1975 Checked-Out
CAMPOS DOS SANTOS CAMPOS DOS SANTOS, GABRIEL 12/12/1994 Canceled
7
WHITE WHITE, BRAYLEN 09/25/2006 Checked-Out
VISHNUBHOTLA VISHNUBHOTLA, SUSHMA 02/24/1989 Checked-Out
LAKEY LAKEY, ANGIE M 10/09/1974 ins Verified
ALLEN ALLEN, CHRISTOPHER S 06/25/1970 Checked-Out
HANSEN HANSEN, RICHARD R 12/03/1950 Checked-Out
WELCH WELCH, ANGELA 04/07/1967 Checked-Out
DAVENPORT DAVENPORT, MACI 09/03/2006 Checked-Out
JEFCOAT JEFCOAT, HAYLEE 05/13/1995 Checked-Out
GARCIA GARCIA, JESSI 11/21/1989 Checked-Out
BALSER BALSER, LINDSEY NICHOLE 02/03/1988 ins Verified
LEITERMAN LEITERMAN, ANTONIA 02/13/1976 ins Verified
JOHNSON JOHNSON, WENDI R 07/06/1985 Checked-Out
BIRD BIRD, KATHRYN 07/03/1947 Checked-Out
OSBORNE OSBORNE, SARA B 03/24/1980 Checked-Out
HENRY HENRY, TIFFANY 04/15/1983 Checked-Out
STORY STORY, RICKY M 04/21/1993 ins Verified
GARZA GARZA, VELINDA 12/07/1989 ins Verified
DYER DYER, GENESIS 07/14/2006 Checked-Out
FONTES FONTES, KIMBERLY ANN 12/20/1975 Checked-Out
HALE HALE, JASON 12/24/1980 Canceled
OSBORNE OSBORNE, MICHAELA D 09/15/2005 Checked-Out
HOLMBERG HOLMBERG, JEREMY 06/25/1975 Checked-Out
VELARDE VELARDE, ALYSSA 06/25/1996 Checked-Out
DEVANE DEVANE, JENNIFER M 05/04/1994 Checked-Out
BAUCUM BAUCUM, SUMMER 05/30/2005 Checked-Out
25
KNIGHT KNIGHT, JESSICA L 01/22/1980 Checked-Out
BELL KNOX BELL KNOX, JALITHA B 08/18/1965 Checked-Out
GAMEZ GAMEZ, DANIELA 09/04/2004 No Show
VASQUEZ VASQUEZ, CHRISTINE M 12/27/1972 No Show
STEWART STEWART, EMILY C 08/06/1985 Checked-Out
BAUGH BAUGH, SOPHIA 06/05/2009 Checked-Out
ANDRADO ANDRADO, MARY H 10/09/1948 Checked-Out
HOWELL HOWELL, CARLIE 10/04/2004 Rescheduled
OLIVARES OLIVARES, ARON D 08/23/2000 Rescheduled
LAWSON LAWSON, KIMBERLY A 06/02/1960 Checked-Out
SERRANO SERRANO, JESSICA 03/13/1980 Checked-Out
KHAN KHAN, LAL 04/20/1956 No Show
CANALES CANALES, CALEB 07/27/2012 Checked-Out
BLACK BLACK, ERILYN J 01/05/2006 Checked-Out
RAMIREZ RAMIREZ, MICHAEL 11/27/2014 Checked-Out
CANALES CANALES, EZEQUIEL 04/26/2016 Checked-Out
ALVARADO ALVARADO, ANGEL 09/23/2007 Canceled
NELSON NELSON, JACOB 08/08/1995 Checked-Out
GONZALEZ GONZALEZ, JESSICA 02/16/1975 Checked-Out
CIENFUEGOS CIENFUEGOS, VIANEY C 08/08/1963 Rescheduled
MARTINEZ MARTINEZ, VANESSA 11/19/2001 Checked-Out
BUSTAMANTE BUSTAMANTE, ANDREA CHRISTIAN 05/13/1992 Checked-Out
GOMEZ GOMEZ, TIM E 05/24/1950 Checked-Out
SHORES SHORES, KRISTEN 10/01/1992 Checked-Out
ROMERO ROMERO, CHRISTOPHER A 07/09/1992 No Show
FLORES FLORES, CATHERINE N 08/22/2000 No Show
RODRIGUEZ RODRIGUEZ, YAZMIN 03/09/2005 Rescheduled
TORRES TORRES, JESUS 01/26/2009 Rescheduled
JONES-STEWART JONES-STEWART, DEBRA 06/15/1966 Checked-Out
ADAME ADAME, JOSE 12/06/1969 Rescheduled
CHOURIO CHOURIO, GENESIS 04/18/1993 Checked-Out
HAWS HAWS, ASHLIE 08/29/1989 Checked-Out
GARCIA GARCIA, YAMILET 11/22/1992 Checked-Out
SANCHEZ SANCHEZ, ROSA 07/15/1998 Checked-Out
34
SWARB SWARB, JOYCE E 05/13/1974 Checked-Out
DAVIS DAVIS, GINA 09/21/1983 Checked-Out
SHUTE SHUTE, JOHN L 01/22/1967 ins Verified
GALLISHAW GALLISHAW, JOSEPH C 12/16/1955 Checked-Out
GARZA GARZA, DAVE 11/25/2007 Checked-Out
HERNANDEZ HERNANDEZ, ALICIA 10/26/1988 ins Verified
BUTLER BUTLER, ALEEZA 08/27/1997 Checked-Out
SIDHWANI SIDHWANI, KIRAN 08/19/1952 ins Verified
COOK JR COOK JR, SOLOMON R 05/18/1987 Checked-Out
ZARATE ZARATE, BENJAMIN R 07/29/1983 ins Verified
MARTINEZ MARTINEZ, ALBERTO 02/08/1991 Checked-Out
BECK BECK, ADAM R 03/09/1999 Checked-Out
KHAN KHAN, SHARJEEL 06/08/1989 ins Verified
GAUNTT GAUNTT, SARRA 02/24/2004 Checked-Out
LOVELADY LOVELADY, KATHERINE C 01/29/1977 Checked-Out
JONES JONES, KING 08/31/2009 Checked-Out
LUECK LUECK, LAURA A 03/04/1985 Checked-Out
LOTT LOTT, KENESHA 12/21/1990 Checked-Out
ALLEN ALLEN, DONTRAYVION 02/07/2012 Checked-Out
PUTNAM PUTNAM, CAMILLE 07/21/2006 Checked-Out
COTTER COTTER, PATRICIA 11/01/1997 Checked-Out
GODINEZ GODINEZ, LEONEL 12/26/2001 ins Verified
NUNEZ NUNEZ, JORGE 08/24/1989 ins Verified
23
DEUTSCH DEUTSCH, CHARLI R 02/02/2004 Checked-Out
VALDEZ VALDEZ, ADREANA 10/12/2007 Checked-Out
VALDEZ VALDEZ, ALEXANDRA 01/27/2005 Checked-Out
JENKINS JENKINS, DAN M 03/28/1975 Checked-Out
BRANDON BRANDON, BELLA 07/07/2009 Canceled
SKELTON SKELTON, JEFFREY 03/13/1973 Checked-Out
AUGUSTUS AUGUSTUS, DEANDRE I 02/20/2004 No Show
HORDGE HORDGE, SHANEON 04/22/2004 No Show
EDGERTON EDGERTON, SANDRA E 03/22/1949 Checked-Out
HARRIS HARRIS, SEVEN P 04/14/2009 Checked-Out
TIERCE TIERCE, D ANGELIQUE 12/21/1970 Checked-Out
TEAGUE-DAVIS TEAGUE-DAVIS, AUTUMN T 05/08/1974 Checked-Out
HARGIS HARGIS, BROOKE C 10/09/1998 Checked-Out
PREMEAUX PREMEAUX, RICHARD 05/20/2015 Checked-Out
NUNEZ NUNEZ, ANDERSON 01/05/1983 Checked-Out
RICKER RICKER, KIMBERLEE J 06/10/1961 Checked-Out
PREMEAUX PREMEAUX, ALIYAH 06/18/2011 Checked-Out
URQUIDEZ URQUIDEZ, ALEX 02/15/1989 Checked-Out
GUTIERREZ GUTIERREZ, EDNA GOMEZ 09/05/1985 Checked-Out
COLTON COLTON, KIYA RAINNE 05/07/2007 Checked-Out
MOSLEY MOSLEY, ANTOINETTE E 10/12/1997 Checked-Out
OSBORNE OSBORNE, JANE C 03/08/1957 Checked-Out
YOUNG YOUNG, KYLIE 04/22/2004 Checked-Out
MCCARTY MCCARTY, DESTINY I 03/30/2012 Checked-Out
GAINES GAINES, ZOEY L 02/25/2014 No Show
MORK MORK, ALVIN 09/15/1953 Checked-Out
LOWE LOWE, ELIZABETH G 06/13/1938 Checked-Out
HENRIQUEZ ORELLANA HENRIQUEZ ORELLANA, RODOLFO ADONAY 02/15/2006 Checked-Out
BAKEER BAKEER, ANAS 01/22/1990 Checked-Out
BROWN BROWN, NEVAEH 03/25/2008 Checked-Out
ROBINSON ROBINSON, BRANDON 12/06/1982 Canceled
HIDALGO HIDALGO, HARRISON G 07/18/2001 Checked-Out
32
194
Pat. Primary Payer Name Primary Member ID
UNITED HEALTHCARE 984811672
SUPERIOR HEALTH 601348646
SELF PAY 644-26-7999
BLUE CROSS AND BLUE SHIELD OF TEXAS ZGP666983819
AMBETTER U9279337401
AMERIGROUP 711753884
AETNA W273391552
TEXAS MEDICARE 6RR0DC7UV08
TEXAS MEDICARE 2DY0PV8MJ35
CIGNA 919191060482
AETNA W120711186
HUMANA H08787495
SELF PAY 99999999999
CIGNA 919191059690
MAGELLAN BEHAVIORAL HEALTH D6RHC2
CIGNA U8403101503
MOLINA HEALTHCARE OF TEXAS 0011805731
AETNA W243048816
AMBETTER U92998081
AETNA W268028758
WELLCARE TEXAN PLUS 045012754
CIGNA 919191026958
BCBS MAGELLAN 925626420EP
AETNA W273635446
MOLINA HEALTHCARE OF TEXAS 0009038224

TEXAS CHILDRENS HEALTH PLAN 528545895
TEXAS MEDICARE 4VK9GF9UP10
CIGNA 996154029
BLUE CROSS AND BLUE SHIELD OF TEXAS WJW831755201
BLUE CROSS AND BLUE SHIELD OF TEXAS ZGA841532311

OSCAR MENTAL HEALTH 645070919
BLUE CROSS AND BLUE SHIELD OF TEXAS XOF822366443
CIGNA U4485501803
AETNA W059133533
CIGNA U8705133801
CIGNA 919191025869
BLUE CROSS AND BLUE SHIELD OF TEXAS HSJ3HZN95341870
BLUE CROSS MEDICARE ADVANTAGE SFZ847939663
TEXAS MEDICARE 3EU7QX8WA64
BLUE CROSS MEDICARE ADVANTAGE SRC276687868533
BLUE CROSS AND BLUE SHIELD OF TEXAS SRC276687868533
MERITAIN 4785920660
UNITED HEALTHCARE COMMUNITY PLAN 611434589
COMMUNITY HEALTH CHOICE MEDICAID 715495145
BCBS MEDICARE ADVANTAGE K5S7048248CH
TRICARE EAST 005078292
CIGNA U6627662603
RIVER OAKS HOSPITAL 322898
UMR 21864116
BLUE CROSS AND BLUE SHIELD OF TEXAS MRT820928869
ALLEGIANCE BENEFIT PLAN MANAGEMENT INC. 77974120932200

BCBS MAGELLAN 92420267201
BLUE CROSS AND BLUE SHIELD OF TEXAS DOMAN6708179
BLUE CROSS AND BLUE SHIELD OF TEXAS DJM831974851
BLUE CROSS AND BLUE SHIELD OF TEXAS HZY805457536
RIVER OAKS HOSPITAL 999999999
BLUE CROSS MEDICARE ADVANTAGE T2S830465696
BLUE CROSS AND BLUE SHIELD OF TEXAS CXA841285177
BLUE CROSS AND BLUE SHIELD OF TEXAS HEB831360426

HUMANA H44398229
HUMANA H40393774
BLUE CROSS AND BLUE SHIELD OF TEXAS TEA806406193
AETNA W277975522

BLUE CROSS AND BLUE SHIELD OF TEXAS T2U843524957
AETNA 101554566000
HUMANA H67223305
AETNA 101669127900
MOLINA MEDICAID 510727866
UNITED HEALTHCARE COMMUNITY PLAN 528960219
UNITED HEALTHCARE MEDICARE 997921635
CIGNA 919191021933
TEXAS MEDICARE 7UX1N06NX95
DRISCOLL CHILDRENS HEALTH PLAN 509830896
CIGNA U0664301403
SUPERIOR HEALTH U9212002801
AETNA W190560901
AMBETTER-VALUE U9708587501
TEXAS MEDICARE 3W28AH8QN31

SELF PAY 33333333333
UMR 21521151
UMR 32612000
HEALTHEZ LTF0736AF46
UMR 17533132
AETNA 101557751500
CIGNA 10690310301
UNITED HEALTHCARE MEDICAID 617528168
ALLEGIANCE BENEFIT PLAN MANAGEMENT INC. 919191073945
CIGNA 36373366
AETNA 101461340900
BLUE CROSS AND BLUE SHIELD OF TEXAS RNGAN8221484
BLUE CROSS AND BLUE SHIELD OF TEXAS T2U924157905
WELLCARE TEXAN PLUS 35058547
COMMUNITY HEALTH MARKETPLACE 000863852100
BLUE CROSS AND BLUE SHIELD OF TEXAS XUP202605147
HUMANA H62246435
HUMANA H70946508
MAGELLAN BEHAVIORAL HEALTH DHPDERAS8
TEXAS MEDICARE 6C14N31RW67
TEXAS MEDICARE 5PY3DP8GV74
CIGNA 10750055500
BLUE CROSS AND BLUE SHIELD OF TEXAS AEX828703978
AETNA W269179406
BLUE CROSS AND BLUE SHIELD OF TEXAS ZGT902083749
HUMANA H73002699
CIGNA 10859730100
AETNA W080074881
AETNA W266549314
BLUE CROSS MEDICARE ADVANTAGE SFZ847939663

BLUE CROSS AND BLUE SHIELD OF TEXAS R60207105
BLUE CROSS AND BLUE SHIELD OF TEXAS R60207105
BCBS MEDICARE ADVANTAGE ZGD804304556
BLUE CROSS AND BLUE SHIELD OF TEXAS Q8C133923977001
AETNA W277015003
CIGNA U5550157104
AETNA 101286157400
UNITED HEALTHCARE MEDICAID 530214049
CIGNA U1048768502
BEACON HEALTH OPTIONS 828192870
MAGELLAN BEHAVIORAL HEALTH D3H29G
TEXAS MEDICAID 608825594
BEACON HEALTH OPTIONS 050M87385
CIGNA 10822599702
BLUE CROSS AND BLUE SHIELD OF TEXAS UTS0Z34DK3CD
UNITED HEALTHCARE MEDICARE 990854086
CIGNA U5793382504
AETNA W273000196
AETNA 101112454700
POINT COMFORT UNDERWRITERS 246733322
CIGNA U8036985402
CIGNA 10282976405
Pat. Secondary Payer Name Secondary Member ID Patient Credits Patient Ins Credits
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$65.00 $0.00
$0.00 $0.00
$0.00 $0.00
$670.00 $0.00
$9.58 $0.00
$15.00 $0.00
AMERIGROUP 727616963 $0.00 $0.00
$80.00 $0.00
$0.00 $0.00
$70.00 $0.00
$0.00 $0.00
$25.00 $0.00
$150.00 $0.00
$190.43 $0.00
$0.00 $0.00
$40.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $199.62
$0.00 $0.00
$0.00 $0.00
$60.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
TRICARE EAST 00447228100 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$130.00 $0.00
$5.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$115.40 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$1.79 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$70.00 $0.00
$0.00 $0.00
$0.00 $0.00
$25.00 $0.00
$0.00 $0.00
$0.00 $0.00
$52.00 $0.00
$0.00 $0.00
$0.00 $0.00
$15.00 $254.29
$100.00 $0.00
$275.00 $0.00
$8.00 $0.00
$20.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$16.43 $0.00
$0.00 $0.00
$0.00 $0.00
MOLINA MEDICAID 735309300 $0.00 $0.00
$40.00 $0.00
$0.00 $0.00
$0.00 $0.00
$176.20 $0.00
AMBETTER-VALUE U94474832 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$50.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$50.00 $0.00
$0.00 $0.00
$0.00 $0.00
$79.24 $0.00
$0.00 $0.00
$0.00 $0.00
TEXAS MEDICAID 614238626 $0.00 $0.00

$0.00 $0.00
$0.00 $0.00
$70.00 $0.00
$0.00 $0.00
$1.86 $0.00
$50.00 $0.00
$0.00 $0.00
$15.00 $0.00
UNITED HEALTHCARE 750559782 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$150.00 $0.00
$40.03 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$100.00 $0.00
UNITED HEALTHCARE MEDICAID 718516774 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$10.00 $0.00
$75.00 $0.00
$0.00 $0.00
$0.00 $0.00
$150.00 $0.00
$472.00 $0.00
$120.00 $0.00
$45.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
AARP 34839898711 $0.00 $0.00
TEXAS MEDICAID 708948982 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$25.00 $0.00
$0.00 $0.00
TEXAS MEDICAID 505512465 $0.00 $0.00
$0.00 $0.00
$35.00 $0.00
$50.00 $0.00
$0.00 $0.00
$50.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$345.00 $0.00
$30.00 $0.00
$60.00 $0.00
$60.00 $0.00
$0.00 $0.00
$50.00 $0.00
$0.00 $0.00
$25.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
AMERIGROUP 733470691 $0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
$100.00 $0.00
$0.00 $0.00
$100.00 $0.00
$0.00 $0.00
$0.00 $0.00
$0.00 $0.00
TEXAS MEDICARE 2KU1RX2FG99 $0.00 $0.00
$80.00 $0.00
$0.00 $0.00
$30.00 $0.00
$0.00 $0.00
$0.00 $0.00
$50.00 $0.00
Patient Balance Patient Ins. Balance Last Eligibility Check Last Patient Payment
$48.15 $0.00 05/02/2023
$0.00 $2,200.00 05/04/2023
$1,375.00 $0.00 05/03/2023 10/22/2021
$830.00 $0.00 05/02/2023 01/10/2022
-$25.00 $0.00 05/03/2023 05/03/2023
$0.00 $0.00 05/02/2023
$0.00 $1,926.00 05/05/2023
$464.09 $642.00 05/11/2023 04/10/2023
$531.89 $0.00 05/02/2023 04/06/2023
-$15.00 $0.00 05/02/2023 05/03/2023
$0.00 $0.00 05/02/2023
-$80.00 $0.00 05/02/2023 05/12/2021
$15.00 $0.00 05/02/2023 02/23/2023
-$70.00 $642.00 05/02/2023 10/25/2022
$1,790.00 $0.00 09/15/2021 02/15/2023
-$25.00 $0.00 05/02/2023 05/03/2023
-$150.00 $0.00 05/02/2023 10/21/2021
-$190.43 $0.00 05/02/2023 01/29/2022
$100.00 $0.00 05/02/2023 02/03/2023
-$40.00 $0.00 05/02/2023 08/08/2022
$0.00 $300.00 05/02/2023 05/01/2023
$0.00 $0.00 05/02/2023 04/28/2023
$365.00 $1,100.38 05/08/2023
$0.00 $0.00 05/03/2023
$120.00 $0.00 05/03/2023 03/25/2023
-$20.00 $0.00 05/02/2023 04/21/2023
$0.00 $642.00 05/09/2023
$0.00 $0.00 05/09/2023 05/10/2023
$0.00 $1,480.00 05/11/2023 04/25/2023
$72.00 $0.00 05/02/2023
$352.11 $642.00 05/10/2023 02/18/2023
$0.00 $735.00 05/09/2023

$0.00 $4,912.00 05/09/2023
$0.00 $0.00 05/02/2023
$0.00 $2,215.00 05/03/2023
$518.97 $0.00 05/10/2023 03/16/2023
$20.00 $0.00 05/03/2023
$15.00 $0.00 05/03/2023 04/04/2023
$135.99 $0.00 05/02/2023 03/07/2023

$0.00 $0.00 05/02/2023
$15.00 $967.00 05/02/2023 04/26/2023
$30.00 $0.00 05/02/2023 03/03/2023
-$30.00 $642.00 05/03/2023 04/18/2023
$25.00 $0.00 05/02/2023 03/08/2023
$35.00 $38.33 05/02/2023
$0.00 $0.00 05/02/2023
$0.00 $0.00 05/02/2023 04/05/2023
-$115.40 $0.00 04/18/2023 05/03/2023
$40.10 $0.00 05/02/2023 03/28/2023
$585.56 $0.00 05/02/2023 12/28/2022
$325.00 $0.00 05/10/2023 02/03/2023
$140.00 $0.00 05/03/2023 10/13/2022
$0.00 $1,631.00 05/02/2023
$0.00 $642.00 05/02/2023
$90.97 $0.00 05/02/2023 05/07/2023
$72.00 $642.00 05/02/2023 03/08/2023
-$1.79 $0.00 05/02/2023 04/07/2023
$0.00 $4,497.00
$0.00 $642.00 05/03/2023
$124.28 $2,093.00 05/10/2023
$0.00 $0.00 05/03/2023 05/01/2023
$0.00 $1,480.00 05/02/2023
$0.00 $0.00 05/02/2023
$0.00 $0.00 05/03/2023 05/03/2023
$418.26 $8,142.00 05/02/2023 03/07/2023

$41.92 $375.00 03/23/2023 02/09/2023
$0.00 $0.00 05/02/2023 04/05/2023
$67.48 $0.00 05/04/2023 05/04/2023
$0.00 $0.00 05/02/2023 05/02/2023
$0.00 $0.00
-$52.00 $0.00 05/02/2023 04/18/2023
$0.00 $0.00 05/03/2023
$0.00 $0.00 04/27/2023
$0.00 $9,167.71 05/04/2023 04/28/2023

-$40.00 $12,730.00 05/11/2023 04/21/2022
-$215.00 $12,088.00 05/04/2023 05/05/2023
$3.00 $0.00 05/08/2023 04/05/2023
$762.00 $0.00 05/10/2023 01/11/2023
$0.00 $0.00 05/09/2023
$0.00 $0.00 05/03/2023 05/03/2023
$0.00 $642.00 05/02/2023

-$16.43 $0.00 05/03/2023 03/30/2023
$0.00 $2,019.00 05/05/2023
$90.00 $0.00 05/02/2023 01/20/2023
$0.00 $1,792.00 05/02/2023
-$40.00 $642.00 05/02/2023 05/18/2022
$0.00 $0.00 05/03/2023
$0.00 $0.00 05/02/2023
-$65.40 $0.00 05/02/2023 05/04/2023
$240.00 $0.00 05/02/2023 04/06/2023
$0.00 $642.00 05/05/2023
$0.00 $2,592.00 05/11/2023
$0.00 $735.00 05/02/2023
$0.00 $642.00 05/03/2023
-$50.00 $735.00 05/10/2023 02/03/2023
$151.74 $0.00 05/08/2023
$0.00 $642.00 05/05/2023
$15.00 $364.00 05/02/2023 04/25/2023
$0.00 $0.00 05/03/2023
-$25.00 $642.00 05/02/2023 04/18/2023
$0.00 $838.00 05/02/2023
$0.00 $642.00 05/04/2023 05/07/2023
-$79.24 $0.00 05/02/2023 05/03/2023
$0.00 $0.00 05/10/2023
$0.00 $0.00 05/02/2023
$0.00 $20.05 05/10/2023 09/13/2022

$225.00 $1,810.00 05/02/2023 02/08/2023
$360.00 $325.00 02/22/2023 04/12/2022
$0.00 $0.00 05/04/2023 05/04/2023
$0.00 $0.00 05/02/2023 04/05/2023
$118.52 $642.00 05/03/2023 01/27/2023
-$20.00 $0.00 05/02/2023 05/03/2023
$250.00 $0.00 05/03/2023 11/10/2022
-$15.00 $0.00 05/03/2023 05/04/2023
$0.00 $650.00 05/02/2023
$0.00 $0.00 05/02/2023 12/28/2022
$34.74 $0.00 05/08/2023
$0.00 $642.00 05/02/2023
$35.00 $0.00 05/03/2023
$0.00 $0.00 05/02/2023
$0.00 $642.00 05/02/2023
$0.00 $0.00 05/02/2023
-$50.00 $0.00 05/03/2023 05/03/2023
-$20.03 $1,675.00 05/11/2023 03/14/2023
$0.00 $0.00 05/09/2023
$0.00 $2,122.00 03/29/2023
$0.00 $0.00 05/02/2023
$0.00 $0.00 05/03/2023
$108.68 $642.00 05/03/2023 05/03/2023
$0.00 $1,284.00 05/03/2023
$0.00 $0.00 05/04/2023 04/05/2023
$0.00 $642.00 03/28/2023
$0.00 $838.00 05/10/2023
$25.00 $0.00 05/03/2023
$0.00 $4,838.00 05/02/2023
-$10.00 $0.00 05/11/2023 05/03/2023
-$75.00 $0.00 05/09/2023
$0.00 $0.00 05/08/2023
$0.00 $0.00 05/04/2023
-$150.00 $642.00 05/02/2023 04/19/2022

-$90.00 $1,738.00 05/09/2023 05/03/2023
-$120.00 $0.00 05/02/2023 05/05/2022
-$15.00 $0.00 05/02/2023 04/18/2023
$0.00 $642.00 05/03/2023
$0.00 $0.00 05/03/2023
$30.00 $0.00 05/02/2023 05/11/2023
$160.27 $26.32 05/03/2023 04/11/2023
$0.00 $668.32 05/03/2023
$368.11 $0.00 05/02/2023 03/29/2023
$0.00 $0.00 05/02/2023 05/05/2023
$265.37 $642.00 05/02/2023 03/14/2023
-$25.00 $1,480.00 03/22/2023 03/13/2023
$0.00 $2,147.00 05/09/2023 05/11/2023
$0.00 $2,122.00 05/02/2023
$0.00 $642.00 05/03/2023
-$35.00 $1,480.00 05/02/2023 04/10/2023
-$25.00 $0.00 05/02/2023 05/04/2023
$0.00 $838.00 04/19/2023
-$50.00 $642.00 05/02/2023 05/03/2023
$0.00 $0.00 05/03/2023
$0.00 $3,051.00 05/05/2023
$0.00 $0.00 05/08/2023
-$115.02 $0.00 04/11/2023 05/03/2023

-$30.00 $0.00 05/03/2023 05/03/2023
-$30.00 $0.00 05/03/2023 05/03/2023
-$60.00 $0.00 05/03/2023 05/03/2023
$0.00 $642.00 05/02/2023
-$50.00 $0.00 05/03/2023 05/03/2023
$120.00 $0.00 05/09/2023
$0.00 $0.00 05/02/2023 12/30/2022
$105.00 $0.00 05/03/2023
$0.00 $1,625.00 05/02/2023
$0.00 $642.00 05/03/2023 04/23/2023
$209.56 $1,926.00 05/09/2023
$40.00 $642.00 05/02/2023 03/06/2023
$100.00 $642.00 04/19/2023 03/28/2023
$0.00 $5,194.00 05/03/2023
$0.00 $0.00 05/02/2023
$892.00 $1,926.00 05/02/2023
$4.50 $1,040.00 04/04/2023 04/25/2023
$0.00 $0.00 05/02/2023 04/12/2023
-$50.00 $0.00 05/02/2023 05/03/2023
$80.00 $0.00 05/11/2023 03/14/2023
$53.60 $735.00 05/02/2023 05/03/2023
$36.00 $0.00 05/02/2023 05/03/2023
$0.00 $1,827.00 05/10/2023
$40.00 $642.00 05/02/2023 04/21/2023
$23.67 $0.00 05/02/2023 05/01/2023
-$80.00 $0.00 05/02/2023 05/03/2023
$0.00 $1,480.00 05/03/2023
-$30.00 $0.00 05/04/2023 05/03/2023
$0.00 $0.00 05/03/2023
$0.00 $0.00
-$50.00 $0.00 05/03/2023 05/03/2023
Patient Last Payment Amount Appointment Comment
Copay: $48.15
$0.00
Balance: $96.30
Copay: $0.00
$0.00
Balance:
Copay: $0.00
$150.00
$100.00 Balance: $1525.00
Copay: $30.00
$50.00 Balance: $860.00
Copay: $25.00
$90.00
Balance: $90.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$100.00
Balance: $584.09
Deductible: $25.46
$100.00
Balance: $511.84
Copay: $15.00
$15.00
Balance: $15.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$20.00
Balance Prepaid:
Copay: $15.00 $80.00
$15.00
Balance: $30.00
Copay: $0.00
$35.00
Balance: Prepaid
Copay: $150.00 $70.00
$50.00
Balance: $1940
Copay: $25.00
$25.00
Balance: $25.00
Copay: $0.00
$25.00
Balance Prepaid:
Copay: $0.00$150.00
$190.43
Balance Prepaid:
Copay: $50.00$190.43
$100.00 Balance: $150.00
Copay: $30.00
$450.00 Balance Prepaid: $10.00
Copay: $20.00
$20.00 Balance: $20.00
Deductible: $118.37
$467.34
Balance: $0.00
Copay: $20.00
$0.00
Balance:
Copay: $385.00
$0.00
$0.00
Balance: $0.00
$50.00 Insurance Inactive
Copay: $20.00
$60.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $25.00
$25.00
Balance: $75.00
Copay: $0.00
$50.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Deductible: $118.37
$866.62
Balance: $352.11
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Pt is on deductible of $114.99.
$50.00
Balance: $403.98
Copay: $20.00
$0.00
Balance: $40.00
Copay: $45.00
$45.00
Balance: $45.00
Deductible: $114.99
$160.97
Balance: $135.99
Copay: $75.00
$0.00
Balance: $75.00
Copay: $15.00
$15.00
Balance: $45.00
Copay: $30.00
$30.00
Balance:
Copay:$60.00
$25
$100.00
Balance: $20
Copay: $25.00
$20.00
Balance: $50.00
Copay: $35.00
$0.00
Balance: $70.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $30.00
$30.00
Balance: $30.00
Deductible: $114.99
$345.00
Balance: $229.60
Co-insurance: $20.05
$144.25
Balance: $60.15
Coins: $22.99
$152.00
Balance: $608.55
Coinsurance: $23.00
$200.00
Balance: $348.00
Insurance Inactive
$35.00
Balance: $140
Copay: $0.00
$0.00
Balance: $0.0
Copay: $0.00
$0.00
Balance: $0.00
Coinsurance: $23.00
$300.00
Balance: $413.97
Copay: $36.00
$72.00
Balance: $144.00
Deductible: $84.39
$170.00
Balance
Copay: $0.00$1.79
Prepaid:
$0.00 Balance: $0.00
Insurance is Terminated.
$0.00
$0.00 Copay: $0.00
Balance$15.00
Copay: $0.00
$15.00 Auth req
Balance: $15.00
$0.00 Copay: $0.00
Copay: $25.00
Balance: $0.00
$0.00 Coinsurance: $31.24
Balance: $50.00
-$25.00 Balance: $31.24
Auth Req
Copay: $70.00
$70.00
Balance: $558.26
Coinsurance: $19.44
$32.00 Balance: $61.36
Copay: $45.00
$45.00
Balance: $45.00
Copay: $25.00
$25.00
Balance: $142.48
Copay: $25.00
$25.00
Balance: $25.00
Copay: $0.00
$0.00
Balance: $0.00
Coinsurance: $34.50
$52.00
Balance: $34.70
Coinsurance: $34.80
$0.00
Balance: $34.80
$0.00 Insurance Info Missing
Copay: $0.00
$15.00
Balance:$0.00
Copay: $15
$35.00
Balance Prepaid:
Copay: $10.00
$30.00
$90.00
Balance: $145.00
Copay: $33.00
$44.00
Balance: $33.00
Insurance Terminated
$40.00
Balance:
Copay: $642.00
$0.00
$0.00
Balance: $0.00
Coinsurance: $42.54
-$42.54
Balance: $42.54
$0.00 Copay: $0.00

Balance: $0.00
Insurance Inactive
$30.00
Balance: Prepaid
Copay: $16.43
$0.00
$0.00
Balance: $0.00
Copay $30.00
$30.00
Balance
Copay:$120.00
$0.00
$0.00
Balance: $0.00
Copay: $0.00
$40.00
Balance: Prepaid$40.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Deductible: $64.80
$241.00
Balance: $175.60
Copay: $0.00
$25.00
Balance:
Copay: $240.00
$0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$100.00
Balance:
Copay: $40.42 Prepaid
Towards$50.00
Deductible
$0.00
Balance: $126.28
Copay: $0.00
$0.00
Balance: $0.00
Copay: $15.00
$15.00 Copay: $0.00
Balance: $30.00
$0.00 Balance: $0.00
Copay: $25.00
$25.00 Balance: $25.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$25.00
Coinsurance:$0.00
Balance: $31.24
$31.24 Coinsurance: $31.24
Balance: $31.12
$0.00 Balance: $110.36
Copay:
Auth$20.00
Req
$0.00
Balance: $20.00
Copay: $0.00
$120.00
Balance: $0.00
Copay: $35.00
$35.00
Balance: $260.00
Copay: $150.00
$250.00 Balance: $510.00
Copay: $35.00
$35.00
Balance: $70.00
Copay: $30.00
$30.00
Balance: $30.00
Copay: $0.00
$363.00
Balance: $118.52
Copay: $10.00
$10.00
Balance: $0.00
Copay: $50.00
$100.00
Balance: $300.00
Copay: $15.00
$15.00
Balance: $15.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$50.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $34.74
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $35.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $50.00
$150.00
Balance:
Copay: $150.00
$0.00
$40.00 Balance: Prepaid $20.03
Copay: $0.00
$0.00 Auth Req
Balance: $0.00
$0.00 Copay: $0.00
Copay: $0.00
Balance: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Deductible: $0.00
Balance: $114.99
$100.00
Balance: $208.68
Copay: $0.00
$0.00
Balance: $0.00
Copay: $30.00
$30.00
Balance: $30.00
Copay: $0.00
$0.00
Balance: $0.00
$0.00 inactive insurance
Inactive insurance.
$0.00
Balance: $25.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $10.00
$10.00
Balance: $10.00
Copay: $25.00
$50.00
Balance: $50.00
$0.00 Insurance Inactive
Copay: $40.00
$0.00
Balance: $40.00
Copay: $0.00
$35.00
Balance:Auth req $150.00
Prepaid
$30.00 Copay: $30.00
Copay: $0.00
Balance: $60.00
$30.00
Balance: Prepaid
Copay: $120.00
$15.00
$15.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $15.00
$30.00 Balance: $75.00
Copay: $0.00
$40.00 Balance:
Copay: $160.27
$0.00
$0.00
Deductible$0.00
Balance: $84.39
$100.00
Balance: $368.11
Copay: $15.00
$15.00
Balance: $30.00
Copay: $0.00
$23.00
Balance: $265.37
Copay: $25.00
$25.00 Balance: $50.00
Copay: $0.00
$81.97
Balance: $81.97
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $35.00
$35.00
Balance: $70.00
Copay: $25.00
$50.00 Copay: $0.00
Balance: $50.00
$0.00 Balance: $0.00
Copay: $25
Auth Req
$50.00
Balance: $50
Copay: $17.02
$0.00
Balance: $17.02
Copay: $0.00
$0.00
Balance: $0.00
Copay: $25.00
$0.00
Balance: $25.00
Pt is on deductible of 114.99
$345.00
Balance: $229.98
Copay: $30.00
$30.00
Balance: $0.00
Copay: $30.00
$30.00
Balance: $0.00
Copay: $30.00
$30.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $50.00
$50.00
Balance: $50.00
Copay: $40.00
$0.00
Balance: $160.00
Copay: $25.00
$50.00
Balance: $25.00
Copay: $15.00
$0.00
Balance:
Copay: $120.00
$0.00
$0.00
Balance: $0.00
Copay: $60.00
$60.00
Balance: $120.00
Copay: $0.00
$0.00
Balance: $209.56
Copay: $40.00
$40.00
Balance:
Copay: $120.00
$0.00
$25.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance: $0.00
Copay: $0.00
$0.00
Balance:
Copay: $892.00
$0.00
$4.50
Balance: $0.00
Copay: $60.00
$180.00
Balance: $60.00
Copay: $50.00
$50.00
Balance: $50.00
Copay: $30.00
$10.00
Balance: $110.00
Deductible: $53.00
$100.00
Balance: $143.00
Copay: $36.00
$36.00
Balance:
Copay: $108.00
$0.00
$0.00
Balance: $0.00
Copay: $40.00
$40.00
PtBalance: $120.00
is on deductible.
$212.53
Balance: $0.00
Copay: $40.00
$40.00
Balance: $40.00
$0.00 Auth Req
Copay: $30.00
$30.00 Copay: $0.00
Balance: $30.00
$0.00 Balance: $0.00
$0.00 Auth
Profile Req
Incomplete
$50.00 Copay: $50.00
Balance: $50.00

Date/Time Patient PT Status Age Sex

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Date/Time Patient PT Status Age Sex

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Date/Time Patient Pt Status Age Sex

5/3/2023 10:15 ADAM BECK Active 24 M

3/9/1999 Memorial Clinic TAI JOHNSON, NP

T - Est Pt, Outpatient Office Visit Aetna-MedicarePPO / Checked-Out

AMY VARGHESE 05/03/2023 May 2023 REBECCA

APRIL LEWIS 05/03/2023 May 2023 XAVIER

CASSANDRA BODUCH 05/03/2023 May 2023 VIRGINIA

CATHERINE CHANG, MD 05/03/2023 May 2023 VICTORIA

DR. MASOOD JILANI 05/03/2023 May 2023 SELIA

RANDI KATZ 05/03/2023 May 2023 BRAYLEN

SHAMARUKH KABIR 05/03/2023 May 2023 JESSICA

TAI JOHNSON, NP 05/03/2023 May 2023 JOYCE

WILLICIA TORAN 05/03/2023 May 2023 CHARLI

MOLINA HEALTHCARE OF TEXAS 0009038224

BLUE CROSS AND BLUE SHIELD OF TEXAS ZGP848823444

ALLEGIANCE BENEFIT PLAN MANAGEMENT INC. 77974120932200

BLUE CROSS AND BLUE SHIELD OF TEXAS HEB831360426

COMMUNITY HEALTH CHOICE MEDICAID 527036015

TEXAS MEDICARE 3W28AH8QN31

BLUE CROSS MEDICARE ADVANTAGE SFZ847939663

TEXAS MEDICAID 614238626 $0.00 $0.00

$352.11 $642.00 05/10/2023 02/18/2023

$0.00 $735.00 05/09/2023

$135.99 $0.00 05/02/2023 03/07/2023

$418.26 $8,142.00 05/02/2023 03/07/2023

$0.00 $9,167.71 05/04/2023 04/28/2023

$0.00 $642.00 05/02/2023

$0.00 $20.05 05/10/2023 09/13/2022

-$150.00 $642.00 05/02/2023 04/19/2022

-$115.02 $0.00 04/11/2023 05/03/2023

$0.00 Copay: $0.00

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