Parkhurst Chiropractic Life Center PLC

364 Garden Ave.

Holland, MI 49424-8656
616-392-9500
office@parkhurstchiropractic.com

Insurance Accounts Receivable Report

All Dates
Visit First Last Aged Aged Aged Aged Aged Total
Charge Disputed
Date Billed Billed 0 to 30 31 to 60 61 to 90 91 to 120 121+ Owed
AARP Healthcare 800-523-5800
BOWBA000 Bowen, Barbara Group:
DOB: 06/20/1949 Insured ID: 032773928-12
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/26/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 7.76 0.00 0.00 0.00 7.76
DROMA000 Drost, Marla Group: PLAN F
DOB: 06/13/1947 Insured ID: 038536341-12
98942-AT -
09/15/21 Manipulation 5 No 09/21/21 10/21/22 0.00 0.00 0.00 0.00 10.27 10.27
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 10.27 10.27
LACRO000 Lacy, Rosemary Group:
DOB: 01/17/1955 Insured ID: 343996195-12
98941-AT -
07/25/22 Manipulation 3-4 No 08/01/22 10/13/22 0.00 0.00 0.00 38.78 0.00 38.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 38.78 0.00 38.78
LANDE000 Lankheet, Dennis Group:
DOB: 05/30/1938 Insured ID: 047560181-11
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 10/24/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 7.76 0.00 0.00 0.00 7.76
Carrier Totals: 0.00 15.52 0.00 38.78 10.27 64.57
AETNA 888-632-3862
AGAJE001 Agar, Jennifer Group: 469618-12-001
DOB: 07/03/1975 Insured ID: W211497084
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 29.14 0.00 0.00 0.00 0.00 29.14
Regions
Provider: Dr James Friess DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 29.14 0.00 0.00 0.00 0.00 29.14
Regions
Provider: Dr James Friess DC
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr James Friess DC

10/25/22 97140-GP-59-97 - No 10/31/22 10/31/22 46.26 0.00 0.00 0.00 0.00 46.26

Parkhurst Chiropractic Life Center PLC Page 1 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Therapy-Manual
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 130.12 0.00 0.00 0.00 0.00 130.12
AGAJO001 Agar, Joshua Group: 46961812001
DOB: 07/23/2004 Insured ID: W211497084
97140-GP-59-97 -
Therapy-Manual
10/18/22 No 10/24/22 10/24/22 46.26 0.00 0.00 0.00 0.00 46.26
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
98942-AT -
09/23/22 Manipulation 5 No 09/29/22 09/29/22 0.00 37.46 0.00 0.00 0.00 37.46
Regions
Provider: Dr James Friess DC
Patient Totals: 46.26 37.46 0.00 0.00 0.00 83.72
BAREM000 Barry, Emily, R Group: 028390001400007
DOB: 03/01/2000 Insured ID: W223870061
72070 - X-ray
09/19/22 Thoracic Spine - 2-3 No 09/29/22 09/29/22 0.00 56.50 0.00 0.00 0.00 56.50
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
09/19/22 Lumbosacral 2-3 No 09/29/22 09/29/22 0.00 68.50 0.00 0.00 0.00 68.50
Views
Provider: Dr Russell Sweet DC
72040 - X-ray
09/19/22 Cervical Spine - 2-3 No 09/29/22 09/29/22 0.00 68.00 0.00 0.00 0.00 68.00
Views
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/04/22 No 10/05/22 10/05/22 0.00 14.06 0.00 0.00 0.00 14.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 207.06 0.00 0.00 0.00 207.06
BLOJO001 Bloemers, Jonathan Group: 477158-012-00006
DOB: 09/06/2005 Insured ID: W251105281
99202-25 - New
09/27/22 Patient Exam - 15- No 10/03/22 10/03/22 0.00 49.08 0.00 0.00 0.00 49.08
29 Min
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 49.08 0.00 0.00 0.00 49.08
CRUAL000 Cruz, Alicia Group: 144124-020-00011
DOB: 07/23/1997 Insured ID: W265118909
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 29.14 0.00 0.00 0.00 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 10/20/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 78.20 0.00 0.00 0.00 0.00 78.20
ECCRY000 Eccker, Ryan Group: 0326476-010-00143
DOB: 11/09/1995 Insured ID: W821333173
97110-GP-97 -
Therapy-
09/21/22 No 09/26/22 09/26/22 0.00 39.25 0.00 0.00 0.00 39.25
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 2 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
09/21/22 No 09/26/22 09/26/22 0.00 39.25 0.00 0.00 0.00 39.25
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 78.50 0.00 0.00 0.00 78.50
FILSU000 Filipovic, Suvada Group: 469618-11-001
DOB: 09/01/1973 Insured ID: W168503278
97012-GP -
09/21/22 Therapy- No 09/26/22 09/26/22 0.00 0.25 0.00 0.00 0.00 0.25
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/23/22 Therapy- No 09/29/22 09/29/22 0.00 0.25 0.00 0.00 0.00 0.25
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/30/22 Therapy- No 10/05/22 10/05/22 0.00 0.25 0.00 0.00 0.00 0.25
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.75 0.00 0.00 0.00 0.75
HOFRO000 Hoffman, Robert Group: 608598-40-142
DOB: 12/18/1931 Insured ID: W013065253
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 7.76 0.00 7.76
LAKJE000 Lake, Jennifer Group: 469618-10-001
DOB: 03/02/1983 Insured ID: W222460677
97012-GP -
10/12/22 Therapy- No 10/31/22 10/31/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/07/22 Therapy- No 10/31/22 10/31/22 0.00 12.79 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/10/22 Therapy- No 10/31/22 10/31/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/24/22 Therapy- No 10/31/22 10/31/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/14/22 Therapy- No 10/31/22 10/31/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/17/22 Therapy- No 10/31/22 10/31/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/14/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 3 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
10/12/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/17/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/24/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/20/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/10/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/07/22 Manipulation 5 No 10/31/22 10/31/22 0.00 37.46 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
99213-25 -
10/07/22 Established Patient No 10/31/22 10/31/22 0.00 58.27 0.00 0.00 0.00 58.27
Exam - 20-29 Min
Provider: Dr Karla A Parkhurst DC
Patient Totals: 337.77 108.52 0.00 0.00 0.00 446.29
POLDE000 Pols, Debbie Group: 141987-10-001
DOB: 08/22/1964 Insured ID: W253365428
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 7.46 0.00 0.00 0.00 0.00 7.46
Regions
Provider: Dr James Friess DC
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 7.46 0.00 0.00 0.00 0.00 7.46
Regions
Provider: Dr James Friess DC
Patient Totals: 14.92 0.00 0.00 0.00 0.00 14.92
RAMPA000 Ramos, Patty Group: 469618-12-001
DOB: 12/24/1965 Insured ID: W168503018
98941-AT -
10/06/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 29.14 0.00 0.00 0.00 29.14
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 29.14 0.00 0.00 0.00 29.14
ROMLU000 Romano, Luca Group: 285583-10-001
DOB: 08/31/2002 Insured ID: W254526006
97012-GP -
08/17/22 Therapy- No 08/22/22 10/05/22 0.00 0.00 12.79 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
09/01/22 Therapy- No 09/07/22 09/07/22 0.00 0.00 12.79 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
09/14/22 Therapy- No 09/19/22 09/19/22 0.00 12.79 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
08/05/22 Therapy- No 08/11/22 10/05/22 0.00 0.00 0.00 12.79 0.00 12.79

Parkhurst Chiropractic Life Center PLC Page 4 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/28/22 No 10/03/22 10/03/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/05/22 No 10/10/22 10/10/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/15/22 No 09/22/22 09/22/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/24/22 No 08/29/22 10/05/22 0.00 0.00 49.06 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/01/22 No 09/07/22 09/07/22 0.00 0.00 49.06 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/10/22 No 08/15/22 10/05/22 0.00 0.00 0.00 49.06 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/17/22 No 08/22/22 10/05/22 0.00 0.00 49.06 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/05/22 No 08/11/22 10/05/22 0.00 0.00 0.00 49.06 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
06/21/22 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 49.06 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97012-GP -
09/28/22 Therapy- No 10/03/22 10/03/22 0.00 12.79 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 10/05/22 0.00 0.00 0.00 29.14 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/17/22 Manipulation 3-4 No 08/22/22 10/05/22 0.00 0.00 29.14 0.00 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 29.14 0.00 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 29.14 0.00 0.00 0.00 29.14

Parkhurst Chiropractic Life Center PLC Page 5 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 29.14 0.00 0.00 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 231.04 231.04 140.05 49.06 651.19
TAUGE000 Taubert, Gerald, T Group: 100008-02EG0009
DOB: 03/30/1949 Insured ID: 101235782100
98942-AT -
06/06/22 Manipulation 5 No 06/09/22 09/19/22 0.00 0.00 0.00 0.00 17.46 17.46
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 17.46 17.46
VANBR004 VanKley, Brian Group: 039363002700002
DOB: 12/13/1973 Insured ID: W273547226
98941-AT -
05/25/22 Manipulation 3-4 No 06/02/22 10/31/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 50.00 50.00
Carrier Totals: 607.27 741.55 231.04 147.81 116.52 1,844.19
AETNA 800-345-4061
MANTO000 Mannes, Tonya Group: 144124-020-00011
DOB: 02/25/1975 Insured ID: W257370741
97012-GP -
09/21/22 Therapy- No 09/26/22 09/26/22 0.00 11.93 0.00 0.00 0.00 11.93
Traction/Mechanical
Provider: Dr James Friess DC
97032-GP-59-97 -
10/10/22 Therapy - E-Stim No 10/13/22 10/13/22 8.42 0.00 0.00 0.00 0.00 8.42
Attended
Provider: Dr James Friess DC
97032-GP-59-97 -
10/03/22 Therapy - E-Stim No 10/10/22 10/10/22 0.00 8.42 0.00 0.00 0.00 8.42
Attended
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/10/22 No 10/13/22 10/13/22 24.53 0.00 0.00 0.00 0.00 24.53
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 24.53 0.00 0.00 0.00 24.53
Therapeutic
Exercise
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/03/22 No 10/10/22 10/10/22 0.00 16.26 0.00 0.00 0.00 16.26
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/10/22 No 10/13/22 10/13/22 16.26 0.00 0.00 0.00 0.00 16.26
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 49.21 61.14 0.00 0.00 0.00 110.35
WEBLO000 Weber, Lori Group: 086867102500002
DOB: 06/01/1962 Insured ID: W263964144
72040 - X-ray
10/04/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 0.00 71.00 0.00 0.00 0.00 71.00

Parkhurst Chiropractic Life Center PLC Page 6 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Views
Provider: Dr Russell Sweet DC
99203-25 - New
10/04/22 Patient Exam - 30- No 10/17/22 10/17/22 0.00 37.77 0.00 0.00 0.00 37.77
44 Min
Provider: Dr Russell Sweet DC
72070 - X-ray
10/04/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 0.00 59.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
10/04/22 Lumbosacral 2-3 No 10/24/22 10/24/22 0.00 72.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 239.77 0.00 0.00 0.00 239.77
Carrier Totals: 49.21 300.91 0.00 0.00 0.00 350.12
AETNA Medicare / Managed Care
HOLAR000 Holden, Ardice Group:
DOB: 02/12/1950 Insured ID: MEBVNV8T
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 17.46 0.00 0.00 0.00 0.00 17.46
Regions
Provider: Dr James Friess DC
98941-AT -
10/06/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 9.14 0.00 0.00 0.00 9.14
Regions
Provider: Dr James Friess DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 9.14 0.00 0.00 0.00 0.00 9.14
Regions
Provider: Dr James Friess DC
Patient Totals: 26.60 9.14 0.00 0.00 0.00 35.74
MALJU000 Malone, Julia Group:
DOB: 03/25/1965 Insured ID: 101549187600
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/01/22 Manipulation 5 No 09/07/22 09/07/22 0.00 0.00 37.46 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 37.46 0.00 37.46 0.00 0.00 74.92
MOOGE000 Moorman, George Group: 354647
DOB: 08/25/1955 Insured ID: MEBT44ZD
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 9.14 0.00 0.00 0.00 0.00 9.14
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 9.14 0.00 0.00 0.00 0.00 9.14
RETMI000 Rettler, Mia Group: 467248
DOB: 05/03/1998 Insured ID: MEBT9VVT
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 37.46 0.00 0.00 0.00 0.00 37.46
TEUAD000 Teunissen, Adrian Group:
DOB: 06/30/1950 Insured ID: MEBS8JRP
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 17.46 0.00 0.00 0.00 0.00 17.46

Parkhurst Chiropractic Life Center PLC Page 7 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 17.46 0.00 0.00 0.00 0.00 17.46
TEUBA000 Teunissen, Barbara Group:
DOB: 06/02/1949 Insured ID: MEBS724P
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 17.46 0.00 0.00 0.00 0.00 17.46
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 17.46 0.00 0.00 0.00 0.00 17.46
Carrier Totals: 145.58 9.14 37.46 0.00 0.00 192.18
AETNA PPO 800-231-7729
HILAB000 Hilleshiem, Abigail Group: 479260-013-00001
DOB: 07/12/1986 Insured ID: W206850727
97110-GP-97 -
Therapy-
03/08/22 No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 21.71 21.71
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
03/08/22 Therapeutic No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 35.46 35.46
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 57.17 57.17
Carrier Totals: 0.00 0.00 0.00 0.00 57.17 57.17
AETNA PPO 888-632-3862
JOHNI000 Johns, Nicole Group: 144124-021-00011
DOB: 11/07/1980 Insured ID: W259496241
97012-GP -
10/12/22 Therapy- No 10/17/22 10/17/22 11.93 0.00 0.00 0.00 0.00 11.93
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
09/21/22 Therapy- No 09/26/22 09/26/22 0.00 11.93 0.00 0.00 0.00 11.93
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
09/28/22 Therapy- No 10/03/22 10/03/22 0.00 11.93 0.00 0.00 0.00 11.93
Traction/Mechanical
Provider: Dr Russell Sweet DC
Patient Totals: 11.93 23.86 0.00 0.00 0.00 35.79
Carrier Totals: 11.93 23.86 0.00 0.00 0.00 35.79
AETNA US Healthcare 877-204-9064
ARRCA000 Arreola, Carrie Group:
DOB: 09/22/1975 Insured ID: W263957898
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 29.14 0.00 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/28/22 Therapy- No 10/03/22 10/03/22 0.00 12.79 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 41.93 0.00 0.00 0.00 41.93
GARAN000 Garza, Anita Group: 283912-040-00100
DOB: 03/19/1971 Insured ID: W235597891
97012-GP -
10/13/22 Therapy- No 10/20/22 10/20/22 1.93 0.00 0.00 0.00 0.00 1.93
Traction/Mechanical
Provider: Dr James Friess DC

Parkhurst Chiropractic Life Center PLC Page 8 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97012-GP -
09/22/22 Therapy- No 09/29/22 09/29/22 0.00 1.93 0.00 0.00 0.00 1.93
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 1.93 1.93 0.00 0.00 0.00 3.86
LEMAV000 Lemire, Ava Group: 469618-12-001
DOB: 06/13/2008 Insured ID: W168501695
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 23.31 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 39.25 0.00 0.00 0.00 0.00 39.25
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 109.18 23.31 0.00 0.00 0.00 132.49
LEMEL000 Lemire, Ellery Group: 469618-12-001
DOB: 06/29/2014 Insured ID: W168501695
98941-AT -
09/22/22 Manipulation 3-4 No 09/29/22 09/29/22 0.00 23.31 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 23.31 0.00 0.00 0.00 23.31
LEMRY000 Lemire, Ryan Group: 469618-12-001
DOB: 01/05/1977 Insured ID: W168501695
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 09/29/22 0.00 23.31 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 23.31 0.00 0.00 0.00 0.00 23.31
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 69.93 23.31 0.00 0.00 0.00 93.24
Carrier Totals: 181.04 113.79 0.00 0.00 0.00 294.83
AMERISURE INSURANCE 800-257-1900
CAVJE000 Cavanagh, Jeff Group:
DOB: 02/03/1964 Insured ID: 588141
97012-GP -
04/13/22 Therapy- No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 24.00 24.00
Traction/Mechanical

Parkhurst Chiropractic Life Center PLC Page 9 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
98942-AT -
04/13/22 Manipulation 5 No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 60.00 60.00
Regions
Provider: Dr James Friess DC
98942-AT -
05/09/22 Manipulation 5 No 05/12/22 10/21/22 0.00 0.00 0.00 0.00 60.00 60.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 144.00 144.00
Carrier Totals: 0.00 0.00 0.00 0.00 144.00 144.00
ASR Corporation 616-957-1751
MULAN000 Mulder, Anna Group: 1153
DOB: 10/13/1963 Insured ID: P0424938
98940-AT -
11/23/21 Manipulation 1-2 No 11/30/21 10/20/22 0.00 0.00 0.00 0.00 5.44 5.44
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
12/14/21 Manipulation 1-2 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 5.44 5.44
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 10.88 10.88
Carrier Totals: 0.00 0.00 0.00 0.00 10.88 10.88
Auto Owners - Care Works 877-876-5621
HANLI000 Hanges, Lindsey Group:
DOB: 05/02/1982 Insured ID: 0660005145-2010
98941-AT -
10/25/22 Manipulation 3-4 No 10/26/22 10/26/22 37.52 0.00 0.00 0.00 0.00 37.52
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/21/22 10/21/22 37.52 0.00 0.00 0.00 0.00 37.52
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/17/22 10/17/22 37.52 0.00 0.00 0.00 0.00 37.52
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/06/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/03/22 11/03/22 37.52 0.00 0.00 0.00 0.00 37.52
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 150.08 0.00 50.00 0.00 0.00 200.08
HANTR000 Hanges, Travis Group:
DOB: 04/24/1980 Insured ID: 066-0005145-2010
98941-AT -
07/21/22 Manipulation 3-4 No 07/28/22 10/21/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/14/22 Manipulation 3-4 No 07/21/22 10/21/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/28/22 Manipulation 3-4 No 08/04/22 11/07/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC

Parkhurst Chiropractic Life Center PLC Page 10 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 0.00 0.00 0.00 136.72 0.00 136.72
Carrier Totals: 150.08 0.00 50.00 136.72 0.00 336.80
BCBS Federal 800-482-3600
CHAMO000 Chartrand, Monica Group: 106
DOB: 01/21/1967 Insured ID: R59177250
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 44.52 0.00 0.00 0.00 0.00 44.52
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 105.52 0.00 0.00 0.00 0.00 105.52
JEFJE000 Jefferson, Jeannie Group:
DOB: 12/02/1979 Insured ID: R61200807
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 39.52 0.00 0.00 0.00 0.00 39.52
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 39.52 0.00 0.00 0.00 0.00 39.52
JEFMA000 Jefferson, Matthew, C Group:
DOB: 01/19/1979 Insured ID: R61200807
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 32.72 0.00 0.00 0.00 0.00 32.72
MCMSU000 McMahon, Susan Group:
DOB: 10/26/1969 Insured ID: R60023002
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 16.36 0.00 0.00 0.00 0.00 16.36
MUSLI000 Musgrove, Linda Group: 112
DOB: 02/16/1952 Insured ID: R58717078
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 4.76 0.00 0.00 0.00 0.00 4.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
10/31/22 No 11/03/22 11/03/22 63.94 0.00 0.00 0.00 0.00 63.94
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 85.06 0.00 0.00 0.00 0.00 85.06
WOORO000 Woodburn, Ronald, K Group: 106
DOB: 07/16/1953 Insured ID: R22452158
97110-GP-97 -
10/25/21 No 03/28/22 10/20/22 0.00 0.00 0.00 0.00 68.00 68.00
Therapy-

Parkhurst Chiropractic Life Center PLC Page 11 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
01/17/22 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 68.00 68.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 136.00 136.00
Carrier Totals: 279.18 0.00 0.00 0.00 136.00 415.18
Blue Care Network 800-255-1690
BALSA000 Bale, Sandra Group: 00285843
DOB: 05/09/1969 Insured ID: XYHM05471999
97110-GP-97 -
Therapy-
08/03/22 No 08/08/22 09/07/22 0.00 0.00 0.00 4.43 0.00 4.43
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97032-GP-59-97 -
08/03/22 Therapy - E-Stim No 08/08/22 09/07/22 0.00 0.00 0.00 18.00 0.00 18.00
Attended
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 17.14 0.00 0.00 22.43 0.00 39.57
BARAD000 Barksdale, Adam Group: 00185486
DOB: 03/05/1977 Insured ID: XYH894807836
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 17.14 0.00 0.00 0.00 0.00 17.14
BIRTR000 Birce, Travis Group: 00276603
DOB: 07/17/1989 Insured ID: XYH916132241
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 34.28 0.00 0.00 0.00 0.00 34.28
BUSJE000 Bush, Jean Group: 00285687
DOB: 06/28/1963 Insured ID: XYH891876401
98941-AT -
10/19/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
06/22/22 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 69.30 69.30
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 17.14 0.00 0.00 0.00 69.30 86.44
CALAL000 Calderon, Alexa Group: 00282466
DOB: 06/14/2004 Insured ID: XYH910419571
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 22.99 0.00 0.00 0.00 0.00 22.99
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.99 0.00 0.00 0.00 0.00 22.99
KURSA000 Cockrum, Sandra Group: 00172582
DOB: 07/26/1964 Insured ID: XYH890626054
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 34.28 0.00 0.00 0.00 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 34.28 0.00 0.00 0.00 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 34.28 0.00 0.00 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 34.28 0.00 0.00 0.00 0.00 34.28
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/12/22 No 10/17/22 10/17/22 23.10 0.00 0.00 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
09/29/22 No 10/05/22 10/05/22 0.00 23.10 0.00 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
09/16/22 No 09/22/22 09/22/22 0.00 23.10 0.00 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
08/31/22 No 09/07/22 09/07/22 0.00 0.00 23.10 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 23.10 0.00 0.00 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
09/29/22 Therapy - E-Stim No 10/05/22 10/05/22 0.00 18.00 0.00 0.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/12/22 Therapy - E-Stim No 10/17/22 10/17/22 18.00 0.00 0.00 0.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/28/22 Therapy - E-Stim No 11/03/22 11/03/22 18.00 0.00 0.00 0.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
08/31/22 Therapy - E-Stim No 09/07/22 09/07/22 0.00 0.00 18.00 0.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
09/16/22 Therapy - E-Stim No 09/22/22 09/22/22 0.00 18.00 0.00 0.00 0.00 18.00
Attended

Parkhurst Chiropractic Life Center PLC Page 13 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/29/22 No 10/05/22 10/05/22 0.00 21.33 0.00 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
08/31/22 No 09/07/22 09/07/22 0.00 0.00 21.33 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 21.33 0.00 0.00 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/16/22 No 09/22/22 09/22/22 0.00 21.33 0.00 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/12/22 No 10/17/22 10/17/22 21.33 0.00 0.00 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
07/13/22 No 07/18/22 10/17/22 0.00 0.00 0.00 23.10 0.00 23.10
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
07/13/22 Therapy - E-Stim No 07/18/22 10/17/22 0.00 0.00 0.00 18.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/06/22 Manipulation 3-4 No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 34.28 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/20/22 Manipulation 3-4 No 07/25/22 10/05/22 0.00 0.00 0.00 34.28 0.00 34.28
Regions
Provider: Dr Karla A Parkhurst DC
99212-25 -
07/06/22 Established Patient No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 23.05 23.05
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
99212-25 -
07/20/22 Established Patient No 07/25/22 10/05/22 0.00 0.00 0.00 23.05 0.00 23.05
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
07/13/22 No 07/18/22 10/17/22 0.00 0.00 0.00 21.33 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 159.14 193.42 96.71 119.76 57.33 626.36
CUNFR000 Cunningham, Fredrick Group: 00283150
DOB: 12/23/1981 Insured ID: XYH918543243
97032-GP-59-97 -
09/13/22 Therapy - E-Stim No 09/14/22 09/14/22 0.00 18.00 0.00 0.00 0.00 18.00
Attended
Provider: Dr Russell Sweet DC
09/13/22 97110-GP-97 - No 09/14/22 09/14/22 0.00 23.10 0.00 0.00 0.00 23.10

Parkhurst Chiropractic Life Center PLC Page 14 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Therapy-
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
09/13/22 No 09/14/22 09/14/22 0.00 21.33 0.00 0.00 0.00 21.33
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 62.43 0.00 0.00 0.00 62.43
DAREL000 Dargis, Elizabeth Group: 00275729
DOB: 10/24/1970 Insured ID: XYS921748509
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 22.99 0.00 0.00 0.00 0.00 22.99
Regions
Provider: Dr James Friess DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 22.99 0.00 0.00 0.00 0.00 22.99
Regions
Provider: Dr James Friess DC
Patient Totals: 45.98 0.00 0.00 0.00 0.00 45.98
ELSJA000 Elston, Jason Group: 00609563
DOB: 02/12/1976 Insured ID: XYW919105625
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 30.85 0.00 0.00 0.00 0.00 30.85
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 30.85 0.00 0.00 0.00 0.00 30.85
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 41.58 0.00 0.00 0.00 0.00 41.58
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 41.58 0.00 0.00 0.00 0.00 41.58
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 144.86 0.00 0.00 0.00 0.00 144.86
ELSJE001 Elston, Jennifer, M Group: 00609563
DOB: 11/13/1973 Insured ID: XYW919105625
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 20.79 0.00 0.00 0.00 0.00 20.79
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 41.38 0.00 0.00 0.00 0.00 41.38
Regions
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/31/22 No 11/03/22 11/03/22 19.20 0.00 0.00 0.00 0.00 19.20
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 81.37 0.00 0.00 0.00 0.00 81.37
HARWI000 Harrington, William , T Group: 00276603
DOB: 01/21/1970 Insured ID: XYH898195610
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 17.14 0.00 0.00 0.00 0.00 17.14

Parkhurst Chiropractic Life Center PLC Page 15 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 17.14 0.00 0.00 0.00 0.00 17.14
HAWDO000 Hawkins, Dominique Group: 00009214
DOB: 03/30/2001 Insured ID: XYHM09546994
98941-AT -
09/21/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 34.28 0.00 0.00 0.00 34.28
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 17.14 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/04/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 17.14 0.00 0.00 0.00 17.14
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 17.14 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
99213-25 -
09/21/22 Established Patient No 10/03/22 10/03/22 0.00 53.25 0.00 0.00 0.00 53.25
Exam - 20-29 Min
Provider: Dr Brian S Parkhurst DC
Patient Totals: 119.98 138.95 0.00 0.00 0.00 258.93
JONME000 Jones, Melissa Group: 00281401
DOB: 06/17/1983 Insured ID: XYH912467556
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 22.99 0.00 0.00 0.00 0.00 22.99
Regions
Provider: Dr James Friess DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 22.99 0.00 0.00 0.00 0.00 22.99
Regions

Parkhurst Chiropractic Life Center PLC Page 16 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
Patient Totals: 45.98 0.00 0.00 0.00 0.00 45.98
MAASA001 Maas, Sandra Group: 00100582
DOB: 11/14/1960 Insured ID: XYS926479782
97110-GP-97 -
Therapy-
03/17/22 No 03/25/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
03/02/22 No 03/07/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
03/14/22 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
03/10/22 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
02/28/22 No 03/03/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
03/07/22 No 03/10/22 10/26/22 0.00 0.00 0.00 0.00 26.20 26.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
02/21/22 Manipulation 3-4 No 03/03/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
03/02/22 Manipulation 3-4 No 03/07/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
03/14/22 Manipulation 3-4 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/07/22 Manipulation 3-4 No 03/10/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
03/10/22 Manipulation 3-4 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/17/22 Manipulation 3-4 No 03/25/22 10/26/22 0.00 0.00 0.00 0.00 14.28 14.28
Regions
Provider: Dr Brian S Parkhurst DC
99202-25 - New
02/21/22 Patient Exam - 15- No 03/03/22 10/26/22 0.00 0.00 0.00 0.00 45.42 45.42
29 Min
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 288.30 288.30
MALJU000 Malone, Julia Group: 00291654

Parkhurst Chiropractic Life Center PLC Page 17 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
DOB: 03/25/1965 Insured ID: XYW920762794
98941-AT -
12/03/21 Manipulation 3-4 No 12/07/21 10/26/22 0.00 0.00 0.00 0.00 34.28 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
12/16/21 Manipulation 3-4 No 12/21/21 10/26/22 0.00 0.00 0.00 0.00 34.28 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
12/27/21 Manipulation 3-4 No 12/30/21 10/26/22 0.00 0.00 0.00 0.00 34.28 34.28
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/23/22 Manipulation 5 No 09/29/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/19/22 Manipulation 5 No 09/22/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/16/22 Manipulation 5 No 09/22/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 60.00 0.00 0.00 102.84 162.84
ROBMA000 Roberts, Matthew Group: 00111161
DOB: 09/17/1982 Insured ID: XYH917659289
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 23.10 0.00 0.00 0.00 0.00 23.10
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 57.38 0.00 0.00 0.00 0.00 57.38
SCHJI000 Schutte, Jill Group: 00167361
DOB: 04/13/1990 Insured ID: XYHM07064803
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 34.28 0.00 0.00 0.00 0.00 34.28
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 34.28 0.00 0.00 0.00 0.00 34.28
SCRMI000 Scripps, Michelle Group: 00285241
DOB: 02/06/1981 Insured ID: XYHM07622539
98941-AT -
10/17/22 Manipulation 3-4 No 10/31/22 10/31/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr James Friess DC
Patient Totals: 17.14 0.00 0.00 0.00 0.00 17.14
VALLA000 Vall, Laurie, A Group: 00187213
DOB: 09/15/1967 Insured ID: XYH892732269
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 18 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 17.14 0.00 0.00 0.00 0.00 17.14
VANAS000 Vanslooten, Ashley Group: 00285687
DOB: 02/24/1987 Insured ID: XYH925868229
98941-AT -
10/17/22 Manipulation 3-4 No 10/31/22 10/31/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 17.14 0.00 0.00 0.00 0.00 17.14
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 34.28 0.00 0.00 0.00 0.00 34.28
WYSCH000 Wysong, Christopher Group: 00224582
DOB: 07/24/1965 Insured ID: XYH894197710
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 36.78 0.00 0.00 0.00 0.00 36.78
Regions
Provider: Dr James Friess DC
98942-AT -
10/07/22 Manipulation 5 No 10/13/22 10/13/22 0.00 36.78 0.00 0.00 0.00 36.78
Regions
Provider: Dr James Friess DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 36.78 0.00 0.00 0.00 0.00 36.78
Regions
Provider: Dr James Friess DC
98942-AT -
10/21/22 Manipulation 5 No 10/26/22 10/26/22 36.78 0.00 0.00 0.00 0.00 36.78
Regions
Provider: Dr James Friess DC
Patient Totals: 110.34 36.78 0.00 0.00 0.00 147.12
Carrier Totals: 993.70 491.58 96.71 142.19 517.77 2,241.95
Blue Care Network - Advantage 800-450-3680
HARBR000 Harmon, Bruce Group: 00275566
DOB: 06/10/1956 Insured ID: XYK993609568
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr James Friess DC
Patient Totals: 31.35 0.00 0.00 0.00 0.00 31.35
HARJA001 Harper, James Group: 00275566
DOB: 03/17/1949 Insured ID: XYK891592068
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 19.10 0.00 0.00 0.00 0.00 19.10
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.10 0.00 0.00 0.00 0.00 19.10
HERAM000 Herrera, Amparo Group: 00275566
DOB: 05/26/1942 Insured ID: XYK992254343
98941-AT -
09/15/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 19.71 0.00 0.00 0.00 19.71
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 19.71 19.71 0.00 0.00 0.00 39.42
KRANA000 Kraak, Nancy, L Group: 00275566
DOB: 06/11/1949 Insured ID: XYK992287055
10/28/22 98941-AT - No 11/03/22 11/03/22 19.10 0.00 0.00 0.00 0.00 19.10

Parkhurst Chiropractic Life Center PLC Page 19 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.10 0.00 0.00 0.00 0.00 19.10
MARCO000 Marques, Cora Group: 00275566
DOB: 10/07/1945 Insured ID: XYK894277254
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.71 0.00 0.00 0.00 0.00 19.71
MCGLE000 McGowan, Leslie, H Group: 00275566
DOB: 05/09/1955 Insured ID: XYK993521282
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr James Friess DC
Patient Totals: 19.71 0.00 0.00 0.00 0.00 19.71
SHAHO000 Shank, Holly Group: 00275566
DOB: 12/26/1949 Insured ID: XYK918807751
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr James Friess DC
Patient Totals: 39.42 0.00 0.00 0.00 0.00 39.42
TAYCH000 Taylor, Christine, C Group: 00275566
DOB: 03/25/1957 Insured ID: XYK993577545
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 19.71 0.00 0.00 0.00 0.00 19.71
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 19.71 0.00 0.00 0.00 0.00 19.71
VANJI000 VanDam, Jill Group: 00275566
DOB: 05/04/1951 Insured ID: XYK992898693
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/07/22 Manipulation 5 No 10/13/22 10/13/22 0.00 31.35 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/10/22 Manipulation 5 No 10/13/22 10/13/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
09/29/22 Manipulation 5 No 10/05/22 10/05/22 0.00 31.35 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 20 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
09/26/22 Manipulation 5 No 09/29/22 09/29/22 0.00 31.35 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/13/22 Manipulation 5 No 10/20/22 10/20/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/17/22 Manipulation 5 No 10/20/22 10/20/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
09/22/22 Manipulation 5 No 09/29/22 09/29/22 0.00 31.35 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 188.10 125.40 0.00 0.00 0.00 313.50
WISSA000 Wissink, Sally Group: 00275566
DOB: 04/12/1959 Insured ID: XYK911992677
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 19.55 0.00 0.00 0.00 0.00 19.55
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.55 0.00 0.00 0.00 0.00 19.55
Carrier Totals: 395.46 145.11 0.00 0.00 0.00 540.57
Blue Cross Blue Shield
BEHJE000 Behrendt, Jeanine Group: 71453
DOB: 06/30/1969 Insured ID: MMJ892419700
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 130.26 0.00 0.00 0.00 0.00 130.26
BOWCA000 Bowen, Cara Group: 71453
DOB: 05/02/1986 Insured ID: MMJ911741218
98942-AT -
10/21/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97012-GP -
10/21/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 77.53 0.00 0.00 0.00 0.00 77.53
BURHE000 Burleson, Heather Group: 71452
DOB: 01/18/1986 Insured ID: MMJ916375238
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
CHAAL000 Chatten, Alison Group: 71453
DOB: 05/12/1992 Insured ID: MMJ923197183
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 21 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 77.53 0.00 0.00 0.00 0.00 77.53
DYKCL000 Dykhouse, Clayton Group: 71453
DOB: 03/06/2001 Insured ID: MMJ892728153
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
FENMI001 Fenlon, Mirra Group: 71453
DOB: 10/10/2007 Insured ID: MMJ890750273
98941-AT -
12/17/21 Manipulation 3-4 No 12/21/21 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/20/21 Manipulation 3-4 No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/13/21 Manipulation 3-4 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/10/21 Manipulation 3-4 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 166.00 166.00
GRADA000 Grassmid, Danielle Group: 71453
DOB: 09/22/1987 Insured ID: MMJ913317894
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97012-GP -
09/28/22 Therapy- No 10/03/22 10/03/22 0.00 16.06 0.00 0.00 0.00 16.06
Traction/Mechanical
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
09/28/22 No 10/03/22 10/03/22 0.00 66.50 0.00 0.00 0.00 66.50
Therapeutic
Exercise
Provider: Dr James Friess DC
98942-AT -
06/08/22 Manipulation 5 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr James Friess DC
97012-GP -
06/08/22 Therapy- No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 16.12 16.12
Traction/Mechanical
Provider: Dr James Friess DC

Parkhurst Chiropractic Life Center PLC Page 22 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97124-59-GP -
06/08/22 Therapeutic No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 49.50 49.50
Massage w/AIS
Provider: Dr James Friess DC
97124-59-GP -
06/16/22 Therapeutic No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 49.50 49.50
Massage w/AIS
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
06/16/22 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 32.60 32.60
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
06/08/22 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 32.60 32.60
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 130.26 82.56 0.00 0.00 237.29 450.11
GRARO001 Grassmid, Robert Group: 71453
DOB: 04/23/2022 Insured ID: MMJ913317894
99202-25 - New
07/27/22 Patient Exam - 15- No 08/01/22 10/05/22 0.00 0.00 0.00 89.83 0.00 89.83
29 Min
Provider: Dr James Friess DC
98940-AT -
07/27/22 Manipulation 1-2 No 08/01/22 10/05/22 0.00 0.00 0.00 30.97 0.00 30.97
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 120.80 0.00 120.80
GREKA000 Greene, Kathryn Group: 71565
DOB: 03/27/1978 Insured ID: WYOM09024247
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 14.76 0.00 0.00 0.00 0.00 14.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/20/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 66.51 0.00 0.00 0.00 0.00 66.51
HESCH000 Hester, Charles, O Group: 072378
DOB: 12/20/1965 Insured ID: RYD834549262
98942-AT -
01/17/22 Manipulation 5 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
12/15/21 Manipulation 3-4 No 12/21/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/13/21 Manipulation 3-4 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/01/21 Manipulation 3-4 No 12/07/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/09/21 Manipulation 3-4 No 12/14/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions

Parkhurst Chiropractic Life Center PLC Page 23 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Matthew Meiste DC
98941-AT -
12/07/21 Manipulation 3-4 No 12/10/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/03/21 Manipulation 3-4 No 12/07/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
12/20/21 Manipulation 3-4 No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/03/22 Manipulation 3-4 No 01/07/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
99202-25 - New
11/23/21 Patient Exam - 15- No 12/06/21 10/20/22 0.00 0.00 0.00 0.00 25.00 25.00
29 Min
Provider: Dr Matthew Meiste DC
72040 - X-ray
11/23/21 Cervical Spine - 2-3 No 12/06/21 10/20/22 0.00 0.00 0.00 0.00 62.85 62.85
Views
Provider: Dr Matthew Meiste DC
72070 - X-ray
11/23/21 Thoracic Spine - 2-3 No 12/06/21 10/20/22 0.00 0.00 0.00 0.00 51.92 51.92
Views
Provider: Dr Matthew Meiste DC
72100 - X-ray
11/23/21 Lumbosacral 2-3 No 12/06/21 10/20/22 0.00 0.00 0.00 0.00 63.40 63.40
Views
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 383.17 383.17
HOETO000 Hoeker, Tobi Group: 71453
DOB: 01/29/1979 Insured ID: MMJ892425427
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
10/26/22 Therapeutic No 10/31/22 10/31/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 132.87 0.00 0.00 0.00 0.00 132.87
HOLCO000 Holtrust, Conner Group: 71565
DOB: 06/17/2001 Insured ID: WYO891403313
97012-GP -
10/24/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
JANMA000 Janicik, Marissa Group: 71453
DOB: 10/15/1983 Insured ID: MMJ917944880

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364 Garden Ave., Holland, MI 49424-8656
 97012-GP -
10/28/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 294.10 0.00 0.00 0.00 0.00 294.10
JOHDA000 Johnston, David Group: 71453
DOB: 08/10/1969 Insured ID: MMJ893146867
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
Patient Totals: 77.53 0.00 0.00 0.00 0.00 77.53
JONLE000 Jones, Lee Ann Group: 71452
DOB: 02/14/1965 Insured ID: MMJ891828325
97124-59-GP -
10/26/22 Therapeutic No 10/31/22 10/31/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
KREKR000 Krefeld Freier, Krista Group: 71565
DOB: 08/19/1969 Insured ID: WYO893053461
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
10/27/22 Therapy- No 11/03/22 11/03/22 14.76 0.00 0.00 0.00 0.00 14.76
Therapeutic

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364 Garden Ave., Holland, MI 49424-8656
 Exercise
Provider: Dr Karla A Parkhurst DC
97124-59-GP -
10/27/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Karla A Parkhurst DC
Patient Totals: 92.87 0.00 0.00 0.00 0.00 92.87
KROBR000 Kropscott, Brysen, R Group: 71453
DOB: 09/10/2014 Insured ID: MMJ911630343
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
Patient Totals: 92.72 0.00 0.00 0.00 0.00 92.72
KRODA001 Kropscott, David Group: 71453
DOB: 05/08/1983 Insured ID: MMJ911630343
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr James Friess DC
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/24/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 294.10 0.00 0.00 0.00 0.00 294.10
KROHE000 Kropscott, Heather Group: 71453
DOB: 03/01/1983 Insured ID: MMJ911630343
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
Patient Totals: 121.48 0.00 0.00 0.00 0.00 121.48
LACCH000 Lacny, Charles Group: 71453
DOB: 09/01/2005 Insured ID: MMJ891213482
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
LECCH000 Leclair, Christopher Group: 71453
DOB: 12/20/1983 Insured ID: MMJ917212174
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/26/22 Therapeutic No 10/31/22 10/31/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
Patient Totals: 149.66 0.00 0.00 0.00 0.00 149.66
STACO000 Leeuwenburg, Courtney Group: 71453
DOB: 10/20/1989 Insured ID: MMJ922520202
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
10/26/22 Therapeutic No 10/31/22 10/31/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 149.66 0.00 0.00 0.00 0.00 149.66
MAITI000 Maillet, Timothy Group: 049218
DOB: 03/28/1983 Insured ID: YAQ869210946M
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 32.45 0.00 0.00 0.00 0.00 32.45
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 32.45 0.00 0.00 0.00 0.00 32.45
MELCH000 Melvin , Christine Group: 71453
DOB: 09/03/1997 Insured ID: MMJ923085425
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
97012-GP -
10/17/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC

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364 Garden Ave., Holland, MI 49424-8656
 97012-GP -
10/10/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/12/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
98942-AT -
10/14/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/12/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/10/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/17/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97012-GP -
10/27/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/14/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
72040 - X-ray
10/10/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 70.63 0.00 0.00 0.00 0.00 70.63
Views
Provider: Dr James Friess DC
72070 - X-ray
10/10/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 58.67 0.00 0.00 0.00 0.00 58.67
Views
Provider: Dr James Friess DC
72100 - X-ray
10/10/22 Lumbosacral 2-3 No 10/24/22 10/24/22 71.23 0.00 0.00 0.00 0.00 71.23
Views
Provider: Dr James Friess DC
99203-25 - New
10/10/22 Patient Exam - 30- No 10/24/22 10/24/22 132.96 0.00 0.00 0.00 0.00 132.96
44 Min
Provider: Dr James Friess DC
97124-59-GP -
10/27/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 856.42 0.00 0.00 0.00 0.00 856.42
MULHE000 Mulder, Heather Group: 71565
DOB: 12/09/1965 Insured ID: WYO890772291

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364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 54.67 0.00 0.00 0.00 0.00 54.67
Regions
Provider: Dr James Friess DC
Patient Totals: 54.67 0.00 0.00 0.00 0.00 54.67
MULPA000 Mulder, Paul Group: 71565
DOB: 03/10/1966 Insured ID: WYO890772291
97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 15.11 0.00 0.00 0.00 0.00 15.11
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr James Friess DC
Patient Totals: 56.83 0.00 0.00 0.00 0.00 56.83
MUMGA000 Mummert, Gabrielle Group: 000071565
DOB: 03/06/1997 Insured ID: WYO922692008
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/05/22 No 10/10/22 10/20/22 0.00 69.52 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/12/22 No 10/17/22 10/20/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 301.28 69.52 0.00 0.00 0.00 370.80
NGUTA000 Nguyen, Tammy Group: 71452
DOB: 08/31/1972 Insured ID: MMJ890049963
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/19/22 Therapeutic No 10/24/22 10/24/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25

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364 Garden Ave., Holland, MI 49424-8656
PATJU000 Paterick, Julie Group: 71453
DOB: 06/17/1975 Insured ID: MMJ891962454
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/20/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
PERDI000 Perez, Diane Group: 74153
DOB: 06/09/1963 Insured ID: MMJ890306138
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
PRIBR000 Prieditis, Bradley Group: 71453
DOB: 08/24/1972 Insured ID: MMJ894544304
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 132.67 0.00 0.00 0.00 0.00 132.67
STOMA000 Stout, Matthew Group: 71453
DOB: 05/28/1988 Insured ID: MMJ922632308
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
10/24/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 132.87 0.00 0.00 0.00 0.00 132.87
STOMI000 Stout, Micah Group: 71453
DOB: 11/24/2021 Insured ID: MMJ922632308
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36

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364 Garden Ave., Holland, MI 49424-8656
TAYJE000 Taylor, Jennifer Group: 71453
DOB: 01/10/1972 Insured ID: MMJ894410152
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
10/28/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
TAYMA000 Taylor, Margaret Group: 71453
DOB: 09/21/2007 Insured ID: MMJ894410152
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97012-GP -
10/18/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
VANSU003 Vanderbilt, Susan Group: 71453
DOB: 11/23/1969 Insured ID: MMJ892603982
97012-GP -
10/21/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
10/25/22 Therapy- No 10/31/22 10/31/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/25/22 Manipulation 5 No 10/31/22 10/31/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/21/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
72070 - X-ray
10/19/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 58.67 0.00 0.00 0.00 0.00 58.67
Views
Provider: Dr Russell Sweet DC
10/19/22 72100 - X-ray No 10/24/22 10/24/22 71.23 0.00 0.00 0.00 0.00 71.23

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364 Garden Ave., Holland, MI 49424-8656
 Lumbosacral 2-3
Views
Provider: Dr Russell Sweet DC
99203-25 - New
10/19/22 Patient Exam - 30- No 10/24/22 10/24/22 132.96 0.00 0.00 0.00 0.00 132.96
44 Min
Provider: Dr Russell Sweet DC
97124-59-GP -
10/21/22 Therapeutic No 10/26/22 10/26/22 34.50 0.00 0.00 0.00 0.00 34.50
Massage w/AIS
Provider: Dr Russell Sweet DC
72040 - X-ray
10/19/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 70.63 0.00 0.00 0.00 0.00 70.63
Views
Provider: Dr Russell Sweet DC
Patient Totals: 635.34 0.00 0.00 0.00 0.00 635.34
VANDO002 Vanderhulst, Dominic Group: 71453
DOB: 06/13/2007 Insured ID: MMJ891517239
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
VANKA004 Vanderhulst, Kaylie Group: 71453
DOB: 12/28/2004 Insured ID: MMJ891517239
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
VANAM003 Vandermeulen, Amanda Group: 71565
DOB: 08/12/1976 Insured ID: WYO894190112
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
Patient Totals: 60.74 0.00 0.00 0.00 0.00 60.74
VANBR003 Vandermeulen, Breslyn Group: 71565
DOB: 07/08/2013 Insured ID: WYO894190112
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
VANBR002 Vandermeulen, Brynlee Group: 71565
DOB: 03/23/2010 Insured ID: WYO894190112
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
VANCA000 Vanfaasen, Carl Group: 71453
DOB: 02/25/1970 Insured ID: MMJ892007429

Parkhurst Chiropractic Life Center PLC Page 32 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/19/22 Therapeutic No 10/24/22 10/24/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
Patient Totals: 164.04 0.00 0.00 0.00 0.00 164.04
VANPA000 Vanfaasen, Pamela Group: 71453
DOB: 11/27/1973 Insured ID: MMJ892007429
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/28/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
MULKR000 VanKoevering, Kristen Group: 51565
DOB: 06/20/1997 Insured ID: WYO890772291
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 54.67 0.00 0.00 0.00 0.00 54.67
Regions
Provider: Dr James Friess DC
Patient Totals: 54.67 0.00 0.00 0.00 0.00 54.67
VOSBR000 Voss, Bryan Group:
DOB: 08/24/1970 Insured ID: MMJ891872817
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
97124-59-GP -
10/24/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 132.87 0.00 0.00 0.00 0.00 132.87
VOSJE000 Voss, Jenanne Group: 71453
DOB: 09/20/1970 Insured ID: MMJ891872817
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 33 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97124-59-GP -
10/28/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Karla A Parkhurst DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
VRIDE000 Vriesman, Deirdre Group: 71453
DOB: 02/19/1979 Insured ID: MMJ890604289
98942-AT -
10/21/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97124-59-GP -
10/21/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 147.25 0.00 0.00 0.00 0.00 147.25
WELAN000 Welsh-Lloyd, Angela Group: 71453
DOB: 05/21/1975 Insured ID: MMJ891979060
97124-59-GP -
12/22/21 Therapeutic No 12/30/21 10/26/22 0.00 0.00 0.00 0.00 47.25 47.25
Massage w/AIS
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
12/22/21 No 12/30/21 10/26/22 0.00 0.00 0.00 0.00 31.12 31.12
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 78.37 78.37
WHIKA001 Whitmyer, Kati Group: 71453
DOB: 07/16/1978 Insured ID: MMJ892557352
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Karla A Parkhurst DC
97124-59-GP -
10/24/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 132.87 0.00 0.00 0.00 0.00 132.87
WHINA000 Whitmyer, Nathan Group: 71453
DOB: 12/24/1977 Insured ID: MMJ892557352
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical

Parkhurst Chiropractic Life Center PLC Page 34 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
Patient Totals: 77.53 0.00 0.00 0.00 0.00 77.53
WURBE000 Wurst, Beth Group: 71453
DOB: 09/03/1972 Insured ID: MMJ894072454
97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/21/22 Therapeutic No 10/26/22 10/26/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
97124-59-GP -
10/27/22 Therapeutic No 11/03/22 11/03/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
Patient Totals: 233.76 0.00 0.00 0.00 0.00 233.76
Carrier Totals: 6,570.75 152.08 0.00 120.80 864.83 7,708.46
Blue Cross Blue Shield
ARNLA000 Arnett, Laura Group: 020422
DOB: 10/12/1965 Insured ID: CUY000495330
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 31.36 0.00 0.00 0.00 0.00 31.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 31.36 0.00 0.00 0.00 0.00 31.36
BELTE000 Bellingar, Teresa, A Group:
DOB: 06/14/1964 Insured ID: HAW920519136
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 30.74 0.00 0.00 0.00 0.00 30.74
Regions
Provider: Dr James Friess DC
Patient Totals: 30.74 0.00 0.00 0.00 0.00 30.74
BENGA001 Benavidez, Gabriel Group: 007000562
DOB: 11/13/1977 Insured ID: MIG914411035
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC

Parkhurst Chiropractic Life Center PLC Page 35 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97032-GP-59-97 -
10/21/22 Therapy - E-Stim No 10/26/22 10/26/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/21/22 No 10/26/22 10/26/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 222.99 0.00 0.00 0.00 0.00 222.99
BENNO000 Benavidez, Nora Group: 007000562
DOB: 09/15/1982 Insured ID: MIG914411035
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
09/30/22 No 10/18/22 11/03/22 0.00 34.76 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97032-GP-59-97 -
09/30/22 Therapy - E-Stim No 10/18/22 11/03/22 0.00 17.18 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
97032-GP-59-97 -
10/31/22 Therapy - E-Stim No 11/03/22 11/03/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/21/22 No 10/26/22 10/26/22 63.94 0.00 0.00 0.00 0.00 63.94
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
09/30/22 No 10/18/22 11/03/22 0.00 31.97 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/31/22 No 11/03/22 11/03/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 295.70 83.91 0.00 0.00 0.00 379.61

Parkhurst Chiropractic Life Center PLC Page 36 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
BERRA000 Bergman, Rachelle Group:
DOB: 10/20/1977 Insured ID: KQD3HZN14745300
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
BLYSA001 Blystra, Sara Group: 5803289-DC10
DOB: 02/17/1976 Insured ID: WGJ837762312
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
BOEBE000 Boetsma, Berrett Group: 5803289-DC10
DOB: 05/29/2009 Insured ID: WGJ835801799
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 92.72 0.00 0.00 0.00 0.00 92.72
BOEBR000 Boetsma, Brylee Group: 5803289-DC10
DOB: 09/22/2005 Insured ID: WGJ835801799
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 185.44 0.00 0.00 0.00 0.00 185.44
BOEJU000 Boetsma, Julie Group: 5803289-DC10
DOB: 11/02/1980 Insured ID: WGJ835801799
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 6.36 0.00 0.00 0.00 0.00 6.36
BOEMO000 Boeve, Monica Group: 71565
DOB: 12/06/1981 Insured ID: WYO911217444
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC

Parkhurst Chiropractic Life Center PLC Page 37 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97140-GP-59-97 -
Therapy-Manual
10/24/22 No 10/26/22 10/26/22 63.94 0.00 0.00 0.00 0.00 63.94
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 159.44 0.00 0.00 0.00 0.00 159.44
BORKI000 Borri, Kimberly Group: W0088557
DOB: 08/06/1967 Insured ID: XEA910465013
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/26/22 Therapy - E-Stim No 10/31/22 10/31/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 105.27 0.00 0.00 0.00 0.00 105.27
BORSA000 Borri, Samuel Group: W0088557
DOB: 07/14/1999 Insured ID: XEA910465013
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 44.52 0.00 0.00 0.00 0.00 44.52
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 44.52 0.00 0.00 0.00 0.00 44.52
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 110.40 0.00 0.00 0.00 0.00 110.40
BRABR000 Bradshaw, Britney Group: 201060M1A1
DOB: 06/11/1986 Insured ID: XRQ819W09165
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
BROME000 Brown, Melissa, J Group: 71565
DOB: 06/01/1968 Insured ID: WYO892628550
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
COMPA000 Compagner, Paula Group: 074224
DOB: 03/17/1968 Insured ID: YFE826441505
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/19/22 Therapy - E-Stim No 10/24/22 10/24/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/19/22 No 10/24/22 10/24/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 130.27 0.00 0.00 0.00 0.00 130.27
CONLI000 Conti, Lisa Group: 10567865
DOB: 12/22/1966 Insured ID: H6U104151946001
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 92.67 0.00 0.00 0.00 0.00 92.67
COOLA000 Cook, Laura Group: 007017055
DOB: 12/19/1975 Insured ID: XYQ920739457
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
COYSU000 Coy, Susan Group: 007000562
DOB: 10/09/1973 Insured ID: MIG890788924
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/28/22 Therapy - E-Stim No 11/03/22 11/03/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 43.94 0.00 0.00 0.00 0.00 43.94
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 39 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 148.60 0.00 0.00 0.00 0.00 148.60
DALTO000 Dalman, Todd Group: 71350
DOB: 11/24/1968 Insured ID: RGI893455836
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/18/22 No 10/24/22 10/24/22 44.52 0.00 0.00 0.00 0.00 44.52
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
11/01/22 No 11/09/22 11/09/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 135.40 0.00 0.00 0.00 0.00 135.40
DAMCA000 Dampier, Caitlin Group: 71553
DOB: 03/18/1990 Insured ID: haw922576200
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97032-GP-59-97 -
10/26/22 Therapy - E-Stim No 10/31/22 10/31/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 269.35 0.00 0.00 0.00 0.00 269.35
DAMMI000 Dampier, Michael Group: 000071553
DOB: 07/12/1985 Insured ID: HAW922576200
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 16.36 0.00 0.00 0.00 0.00 16.36

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Russell Sweet DC
Patient Totals: 49.08 0.00 0.00 0.00 0.00 49.08
DELTR000 Dellavecchia, Tracey Group: 007004452
DOB: 12/28/1976 Insured ID: MJU916962311
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/05/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
04/22/22 Therapy- No 04/28/22 10/05/22 0.00 0.00 0.00 0.00 24.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 74.00 74.00
DEMMI000 Demott, Michelle Group: 270130MPD1
DOB: 04/06/1983 Insured ID: HFY972W07102
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
Patient Totals: 167.84 0.00 0.00 0.00 0.00 167.84
DEVGA000 DeVries, Gail Group: JWI003
DOB: 12/17/1965 Insured ID: LBN1229966MB
98942-AT -
10/07/22 Manipulation 5 No 10/13/22 10/13/22 0.00 40.74 0.00 0.00 0.00 40.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/17/22 Manipulation 5 No 10/20/22 10/20/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 81.48 40.74 0.00 0.00 0.00 122.22
DEVMI000 DeVries, Michael Group: 71792
DOB: 05/22/1996 Insured ID: SEE923300334
97110-GP-97 -
Therapy-
10/10/22 No 10/13/22 10/13/22 49.52 0.00 0.00 0.00 0.00 49.52
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 49.52 0.00 0.00 0.00 0.00 49.52
DEWDA001 Dewaard, Damien Group: 71557
DOB: 07/30/2000 Insured ID: OLZ922650313
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr James Friess DC

Parkhurst Chiropractic Life Center PLC Page 41 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/27/22 Therapy- No 11/03/22 11/03/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 101.04 0.00 0.00 0.00 0.00 101.04
DORPA000 Dorn, Paul Group: 007013084
DOB: 12/07/1973 Insured ID: XYQM61881196
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 12.72 0.00 0.00 0.00 0.00 12.72
EAKKE000 Eakley, Kennedi Group: 71549
DOB: 04/24/2001 Insured ID: KMT892581274
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
EAKTH000 Eakley, Thomas Group: 71549
DOB: 10/04/1968 Insured ID: KMT892581274
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
ERSER000 Ersfeld, Ernest Group: 00935000070
DOB: 03/20/1943 Insured ID: NJX3HZN10213510
98942-AT -
07/08/22 Manipulation 5 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 10.18 10.18
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
08/08/22 Manipulation 5 No 08/11/22 10/05/22 0.00 0.00 0.00 10.18 0.00 10.18
Regions
Provider: Dr James Friess DC
98942-AT -
08/19/22 Manipulation 5 No 08/25/22 09/26/22 0.00 0.00 10.18 0.00 0.00 10.18
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 10.18 10.18 10.18 30.54
ERSPA000 Ersfeld, Pamela Group: 00935000070
DOB: 02/22/1944 Insured ID: NJX3HZN99578530
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 10/13/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 09/29/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/20/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/03/22 Manipulation 3-4 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/26/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/09/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/13/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 7.76 7.76 0.00 46.56 62.08
ESPPA000 Espinoza, Paul Group: 007047642
DOB: 11/26/1965 Insured ID: LFIM04107707
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr James Friess DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
FEGST000 Fegel, Stephanie Group: 007013084
DOB: 10/08/1987 Insured ID: XYQ914895601
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97032-GP-59-97 -
10/20/22 Therapy - E-Stim No 10/26/22 10/26/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
10/20/22 No 10/26/22 10/26/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 130.27 0.00 0.00 0.00 0.00 130.27
FRAJA001 Frazier, Ja-mariah Group: 71440
DOB: 08/22/2005 Insured ID: NHT922166138
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
10/24/22 Therapy- No 10/26/22 10/26/22 29.52 0.00 0.00 0.00 0.00 29.52
Therapeutic

Parkhurst Chiropractic Life Center PLC Page 43 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 29.52 0.00 0.00 0.00 0.00 29.52
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/24/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
Patient Totals: 105.34 0.00 0.00 0.00 0.00 105.34
GEMRE000 Gemmill, Rene Group: 71549
DOB: 02/02/1971 Insured ID: KMT891844716
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
GEURY000 Geurink, Ryan Group: 270130MPD1
DOB: 08/03/1991 Insured ID: HFY857W07102
97110-GP-97 -
Therapy-
10/18/22 No 10/24/22 10/24/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
97124-59-GP -
10/18/22 Therapeutic No 10/24/22 10/24/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 86.51 0.00 0.00 0.00 0.00 86.51
GIBJO000 Gibson, Joanne Group: 174208M8AE
DOB: 09/17/1958 Insured ID: VWW318M87256
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 83.44 0.00 0.00 0.00 0.00 83.44
GIBME000 Gibson, Melissa, J Group: 71372
DOB: 04/14/1986 Insured ID: MZO910970356
98941-AT -
06/16/22 Manipulation 3-4 No 06/23/22 09/29/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/15/22 Manipulation 3-4 No 06/23/22 09/29/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/18/22 Manipulation 3-4 No 08/25/22 09/12/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 09/29/22 0.00 0.00 0.00 25.00 0.00 25.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 09/29/22 0.00 0.00 0.00 25.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 09/29/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/22/22 Manipulation 3-4 No 06/28/22 09/29/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 09/29/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 09/26/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/14/22 09/29/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/29/22 Manipulation 3-4 No 10/05/22 10/24/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/31/22 25.00 0.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
99203-25 - New
06/15/22 Patient Exam - 30- No 06/23/22 09/29/22 0.00 0.00 0.00 0.00 63.84 63.84
44 Min
Provider: Dr Karla A Parkhurst DC
Patient Totals: 25.00 50.00 50.00 50.00 188.84 363.84
GOEAU001 Goerner, Aubrey Group: 197162
DOB: 12/02/1998 Insured ID: HJD829647380
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
GRAJE000 Gradler, Jessica Group: 213019M113
DOB: 03/29/2002 Insured ID: KEF160A24915
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr James Friess DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
GRARO000 Gradler, Roger Group: 213019M113
DOB: 09/11/2000 Insured ID: KEF160A24915
97012-GP -
10/13/22 Therapy- No 10/20/22 10/20/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr James Friess DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15

Parkhurst Chiropractic Life Center PLC Page 45 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
GREAL000 Greene, Alice Group: 007050036
DOB: 02/17/1975 Insured ID: XYQ890767509
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions
Provider: Dr James Friess DC
Patient Totals: 48.59 0.00 0.00 0.00 0.00 48.59
GUIHO000 Guillozet, Holly Group: 71372
DOB: 12/09/1974 Insured ID: MZO922004450
72070 - X-ray
10/18/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 58.67 0.00 0.00 0.00 0.00 58.67
Views
Provider: Dr Samantha J Spooner DC
72100 - X-ray
10/18/22 Lumbosacral 2-3 No 10/24/22 10/24/22 71.23 0.00 0.00 0.00 0.00 71.23
Views
Provider: Dr Samantha J Spooner DC
99203-25 - New
10/18/22 Patient Exam - 30- No 10/24/22 10/24/22 132.96 0.00 0.00 0.00 0.00 132.96
44 Min
Provider: Dr Samantha J Spooner DC
72040 - X-ray
10/18/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 70.63 0.00 0.00 0.00 0.00 70.63
Views
Provider: Dr Samantha J Spooner DC
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 44.76 0.00 0.00 0.00 0.00 44.76
(Trigger Point,
Myofascial Release)
Provider: Dr Samantha J Spooner DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Samantha J Spooner DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 24.33 0.00 0.00 0.00 0.00 24.33
Therapeutic
Exercise
Provider: Dr Samantha J Spooner DC
97110-GP-97 -
Therapy-
10/21/22 No 10/31/22 10/31/22 44.52 0.00 0.00 0.00 0.00 44.52
Therapeutic
Exercise
Provider: Dr Samantha J Spooner DC
97110-GP-97 -
Therapy-
10/25/22 No 10/31/22 10/31/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Samantha J Spooner DC
97110-GP-97 -
Therapy-
11/01/22 No 11/09/22 11/09/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Samantha J Spooner DC
Patient Totals: 692.94 0.00 0.00 0.00 0.00 692.94
HARJO002 Hardy, John, J Group: 007013847
DOB: 09/24/1959 Insured ID: MSR911061188
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 41.72 0.00 0.00 0.00 0.00 41.72
HARJA000 Harshberger, Jamie Group: 71453
DOB: 06/25/1970 Insured ID: MMJ890779255
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
HAVSA000 Haverdink, Sandra Group: 007013847
DOB: 07/10/1970 Insured ID: MSR890944160
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 83.44 0.00 0.00 0.00 0.00 83.44
HENRO000 Henley, Roseann Group: P13346
DOB: 03/13/1962 Insured ID: NEI800880861
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
HENSU000 Henry, Susan Group: 007017055
DOB: 06/29/1966 Insured ID: XYQ916736522
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/27/22 No 11/03/22 11/03/22 43.94 0.00 0.00 0.00 0.00 43.94
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 105.06 0.00 0.00 0.00 0.00 105.06
HESJA000 Hester, Jacki Group: 072378
DOB: 09/30/1966 Insured ID: RYD834549262
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 47 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/14/22 Therapy- No 10/20/22 10/20/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 115.06 0.00 0.00 0.00 0.00 115.06
HOFMA001 Hoffman, Mary Group: 1877BJ
DOB: 05/11/1972 Insured ID: WLU621M77013
97110-GP-97 -
Therapy-
08/24/22 No 08/29/22 08/29/22 0.00 0.00 33.25 0.00 0.00 33.25
Therapeutic
Exercise
Provider: Dr James Friess DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 5.74 0.00 0.00 0.00 0.00 5.74
Regions
Provider: Dr James Friess DC
97124-59-GP -
10/19/22 Therapeutic No 10/24/22 10/24/22 31.51 0.00 0.00 0.00 0.00 31.51
Massage w/AIS
Provider: Dr James Friess DC
Patient Totals: 37.25 0.00 33.25 0.00 0.00 70.50
HOUAS000 Houdek, Ashley Group: 002356142
DOB: 11/24/1986 Insured ID: MCX967535027
72040 - X-ray
08/12/22 Cervical Spine - 2-3 No 08/17/22 10/26/22 0.00 0.00 67.56 0.00 0.00 67.56
Views
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
08/12/22 Thoracic Spine - 2-3 No 08/17/22 10/26/22 0.00 0.00 56.12 0.00 0.00 56.12
Views
Provider: Dr Brian S Parkhurst DC
72100 - X-ray
08/12/22 Lumbosacral 2-3 No 08/17/22 10/26/22 0.00 0.00 68.13 0.00 0.00 68.13
Views
Provider: Dr Brian S Parkhurst DC
99203-25 - New
08/12/22 Patient Exam - 30- No 08/17/22 10/26/22 0.00 0.00 127.18 0.00 0.00 127.18
44 Min
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 10/26/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/24/22 Manipulation 3-4 No 08/29/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
09/07/22 Manipulation 3-4 No 09/12/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/19/22 10/26/22 0.00 4.34 0.00 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/26/22 0.00 4.34 0.00 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 10/26/22 0.00 4.34 0.00 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/04/22 Manipulation 3-4 No 10/10/22 10/26/22 0.00 6.36 0.00 0.00 0.00 6.36
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/26/22 0.00 4.34 0.00 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/26/22 0.00 6.36 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/26/22 0.00 4.34 0.00 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/12/22 Manipulation 3-4 No 08/17/22 10/26/22 0.00 0.00 4.34 0.00 0.00 4.34
Regions
Provider: Dr Brian S Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 49 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 29.52 0.00 0.00 0.00 0.00 29.52
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/23/22 No 09/29/22 09/29/22 0.00 66.50 0.00 0.00 0.00 66.50
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/14/22 No 09/19/22 10/26/22 0.00 66.50 0.00 0.00 0.00 66.50
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/09/22 No 09/14/22 10/26/22 0.00 0.00 66.50 0.00 0.00 66.50
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/24/22 No 08/29/22 10/26/22 0.00 0.00 66.50 0.00 0.00 66.50
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/31/22 No 09/07/22 10/26/22 0.00 0.00 26.50 0.00 0.00 26.50
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 67.68 167.42 548.87 0.00 0.00 783.97
HOUJE000 Houdek, Jeremy Group: 002356142
DOB: 10/13/1984 Insured ID: MCX967535027
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 6.36 0.00 0.00 0.00 0.00 6.36
HUMWE000 Humbarger, Wendy Group: 71372
DOB: 12/10/1965 Insured ID: MZO922005530
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr James Friess DC
Patient Totals: 52.72 0.00 0.00 0.00 0.00 52.72
IGLJA000 Iglesias, Jamie Group: 320033
DOB: 05/02/1988 Insured ID: J5C830223690
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/27/22 Therapy - E-Stim No 11/03/22 11/03/22 15.46 0.00 0.00 0.00 0.00 15.46
Attended
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
10/19/22 Therapy - E-Stim No 10/24/22 10/24/22 15.46 0.00 0.00 0.00 0.00 15.46
Attended
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 50 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 31.28 0.00 0.00 0.00 0.00 31.28
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 31.28 0.00 0.00 0.00 0.00 31.28
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/19/22 No 10/24/22 10/24/22 28.77 0.00 0.00 0.00 0.00 28.77
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/27/22 No 11/03/22 11/03/22 28.77 0.00 0.00 0.00 0.00 28.77
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 192.74 0.00 0.00 0.00 0.00 192.74
IVANI000 Ivanov, Nichole Group: 1902416-0001
DOB: 07/16/1984 Insured ID: MYY812441754
98941-AT -
09/08/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/29/22 Manipulation 3-4 No 10/05/22 10/05/22 0.00 44.34 0.00 0.00 0.00 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
97032-GP-59-97 -
09/29/22 Therapy - E-Stim No 10/05/22 10/05/22 0.00 16.43 0.00 0.00 0.00 16.43
Attended
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
09/08/22 No 10/03/22 10/03/22 0.00 0.00 33.25 0.00 0.00 33.25
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
09/29/22 No 10/05/22 10/05/22 0.00 33.25 0.00 0.00 0.00 33.25
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
09/08/22 No 10/03/22 10/03/22 0.00 0.00 31.16 0.00 0.00 31.16
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
09/29/22 No 10/05/22 10/05/22 0.00 0.58 0.00 0.00 0.00 0.58
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 94.60 108.75 0.00 0.00 203.35
JAGKA000 Jager, Katie Group: 007013416
DOB: 01/23/1979 Insured ID: KEI915999429
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
JELJU000 Jelsema, Justin Group: 002312289

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364 Garden Ave., Holland, MI 49424-8656
DOB: 06/16/1990 Insured ID: XXP960735382
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr James Friess DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr James Friess DC
97012-GP -
10/21/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 83.89 0.00 0.00 0.00 0.00 83.89
JOHNA000 Johnson, Naomi Group: 007039465
DOB: 01/02/1991 Insured ID: WWZ928957391
72040 - X-ray
09/29/22 Cervical Spine - 2-3 No 10/10/22 10/26/22 0.00 67.56 0.00 0.00 0.00 67.56
Views
Provider: Dr Samantha J Spooner DC
97140-GP-59-97 -
Therapy-Manual
10/17/22 No 10/20/22 11/03/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
72100 - X-ray
09/29/22 Lumbosacral 2-3 No 10/10/22 10/26/22 0.00 68.13 0.00 0.00 0.00 68.13
Views
Provider: Dr Samantha J Spooner DC
72070 - X-ray
09/29/22 Thoracic Spine - 2-3 No 10/10/22 10/26/22 0.00 56.12 0.00 0.00 0.00 56.12
Views
Provider: Dr Samantha J Spooner DC
97032-GP-59-97 -
10/17/22 Therapy - E-Stim No 10/20/22 11/03/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 83.91 191.81 0.00 0.00 0.00 275.72
KETDA000 Ketchum, Daniel Group: 270130MPD1
DOB: 04/05/1993 Insured ID: HFY507W07103
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Russell Sweet DC
97032-GP-59-97 -
10/17/22 Therapy - E-Stim No 10/20/22 10/20/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 26.73 0.00 0.00 0.00 0.00 26.73
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 50.27 0.00 0.00 0.00 0.00 50.27
KETBE000 Ketner, Benjamin Group: 191232
DOB: 03/19/1978 Insured ID: UDH842793128
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
KHOSO000 Khounlameth, Somphone Group: 270130MPD1
DOB: 09/21/1987 Insured ID: HFY665W07106
97110-GP-97 -
Therapy-
09/15/22 No 09/22/22 09/22/22 0.00 23.83 0.00 0.00 0.00 23.83
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 23.83 0.00 0.00 0.00 23.83
KLOLI000 Kloosterman, Lindsey Group: 280629MG61
DOB: 08/25/1995 Insured ID: XDP708W12536
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 30.74 0.00 0.00 0.00 0.00 30.74
Regions
Provider: Dr James Friess DC
Patient Totals: 30.74 0.00 0.00 0.00 0.00 30.74
KOEJO001 Koedyker, Joel Group: 71492
DOB: 05/12/1979 Insured ID: RQO919295186
98942-AT -
10/18/22 Manipulation 5 No 10/24/22 10/24/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 48.59 0.00 0.00 0.00 0.00 48.59
KOUNI000 Kouw, Nicole, C Group: 71565
DOB: 12/05/1980 Insured ID: WYO929645749
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 95.88 0.00 0.00 0.00 0.00 95.88
KUIMI000 Kuiper, Michelle Group: 007037412
DOB: 09/29/1967 Insured ID: NPK920662678
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
72070 - X-ray
10/26/22 Thoracic Spine - 2-3 No 10/31/22 10/31/22 58.67 0.00 0.00 0.00 0.00 58.67
Views
Provider: Dr Russell Sweet DC
72040 - X-ray
10/26/22 Cervical Spine - 2-3 No 10/31/22 10/31/22 70.63 0.00 0.00 0.00 0.00 70.63
Views
Provider: Dr Russell Sweet DC
99203-25 - New
10/26/22 Patient Exam - 30- No 10/31/22 10/31/22 132.96 0.00 0.00 0.00 0.00 132.96
44 Min
Provider: Dr Russell Sweet DC
72100 - X-ray
10/26/22 Lumbosacral 2-3 No 10/31/22 10/31/22 71.23 0.00 0.00 0.00 0.00 71.23
Views

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
Patient Totals: 426.21 0.00 0.00 0.00 0.00 426.21
LAMCH000 Lamar, Chad Group: 007013034
DOB: 04/12/1972 Insured ID: XYQ891977025
72040 - X-ray
10/20/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 56.50 0.00 0.00 0.00 0.00 56.50
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/20/22 Patient Exam - 30- No 10/26/22 10/26/22 106.37 0.00 0.00 0.00 0.00 106.37
44 Min
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/20/22 Lumbosacral 2-3 No 10/26/22 10/26/22 56.98 0.00 0.00 0.00 0.00 56.98
Views
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/20/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 46.94 0.00 0.00 0.00 0.00 46.94
Views
Provider: Dr Jeremy Lengkeek DC
97012-GP -
10/20/22 Therapy- No 10/26/22 10/26/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 428.58 0.00 0.00 0.00 0.00 428.58
LINAL000 Lindberg, Alexandria Group: 007028602
DOB: 04/29/1995 Insured ID: XYQM61882840
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
LUNAL000 Luna, Alissa Group: 71492
DOB: 08/03/1998 Insured ID: RQO912620455
98941-AT -
02/14/22 Manipulation 3-4 No 03/03/22 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 41.50 41.50
MAAAM000 Maatman, Amy, L Group: 72622
DOB: 06/17/1976 Insured ID: LWG921748731
98942-AT -
07/13/22 Manipulation 5 No 07/18/22 10/05/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
07/13/22 97012-GP - No 07/18/22 10/05/22 0.00 0.00 0.00 24.00 0.00 24.00

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364 Garden Ave., Holland, MI 49424-8656
 Therapy-
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/13/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 09/22/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/05/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 36.72 36.72 97.44 0.00 170.88
MARAN000 Martinez, Angie, M Group: 007016463
DOB: 09/09/1975 Insured ID: XYQ893623455
98942-AT -
10/18/22 Manipulation 5 No 10/24/22 10/24/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 60.74 0.00 0.00 0.00 0.00 60.74
MCPJE001 McParlan, Jeffrey Group: 007040387
DOB: 10/21/1973 Insured ID: XYQ891056492
98942-AT -
11/01/22 Manipulation 5 No 11/09/22 11/09/22 30.74 0.00 0.00 0.00 0.00 30.74
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 30.74 0.00 0.00 0.00 0.00 30.74
MCPRE000 McParlan, Renee Group: 007040387
DOB: 06/06/1976 Insured ID: XYQ891056492
97032-GP-59-97 -
10/28/22 Therapy - E-Stim No 11/03/22 11/03/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 39.52 0.00 0.00 0.00 0.00 39.52
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 1.97 0.00 0.00 0.00 0.00 1.97
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 162.95 0.00 0.00 0.00 0.00 162.95
MCQAV000 McQueen, Avery Group: 10406956
DOB: 02/01/2008 Insured ID: YYM131538283001
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
MCQBR000 McQueen, Brady Group: 10406956
DOB: 10/27/2005 Insured ID: YYM131538283001
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
MCQDO000 McQueen, Donald Group: 10406956
DOB: 08/27/1974 Insured ID: YYM131538283001
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
MEYKA000 Meyer, Kathie Group: 71372
DOB: 01/25/1970 Insured ID: MZO922005644
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
MILKE000 Miller, Kenneth Group: 000071350
DOB: 04/02/1998 Insured ID: RGIM01894294
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 11.36 0.00 0.00 0.00 0.00 11.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.36 0.00 0.00 0.00 0.00 11.36
MONCH000 Montgomery, Chloe Group: 174208M1A0
DOB: 07/19/1999 Insured ID: VWW436M97263
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
99212-25 -
10/26/22 Established Patient No 10/31/22 10/31/22 58.97 0.00 0.00 0.00 0.00 58.97
Exam - 10-19 Min
Provider: Dr Russell Sweet DC
Patient Totals: 105.33 0.00 0.00 0.00 0.00 105.33
MONLI000 Montgomery, Lisa, S Group: 174208M1A0
DOB: 08/20/1961 Insured ID: VWW436M97263
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 60.74 0.00 0.00 0.00 0.00 60.74
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 60.74 0.00 0.00 0.00 0.00 60.74
MOOJU000 Moore, Julia Group: 76312-0116
DOB: 07/28/2005 Insured ID: D4M3HZN10544970
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr James Friess DC
Patient Totals: 40.74 0.00 0.00 0.00 0.00 40.74
MUMRU000 Mummert, RuthAnn Group: 71565
DOB: 09/01/1956 Insured ID: WYO922692008
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 54.67 0.00 0.00 0.00 0.00 54.67
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 54.67 0.00 0.00 0.00 0.00 54.67

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364 Garden Ave., Holland, MI 49424-8656
MYSTI000 Mysen, Tiffany Group: 024S75
DOB: 03/24/1982 Insured ID: YOAT50506225
97032-GP-59-97 -
10/24/22 Therapy - E-Stim No 10/26/22 10/26/22 13.74 0.00 0.00 0.00 0.00 13.74
Attended
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/24/22 No 10/26/22 10/26/22 51.15 0.00 0.00 0.00 0.00 51.15
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 27.81 0.00 0.00 0.00 0.00 27.81
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 92.70 0.00 0.00 0.00 0.00 92.70
NAGAN000 Nagy, Anne Group: 71372
DOB: 02/27/1960 Insured ID: MZO922006109
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 52.72 0.00 0.00 0.00 0.00 52.72
CHASO000 Niewoonder, Souphanh, N Group: 007046247
DOB: 10/30/1987 Insured ID: XYQ917560457
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 26.36 0.00 0.00 0.00 0.00 26.36
OVEAG000 Overbeek, Augustus Group: 007013034
DOB: 11/13/2001 Insured ID: XYQ891977025
98941-AT -
05/09/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/13/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/05/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/13/22 Therapy- No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 16.12 16.12
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/16/22 Therapy- No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 16.12 16.12
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/05/22 Therapy- No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 16.12 16.12

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364 Garden Ave., Holland, MI 49424-8656
 Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/09/22 Therapy- No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 16.12 16.12
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
99203-25 - New
05/05/22 Patient Exam - 30- No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 127.18 127.18
44 Min
Provider: Dr Brian S Parkhurst DC
72082 - X-Ray Full
05/05/22 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 116.80 116.80
Spine - 2-3 views
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 482.34 482.34
OVEBR000 Overbeek, Bryce Group: 71542
DOB: 11/10/2005 Insured ID: LZC916679409
98941-AT -
04/15/22 Manipulation 3-4 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
OVECH000 Overbeek, Channa Group: 71542
DOB: 01/24/1980 Insured ID: LZC916679409
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 92.72 0.00 0.00 0.00 0.00 92.72
OVEDR000 Overbeek, Drake Group: 71542
DOB: 03/15/2010 Insured ID: LZC916679409
98941-AT -
04/29/22 Manipulation 3-4 No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/05/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 73.44 73.44
OVELE000 Overbeek, Levi Group: 71542
DOB: 05/18/1981 Insured ID: LZC916679409
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/03/22 Manipulation 3-4 No 10/10/22 10/31/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 36.72 0.00 36.72 0.00 73.44
OVITE000 Oviedo, Teresa, L Group:
DOB: 05/09/1970 Insured ID: ARI1684027200
98941-AT -
05/05/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 50.00 50.00

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364 Garden Ave., Holland, MI 49424-8656
POLAL000 Poland, Alexandra Group: 71712
DOB: 09/28/1999 Insured ID: JXP912339804
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 11.36 0.00 0.00 0.00 0.00 11.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 11.36 0.00 0.00 0.00 0.00 11.36
PRIRA000 Prins, Rachel, J Group: 71372
DOB: 08/26/1971 Insured ID: MZO913931681
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 21.36 0.00 0.00 0.00 0.00 21.36
PUHMI000 Puhar, Michael Group: 174573BER1
DOB: 10/12/1965 Insured ID: QUP717M98752
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
RAMRO000 Ramirez-Pena, Rodolfo Group: 10444600
DOB: 02/20/1962 Insured ID: YYM130370938001
98942-AT -
03/03/22 Manipulation 5 No 03/07/22 10/21/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr James Friess DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/13/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr James Friess DC
98941-AT -
05/27/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr James Friess DC
98941-AT -
03/31/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 25.00 0.00 0.00 75.00 100.00
RATLE000 Rattin, Leilani Group: P13168
DOB: 05/13/1958 Insured ID: TEA806138154
97110-GP-97 -
Therapy-
10/06/22 No 10/20/22 10/20/22 0.00 27.81 0.00 0.00 0.00 27.81
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/06/22 Therapeutic No 10/20/22 10/20/22 0.00 41.40 0.00 0.00 0.00 41.40
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 69.21 0.00 0.00 0.00 69.21
REYGA000 Reynoso, Gaudencio Group: 10444600
DOB: 02/11/1986 Insured ID: YYM130371236001
97124-59-GP -
10/19/22 Therapeutic No 10/24/22 10/24/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Jeremy Lengkeek DC
97124-59-GP -
10/11/22 Therapeutic No 10/20/22 10/20/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Jeremy Lengkeek DC

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364 Garden Ave., Holland, MI 49424-8656
 97124-59-GP -
10/25/22 Therapeutic No 10/31/22 10/31/22 51.75 0.00 0.00 0.00 0.00 51.75
Massage w/AIS
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/11/22 No 10/20/22 10/20/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/25/22 No 10/31/22 10/31/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/20/22 10/20/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 352.25 0.00 0.00 0.00 0.00 352.25
RHOBR000 Rhoda, Brenda Group: 074224
DOB: 07/30/1963 Insured ID: YFE843764870
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 74.18 0.00 0.00 0.00 0.00 74.18
RHOKR000 Rhodes, Kristi Group: 76312-0124
DOB: 01/19/1966 Insured ID: D4M3HZN70471590
97032-GP-59-97 -
09/14/22 Therapy - E-Stim No 09/19/22 09/19/22 0.00 16.43 0.00 0.00 0.00 16.43
Attended
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 09/14/22 0.00 24.34 0.00 0.00 0.00 24.34
Regions
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
09/14/22 No 09/19/22 09/19/22 0.00 33.25 0.00 0.00 0.00 33.25
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
09/14/22 No 09/19/22 09/19/22 0.00 41.16 0.00 0.00 0.00 41.16
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 115.18 0.00 0.00 0.00 115.18
RICAN000 Rich, Andrea Group: L05816M019
DOB: 12/28/1987 Insured ID: Q9A906W13599

09/16/22 98940-AT - No 09/29/22 09/29/22 0.00 30.97 0.00 0.00 0.00 30.97

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 1-2
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
09/13/22 Manipulation 1-2 No 09/26/22 09/26/22 0.00 30.97 0.00 0.00 0.00 30.97
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
09/21/22 Manipulation 1-2 No 09/26/22 09/26/22 0.00 30.97 0.00 0.00 0.00 30.97
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
09/19/22 Manipulation 1-2 No 09/29/22 09/29/22 0.00 30.97 0.00 0.00 0.00 30.97
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 123.88 0.00 0.00 0.00 123.88
ROMLU000 Romano, Luca Group: 000784
DOB: 08/31/2002 Insured ID: ILT822314366
97012-GP -
03/30/22 Therapy- No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
03/23/22 Therapy- No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
04/20/22 Therapy- No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/11/22 Therapy- No 05/16/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
03/09/22 Therapy- No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
04/27/22 Therapy- No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 11.21 11.21
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
06/22/22 Therapy- No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 11.21 11.21
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
05/25/22 Therapy- No 06/02/22 10/21/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
07/20/22 Therapy- No 07/25/22 10/05/22 0.00 0.00 0.00 12.18 0.00 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
06/08/22 Therapy- No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 12.18 12.18
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98942-AT -
03/09/22 Manipulation 5 No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 22.54 22.54
Regions
Provider: Dr James Friess DC

03/16/22 98942-AT - No 03/21/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 5
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
12/08/21 No 12/14/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
12/16/21 No 12/21/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
06/08/22 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
05/31/22 No 06/06/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
05/25/22 No 06/02/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
07/13/22 No 07/25/22 10/05/22 0.00 0.00 0.00 41.20 0.00 41.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
07/29/22 No 08/04/22 10/07/22 0.00 0.00 0.00 20.00 0.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
07/20/22 No 07/25/22 10/05/22 0.00 0.00 0.00 21.20 0.00 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
06/29/22 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 41.20 41.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
04/14/22 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
04/26/22 No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
05/18/22 No 05/23/22 10/21/22 0.00 0.00 0.00 0.00 41.20 41.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
05/03/22 Therapy- No 05/09/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic

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364 Garden Ave., Holland, MI 49424-8656
 Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
05/11/22 No 05/16/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
04/20/22 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
03/23/22 No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
02/23/22 No 02/28/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
03/09/22 No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
03/30/22 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
11/30/21 No 12/06/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
04/06/22 No 04/11/22 10/21/22 0.00 0.00 0.00 0.00 21.20 21.20
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97012-GP -
10/27/21 Therapy- No 11/04/21 10/21/22 0.00 0.00 0.00 0.00 2.59 2.59
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
11/17/21 Manipulation 3-4 No 11/23/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
01/05/22 Manipulation 3-4 No 01/12/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/22/21 Manipulation 3-4 No 12/30/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/19/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
01/26/22 Manipulation 3-4 No 02/01/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions

Parkhurst Chiropractic Life Center PLC Page 63 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
98941-AT -
02/02/22 Manipulation 3-4 No 02/08/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/27/21 Manipulation 3-4 No 11/04/21 10/21/22 0.00 0.00 0.00 0.00 20.86 20.86
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/06/22 Manipulation 3-4 No 04/11/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/30/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 40.86 40.86
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
03/23/22 Manipulation 3-4 No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 40.86 40.86
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
02/23/22 Manipulation 3-4 No 02/28/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
02/16/22 Manipulation 3-4 No 02/21/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
02/08/22 Manipulation 3-4 No 02/17/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
04/27/22 Manipulation 3-4 No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/13/22 Manipulation 3-4 No 04/18/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/20/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/11/22 Manipulation 3-4 No 05/16/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
06/08/22 Manipulation 3-4 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 20.86 20.86
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/25/22 Manipulation 3-4 No 06/02/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/20/22 Manipulation 3-4 No 07/25/22 10/05/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
06/22/22 Manipulation 3-4 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions

Parkhurst Chiropractic Life Center PLC Page 64 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/06/21 Manipulation 3-4 No 12/10/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
12/01/21 Manipulation 3-4 No 12/07/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/15/21 Manipulation 3-4 No 12/21/21 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
72100 - X-ray
10/27/21 Lumbosacral 2-3 No 11/04/21 10/21/22 0.00 0.00 0.00 0.00 63.40 63.40
Views
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
10/27/21 Thoracic Spine - 2-3 No 11/04/21 10/21/22 0.00 0.00 0.00 0.00 51.92 51.92
Views
Provider: Dr Brian S Parkhurst DC
72040 - X-ray
10/27/21 Cervical Spine - 2-3 No 11/04/21 10/21/22 0.00 0.00 0.00 0.00 62.85 62.85
Views
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 114.58 1,245.22 1,359.80
ROSLA000 Rosenberg, Laura Group: 000784
DOB: 08/16/1968 Insured ID: ILT822314366
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/13/22 Therapy- No 10/20/22 10/20/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 50.52 0.00 0.00 0.00 0.00 50.52
RUIDE000 Ruiz, Declan, I Group: L02510M003
DOB: 10/04/2000 Insured ID: AJS282W12344
97012-GP -
10/28/22 Therapy- No 11/03/22 11/03/22 13.15 0.00 0.00 0.00 0.00 13.15
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 13.15 0.00 0.00 0.00 0.00 13.15
RUSJI000 Russell, Jill Group: 007013084
DOB: 12/31/1970 Insured ID: XYQ924220836
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 20.74 0.00 0.00 0.00 0.00 20.74
Regions
Provider: Dr James Friess DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 20.74 0.00 0.00 0.00 0.00 20.74
Regions
Provider: Dr James Friess DC
Patient Totals: 41.48 0.00 0.00 0.00 0.00 41.48
SANMA001 Sanders, MacKenzie Group:
DOB: 02/22/2006 Insured ID: YFE841406190
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09

Parkhurst Chiropractic Life Center PLC Page 65 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
SANTI000 Sanders, Timothy Group:
DOB: 10/10/1972 Insured ID: YFE841406190
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr James Friess DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
SAUJA000 Sauers, James Group:
DOB: 06/18/1985 Insured ID: SFO960983797
97012-GP -
11/01/22 Therapy- No 11/09/22 11/09/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 63.15 0.00 0.00 0.00 0.00 63.15
SEEDA000 Seely, Dawn Group: 007017168
DOB: 07/29/1965 Insured ID: BDS912178097
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
SEGAS001 Seguin, Ashley Group: 10039895
DOB: 10/05/1992 Insured ID: P6V210032026
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 6.36 0.00 0.00 0.00 0.00 6.36
SILKE000 Sills, Kendal Group: 0000715651020029
DOB: 08/08/2005 Insured ID: WYO894228517
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 26.36 0.00 0.00 0.00 0.00 26.36
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/28/22 Therapy- No 11/03/22 11/03/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 43.15 0.00 0.00 0.00 0.00 43.15
SKUDA000 Skutt, David Group: 007000562
DOB: 07/24/1959 Insured ID: MIG891116983
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 40.74 0.00 0.00 0.00 0.00 40.74
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 62.57 0.00 0.00 0.00 0.00 62.57
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 103.31 0.00 0.00 0.00 0.00 103.31
BARRA001 Slagh, Raleigh Group: 074224
DOB: 03/11/2000 Insured ID: YFE843007038
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 66 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 62.02 0.00 0.00 0.00 0.00 62.02
SMISY000 Smith, Sydni Group: 007047117
DOB: 10/13/2007 Insured ID: XYQM62668831
98941-AT -
07/19/22 Manipulation 3-4 No 07/25/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 46.36 0.00 0.00 44.34 0.00 90.70
SPRSH000 Sprick, Shanda Group: 300207
DOB: 10/21/1972 Insured ID: PAS828435436
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 83.44 0.00 0.00 0.00 0.00 83.44
SULCA001 Sullivan, Carrie Group:
DOB: 09/07/1977 Insured ID: BGO100010301141
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 11.36 0.00 0.00 0.00 0.00 11.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.36 0.00 0.00 0.00 0.00 11.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 22.72 0.00 0.00 0.00 0.00 22.72
SULSY000 Sullivan, Sylvia Group: 230018AAA2
DOB: 05/31/1980 Insured ID: UCR241A23604
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 15.11 0.00 0.00 0.00 0.00 15.11
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 15.11 0.00 0.00 0.00 0.00 15.11
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 41.72 0.00 0.00 0.00 0.00 41.72
Regions
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
10/19/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 63.57 0.00 0.00 0.00 0.00 63.57
Views
Provider: Dr Karla A Parkhurst DC
99203-25 - New
10/19/22 Patient Exam - 30- No 10/24/22 10/24/22 119.66 0.00 0.00 0.00 0.00 119.66
44 Min

Parkhurst Chiropractic Life Center PLC Page 67 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
10/19/22 Lumbosacral 2-3 No 10/24/22 10/24/22 64.11 0.00 0.00 0.00 0.00 64.11
Views
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
10/19/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 52.80 0.00 0.00 0.00 0.00 52.80
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 413.80 0.00 0.00 0.00 0.00 413.80
TARKU000 Taratuta, Kurt Group: 71553
DOB: 03/27/1968 Insured ID: HAW920519299
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 16.36 0.00 0.00 0.00 0.00 16.36
Regions
Provider: Dr James Friess DC
97032-GP-59-97 -
10/27/22 Therapy - E-Stim No 11/03/22 11/03/22 17.18 0.00 0.00 0.00 0.00 17.18
Attended
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/27/22 No 11/03/22 11/03/22 31.97 0.00 0.00 0.00 0.00 31.97
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 34.76 0.00 0.00 0.00 0.00 34.76
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 100.27 0.00 0.00 0.00 0.00 100.27
TATMA000 Tate, Marilyn Group: CS040A
DOB: 06/24/1945 Insured ID: XDD293A66610
98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/14/22 Manipulation 3-4 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 24.31 24.31
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/08/22 Manipulation 3-4 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/08/22 Manipulation 3-4 No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 7.76 109.63 117.39
TENJI000 Tenbrink, Jill, A Group: 71565
DOB: 01/02/1971 Insured ID: WYO914436228
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/04/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions

Parkhurst Chiropractic Life Center PLC Page 68 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/07/22 Manipulation 3-4 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/03/22 Manipulation 3-4 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/26/22 Manipulation 3-4 No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/19/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/17/22 Manipulation 3-4 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/13/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/21/22 Manipulation 3-4 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 44.34 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/27/22 Manipulation 3-4 No 08/01/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/03/22 Manipulation 3-4 No 08/08/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/16/22 Manipulation 3-4 No 08/22/22 10/05/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions

Parkhurst Chiropractic Life Center PLC Page 69 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
98941-AT -
09/13/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 44.34 0.00 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/20/22 Manipulation 3-4 No 09/26/22 09/26/22 0.00 44.34 0.00 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/06/22 Manipulation 3-4 No 09/12/22 09/12/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/24/22 Manipulation 3-4 No 08/29/22 10/05/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
04/08/22 No 04/18/22 10/21/22 0.00 0.00 0.00 0.00 59.98 59.98
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
99213-25 -
06/03/22 Established Patient No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 88.57 88.57
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
99213-25 -
04/26/22 Established Patient No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 88.57 88.57
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
99213-25 -
09/27/22 Established Patient No 10/03/22 10/03/22 0.00 97.23 0.00 0.00 0.00 97.23
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
99213-25 -
08/24/22 Established Patient No 08/29/22 10/05/22 0.00 0.00 93.01 0.00 0.00 93.01
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
99213-25 -
07/13/22 Established Patient No 07/21/22 10/05/22 0.00 0.00 0.00 93.01 0.00 93.01
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
Patient Totals: 92.72 278.63 270.37 270.37 585.75 1,497.84
TUBRY000 Tubbergen, Ryan Group: 5803289-DC10
DOB: 05/02/1979 Insured ID: WGJ833567915
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 0.00 0.00 0.00 0.00 46.36
TUTBR000 Tuttle, Brenda Group: 073909
DOB: 11/08/1966 Insured ID: YFE845112268
98942-AT -
10/21/22 Manipulation 5 No 10/26/22 10/26/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions
Provider: Dr James Friess DC
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions
Provider: Dr James Friess DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 48.59 0.00 0.00 0.00 0.00 48.59
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
Patient Totals: 145.77 0.00 0.00 0.00 0.00 145.77
VANOL000 Vanrandwyk, Olivia Group: 428030243
DOB: 08/30/2012 Insured ID: ZIDV871785217000
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 6.36 0.00 0.00 0.00 0.00 6.36
VELAB000 Veltman, Abigail Group: 007013084
DOB: 09/12/1985 Insured ID: XYQ913423211
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 20.74 0.00 0.00 0.00 0.00 20.74
Regions
Provider: Dr James Friess DC
Patient Totals: 20.74 0.00 0.00 0.00 0.00 20.74
VELMI000 Veltman, Michael Group: 007013084
DOB: 09/30/1977 Insured ID: XYQ913423211
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 20.74 0.00 0.00 0.00 0.00 20.74
Regions
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 11/03/22 69.52 0.00 0.00 0.00 0.00 69.52
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/26/22 No 10/31/22 10/31/22 29.52 0.00 0.00 0.00 0.00 29.52
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 119.78 0.00 0.00 0.00 0.00 119.78
WEAJE000 Weaver, Jennifer Group:
DOB: 03/09/1986 Insured ID: XYQ892544042
98942-AT -
06/02/22 Manipulation 5 No 06/09/22 09/12/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
05/31/22 Manipulation 5 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
05/18/22 Manipulation 5 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
07/11/22 Manipulation 5 No 07/21/22 09/12/22 0.00 0.00 0.00 0.00 58.10 58.10
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
06/20/22 Manipulation 5 No 06/23/22 09/12/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
06/07/22 Manipulation 5 No 06/13/22 09/12/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
06/09/22 Manipulation 5 No 06/16/22 09/12/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC

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 98942-AT -
05/24/22 Manipulation 5 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Matthew Meiste DC
97032-GP-59-97 -
06/01/22 Therapy - E-Stim No 06/06/22 09/12/22 0.00 0.00 0.00 0.00 16.12 16.12
Attended
Provider: Dr Matthew Meiste DC
99213-25 -
05/18/22 Established Patient No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 88.57 88.57
Exam - 20-29 Min
Provider: Dr Matthew Meiste DC
72100 - X-ray
05/18/22 Lumbosacral 2-3 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 66.42 66.42
Views
Provider: Dr Matthew Meiste DC
97140-GP-59-97 -
Therapy-Manual
06/01/22 No 06/06/22 09/12/22 0.00 0.00 0.00 0.00 29.99 29.99
(Trigger Point,
Myofascial Release)
Provider: Dr Matthew Meiste DC
72070 - X-ray
05/18/22 Thoracic Spine - 2-3 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 54.40 54.40
Views
Provider: Dr Matthew Meiste DC
72040 - X-ray
05/18/22 Cervical Spine - 2-3 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 65.85 65.85
Views
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
06/01/22 No 06/06/22 09/12/22 0.00 0.00 0.00 0.00 32.60 32.60
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 810.84 810.84
WILDE000 Wilke-Bonette, Deborah Group: 72625
DOB: 10/20/1962 Insured ID: MJE890769661
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 55.62 0.00 0.00 0.00 0.00 55.62
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 55.62 0.00 0.00 0.00 0.00 55.62
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/19/22 Therapy- No 10/24/22 10/24/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/28/22 Therapy- No 11/03/22 11/03/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
Patient Totals: 212.28 0.00 0.00 0.00 0.00 212.28

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364 Garden Ave., Holland, MI 49424-8656
WILKE000 Williams, Kendra Group: 007013084
DOB: 07/27/1966 Insured ID: XYQ910556585
97012-GP -
10/24/22 Therapy- No 10/26/22 10/26/22 16.79 0.00 0.00 0.00 0.00 16.79
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.36 0.00 0.00 0.00 0.00 6.36
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 48.59 0.00 0.00 0.00 0.00 48.59
WINVI000 Winstrom, Victor Group: 007000562
DOB: 05/11/1950 Insured ID: XYR890841871
98941-AT -
08/02/22 Manipulation 3-4 No 08/08/22 10/24/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 09/29/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 7.76 7.76 0.00 15.52
WITDA000 Witham, Dane Group: 71350
DOB: 05/04/1987 Insured ID: RGI914322073
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 21.36 0.00 0.00 0.00 0.00 21.36
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 42.72 0.00 0.00 0.00 0.00 42.72
WREMA000 Wreschinsky, Marlene Group: 120369
DOB: 07/26/1968 Insured ID: AMR834963459
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 55.62 0.00 0.00 0.00 0.00 55.62
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97012-GP -
10/21/22 Therapy- No 10/26/22 10/26/22 13.43 0.00 0.00 0.00 0.00 13.43
Traction/Mechanical

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
Patient Totals: 106.14 0.00 0.00 0.00 0.00 106.14
ZEEPE000 Zeedyk, Peter Group: 71565
DOB: 12/31/1978 Insured ID: WYO912330553
97032-GP-59-97 -
10/24/22 Therapy - E-Stim No 10/26/22 10/26/22 15.46 0.00 0.00 0.00 0.00 15.46
Attended
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 31.28 0.00 0.00 0.00 0.00 31.28
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/24/22 No 10/26/22 10/26/22 28.77 0.00 0.00 0.00 0.00 28.77
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 75.51 0.00 0.00 0.00 0.00 75.51
ZEEME000 Zeerip, Melissa Group: 71557
DOB: 04/22/1980 Insured ID: OLZ922650313
97032-GP-59-97 -
10/24/22 Therapy - E-Stim No 10/26/22 10/26/22 13.74 0.00 0.00 0.00 0.00 13.74
Attended
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 27.81 0.00 0.00 0.00 0.00 27.81
Therapeutic
Exercise
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/24/22 No 10/26/22 10/26/22 25.58 0.00 0.00 0.00 0.00 25.58
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 67.13 0.00 0.00 0.00 0.00 67.13
ZEIJA000 Zeivel, Janice Group: 72625
DOB: 01/27/1960 Insured ID: MJEM66737936
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 37.09 0.00 0.00 0.00 0.00 37.09
Regions
Provider: Dr James Friess DC
Patient Totals: 37.09 0.00 0.00 0.00 0.00 37.09
ZUGTI000 Zugel, Tina, M Group: 71372
DOB: 01/18/1977 Insured ID: MZO922004872
97012-GP -
09/21/22 Therapy- No 09/26/22 09/26/22 0.00 16.06 0.00 0.00 0.00 16.06
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 16.06 0.00 0.00 0.00 16.06
Carrier Totals: 9,856.24 1,361.47 1,073.66 639.15 3,830.02 16,760.54
Blue Cross Complete 888-312-5713
MATST000 Mattila, Stacey Group: 00277723
DOB: 09/27/1994 Insured ID: XYU996113521
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
RONJE000 Ronne, Jessica Group: 00277723
DOB: 04/15/1977 Insured ID: XYU996092018

Parkhurst Chiropractic Life Center PLC Page 74 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
VANBR001 Vandevusse, Bridgette Group:
DOB: 04/02/1989 Insured ID: XYU996068571
98941-AT -
07/28/22 Manipulation 3-4 No 08/04/22 09/19/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/10/22 10/26/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 46.36 0.00 44.34 0.00 90.70
Carrier Totals: 45.96 46.36 0.00 44.34 0.00 136.66
Cigna
KLIJE000 Klinge, Jennifer Group: 32
DOB: 09/16/1998 Insured ID: N32550270
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 16.00 0.00 0.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 16.00 0.00 0.00 0.00 0.00 16.00
WIGER000 Wigent, Erika Group: 3174696
DOB: 04/01/1982 Insured ID: U57904186
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
97012-GP -
10/21/22 Therapy- No 10/26/22 10/26/22 12.79 0.00 0.00 0.00 0.00 12.79
Traction/Mechanical
Provider: Dr James Friess DC
Patient Totals: 49.51 0.00 0.00 0.00 0.00 49.51
Carrier Totals: 65.51 0.00 0.00 0.00 0.00 65.51
Cigna Healthcare
MUMRO000 Mummaw, Robert, E Group: 3328232
DOB: 12/11/1952 Insured ID: U1553520601
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
UZEAN000 Uzelac, Anne Group: 2003035
DOB: 03/16/2007 Insured ID: 779134551322
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 51.40 0.00 0.00 0.00 0.00 51.40
UZEDA000 Uzelac, Danica Group: 2003035
DOB: 09/14/1970 Insured ID: 779134551322
99202-25 - New
10/14/22 No 10/20/22 10/20/22 45.61 0.00 0.00 0.00 0.00 45.61
Patient Exam - 15-

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364 Garden Ave., Holland, MI 49424-8656
 29 Min
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
10/14/22 Cervical Spine - 2-3 No 10/20/22 10/20/22 49.70 0.00 0.00 0.00 0.00 49.70
Views
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
10/14/22 Thoracic Spine - 2-3 No 10/20/22 10/20/22 41.30 0.00 0.00 0.00 0.00 41.30
Views
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
10/14/22 Lumbosacral 2-3 No 10/20/22 10/20/22 50.40 0.00 0.00 0.00 0.00 50.40
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 264.11 0.00 0.00 0.00 0.00 264.11
Carrier Totals: 352.23 0.00 0.00 0.00 0.00 352.23
Cigna Healthcare 866-494-2111
BULEL000 Bullers, Elijah Group: FRC11
DOB: 08/11/2005 Insured ID: 001169066
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
FEEBR001 Feenstra, Bryan Group: 2004022
DOB: 09/30/1983 Insured ID: 779687828322
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/17/22 10/17/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
72070 - X-ray
10/07/22 Thoracic Spine - 2-3 No 10/17/22 10/17/22 0.00 59.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
10/07/22 Lumbosacral 2-3 No 10/17/22 10/17/22 0.00 72.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
 99203-25 - New
10/07/22 Patient Exam - 30- No 10/17/22 10/17/22 0.00 35.16 0.00 0.00 0.00 35.16
44 Min
Provider: Dr Russell Sweet DC
72040 - X-ray
10/07/22 Cervical Spine - 2-3 No 10/17/22 10/17/22 0.00 71.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Russell Sweet DC
Patient Totals: 20.16 273.88 0.00 0.00 0.00 294.04
VANAM004 VanderKamp, Amy Group: 00632780
DOB: 01/11/1984 Insured ID: 106586080
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98942-AT -
10/13/22 Manipulation 5 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 110.16 0.00 0.00 0.00 0.00 110.16
Carrier Totals: 167.04 273.88 0.00 0.00 0.00 440.92
CIGNA HEALTHCARE 800-438-3970
BULMA000 Bullers, Matthew Group: FRC11
DOB: 11/20/1976 Insured ID: 001169066
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
Carrier Totals: 11.72 0.00 0.00 0.00 0.00 11.72
Citizens Insurance - Attn: Claims 800-628-0250
HUNSH000 Hunter, Shane, J Group:
DOB: 03/01/2001 Insured ID: 8500233545
98941-AT -
10/28/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
97012-GP -
10/21/22 Therapy- No 10/31/22 10/31/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Jeremy Lengkeek DC
97012-GP -
10/28/22 Therapy- No 10/31/22 10/31/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Jeremy Lengkeek DC
10/14/22 97012-GP - No 10/31/22 10/31/22 24.00 0.00 0.00 0.00 0.00 24.00

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364 Garden Ave., Holland, MI 49424-8656
 Therapy-
Traction/Mechanical
Provider: Dr Jeremy Lengkeek DC
97012-GP -
10/12/22 Therapy- No 10/31/22 10/31/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/12/22 Cervical Spine - 2-3 No 10/31/22 10/31/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/12/22 Patient Exam - 30- No 10/31/22 10/31/22 133.00 0.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/12/22 Thoracic Spine - 2-3 No 10/31/22 10/31/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/12/22 Lumbosacral 2-3 No 10/31/22 10/31/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 631.00 0.00 0.00 0.00 0.00 631.00
Carrier Totals: 631.00 0.00 0.00 0.00 0.00 631.00
Frankenmuth Insurance 989-652-6121
GUYCH000 Guy, Chad Group:
DOB: 07/25/1973 Insured ID: 000200146104
99213-25 -
10/10/22 Established Patient No 10/13/22 10/13/22 98.00 0.00 0.00 0.00 0.00 98.00
Exam - 20-29 Min
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/19/22 No 10/21/22 10/21/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/23/22 No 09/26/22 10/31/22 0.00 68.00 0.00 0.00 0.00 68.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/07/22 No 10/13/22 10/13/22 0.00 70.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/10/22 No 10/13/22 10/13/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/12/22 No 10/17/22 10/17/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
10/26/22 No 10/31/22 10/31/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapy-

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 Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
11/02/22 No 11/07/22 11/07/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/26/22 10/31/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/17/22 10/26/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
11/02/22 Manipulation 3-4 No 11/07/22 11/07/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 1,108.00 238.00 0.00 0.00 0.00 1,346.00
Carrier Totals: 1,108.00 238.00 0.00 0.00 0.00 1,346.00

Parkhurst Chiropractic Life Center PLC Page 79 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Group Marketing Services 800-354-4768
KOLSH000 Kole, Shawn Group: 3025
DOB: 01/15/1978 Insured ID: 746264075
98941-AT -
02/07/22 Manipulation 3-4 No 02/08/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/27/22 Manipulation 3-4 No 02/08/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/31/22 Manipulation 3-4 No 02/08/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/25/22 Manipulation 3-4 No 01/26/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/18/22 Manipulation 3-4 No 01/20/22 10/21/22 0.00 0.00 0.00 0.00 40.04 40.04
Regions
Provider: Dr Russell Sweet DC
98941-AT -
01/13/22 Manipulation 3-4 No 01/14/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/11/22 Manipulation 3-4 No 01/12/22 10/21/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 340.04 340.04
PYLKA000 Pyle, Kathy Group: 3702
DOB: 01/26/1961 Insured ID: 733484997
98941-AT -
10/28/22 Manipulation 3-4 No 10/31/22 10/31/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 40.00 0.00 0.00 0.00 0.00 40.00
RIEJU000 Rietberg, Julia Group: 3314
DOB: 06/10/1959 Insured ID: 735388102
98941-AT -
10/11/22 Manipulation 3-4 No 10/13/22 10/13/22 30.00 0.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 30.00 0.00 0.00 0.00 0.00 30.00
RIEMC000 Rietberg, Mckenzie Group: 3314
DOB: 01/28/1998 Insured ID: 735388102
98941-AT -
11/04/22 Manipulation 3-4 No 11/07/22 11/07/22 30.00 0.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/05/22 10/05/22 0.00 30.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 30.00 30.00 0.00 0.00 0.00 60.00
VANTO000 VanNoord, Tomieka Group: 3725
DOB: 07/31/1980 Insured ID: 720068441
98941-AT -
10/04/22 Manipulation 3-4 No 10/04/22 10/04/22 0.00 30.00 0.00 0.00 0.00 30.00
Regions

Parkhurst Chiropractic Life Center PLC Page 80 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/09/22 09/09/22 0.00 0.00 30.00 0.00 0.00 30.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
11/07/22 Manipulation 3-4 No 11/07/22 11/07/22 30.00 0.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 30.00 30.00 30.00 0.00 0.00 90.00
Carrier Totals: 130.00 60.00 30.00 0.00 340.04 560.04
Hanover Citizens 800-628-0250
VANLY000 Vanderveen, Lynn Group:
DOB: 05/24/1956 Insured ID: 85-00191347001
98941-AT -
09/01/22 Manipulation 3-4 No 09/12/22 09/29/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/14/22 Therapy- No 09/19/22 09/19/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/21/22 Therapy- No 09/22/22 09/22/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/19/22 Therapy- No 09/22/22 09/22/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/16/22 Therapy- No 09/19/22 09/19/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97012-GP -
09/01/22 Therapy- No 09/12/22 09/29/22 0.00 0.00 24.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Karla A Parkhurst DC
97032-GP-59-97 -
09/13/22 Therapy - E-Stim No 09/19/22 09/19/22 0.00 18.00 0.00 0.00 0.00 18.00
Attended
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
09/01/22 Cervical Spine - 2-3 No 09/12/22 09/29/22 0.00 0.00 68.00 0.00 0.00 68.00
Views
Provider: Dr Karla A Parkhurst DC
09/01/22 72070 - X-ray No 09/12/22 09/29/22 0.00 0.00 56.50 0.00 0.00 56.50

Parkhurst Chiropractic Life Center PLC Page 81 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Thoracic Spine - 2-3
Views
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
09/13/22 No 09/19/22 09/19/22 0.00 34.00 0.00 0.00 0.00 34.00
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/13/22 No 09/19/22 09/19/22 0.00 32.00 0.00 0.00 0.00 32.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
09/01/22 Lumbosacral 2-3 No 09/12/22 09/29/22 0.00 0.00 68.50 0.00 0.00 68.50
Views
Provider: Dr Karla A Parkhurst DC
99203-25 - New
09/01/22 Patient Exam - 30- No 09/12/22 09/29/22 0.00 0.00 129.00 0.00 0.00 129.00
44 Min
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 380.00 396.00 0.00 0.00 776.00
Carrier Totals: 0.00 380.00 396.00 0.00 0.00 776.00
HAP Empowered 888-654-2200
JOHCH000 Johnson, Chloe Group:
DOB: 10/15/2001 Insured ID: 1245569060
97012-GP -
08/08/22 Therapy- No 08/11/22 09/01/22 0.00 0.00 0.00 16.06 0.00 16.06
Traction/Mechanical
Provider: Dr James Friess DC
98942-AT -
05/13/22 Manipulation 5 No 05/19/22 10/26/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr James Friess DC
98942-AT -
05/16/22 Manipulation 5 No 05/19/22 10/26/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr James Friess DC
97012-GP -
05/13/22 Therapy- No 05/19/22 10/26/22 0.00 0.00 0.00 0.00 16.12 16.12
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
08/08/22 Manipulation 3-4 No 08/11/22 09/01/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 60.40 130.06 190.46
Carrier Totals: 0.00 0.00 0.00 60.40 130.06 190.46
HEALTHSCOPE BENEFITS 800-660-6212
UNGMA000 Unglenieks, Mary Anne Group: WHIRL
DOB: 09/20/1963 Insured ID: 810191743
98941-AT -
04/27/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/29/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/20/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions

Parkhurst Chiropractic Life Center PLC Page 82 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/04/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/11/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/18/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/06/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 40.00 40.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 390.00 390.00
Carrier Totals: 0.00 0.00 0.00 0.00 390.00 390.00
Humana Medicare 866-396-8810
ANDLI001 Andersen, Linda Group: Q2945002
DOB: 11/20/1940 Insured ID: H48933108
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 12.70 0.00 0.00 0.00 0.00 12.70
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 12.70 0.00 0.00 0.00 0.00 12.70
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 25.40 0.00 0.00 0.00 0.00 25.40
FRAJA000 Frantz, Janice Group:
DOB: 09/28/1942 Insured ID: H59197889
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 12.70 0.00 0.00 0.00 0.00 12.70
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 12.70 0.00 0.00 0.00 0.00 12.70
HYDMI000 Hyde, Mikki, J Group:
DOB: 05/06/1968 Insured ID: H79488030
98942-AT -
09/08/22 Manipulation 5 No 09/14/22 09/14/22 0.00 0.00 51.35 0.00 0.00 51.35
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 51.35 0.00 0.00 51.35
TAYJO000 Taylor, John Group:
DOB: 04/07/1949 Insured ID: H41294450
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr James Friess DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr James Friess DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 12.70 0.00 0.00 0.00 0.00 12.70
Regions

Parkhurst Chiropractic Life Center PLC Page 83 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
Patient Totals: 75.40 0.00 0.00 0.00 0.00 75.40
VANLI002 Vanderkooi, Linda Group:
DOB: 06/23/1948 Insured ID: H77368486
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 51.35 0.00 0.00 0.00 0.00 51.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 51.35 0.00 0.00 0.00 0.00 51.35
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 51.35 0.00 0.00 0.00 0.00 51.35
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 154.05 0.00 0.00 0.00 0.00 154.05
VENLI000 Ventimiglia, Linda Group:
DOB: 03/12/1941 Insured ID: H60405674
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 31.35 0.00 0.00 0.00 0.00 31.35
Carrier Totals: 298.90 0.00 51.35 0.00 0.00 350.25
Independence - Aramark 877-926-2445
MONCH001 Montijo-Fradera, Christian Group:
DOB: 08/25/1993 Insured ID: LUF1601552700
98941-AT -
09/07/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
72040 - X-ray
09/07/22 Cervical Spine - 2-3 No 09/19/22 09/19/22 0.00 0.00 68.00 0.00 0.00 68.00
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
09/07/22 Lumbosacral 2-3 No 09/19/22 09/19/22 0.00 0.00 68.50 0.00 0.00 68.50
Views
Provider: Dr Russell Sweet DC
72070 - X-ray
09/07/22 Thoracic Spine - 2-3 No 09/19/22 09/19/22 0.00 0.00 56.50 0.00 0.00 56.50
Views
Provider: Dr Russell Sweet DC
99203-25 - New
09/07/22 Patient Exam - 30- No 09/19/22 09/19/22 0.00 0.00 129.00 0.00 0.00 129.00
44 Min
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 372.00 0.00 0.00 372.00
Carrier Totals: 0.00 0.00 372.00 0.00 0.00 372.00
Insight
BRAAU000 Bradfield, Audrey Group: 450
DOB: 12/14/2004 Insured ID: 45000026349
97110-GP-97 -
Therapy-
11/03/22 No 11/07/22 11/07/22 60.00 0.00 0.00 0.00 0.00 60.00
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
98941-AT -
11/03/22 Manipulation 3-4 No 11/07/22 11/07/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 100.00 0.00 0.00 0.00 0.00 100.00
BRACH001 Bradfield, Charlotte Group: 450
DOB: 04/08/2007 Insured ID: 45000026349
98941-AT -
11/03/22 Manipulation 3-4 No 11/07/22 11/07/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 40.00 0.00 0.00 0.00 0.00 40.00
BRAEM000 Bradfield, Emily Group: 450
DOB: 10/06/1981 Insured ID: 45000026349
98941-AT -
10/13/22 Manipulation 3-4 No 10/17/22 10/17/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/22/22 Manipulation 3-4 No 09/26/22 09/26/22 0.00 40.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/17/22 No 10/21/22 10/21/22 60.00 0.00 0.00 0.00 0.00 60.00
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/13/22 No 10/17/22 10/17/22 60.00 0.00 0.00 0.00 0.00 60.00
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
09/22/22 No 09/26/22 09/26/22 0.00 68.00 0.00 0.00 0.00 68.00
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 160.00 108.00 0.00 0.00 0.00 268.00
RUSKE000 Russcher, Kevin Group: 450
DOB: 02/19/1988 Insured ID: 45000026700
97012-GP -
06/01/22 Therapy- No 06/02/22 10/04/22 0.00 0.00 0.00 0.00 24.00 24.00
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
06/01/22 Manipulation 3-4 No 06/02/22 10/04/22 0.00 0.00 0.00 0.00 40.00 40.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/25/22 Manipulation 3-4 No 05/26/22 10/21/22 0.00 0.00 0.00 0.00 40.00 40.00
Regions
Provider: Dr Brian S Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
06/06/22 No 06/24/22 10/04/22 0.00 0.00 0.00 0.00 54.00 54.00
(Trigger Point,
Myofascial Release)
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 158.00 158.00
Carrier Totals: 300.00 108.00 0.00 0.00 158.00 566.00
McLaren Medicaid
PAATE000 Paauwe, Tessa Group:
DOB: 05/10/1984 Insured ID: 0088514608
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions

Parkhurst Chiropractic Life Center PLC Page 85 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
Carrier Totals: 50.00 0.00 0.00 0.00 0.00 50.00
Medica 877-842-3210
RICSC000 Richardson, Scott Group:
DOB: 02/28/1983 Insured ID: 926598569
98941-AT -
09/23/22 Manipulation 3-4 No 10/26/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/26/22 10/26/22 20.00 0.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/12/22 Manipulation 3-4 No 10/26/22 10/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 20.00 20.00 20.00 0.00 0.00 60.00
Carrier Totals: 20.00 20.00 20.00 0.00 0.00 60.00
Medicare
BACDA000 Bachleda, David Group:
DOB: 08/16/1956 Insured ID: 3PM4RR8DE91
98941-AT -
10/07/22 Manipulation 3-4 No 10/20/22 10/20/22 0.00 31.02 0.00 0.00 0.00 31.02
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 31.02 0.00 0.00 0.00 31.02
BARTR000 Bartels, Tricia Group:
DOB: 12/22/1970 Insured ID: 7PQ5PY5MX99
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 50.92 0.00 0.00 0.00 0.00 50.92
BELNA000 Bell, Nathan Group:
DOB: 10/23/1977 Insured ID: 7Y70J03JR48
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 155.12 0.00 0.00 0.00 0.00 155.12
BENTH000 Benson, Theodore Group:
DOB: 10/21/1954 Insured ID: 5YV1UV9AW12
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 31.02 0.00 0.00 0.00 0.00 31.02
Regions
Provider: Dr Russell Sweet DC
10/14/22 98941-AT - No 10/20/22 10/20/22 31.02 0.00 0.00 0.00 0.00 31.02

Parkhurst Chiropractic Life Center PLC Page 86 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 31.02 0.00 0.00 0.00 0.00 31.02
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 93.06 0.00 0.00 0.00 0.00 93.06
BERGA000 Berens, Gale, J Group:
DOB: 05/13/1936 Insured ID: 9WV7FA2KQ37
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 77.56 0.00 0.00 0.00 0.00 77.56
BLABR000 Blackman, Brenda Group:
DOB: 02/16/1950 Insured ID: 9C61PJ1HJ31
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
BOWBA000 Bowen, Barbara Group:
DOB: 06/20/1949 Insured ID: 6FY3N54RG12
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
BOWED000 Bowen, Edward Group:
DOB: 02/07/1947 Insured ID: 7XM7Q50YP49
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
BREBR000 Breuker, Bruce Group:
DOB: 04/29/1948 Insured ID: 3FK6JA3EH63
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC

Parkhurst Chiropractic Life Center PLC Page 87 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 232.68 0.00 0.00 0.00 0.00 232.68
BRESU000 Breuker, Suzann Group:
DOB: 08/16/1953 Insured ID: 8JX7WY9QX45
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 232.68 0.00 0.00 0.00 0.00 232.68
CURJU000 Curnick, Judith Group:
DOB: 07/14/1953 Insured ID: 4WQ0AE1HE44
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
DOMMA000 Dominguez, Maria Group:
DOB: 04/22/1951 Insured ID: 3FP0EX5FF34
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
ERSER000 Ersfeld, Ernest Group:
DOB: 03/20/1943 Insured ID: 5J22VW4QT05
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 50.92 0.00 0.00 0.00 0.00 50.92
ERSPA000 Ersfeld, Pamela Group:
DOB: 02/22/1944 Insured ID: 1G66K39PE70
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
HAKCA000 Hakewessell, Carl Group:
DOB: 11/05/1931 Insured ID: 8M89VP8KK35

Parkhurst Chiropractic Life Center PLC Page 88 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/14/22 Manipulation 5 No 10/20/22 10/20/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 101.84 0.00 0.00 0.00 0.00 101.84
HALDA000 Hall, David Group:
DOB: 06/01/1955 Insured ID: 9MX7VX3QQ59
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
KEMDA000 Kempt, Dawn Group:
DOB: 04/24/1966 Insured ID: 3UG2VX3VJ91
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 31.02 0.00 0.00 0.00 0.00 31.02
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 31.02 0.00 0.00 0.00 0.00 31.02
LOPJU000 Lopez, Juan Group:
DOB: 09/22/1956 Insured ID: 3GE5EE4RE84
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 31.02 0.00 0.00 0.00 0.00 31.02
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 31.02 0.00 0.00 0.00 0.00 31.02
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 62.04 0.00 0.00 0.00 0.00 62.04
ORNMI000 Orns, Michelle Group:
DOB: 06/04/1958 Insured ID: 4WH8YJ5UY44
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
RITSH000 Ritchie, Shela Group:
DOB: 09/28/1950 Insured ID: 8GD6HC0FG85
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 101.84 0.00 0.00 0.00 0.00 101.84
ROERO000 Roe, Roger Group:
DOB: 03/11/1948 Insured ID: 7PM8F60MC39
98942-AT -
06/15/22 Manipulation 5 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 50.92 50.92
ROGBA000 Rogers, Barbara Group:
DOB: 12/18/1943 Insured ID: 4JR9FM1YA12

Parkhurst Chiropractic Life Center PLC Page 89 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
09/12/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 31.02 0.00 0.00 0.00 31.02
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 31.02 0.00 0.00 0.00 31.02
SABMA000 Sabina-Goodwin, Mary Group:
DOB: 08/30/1947 Insured ID: 5PR7HD2JU37
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
SCOBR001 Scofield, Brel Group:
DOB: 10/10/1949 Insured ID: 4HF2T49WV89
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 116.34 0.00 0.00 0.00 0.00 116.34
SMIJO001 Smith, Joy, L Group:
DOB: 01/21/1953 Insured ID: 5G59WN0FP25
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
TOPNA000 Toppen, Nathan Group:
DOB: 07/02/1977 Insured ID: 5UN7JU4CY47
98942-AT -
09/29/22 Manipulation 5 No 10/03/22 10/03/22 0.00 50.92 0.00 0.00 0.00 50.92
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
05/04/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 116.34 50.92 0.00 0.00 38.78 206.04
VANGE000 VanNette, Geraldine Group:
DOB: 11/14/1926 Insured ID: 1U43GV4VN02
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
VARER000 Varvir, Erik Group:
DOB: 07/19/1962 Insured ID: 5PU1C33JR27
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
ZIEKA000 Ziemba, Karen Group:
DOB: 10/30/1949 Insured ID: 7YG4EV2QC84
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
Carrier Totals: 1,926.50 112.96 0.00 0.00 89.70 2,129.16
Medicare
BUYEL000 Buyce, Elizabeth, M Group:
DOB: 04/30/1952 Insured ID: 2PP9Y73TE23
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
KNOMY000 Knoblauch, Myra Group:
DOB: 11/12/1947 Insured ID: 7F83J16GW14
98942-AT -
10/17/22 Manipulation 5 No 10/20/22 10/20/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 50.92 0.00 0.00 0.00 0.00 50.92
KRUYV000 Kruithoff, Yvonne Group:
DOB: 03/01/1952 Insured ID: 7WF6KP5TA43
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
MANCA000 Manning, Carl Group:
DOB: 02/02/1951 Insured ID: 6J80FC8GP18
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
MANJU002 Manning, Judith Group:
DOB: 06/22/1950 Insured ID: 5EX7DD8XX45
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
MOLJU000 Molengraff, Judith Group:
DOB: 09/28/1948 Insured ID: 4NW6EJ8JN75
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78

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364 Garden Ave., Holland, MI 49424-8656
Carrier Totals: 244.82 0.00 0.00 0.00 0.00 244.82
Medicare
BARCH000 Barense, Christine Group:
DOB: 10/18/1946 Insured ID: 6P38QM9XV57
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 50.92 0.00 0.00 0.00 0.00 50.92
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 140.62 0.00 0.00 0.00 0.00 140.62
DELMI001 Delaney, Mitra Group:
DOB: 08/23/1952 Insured ID: 9DM7CF7CN47
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 11/03/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/23/22 Manipulation 3-4 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 40.00 40.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
07/13/22 Manipulation 3-4 No 07/18/22 10/05/22 0.00 0.00 0.00 40.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 09/26/22 0.00 0.00 40.00 0.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 40.00 0.00 40.00 40.00 40.00 160.00
Carrier Totals: 180.62 0.00 40.00 40.00 40.00 300.62
Medicare Plus Blue
ALBBA000 Albers, Barbara Group: 59000
DOB: 09/15/1945 Insured ID: XYL842086905
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 34.90 0.00 0.00 0.00 0.00 34.90
BEERI000 Beers, Richard Group: 59000
DOB: 01/03/1954 Insured ID: XYL991451077
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 34.90 0.00 0.00 0.00 0.00 34.90
GRUAN000 Gruppen, Angeline Group: 60325
DOB: 10/16/1930 Insured ID: XYL993595512
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
HARJI002 Hardy, Jill Group: 59000
DOB: 01/17/1956 Insured ID: XYL992208052

Parkhurst Chiropractic Life Center PLC Page 92 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/03/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 34.90 0.00 0.00 0.00 34.90
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 34.90 0.00 0.00 0.00 34.90
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 34.90 0.00 0.00 0.00 34.90
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 139.60 104.70 0.00 0.00 0.00 244.30
HARJI001 Harry, Jill Group: 35894
DOB: 11/02/1952 Insured ID: XYL991598318
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 19.39 0.00 0.00 0.00 0.00 19.39
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 19.39 0.00 0.00 0.00 0.00 19.39
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
HOAMA000 Hoadley, Margaret Group: 60325
DOB: 01/03/1941 Insured ID: XYL991626561
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Karla A Parkhurst DC
99212-25 -
10/31/22 Established Patient No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
10/31/22 Thoracic Spine - 2-3 No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
10/31/22 Cervical Spine - 2-3 No 11/03/22 11/03/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
10/31/22 Lumbosacral 2-3 No 11/03/22 11/03/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 299.78 0.00 0.00 0.00 0.00 299.78

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364 Garden Ave., Holland, MI 49424-8656
JACWI000 Jacobs, William, H Group: 59000
DOB: 07/23/1946 Insured ID: XYL842109553
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr James Friess DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr James Friess DC
Patient Totals: 69.80 0.00 0.00 0.00 0.00 69.80
LOOMA001 Looman, Marla Group:
DOB: 09/21/1956 Insured ID: XYL993461922
98942-AT -
10/13/22 Manipulation 5 No 10/20/22 10/20/22 31.35 0.00 0.00 0.00 0.00 31.35
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 31.35 0.00 0.00 0.00 0.00 31.35
MCIJU000 Mcinerney, Juliet Group: 59000
DOB: 05/27/1948 Insured ID: XYL910031008
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
SIMLI000 Simmons, Linda Group: 59000
DOB: 04/30/1949 Insured ID: XYL842795518
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 69.80 0.00 0.00 0.00 0.00 69.80
SKUPA000 Skutt, Patricia Group: 35894
DOB: 11/24/1956 Insured ID: XYL993479162
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 18.78 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 19.39 0.00 0.00 0.00 0.00 19.39
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 19.39 18.78 0.00 0.00 0.00 38.17
SMIMA001 Smith, Mary Group: 59000
DOB: 08/21/1931 Insured ID: XYL911952499
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 34.90 0.00 0.00 0.00 0.00 34.90
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 34.90 0.00 0.00 0.00 0.00 34.90
VANSC001 Vanleuwen, Scott Group: 59000
DOB: 01/22/1948 Insured ID: XYL842175045
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78

Parkhurst Chiropractic Life Center PLC Page 94 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
WINVI000 Winstrom, Victor Group: 35894
DOB: 05/11/1950 Insured ID: XYL993634134
98941-AT -
10/04/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 18.78 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 18.78 0.00 0.00 0.00 37.56
WISRI000 Wissink, Ricky Group: 51623
DOB: 09/08/1953 Insured ID: XYL991427217
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 19.39 0.00 0.00 0.00 0.00 19.39
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.39 0.00 0.00 0.00 0.00 19.39
WITSU000 Wittenbach, Susan Group: 26532
DOB: 10/10/1946 Insured ID: XYL993303171
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/13/22 0.00 19.39 0.00 0.00 0.00 19.39
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/03/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 19.39 0.00 0.00 0.00 19.39
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 19.39 0.00 0.00 0.00 0.00 19.39
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.39 38.78 0.00 0.00 0.00 58.17
Carrier Totals: 947.10 181.04 0.00 0.00 0.00 1,128.14
Meridian Medicaid
ANDDA000 Anderson, Darren Group:
DOB: 12/31/1968 Insured ID: 0035188148
98942-AT -
10/12/22 Manipulation 5 No 10/17/22 10/17/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 30.11 0.00 0.00 0.00 0.00 30.11
ANDJU000 Anderson, Julie Group:
DOB: 05/28/1973 Insured ID: 0035188139
98942-AT -
10/12/22 Manipulation 5 No 10/17/22 10/17/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 30.11 0.00 0.00 0.00 0.00 30.11
BRUTE000 Bruursema, Teague Group:
DOB: 11/09/2009 Insured ID: 1021476701
99202-25 - New
10/25/21 Patient Exam - 15- No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 65.16 65.16
29 Min
Provider: Dr James Friess DC
98941-AT -
10/25/21 Manipulation 3-4 No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
11/24/21 Manipulation 3-4 No 11/30/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72

Parkhurst Chiropractic Life Center PLC Page 95 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr James Friess DC
98941-AT -
11/04/21 Manipulation 3-4 No 11/09/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
11/11/21 Manipulation 3-4 No 11/16/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/21 Manipulation 3-4 No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
72100 - X-ray
10/25/21 Lumbosacral 2-3 No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 52.26 52.26
Views
Provider: Dr James Friess DC
72040 - X-ray
10/25/21 Cervical Spine - 2-3 No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 49.59 49.59
Views
Provider: Dr James Friess DC
72070 - X-ray
10/25/21 Thoracic Spine - 2-3 No 11/04/21 10/20/22 0.00 0.00 0.00 0.00 50.66 50.66
Views
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 401.27 401.27
CLAGR000 Clark, Grayson Group:
DOB: 07/21/2022 Insured ID: 1274948579
99202-25 - New
10/19/22 Patient Exam - 15- No 10/31/22 10/31/22 42.00 0.00 0.00 0.00 0.00 42.00
29 Min
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 110.94 0.00 0.00 0.00 0.00 110.94
DAWNA000 Dawson, Natley Group:
DOB: 02/21/1978 Insured ID: 1071803198
98941-AT -
10/24/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/24/22 Patient Exam - 30- No 10/31/22 10/31/22 65.17 0.00 0.00 0.00 0.00 65.17
44 Min
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/24/22 Lumbosacral 2-3 No 10/31/22 10/31/22 72.00 0.00 0.00 0.00 0.00 72.00
Views

Parkhurst Chiropractic Life Center PLC Page 96 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/24/22 Thoracic Spine - 2-3 No 10/31/22 10/31/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/24/22 Cervical Spine - 2-3 No 10/31/22 10/31/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 313.13 0.00 0.00 0.00 0.00 313.13
WALMA001 Walker, Maryellen Group:
DOB: 02/18/1992 Insured ID: 1124746957
98942-AT -
03/18/22 Manipulation 5 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
03/21/22 Manipulation 5 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
04/22/22 Manipulation 5 No 04/28/22 10/05/22 0.00 0.00 0.00 0.00 10.18 10.18
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
04/18/22 Manipulation 5 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 33.64 33.64
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
03/25/22 Manipulation 5 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
03/28/22 Manipulation 5 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
99212-25 -
03/28/22 Established Patient No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 55.00 55.00
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
03/28/22 Thoracic Spine - 2-3 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 56.00 56.00
Views
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
03/28/22 Cervical Spine - 2-3 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 66.00 66.00
Views
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
03/28/22 Lumbosacral 2-3 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 68.00 68.00
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 492.50 492.50
Carrier Totals: 484.29 0.00 0.00 0.00 893.77 1,378.06
Meritain Health 800-397-2122
VANTH000 Vanderby, Thomas Group: 17033
DOB: 03/30/1960 Insured ID: 3617541258
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 1.46 0.00 0.00 0.00 0.00 1.46
Regions
Provider: Dr James Friess DC
Patient Totals: 1.46 0.00 0.00 0.00 0.00 1.46

Parkhurst Chiropractic Life Center PLC Page 97 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Carrier Totals: 1.46 0.00 0.00 0.00 0.00 1.46
Michigan Medicaid
ARRCA000 Arreola, Carrie Group:
DOB: 09/22/1975 Insured ID: 0089307859
98941-AT -
04/01/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
03/30/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 20.00 20.00
BERPE000 Berens, Penny Group:
DOB: 05/25/1942 Insured ID: 0010253390
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 10/24/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/08/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 15.52 0.00 0.00 15.52
BOSRO000 Bosley, Rose Group:
DOB: 07/03/1965 Insured ID: 0007758454
98941-AT -
08/25/22 Manipulation 3-4 No 08/29/22 10/31/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr James Friess DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/22/22 Manipulation 3-4 No 09/26/22 10/31/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr James Friess DC
98941-AT -
06/02/22 Manipulation 3-4 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/21/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
04/14/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
04/07/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
98942-AT -
08/11/22 Manipulation 5 No 08/15/22 10/24/22 0.00 0.00 10.18 0.00 0.00 10.18
Regions
Provider: Dr James Friess DC
98941-AT -
01/07/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
01/13/22 Manipulation 3-4 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 15.52 17.94 0.00 210.62 244.08
BRILI000 Britton-Burnham, Lillian Group:
DOB: 10/09/1938 Insured ID: 0042883776
98941-AT -
01/11/22 Manipulation 3-4 No 01/14/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/20/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/01/22 Manipulation 3-4 No 02/08/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/24/22 Manipulation 3-4 No 03/03/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
03/22/22 Manipulation 3-4 No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/16/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/02/22 Manipulation 3-4 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/05/22 Manipulation 3-4 No 07/11/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/28/22 Manipulation 3-4 No 07/06/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/21/22 Manipulation 3-4 No 06/28/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/12/22 Manipulation 3-4 No 07/18/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/19/22 Manipulation 3-4 No 07/25/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 60.00 200.00 260.00
BRUKA000 Bruursema, Kara Group:
DOB: 09/05/1981 Insured ID: 0025344768
04/25/22 98941-AT - No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 7.34 7.34

Parkhurst Chiropractic Life Center PLC Page 99 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr James Friess DC
98941-AT -
05/26/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 7.34 7.34
Regions
Provider: Dr James Friess DC
98941-AT -
06/15/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 7.34 7.34
Regions
Provider: Dr James Friess DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/24/22 0.00 0.00 7.34 0.00 0.00 7.34
Regions
Provider: Dr James Friess DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 10/24/22 0.00 0.00 0.00 7.34 0.00 7.34
Regions
Provider: Dr James Friess DC
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 7.34 0.00 7.34
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 7.34 14.68 22.02 44.04
BUIRO000 Buikema, Robert Group:
DOB: 11/14/2006 Insured ID: 0034740902
98941-AT -
07/19/22 Manipulation 3-4 No 07/25/22 10/19/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 36.72 0.00 36.72
BULEL000 Bullers, Elijah Group:
DOB: 08/11/2005 Insured ID: 0030393235
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/31/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/04/22 Manipulation 3-4 No 10/10/22 10/31/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/11/22 Manipulation 3-4 No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/20/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 25.00 0.00 25.00
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 50.00 25.00 25.00 75.00 175.00
BUNJA000 Bunker, Jami Group:

Parkhurst Chiropractic Life Center PLC Page 100 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
DOB: 01/03/1978 Insured ID: 94788633100
98941-AT -
09/26/22 Manipulation 3-4 No 09/29/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/20/22 Manipulation 3-4 No 07/25/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/27/22 Manipulation 3-4 No 08/01/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
99202-25 - New
07/20/22 Patient Exam - 15- No 07/25/22 10/24/22 0.00 0.00 0.00 91.00 0.00 91.00
29 Min
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
07/20/22 Thoracic Spine - 2-3 No 07/25/22 10/24/22 0.00 0.00 0.00 56.50 0.00 56.50
Views
Provider: Dr Brian S Parkhurst DC
72040 - X-ray
07/20/22 Cervical Spine - 2-3 No 07/25/22 10/24/22 0.00 0.00 0.00 68.00 0.00 68.00
Views
Provider: Dr Brian S Parkhurst DC
72100 - X-ray
07/20/22 Lumbosacral 2-3 No 07/25/22 10/24/22 0.00 0.00 0.00 68.50 0.00 68.50
Views

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 100.00 40.00 384.00 0.00 524.00
CALAL000 Calderon, Alexa Group:
DOB: 06/14/2004 Insured ID: 1273684814
98942-AT -
08/29/22 Manipulation 5 No 09/01/22 10/24/22 0.00 0.00 22.99 0.00 0.00 22.99
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/01/22 Manipulation 5 No 09/07/22 10/24/22 0.00 0.00 22.99 0.00 0.00 22.99
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 45.98 0.00 0.00 45.98
CHRJO000 Christiansen, Joan Group:
DOB: 02/03/1949 Insured ID: 0089085282
98941-AT -
01/20/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
03/03/22 Manipulation 3-4 No 03/07/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 77.56 77.56
CHRLA000 Christiansen, Lawrence Group:
DOB: 07/30/1971 Insured ID: 1025059449
98942-AT -
09/28/22 Manipulation 5 No 10/03/22 10/24/22 0.00 9.20 0.00 0.00 0.00 9.20
Regions
Provider: Dr James Friess DC
98942-AT -
08/10/22 Manipulation 5 No 08/15/22 10/24/22 0.00 0.00 0.00 9.20 0.00 9.20
Regions
Provider: Dr James Friess DC
98942-AT -
08/17/22 Manipulation 5 No 08/22/22 10/24/22 0.00 0.00 9.20 0.00 0.00 9.20
Regions
Provider: Dr James Friess DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 16.20 9.20 9.20 0.00 34.60
CLOSH000 Clouse, Sharon Group:
DOB: 02/01/1947 Insured ID: 0007474264
98941-AT -
08/18/22 Manipulation 3-4 No 08/25/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 7.00 0.00 0.00 7.00
CONTR000 Cone, Trevor, C Group:
DOB: 07/17/2000 Insured ID: 0013302443
98941-AT -
01/03/22 Manipulation 3-4 No 01/07/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 38.78 38.78
CRORE000 Cross, Renee Group:
DOB: 02/22/1976 Insured ID: 1228051181
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 46.36 0.00 0.00 0.00 46.36
CRUAL000 Cruz, Alicia Group:
DOB: 07/23/1997 Insured ID: 0021819783
97110-GP-97 -
Therapy-
09/15/22 No 09/22/22 10/24/22 0.00 30.00 0.00 0.00 0.00 30.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
02/21/22 Manipulation 3-4 No 02/24/22 10/20/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
03/21/22 Manipulation 3-4 No 03/25/22 10/21/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/13/21 Manipulation 3-4 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
01/10/22 Manipulation 3-4 No 01/14/22 10/20/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/23/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 29.14 0.00 29.14
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/24/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 30.00 0.00 29.14 174.84 233.98
DAUAL000 Dauphinais, Alayna, M Group:
DOB: 06/22/2016 Insured ID: 1177643657
99202-25 - New
05/19/22 Patient Exam - 15- No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 3.28 3.28
29 Min
Provider: Dr James Friess DC
98940-AT -
05/19/22 Manipulation 1-2 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 40.00 40.00
DAVAN000 Davis, Andrea Group:
DOB: 05/10/1972 Insured ID: 0086518626
98941-AT -
09/22/22 Manipulation 3-4 No 09/26/22 10/31/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 7.76 0.00 0.00 0.00 7.76
DEKIN000 Dekker, Ina Group:
DOB: 04/03/1953 Insured ID: 0008679327
98942-AT -
01/31/22 Manipulation 5 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 9.20 9.20
Regions
Provider: Dr Brian S Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
 99202-25 - New
01/31/22 Patient Exam - 15- No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 86.00 86.00
29 Min
Provider: Dr Brian S Parkhurst DC
72082 - X-Ray Full
01/31/22 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 10.00 10.00
Spine - 2-3 views
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 105.20 105.20
DOMMA000 Dominguez, Maria Group:
DOB: 04/22/1951 Insured ID: 0059637488
98941-AT -
01/20/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 38.78 38.78
DREQU000 Drew, Quinn Group:
DOB: 04/27/2003 Insured ID: 0022592324
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 11/03/22 20.00 0.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
03/15/22 Manipulation 3-4 No 03/21/22 10/26/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/24/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/26/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/07/22 Manipulation 3-4 No 09/12/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/13/22 Manipulation 3-4 No 07/18/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/21/22 Manipulation 3-4 No 06/28/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/27/22 Manipulation 3-4 No 08/01/22 10/24/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/17/22 Manipulation 3-4 No 08/22/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 20.00 0.00 40.00 40.00 80.00 180.00
EVAIS000 Evans, Isabel Group:
DOB: 04/18/2004 Insured ID: 0032691890
99212-25 -
04/27/22 Established Patient No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Exam - 10-19 Min
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 20.00 20.00
EVAZO000 Evans, Zoe Group:

Parkhurst Chiropractic Life Center PLC Page 104 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
DOB: 04/05/2006 Insured ID: 0032691890
98942-AT -
04/27/22 Manipulation 5 No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 20.00 20.00
FITJO000 Fitzhugh, Joey Group:
DOB: 07/17/1955 Insured ID: 0000385748
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/05/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/25/22 10/24/22 0.00 0.00 0.00 7.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/22/22 Manipulation 3-4 No 08/25/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/20/22 Manipulation 3-4 No 09/26/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
99203-25 - New
08/10/22 Patient Exam - 30- No 08/25/22 10/24/22 0.00 0.00 0.00 129.00 0.00 129.00
44 Min
Provider: Dr Russell Sweet DC
72070 - X-ray
08/10/22 Thoracic Spine - 2-3 No 08/25/22 10/24/22 0.00 0.00 0.00 8.80 0.00 8.80
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
08/10/22 Lumbosacral 2-3 No 08/25/22 10/24/22 0.00 0.00 0.00 9.00 0.00 9.00
Views
Provider: Dr Russell Sweet DC
72040 - X-ray
08/10/22 Cervical Spine - 2-3 No 08/25/22 10/24/22 0.00 0.00 0.00 8.30 0.00 8.30
Views
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 28.00 14.00 162.10 0.00 204.10
FORRA000 Forslund, Rachel, N Group:
DOB: 09/11/1988 Insured ID: 1182285997
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/24/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/24/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC

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 98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 3.67 0.00 3.67
Regions
Provider: Dr James Friess DC
98941-AT -
07/11/22 Manipulation 3-4 No 07/18/22 10/24/22 0.00 0.00 0.00 0.00 3.67 3.67
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 73.44 0.00 3.67 3.67 80.78
FOSDA000 Foster, Dana, J Group:
DOB: 11/29/1996 Insured ID: 0096460314
98941-AT -
09/07/22 Manipulation 3-4 No 09/12/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/31/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/31/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 100.00 100.00 0.00 0.00 200.00
GARJO003 Garcia, Josefina Group:
DOB: 03/02/1938 Insured ID: 0035761218
98942-AT -
09/16/22 Manipulation 5 No 09/22/22 10/24/22 0.00 9.20 0.00 0.00 0.00 9.20
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
08/24/22 Manipulation 5 No 08/29/22 10/24/22 0.00 0.00 9.20 0.00 0.00 9.20
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
08/15/22 Manipulation 5 No 08/22/22 10/24/22 0.00 0.00 9.20 0.00 0.00 9.20
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 9.20 18.40 0.00 0.00 27.60
GARAR000 Gardea, Araceli Group:
DOB: 06/05/1969 Insured ID: 1039366138
98941-AT -
09/07/22 Manipulation 3-4 No 09/14/22 10/26/22 0.00 0.00 20.00 0.00 0.00 20.00

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
03/11/22 Manipulation 3-4 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 1.12 1.12
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 40.00 20.00 0.00 1.12 61.12
GARRA000 Gardea, Rafael Group:
DOB: 06/26/1970 Insured ID: 1039365963
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/07/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 40.00 20.00 0.00 0.00 60.00
HYDMI000 Hyde, Mikki, J Group:
DOB: 05/06/1968 Insured ID: 0075475502
98942-AT -
08/17/22 Manipulation 5 No 08/22/22 10/31/22 0.00 0.00 8.66 0.00 0.00 8.66
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 8.66 0.00 0.00 8.66
KAIOL000 Kairney, Olivia Group:
DOB: 05/26/1987 Insured ID: 1024880488
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 11/03/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/06/22 Manipulation 3-4 No 06/09/22 11/03/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 7.00 0.00 7.00 14.00
KHOSA000 Khounlameth, Samantha Group:
DOB: 07/22/1993 Insured ID: 0040935739
98941-AT -
07/15/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 40.00 0.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/24/22 0.00 0.00 0.00 0.00 40.00 40.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 40.00 40.00 80.00
KNOAD000 Knowles, Adriana Group:
DOB: 08/11/2007 Insured ID: 0037158102
04/27/22 99202-25 - New No 05/16/22 10/21/22 0.00 0.00 0.00 0.00 3.28 3.28

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364 Garden Ave., Holland, MI 49424-8656
 Patient Exam - 15-
29 Min
Provider: Dr Russell Sweet DC
98941-AT -
04/27/22 Manipulation 3-4 No 05/16/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 40.00 40.00
LILCY000 Lilley, Cynthia Group:
DOB: 07/02/1967 Insured ID: 0007858991
98941-AT -
12/10/21 Manipulation 3-4 No 12/14/21 10/20/22 0.00 0.00 0.00 0.00 7.82 7.82
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 7.82 7.82
MARAN000 Martinez, Angie, M Group:
DOB: 09/09/1975 Insured ID: 1204141194
98942-AT -
09/27/22 Manipulation 5 No 10/03/22 10/24/22 0.00 60.00 0.00 0.00 0.00 60.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
05/27/22 Manipulation 5 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
05/20/22 Manipulation 5 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
05/24/22 Manipulation 5 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
06/07/22 Manipulation 5 No 06/13/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
06/10/22 Manipulation 5 No 06/16/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
05/10/22 Manipulation 5 No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
08/30/22 Manipulation 5 No 09/07/22 10/24/22 0.00 0.00 58.10 0.00 0.00 58.10
Regions
Provider: Dr Russell Sweet DC
98942-AT -
09/13/22 Manipulation 5 No 09/14/22 10/24/22 0.00 60.00 0.00 0.00 0.00 60.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
07/19/22 Manipulation 5 No 07/25/22 10/24/22 0.00 0.00 0.00 58.10 0.00 58.10
Regions
Provider: Dr Russell Sweet DC
98942-AT -
06/17/22 Manipulation 5 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr Russell Sweet DC
98942-AT -
06/21/22 Manipulation 5 No 06/28/22 10/24/22 0.00 0.00 0.00 0.00 56.97 56.97

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 Regions
Provider: Dr Russell Sweet DC
98942-AT -
08/02/22 Manipulation 5 No 08/08/22 10/24/22 0.00 0.00 0.00 58.10 0.00 58.10
Regions
Provider: Dr Russell Sweet DC
98942-AT -
08/09/22 Manipulation 5 No 08/15/22 10/24/22 0.00 0.00 0.00 58.10 0.00 58.10
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 120.00 58.10 174.30 455.76 808.16
MEYMI000 Meyers, Michelle Group:
DOB: 06/30/1977 Insured ID: 0036388686
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/24/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 14.00 21.00 0.00 0.00 35.00
NIEAD000 Nienhuis, Adam Group:
DOB: 12/13/1985 Insured ID: 1023583059
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/04/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
06/03/22 Manipulation 3-4 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/08/22 Manipulation 3-4 No 06/13/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions

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Provider: Dr James Friess DC
98941-AT -
06/10/22 Manipulation 3-4 No 06/16/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/27/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
07/06/22 Manipulation 3-4 No 07/11/22 10/24/22 0.00 0.00 0.00 0.00 3.67 3.67
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 334.15 334.15
NIEAN000 Nienhuis, Anna Group:
DOB: 09/08/1988 Insured ID: 1258131757
98941-AT -
06/06/22 Manipulation 3-4 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/18/22 Manipulation 3-4 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 183.60 183.60
NIEIS000 Nienhuis, Isaiah Group:
DOB: 12/24/2020 Insured ID: 1258133573
98940-AT -
04/22/22 Manipulation 1-2 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98940-AT -
06/06/22 Manipulation 1-2 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 73.44 73.44
NOEJO000 Noe, Josephine Group:
DOB: 12/27/2000 Insured ID: 0014070011
98942-AT -
06/08/22 Manipulation 5 No 06/13/22 10/31/22 0.00 0.00 0.00 0.00 60.00 60.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 60.00 60.00
PAAVI000 Paauwe, Vicki Group:
DOB: 09/13/1955 Insured ID: 1030970007
98941-AT -
01/27/22 Manipulation 3-4 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Matthew Meiste DC
01/25/22 98941-AT - No 02/01/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 77.56 77.56
PEDJO000 Pedraza, Josie Group:
DOB: 01/15/2002 Insured ID: 0017850114
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
RETMI000 Rettler, Mia Group:
DOB: 05/03/1998 Insured ID: 0015224149
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 11/03/22 20.00 0.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
03/22/22 Manipulation 5 No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 25.46 25.46
Regions
Provider: Dr Matthew Meiste DC
98942-AT -
12/20/21 Manipulation 5 No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
12/03/21 Manipulation 5 No 12/07/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
11/18/21 Manipulation 5 No 11/23/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
01/26/22 Manipulation 5 No 02/01/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 20.00 0.00 0.00 0.00 105.46 125.46
RUGSY000 Ruger, Sydnee Group:
DOB: 01/01/1995 Insured ID: 0017992066
98941-AT -
05/18/22 Manipulation 3-4 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
RUGTA000 Ruger, Tauren Group:
DOB: 10/22/2020 Insured ID: 1254790618
98940-AT -
05/18/22 Manipulation 1-2 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
SANCH001 Sanders, Charles, A Group:
DOB: 08/01/1986 Insured ID: 1267202105
98941-AT -
08/30/22 Manipulation 3-4 No 09/07/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
08/05/22 Manipulation 1-2 No 08/17/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC

Parkhurst Chiropractic Life Center PLC Page 111 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98940-AT -
08/12/22 Manipulation 1-2 No 08/17/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
08/17/22 Manipulation 1-2 No 08/22/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
09/09/22 Manipulation 1-2 No 09/14/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
08/23/22 Manipulation 1-2 No 08/29/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/09/22 Manipulation 3-4 No 08/17/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
08/05/22 Thoracic Spine - 2-3 No 08/17/22 10/24/22 0.00 0.00 0.00 50.66 0.00 50.66
Views
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
08/05/22 Cervical Spine - 2-3 No 08/17/22 10/24/22 0.00 0.00 0.00 49.59 0.00 49.59
Views
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
08/05/22 Lumbosacral 2-3 No 08/17/22 10/24/22 0.00 0.00 0.00 52.26 0.00 52.26
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
08/05/22 Patient Exam - 30- No 08/17/22 10/24/22 0.00 0.00 0.00 65.16 0.00 65.16
44 Min
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 183.60 291.11 0.00 474.71
SIALA000 Siadak, Laura Group:
DOB: 09/28/1955 Insured ID: 0028398923
98941-AT -
09/26/22 Manipulation 3-4 No 09/29/22 10/18/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/24/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/26/22 20.00 0.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/18/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 10/18/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/21/22 Manipulation 3-4 No 07/28/22 10/18/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 112 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
08/01/22 Manipulation 3-4 No 08/04/22 10/18/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/03/22 Manipulation 3-4 No 08/08/22 10/18/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/07/22 Manipulation 3-4 No 07/13/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/22/22 Manipulation 3-4 No 06/28/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/24/22 Manipulation 3-4 No 06/28/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/29/22 Manipulation 3-4 No 07/06/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/18/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 10/18/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/22/22 Manipulation 3-4 No 08/25/22 10/18/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
99212-25 -
08/22/22 Established Patient No 08/25/22 10/18/22 0.00 0.00 57.00 0.00 0.00 57.00
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 10/18/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/07/22 10/18/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/18/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 10/18/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/07/22 Manipulation 3-4 No 09/12/22 10/24/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 113 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
01/27/22 Manipulation 3-4 No 02/03/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/10/22 Manipulation 3-4 No 01/14/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
01/17/22 Manipulation 3-4 No 01/20/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
01/03/22 Manipulation 3-4 No 01/07/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/04/22 Manipulation 3-4 No 01/07/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/25/22 Manipulation 3-4 No 03/31/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/01/22 Manipulation 3-4 No 04/05/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/05/22 Manipulation 3-4 No 04/11/22 10/19/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/08/22 Manipulation 3-4 No 04/14/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/06/22 Manipulation 3-4 No 04/11/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
03/17/22 Manipulation 3-4 No 03/25/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
03/15/22 Manipulation 3-4 No 03/21/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
03/22/22 Manipulation 3-4 No 03/28/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
02/25/22 Manipulation 3-4 No 03/03/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
02/28/22 Manipulation 3-4 No 03/03/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
03/01/22 Manipulation 3-4 No 03/07/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC

Parkhurst Chiropractic Life Center PLC Page 114 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
03/14/22 Manipulation 3-4 No 03/17/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/11/22 Manipulation 3-4 No 03/17/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
03/08/22 Manipulation 3-4 No 03/14/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
02/07/22 Manipulation 3-4 No 02/10/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
02/01/22 Manipulation 3-4 No 02/08/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
02/04/22 Manipulation 3-4 No 02/10/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
02/11/22 Manipulation 3-4 No 02/17/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
02/15/22 Manipulation 3-4 No 02/21/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
02/22/22 Manipulation 3-4 No 02/28/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/13/22 Manipulation 3-4 No 05/19/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/12/22 Manipulation 3-4 No 04/18/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
04/18/22 Manipulation 3-4 No 04/21/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/20/22 Manipulation 3-4 No 04/25/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 115 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
04/25/22 Manipulation 3-4 No 04/28/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/28/22 Manipulation 3-4 No 05/05/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/03/22 Manipulation 3-4 No 06/09/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/06/22 Manipulation 3-4 No 06/09/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/08/22 Manipulation 3-4 No 06/13/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/15/22 Manipulation 3-4 No 06/23/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/13/22 Manipulation 3-4 No 06/16/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/10/22 Manipulation 3-4 No 06/16/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/26/22 Manipulation 3-4 No 06/02/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/02/22 Manipulation 3-4 No 06/09/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/01/22 Manipulation 3-4 No 06/06/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/23/22 Manipulation 3-4 No 05/26/22 10/18/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
08/22/22 Cervical Spine - 2-3 No 08/25/22 10/18/22 0.00 0.00 35.00 0.00 0.00 35.00
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 20.00 100.00 212.00 80.00 980.00 1,392.00
SILAD000 Silveira, Adahlia Group:
DOB: 11/16/2013 Insured ID: 1218577181
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
07/11/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC

Parkhurst Chiropractic Life Center PLC Page 116 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 99202-25 - New
07/11/22 Patient Exam - 15- No 07/21/22 10/24/22 0.00 0.00 0.00 0.00 65.16 65.16
29 Min
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 36.72 101.88 138.60
SILEV000 Silveira, Evangelia Group:
DOB: 11/27/2011 Insured ID: 1218577163
99202-25 - New
07/11/22 Patient Exam - 15- No 07/21/22 10/24/22 0.00 0.00 0.00 0.00 65.16 65.16
29 Min
Provider: Dr James Friess DC
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98942-AT -
07/11/22 Manipulation 5 No 07/21/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 36.72 101.88 138.60
SMIMI001 Smith, Miriam Group:
DOB: 02/18/1955 Insured ID: 0091718163
98942-AT -
01/21/22 Manipulation 5 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr James Friess DC
98941-AT -
02/04/22 Manipulation 3-4 No 04/21/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
98941-AT -
01/06/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 128.48 128.48
SMISH000 Smith, Shonda, K Group:
DOB: 02/21/1975 Insured ID: 0079234463
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/11/22 Manipulation 3-4 No 07/18/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/13/22 Manipulation 3-4 No 07/18/22 10/24/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/19/22 Manipulation 3-4 No 07/25/22 10/24/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/06/22 Manipulation 3-4 No 07/11/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 7.76 0.00 7.76

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 23.28 31.04 54.32
SOMZA000 Somsouphanh, Zachary Group:
DOB: 03/23/2003 Insured ID: 0022172811
99202-25 - New
08/04/22 Patient Exam - 15- No 08/11/22 10/24/22 0.00 0.00 0.00 3.28 0.00 3.28
29 Min
Provider: Dr James Friess DC
98941-AT -
08/04/22 Manipulation 3-4 No 08/11/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/31/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/25/22 Manipulation 3-4 No 09/01/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/15/22 Manipulation 3-4 No 09/22/22 10/24/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/22/22 Manipulation 3-4 No 09/29/22 10/24/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/19/22 Manipulation 3-4 No 08/25/22 10/24/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/12/22 Manipulation 3-4 No 08/17/22 10/31/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
08/08/22 Manipulation 3-4 No 08/11/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 110.16 146.88 113.44 0.00 370.48
STACH002 Stanley, Chad Group:
DOB: 03/01/1979 Insured ID: 0024193865
98941-AT -
05/23/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr James Friess DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/24/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/18/22 Manipulation 3-4 No 02/24/22 10/26/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/05/22 Manipulation 3-4 No 07/11/22 10/24/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 35.00 35.00
THRAL000 Thrush, Alyssa Group:
DOB: 03/12/2004 Insured ID: 0025744484
98941-AT -
12/28/21 Manipulation 3-4 No 12/30/21 10/20/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
01/04/22 Manipulation 3-4 No 01/07/22 10/20/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 100.00 100.00
TOKCH000 Tokarczyk, Charlene Group:
DOB: 03/25/1957 Insured ID: 1242618250
98942-AT -
08/19/22 Manipulation 5 No 08/25/22 10/24/22 0.00 0.00 8.66 0.00 0.00 8.66
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 8.66 0.00 0.00 8.66
USHAN000 Usher, Angela Group:
DOB: 07/01/1983 Insured ID: 0011867356
98941-AT -
12/10/21 Manipulation 3-4 No 12/14/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
12/15/21 Manipulation 3-4 No 12/21/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
11/24/21 Manipulation 3-4 No 11/30/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
01/12/22 Manipulation 3-4 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
01/05/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
01/19/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
01/24/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/04/22 Manipulation 3-4 No 02/10/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
02/11/22 98941-AT - No 02/17/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr James Friess DC
98941-AT -
02/21/22 Manipulation 3-4 No 02/24/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/28/22 Manipulation 3-4 No 03/03/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/23/22 Manipulation 3-4 No 03/28/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/14/22 Manipulation 3-4 No 03/17/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/31/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/04/22 Manipulation 3-4 No 04/07/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/25/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/18/22 Manipulation 3-4 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/02/22 Manipulation 3-4 No 06/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/08/22 Manipulation 3-4 No 06/13/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/12/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
05/05/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/21/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/28/22 Manipulation 3-4 No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98942-AT -
03/07/22 Manipulation 5 No 03/10/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 881.28 881.28

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364 Garden Ave., Holland, MI 49424-8656
VALNA000 Valero, Nash Group:
DOB: 02/04/2006 Insured ID: 0034242454
98941-AT -
09/07/22 Manipulation 3-4 No 09/14/22 09/14/22 0.00 0.00 22.98 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 22.98 0.00 0.00 22.98
VALNO000 Valero, Nolan Group:
DOB: 06/09/2002 Insured ID: 0019433620
98941-AT -
09/08/22 Manipulation 3-4 No 09/14/22 09/14/22 0.00 0.00 22.98 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/02/22 09/02/22 0.00 0.00 22.98 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 45.96 0.00 0.00 45.96
VANBI000 Vanbrocklin, Bianca Group:
DOB: 08/21/2001 Insured ID: 0016402316
98942-AT -
06/13/22 Manipulation 5 No 06/16/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
06/08/22 Manipulation 5 No 06/13/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/30/22 Manipulation 3-4 No 07/06/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr James Friess DC
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/31/22 0.00 25.00 0.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 10/24/22 0.00 0.00 25.00 0.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 25.00 0.00 25.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 25.00 25.00 25.00 150.00 225.00
VERKA000 Verburg, Kathy Group:
DOB: 02/14/1955 Insured ID: 0014215404
98941-AT -
12/15/21 Manipulation 3-4 No 12/21/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Matthew Meiste DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 0.00 0.00 0.00 0.00 20.00 20.00
WASSA000 Wassinger, Sarah Group:
DOB: 03/14/1996 Insured ID: 1178068228
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 30.00 30.00
WILKA000 Willey, Katie, I Group:
DOB: 05/09/1984 Insured ID: 0035996448
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
07/14/22 Manipulation 3-4 No 07/21/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/15/22 Manipulation 3-4 No 06/23/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/10/22 Manipulation 3-4 No 06/16/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 73.44 146.88 220.32
WINBE000 Winkler, Benjamin Group:
DOB: 01/04/2002 Insured ID: 1248831840
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 11/03/22 20.00 0.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 20.00 20.00 0.00 0.00 0.00 40.00
YOUME000 Young, Melissa Group:
DOB: 08/12/1981 Insured ID: 0003624200
72082 - X-Ray Full
05/25/22 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 118.00 118.00
Spine - 2-3 views
Provider: Dr Karla A Parkhurst DC
99203-25 - New
05/25/22 Patient Exam - 30- No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 129.00 129.00
44 Min
Provider: Dr Karla A Parkhurst DC
98942-AT -
05/25/22 Manipulation 5 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 8.66 8.66
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
05/27/22 Manipulation 5 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 8.66 8.66
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 264.32 264.32
ZUNGE000 Zuniga, Gessel Group:
DOB: 10/04/2003 Insured ID: 0041907345
99213-25 -
07/25/22 Established Patient No 07/28/22 10/24/22 0.00 0.00 0.00 41.41 0.00 41.41
Exam - 20-29 Min
Provider: Dr Karla A Parkhurst DC
98942-AT -
07/25/22 Manipulation 5 No 07/28/22 10/24/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 78.13 0.00 78.13
Carrier Totals: 102.98 945.64 1,120.22 1,736.65 5,556.58 9,462.07
Molina Healthcare 888-898-7969
CLADO000 Clay, Douglas Group:
DOB: 09/21/1966 Insured ID: 0078094662
98941-AT -
11/04/22 Manipulation 3-4 No 11/07/22 11/07/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
MELMA000 Melendez, Max Group:
DOB: 12/19/2014 Insured ID: 1147883705
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
RUBAS000 Rubio, Asia Group:
DOB: 05/25/1998 Insured ID: 0009772784
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
72082 - X-Ray Full
10/26/22 No 11/03/22 11/03/22 126.00 0.00 0.00 0.00 0.00 126.00
Spine - 2-3 views
Provider: Dr Russell Sweet DC
99213-25 -
10/26/22 Established Patient No 11/03/22 11/03/22 98.00 0.00 0.00 0.00 0.00 98.00
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
Patient Totals: 374.00 0.00 0.00 0.00 0.00 374.00
SMIAS000 Smith, Ashley Group:
DOB: 08/26/1986 Insured ID: 0002715823
98942-AT -
06/27/22 Manipulation 5 No 06/30/22 10/26/22 0.00 0.00 0.00 0.00 56.97 56.97
Regions
Provider: Dr James Friess DC
98942-AT -
04/22/22 Manipulation 5 No 04/28/22 10/26/22 0.00 0.00 0.00 0.00 60.00 60.00
Regions
Provider: Dr James Friess DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 0.00 0.00 0.00 0.00 116.97 116.97
TOPNA000 Toppen, Nathan Group:
DOB: 07/02/1977 Insured ID: 0096471701
98941-AT -
05/11/22 Manipulation 3-4 No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
06/07/22 Manipulation 3-4 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
06/09/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
05/18/22 Manipulation 3-4 No 05/23/22 10/24/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
06/02/22 Manipulation 3-4 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 100.84 100.84
Carrier Totals: 474.00 0.00 0.00 0.00 217.81 691.81
Priority Health Insurance 800-956-1954
ADJLA000 Adjei, Laurie Group: 783589
DOB: 03/28/1972 Insured ID: 948256399-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 35.16 0.00 0.00 0.00 0.00 35.16
ALDMI000 Aldrich, Michael Group: 100100
DOB: 08/08/1976 Insured ID: 947729222-01
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
ANSBR000 Anspaugh, Bruce Group: 226510
DOB: 03/27/1964 Insured ID: 948227991-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
ARERI000 Arens, Rick Group: 786773
DOB: 05/17/1959 Insured ID: 947708734-00
97110-GP-97 -
Therapy-
09/29/22 No 10/05/22 10/05/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 0.00 49.06 0.00 0.00 0.00 49.06
AREST000 Arens, Stacy Group: 783589
DOB: 09/16/1971 Insured ID: 947584065-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
Patient Totals: 35.16 0.00 0.00 0.00 0.00 35.16
BABDO000 Babinec, Douglas Group: 786773
DOB: 07/23/1966 Insured ID: 947719368-01
97110-GP-97 -
Therapy-
09/14/22 No 09/19/22 10/10/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 49.06 0.00 0.00 0.00 49.06
BARDA001 Barek, Dawn Group: 250210
DOB: 05/14/1961 Insured ID: 948707160-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
BARBE000 Bareman, Beverly Group: 783589
DOB: 10/07/1970 Insured ID: 947583610-01
98941-AT -
10/10/22 Manipulation 3-4 No 10/17/22 10/17/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/07/22 Manipulation 3-4 No 10/17/22 10/17/22 0.00 29.38 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/17/22 10/17/22 0.00 29.38 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
99203-25 - New
10/05/22 No 10/17/22 10/17/22 0.00 52.13 0.00 0.00 0.00 52.13
Patient Exam - 30-

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 44 Min
Provider: Dr James Friess DC
72100 - X-ray
10/05/22 Lumbosacral 2-3 No 10/17/22 10/17/22 0.00 41.81 0.00 0.00 0.00 41.81
Views
Provider: Dr James Friess DC
72070 - X-ray
10/05/22 Thoracic Spine - 2-3 No 10/17/22 10/17/22 0.00 40.53 0.00 0.00 0.00 40.53
Views
Provider: Dr James Friess DC
72040 - X-ray
10/05/22 Cervical Spine - 2-3 No 10/17/22 10/17/22 0.00 39.67 0.00 0.00 0.00 39.67
Views
Provider: Dr James Friess DC
Patient Totals: 146.90 232.90 0.00 0.00 0.00 379.80
BARAL000 Barense, Alexandria, N Group: 10001
DOB: 11/09/1993 Insured ID: 0088346422
98941-AT -
01/05/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr James Friess DC
98941-AT -
01/24/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr James Friess DC
98941-AT -
02/02/22 Manipulation 3-4 No 02/08/22 10/20/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
02/11/22 Manipulation 3-4 No 02/17/22 10/20/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr James Friess DC
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
04/21/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 210.00 210.00
BAUBE000 Baumann, Beverly, D Group: 10003
DOB: 10/05/1950 Insured ID: 948244693-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
BECJO000 Becerra, Jose Group: 786895
DOB: 02/02/1982 Insured ID: 948484665-04
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
10/10/22 Therapy- No 10/13/22 10/13/22 36.72 0.00 0.00 0.00 0.00 36.72
Therapeutic

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364 Garden Ave., Holland, MI 49424-8656
 Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/05/22 No 10/10/22 10/10/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 183.60 36.72 0.00 0.00 0.00 220.32
BEEJA000 Beecham, Jason Group: 792227
DOB: 11/20/1973 Insured ID: 948999274-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/18/22 No 10/24/22 10/24/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 134.84 49.06 0.00 0.00 0.00 183.90
BLONO000 Blohm, Noa, J Group: 123010
DOB: 08/09/2021 Insured ID: 947933462-03
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
10/18/22 Manipulation 1-2 No 10/24/22 10/24/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 51.40 0.00 0.00 0.00 0.00 51.40
BOUAN000 Bouwkamp, Andrea Group: 100100
DOB: 06/29/1979 Insured ID: 948889312-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
72040 - X-ray
10/19/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Russell Sweet DC
99203-25 - New
10/19/22 Patient Exam - 30- No 10/26/22 10/26/22 40.16 0.00 0.00 0.00 0.00 40.16
44 Min
Provider: Dr Russell Sweet DC
72070 - X-ray
10/19/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
10/19/22 Lumbosacral 2-3 No 10/26/22 10/26/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Russell Sweet DC
Patient Totals: 241.11 0.00 0.00 0.00 0.00 241.11
BRALE000 Bracelin, Levi Group: 567100
DOB: 03/11/2012 Insured ID: 947154945-02
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 13.44 0.00 0.00 0.00 0.00 13.44
BRALI001 Bracelin, Linette Group: 567100
DOB: 03/02/1975 Insured ID: 947154945-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
BRONE000 Brower, Nelly Group: 772173
DOB: 01/21/1982 Insured ID: 949517149-00
72100 - X-ray
10/20/22 Lumbosacral 2-3 No 10/26/22 10/26/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Samantha J Spooner DC
72040 - X-ray
10/20/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Samantha J Spooner DC
72070 - X-ray
10/20/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Samantha J Spooner DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
10/25/22 98941-AT - No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72

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 Manipulation 3-4
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
99202-25 - New
10/20/22 Patient Exam - 15- No 10/26/22 10/26/22 65.16 0.00 0.00 0.00 0.00 65.16
29 Min
Provider: Dr Samantha J Spooner DC
Patient Totals: 244.55 0.00 0.00 0.00 0.00 244.55
BRUKA000 Bruursema, Kara Group: 567100
DOB: 09/05/1981 Insured ID: 949322255-00
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
CABAD000 Cabrera, Adrianna Group:
DOB: 06/17/2005 Insured ID: 947708297-04
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 7.28 7.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/15/22 Manipulation 3-4 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 7.28 7.28
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/01/22 Manipulation 3-4 No 04/05/22 10/21/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/24/22 0.00 0.00 0.00 20.86 0.00 20.86
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 20.86 20.86
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 20.86 55.42 76.28
CALSI000 Calvillo, Silas Group: 733710
DOB: 09/18/2020 Insured ID: 948236538-00
98940-AT -
10/27/22 Manipulation 1-2 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
05/12/22 Manipulation 1-2 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 33.44 33.44
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
04/28/22 Manipulation 1-2 No 05/05/22 10/21/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98940-AT -
04/14/22 Manipulation 1-2 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/09/22 Manipulation 1-2 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
05/26/22 Manipulation 1-2 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
08/30/22 Manipulation 1-2 No 09/07/22 09/07/22 0.00 0.00 16.72 0.00 0.00 16.72
Regions
Provider: Dr Russell Sweet DC
98940-AT -
08/25/22 Manipulation 1-2 No 09/01/22 09/01/22 0.00 0.00 16.72 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
09/01/22 Manipulation 1-2 No 09/07/22 09/07/22 0.00 0.00 16.72 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
09/12/22 Manipulation 1-2 No 09/14/22 09/14/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
08/04/22 Manipulation 1-2 No 08/11/22 10/05/22 0.00 0.00 0.00 16.72 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/23/22 Manipulation 1-2 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
07/07/22 Manipulation 1-2 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
09/29/22 Manipulation 1-2 No 10/05/22 10/05/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 16.72 33.44 50.16 16.72 133.76 250.80
CAZIM000 Cazares, Imelda Group:
DOB: 03/29/1972 Insured ID: 949032143-00
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
CLATA000 Clark, Tammy Group: 791551
DOB: 09/27/1976 Insured ID: 948520048-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr James Friess DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
DANSA000 Danielson, Sarah Group: 772173
DOB: 01/27/1994 Insured ID: 949468439-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Karla A Parkhurst DC
10/12/22 98941-AT - No 10/17/22 10/17/22 6.72 0.00 0.00 0.00 0.00 6.72

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 Manipulation 3-4
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 13.44 0.00 0.00 0.00 0.00 13.44
DATAN000 Dattadeen, Andrea, J Group: 538010
DOB: 06/21/1980 Insured ID: 947960484-01
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
11/01/22 No 11/09/22 11/09/22 16.00 0.00 0.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/18/22 No 10/24/22 10/24/22 16.00 0.00 0.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 48.72 0.00 0.00 0.00 0.00 48.72
DEBJA002 Deblecourt, Jacob Group: 425810
DOB: 09/25/2006 Insured ID: 947049220-11
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 25.70 0.00 0.00 0.00 0.00 25.70
DEJCY000 DeJong, Cynthia, K Group: 464310
DOB: 05/22/1960 Insured ID: 949338587-01
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
DEKJO000 Dekkinga, Johnathan Group: 786895
DOB: 08/03/1999 Insured ID: 948722927-03
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 10/20/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/22/22 No 09/29/22 10/05/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 49.06 36.72 0.00 0.00 0.00 85.78
DEPCH000 Depree, Chelsea Group: 136710
DOB: 11/02/1991 Insured ID: 949077440-01
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
DICAM000 Dickerson, Amy Group: 748100
DOB: 05/11/1960 Insured ID: 948679900-00
10/24/22 98941-AT - No 10/26/22 10/26/22 16.72 0.00 0.00 0.00 0.00 16.72

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 Manipulation 3-4
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
DICST000 Dickerson, Steven Group: 748100
DOB: 08/25/1962 Insured ID: 947249407-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
DIEJA000 Dietsche, Jason Group: 624100
DOB: 03/07/1978 Insured ID: 948915115-01
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
DOCRA000 Dockins, Randy, B Group: 172100
DOB: 09/09/1961 Insured ID: 947107813-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
Patient Totals: 33.44 0.00 0.00 0.00 0.00 33.44
ELDHO000 Elders, Holly Group: 837110
DOB: 12/14/1978 Insured ID: 948616155-00
98941-AT -
08/22/22 Manipulation 3-4 No 08/25/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/12/22 Manipulation 3-4 No 08/17/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/17/22 10/31/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/19/22 Manipulation 3-4 No 08/25/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/03/22 Manipulation 3-4 No 08/08/22 10/31/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 10/31/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/27/22 Manipulation 3-4 No 08/01/22 10/31/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/31/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 10/31/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/31/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
99212-25 -
08/31/22 Established Patient No 09/07/22 10/31/22 0.00 0.00 57.00 0.00 0.00 57.00
Exam - 10-19 Min
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
07/27/22 Cervical Spine - 2-3 No 08/01/22 10/31/22 0.00 0.00 0.00 68.00 0.00 68.00
Views
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
07/27/22 Thoracic Spine - 2-3 No 08/01/22 10/31/22 0.00 0.00 0.00 56.50 0.00 56.50
Views
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/01/22 No 09/07/22 10/31/22 0.00 0.00 64.00 0.00 0.00 64.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/16/22 No 09/22/22 10/31/22 0.00 36.72 0.00 0.00 0.00 36.72
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
08/17/22 No 08/22/22 10/31/22 0.00 0.00 64.00 0.00 0.00 64.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
08/08/22 No 08/17/22 10/31/22 0.00 0.00 0.00 64.00 0.00 64.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
99213-25 -
07/27/22 Established Patient No 08/01/22 10/31/22 0.00 0.00 0.00 93.25 0.00 93.25
Exam - 20-29 Min
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
07/27/22 Lumbosacral 2-3 No 08/01/22 10/31/22 0.00 0.00 0.00 68.50 0.00 68.50
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 73.44 485.00 586.97 0.00 1,145.41
ELEKI000 Elenbaas , Kimberly, J Group: 786773
DOB: 12/13/1965 Insured ID: 948852784-01
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)

Parkhurst Chiropractic Life Center PLC Page 133 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.00 0.00 0.00 0.00 0.00 36.00
ERDJO000 Erdman, Jodie Group: 791497
DOB: 12/21/1977 Insured ID: 948505730-01
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
ESQJO000 Esquivel, John Group: 790660
DOB: 08/24/1988 Insured ID: 949407140-01
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
EVEBR000 Evenson, Brian Group: 793486
DOB: 06/25/1970 Insured ID: 949313481-00
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
FLYHA000 Flynn, Hannah Group: 783589
DOB: 08/02/2002 Insured ID: 947584385-01
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
FOSDA000 Foster, Dana, J Group: 783589
DOB: 11/29/1996 Insured ID: 949083905-00
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
FRAMA001 Franklin, Matthew Group: 792156
DOB: 06/24/1996 Insured ID: 949497915-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 13.44 0.00 0.00 0.00 0.00 13.44
VANSA001 Franklin, Sanne Group: 792156
DOB: 05/26/1996 Insured ID: 949497915-01
98941-AT -
09/29/22 Manipulation 3-4 No 10/03/22 11/03/22 0.00 29.14 0.00 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/18/22 Manipulation 3-4 No 08/22/22 09/29/22 0.00 0.00 29.14 0.00 0.00 29.14
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/14/22 Manipulation 3-4 No 09/19/22 11/03/22 0.00 29.14 0.00 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/09/22 10/18/22 0.00 0.00 29.14 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 08/29/22 09/29/22 0.00 0.00 29.14 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 58.28 87.42 0.00 0.00 145.70
FREAV000 Freeman, Ava Group: 786773
DOB: 03/26/2021 Insured ID: 948637094-02
98940-AT -
10/24/22 Manipulation 1-2 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98940-AT -
10/18/22 Manipulation 1-2 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
FRECO000 Freeman, Conrad Group: 786773
DOB: 04/18/1993 Insured ID: 948637094-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 146.88 0.00 0.00 0.00 0.00 146.88
FREDE000 Freeman, Devan Group: 786773
DOB: 05/02/1994 Insured ID: 948637094-01
97140-GP-59-97 -
Therapy-Manual
10/10/22 No 10/13/22 10/13/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
09/26/22 No 09/29/22 09/29/22 0.00 36.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/25/22 No 10/31/22 10/31/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 182.16 36.00 0.00 0.00 0.00 218.16
FRILO000 Fries, Lou Group: 567100
DOB: 01/14/1967 Insured ID: 947150085-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
09/30/22 No 10/05/22 10/05/22 0.00 19.06 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/12/22 No 10/17/22 10/17/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
09/22/22 No 09/29/22 09/29/22 0.00 19.06 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 77.34 38.12 0.00 0.00 0.00 115.46
FROCH000 Frostenson, Chantelle Group: 774381
DOB: 08/24/1988 Insured ID: 949512014-00
98941-AT -
10/10/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/10/22 Lumbosacral 2-3 No 10/20/22 10/20/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/10/22 Thoracic Spine - 2-3 No 10/20/22 10/20/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/10/22 Patient Exam - 30- No 10/20/22 10/20/22 65.16 0.00 0.00 0.00 0.00 65.16
44 Min
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/10/22 Cervical Spine - 2-3 No 10/20/22 10/20/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 327.83 0.00 0.00 0.00 0.00 327.83
FYLJO000 Fylstra, John Group: 567100
DOB: 05/21/1963 Insured ID: 947148627-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/20/22 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/29/22 No 10/05/22 10/05/22 0.00 19.06 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 45.94 19.06 0.00 0.00 0.00 65.00
GALKI000 Gallup, Kimberly Group: 56700
DOB: 12/05/1966 Insured ID: 947707269-01
97110-GP-97 -
Therapy-
08/16/22 No 08/22/22 10/05/22 0.00 0.00 6.72 0.00 0.00 6.72
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
05/12/22 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 6.72 6.72
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 6.72 0.00 6.72 13.44
GIBAM000 Gibbs, Amy Group: 783589
DOB: 01/06/1977 Insured ID: 948985787-00

Parkhurst Chiropractic Life Center PLC Page 137 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 66.10 0.00 0.00 0.00 0.00 66.10
GIBME000 Gibson, Melissa, J Group: 791161
DOB: 04/14/1986 Insured ID: 948517929-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
GORCH000 Gordon, Cheryl, L Group: 791597
DOB: 07/18/1965 Insured ID: 948895406-00
97140-GP-59-97 -
Therapy-Manual
10/27/22 No 11/03/22 11/03/22 32.40 0.00 0.00 0.00 0.00 32.40
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/04/22 No 10/10/22 10/10/22 0.00 32.40 0.00 0.00 0.00 32.40
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/27/22 No 10/03/22 10/03/22 0.00 32.40 0.00 0.00 0.00 32.40
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 32.40 64.80 0.00 0.00 0.00 97.20
GOVNA000 Govea, Natividad Group: 792856
DOB: 09/22/1995 Insured ID: 948819869-01
72084 - X-Ray Full
02/04/22 No 02/10/22 10/26/22 0.00 0.00 0.00 0.00 121.04 121.04
Spine - 6+ Views
Provider: Dr Russell Sweet DC
98941-AT -
02/04/22 Manipulation 3-4 No 02/10/22 10/26/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
99202-25 - New
02/04/22 Patient Exam - 15- No 02/10/22 10/26/22 0.00 0.00 0.00 0.00 25.16 25.16
29 Min
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 182.92 182.92
GUTJA001 Gutman, James, W Group: 837110
DOB: 02/18/1975 Insured ID: 948184894-00
97110-GP-97 -
Therapy-
10/18/22 No 10/24/22 10/24/22 14.06 0.00 0.00 0.00 0.00 14.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Brian S Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 19.22 0.00 0.00 0.00 0.00 19.22
HANAM000 Hanges, Amanda Group: 793334
DOB: 01/11/1987 Insured ID: 949228611-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
HANTR000 Hanges, Travis Group: 850052
DOB: 04/24/1980 Insured ID: 948788559-00
98941-AT -
09/22/22 Manipulation 3-4 No 09/29/22 09/29/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/18/22 Manipulation 3-4 No 08/25/22 10/05/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/29/22 Manipulation 3-4 No 10/05/22 10/05/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/08/22 Manipulation 3-4 No 09/14/22 09/14/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 09/01/22 0.00 0.00 36.72 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
99212-25 -
09/22/22 Established Patient No 09/29/22 09/29/22 0.00 41.41 0.00 0.00 0.00 41.41
Exam - 10-19 Min
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 110.16 114.85 146.88 0.00 0.00 371.89
HIABE000 Hiatt, Becky Group: 783589
DOB: 11/03/1966 Insured ID: 947583713-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
HICKI000 Hicks, Kimberly Group: 772173

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364 Garden Ave., Holland, MI 49424-8656
DOB: 03/21/1975 Insured ID: 947563686-00
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
HILLA000 Hilbrand, Laura Group: 792227
DOB: 08/28/1964 Insured ID: 94946386600
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
06/13/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
01/24/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
12/13/21 Manipulation 3-4 No 12/17/21 10/20/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
03/14/22 Manipulation 3-4 No 03/17/22 10/21/22 0.00 0.00 0.00 0.00 29.14 29.14
Regions
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
12/01/21 No 12/07/21 10/20/22 0.00 0.00 0.00 0.00 46.80 46.80
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
02/23/22 No 02/28/22 10/20/22 0.00 0.00 0.00 0.00 45.68 45.68
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
97110-GP-97 -
Therapy-
01/12/22 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 46.80 46.80
Therapeutic
Exercise
Provider: Dr Matthew Meiste DC
Patient Totals: 36.72 0.00 0.00 0.00 263.42 300.14
HILJU000 Hill, Judith Group: 795873
DOB: 11/24/1950 Insured ID: 949173431-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
HILTR000 Hill, Travis Group: 501510
DOB: 08/09/1981 Insured ID: 949179809-00
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 10/20/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/07/22 No 10/13/22 10/13/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 49.06 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 85.78 98.12 0.00 0.00 0.00 183.90
HILYV000 Hill, Yvette, P Group: 172100
DOB: 11/17/1971 Insured ID: 947683144-00
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/26/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/26/22 Manipulation 3-4 No 09/29/22 10/26/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/29/22 Manipulation 3-4 No 10/05/22 10/26/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/06/22 Manipulation 3-4 No 10/13/22 10/26/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/26/22 0.00 0.00 0.00 16.72 0.00 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/09/22 Manipulation 3-4 No 09/14/22 10/26/22 0.00 0.00 16.72 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/07/22 10/26/22 0.00 0.00 16.72 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 10/26/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 10/26/22 0.00 -20.00 0.00 0.00 0.00 -20.00
Regions
Provider: Dr James Friess DC
98941-AT -
09/15/22 Manipulation 3-4 No 09/22/22 10/26/22 0.00 16.72 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
04/14/22 Manipulation 3-4 No 04/21/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/07/22 Manipulation 3-4 No 04/14/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
04/18/22 Manipulation 3-4 No 04/21/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr Karla A Parkhurst DC

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 98941-AT -
02/03/22 Manipulation 3-4 No 02/08/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/31/22 Manipulation 3-4 No 04/05/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/10/22 Manipulation 3-4 No 03/17/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/17/22 Manipulation 3-4 No 03/25/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
03/24/22 Manipulation 3-4 No 03/31/22 10/26/22 0.00 0.00 0.00 0.00 -20.00 -20.00
Regions
Provider: Dr James Friess DC
98941-AT -
03/03/22 Manipulation 3-4 No 03/07/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/24/22 Manipulation 3-4 No 03/03/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/17/22 Manipulation 3-4 No 02/24/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/07/22 Manipulation 3-4 No 02/10/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
98941-AT -
02/10/22 Manipulation 3-4 No 02/17/22 10/26/22 0.00 0.00 0.00 0.00 16.72 16.72
Regions
Provider: Dr James Friess DC
99212-25 -
02/03/22 Established Patient No 02/08/22 10/26/22 0.00 0.00 0.00 0.00 41.41 41.41
Exam - 10-19 Min
Provider: Dr James Friess DC
72084 - X-Ray Full
02/03/22 No 02/08/22 10/26/22 0.00 0.00 0.00 0.00 121.04 121.04
Spine - 6+ Views
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
08/12/22 No 08/17/22 10/26/22 0.00 0.00 16.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/10/22 No 10/13/22 10/13/22 16.00 0.00 0.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
09/27/22 No 10/03/22 10/26/22 0.00 16.00 0.00 0.00 0.00 16.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 32.72 79.60 49.44 16.72 343.09 521.57
HINAL000 Hinga, Alexandra Group: 786895

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364 Garden Ave., Holland, MI 49424-8656
DOB: 10/02/1996 Insured ID: 947708335-02
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
HINRE000 Hinken, Rex Group: 250210
DOB: 12/27/1971 Insured ID: 948757864-00
98940-AT -
10/18/22 Manipulation 1-2 No 10/24/22 10/24/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
HOFKE000 Hoffman, Kelly Group: 783589
DOB: 07/17/1959 Insured ID: 947583612-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
HOFMI000 Hoffman, Michelle Group: 780514
DOB: 10/09/1968 Insured ID: 947509123-01
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr James Friess DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
HOUJO000 Houtman-Visser, Jordan Group: 792156
DOB: 02/01/1993 Insured ID: 949183176-01
98941-AT -
02/04/22 Manipulation 3-4 No 02/10/22 10/20/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/05/22 10/24/22 0.00 0.00 0.00 30.00 0.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 30.00 30.00 60.00
ISRTA000 Israels, Taylor Group: 786773
DOB: 01/14/1993 Insured ID: 948078885-01
98941-AT -
04/01/22 Manipulation 3-4 No 04/07/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
JAGLO000 Jager, Lois Group: 285110
DOB: 12/09/1958 Insured ID: 949403608-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
JOHAM000 Johnson, Amanda Group: 12225
DOB: 06/04/1985 Insured ID: 947988492-01
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
JOHJU000 Johnson, Julia Group: 700210
DOB: 01/13/1966 Insured ID: 947009098-01

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 98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
KAMAN000 Kamphuis, Andrea Group: 902510
DOB: 01/31/1993 Insured ID: 949077670-00
97140-GP-59-97 -
Therapy-Manual
10/21/22 No 10/26/22 10/26/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
97140-GP-59-97 -
Therapy-Manual
10/27/22 No 11/03/22 11/03/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Russell Sweet DC
Patient Totals: 72.00 0.00 0.00 0.00 0.00 72.00
KAMBR000 Kamphuis, Brandon Group: 789200
DOB: 04/20/2001 Insured ID: 948697660-02
98941-AT -
10/26/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KAMJO000 Kamphuis, Jordon, K Group: 777145
DOB: 03/20/1986 Insured ID: 947684109-01
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KAMKA001 Kamphuis, Karen Group: 789200
DOB: 07/09/1969 Insured ID: 948697660-01
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KAMTO000 Kamphuis, Todd Group: 789200
DOB: 12/12/1970 Insured ID: 948697660-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KEAAL000 Keag, Alexandria Group: 200026
DOB: 05/18/1988 Insured ID: 948315396-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 58.76 0.00 0.00 0.00 0.00 58.76
KELCH000 Kellum, Chance Group: 771808
DOB: 09/27/2001 Insured ID: 948249216-02
98941-AT -
10/10/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KLOJA002 Klobucher, Jason Group: 100100
DOB: 03/07/1976 Insured ID: 948067717-01
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
KLOMA001 Klobucher, Mary Jo Group: 100100
DOB: 01/10/1987 Insured ID: 948067717-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/28/22 No 11/03/22 11/03/22 11.00 0.00 0.00 0.00 0.00 11.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 22.72 0.00 0.00 0.00 0.00 22.72
KLOMA000 Klomparens, Mark Group: 786773
DOB: 04/03/1966 Insured ID: 947708386-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
KOEGL000 Koeman, Gloria Group: 226510
DOB: 03/31/1947 Insured ID: 948639698-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.72 0.00 0.00 0.00 0.00 26.72
KOLKA000 Koleszar, Katie Group: 7835589
DOB: 11/11/1980 Insured ID: 947773600-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
Patient Totals: 58.76 0.00 0.00 0.00 0.00 58.76
KOLSO000 Koleszar, Sophie Group: 7835589
DOB: 08/06/2008 Insured ID: 947773600-03
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
Patient Totals: 58.76 0.00 0.00 0.00 0.00 58.76
KOSNA000 Koster, Nathan Group: 655100
DOB: 08/24/1985 Insured ID: 947530475-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 1.72 0.00 0.00 0.00 0.00 1.72

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 Regions
Provider: Dr Russell Sweet DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
LAHTE000 Lahaie, Teresa Group: 786895
DOB: 01/05/1963 Insured ID: 947947680-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
LARCO000 Lara, Concepcion, C Group: 783589
DOB: 03/07/1976 Insured ID: 947584280-01
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 35.16 0.00 0.00 0.00 0.00 35.16
LEDRA000 Ledesma, Rachel Group: 794298
DOB: 11/30/1978 Insured ID: 949410956-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr James Friess DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
LEDSO000 Ledesma, Sophia Group: 794298
DOB: 12/11/2010 Insured ID: 949410956-02
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
LEHLI000 Lehman, Lisa Group: 790681
DOB: 11/12/1982 Insured ID: 948319857-00
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
LEMLO000 Lemberger, Lonette Group: 850040
DOB: 07/07/1974 Insured ID: 947075298-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
LEMDA000 Lemke, Danielle Group: 285110
DOB: 03/05/1994 Insured ID: 948690253-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
LEVDY000 Levandoski, Dylan Group: 789782

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364 Garden Ave., Holland, MI 49424-8656
DOB: 07/31/2009 Insured ID: 948596224-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 21.72 0.00 0.00 0.00 0.00 21.72
LEVEL000 Levandoski, Elizabeth Group: 789782
DOB: 01/17/1978 Insured ID: 948596224-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 65.16 0.00 0.00 0.00 0.00 65.16
LEVLI000 Levandoski, Liam Group: 789782
DOB: 10/08/2011 Insured ID: 948596224-04
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 43.44 0.00 0.00 0.00 0.00 43.44
LEWED000 Lewis, Edward, S Group: 792791
DOB: 12/04/2010 Insured ID: 949437135-05
72100 - X-ray
10/26/22 Lumbosacral 2-3 No 10/31/22 10/31/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
10/26/22 Thoracic Spine - 2-3 No 10/31/22 10/31/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Brian S Parkhurst DC
99203-25 - New
10/26/22 Patient Exam - 30- No 10/31/22 10/31/22 65.16 0.00 0.00 0.00 0.00 65.16
44 Min
Provider: Dr Brian S Parkhurst DC
72040 - X-ray
10/26/22 Cervical Spine - 2-3 No 10/31/22 10/31/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 291.11 0.00 0.00 0.00 0.00 291.11
LOEDA000 Loew, Dan Group:
DOB: 12/10/1976 Insured ID: 947243811-00
11/01/22 98941-AT - No 11/09/22 11/09/22 1.72 0.00 0.00 0.00 0.00 1.72

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 5.16 0.00 0.00 0.00 0.00 5.16
LOEHO000 Loew, Holly, M Group: 820810
DOB: 05/12/1980 Insured ID: 947243811-01
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
LOHCL000 Lohman, Claire, J Group: 792566
DOB: 08/20/1995 Insured ID: 949197447-00
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
LOOAP000 Looman, April Group: 200025
DOB: 09/27/1985 Insured ID: 948860024-01
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 25.70 0.00 0.00 0.00 0.00 25.70
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 25.70 0.00 0.00 0.00 0.00 25.70
LUDMA000 Ludwig, Mark Group: 792779
DOB: 09/09/1968 Insured ID: 949385410-00
98940-AT -
10/25/22 Manipulation 1-2 No 10/31/22 10/31/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
MAAJO000 Maat, Joel Group: 786773
DOB: 03/21/1972 Insured ID: 947716209-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
MAITI000 Maillet, Timothy Group: 200026
DOB: 03/28/1983 Insured ID: 949191262-00
98941-AT -
03/28/22 Manipulation 3-4 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 11.19 11.19
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 11.19 11.19
MANHE000 Mantooth, Helen, V Group:
DOB: 11/23/1973 Insured ID: 947372883-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72

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MARKA000 Martin, Kailynne Group: 792156
DOB: 08/12/1988 Insured ID: 948713102-01
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 20.16 0.00 0.00 0.00 0.00 20.16
GAMTA000 Mcdole, Tania Group: 792791
DOB: 11/23/1986 Insured ID: 949437135-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
MEESA000 Meekhof, Sally Group: 793078
DOB: 05/11/1966 Insured ID: 949502240-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 1.72 0.00 0.00 0.00 0.00 1.72
MENLI000 Mendoza, Liliana, T Group: 786773
DOB: 07/26/2007 Insured ID: 947717770-01
98941-AT -
02/15/22 Manipulation 3-4 No 03/14/22 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 20.00 20.00
MORTA000 Morgan, Tammy Group: 783589
DOB: 03/29/1966 Insured ID: 947584852-00
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
MULTI000 Mulder, Timothy Group: 792791
DOB: 05/02/1969 Insured ID: 948800763-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
MULKA000 Mulki, Karen Group: 780779
DOB: 07/03/1979 Insured ID: 948812572-00
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
10/26/22 97110-GP-97 - No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72

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 Therapy-
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 26.88 0.00 0.00 0.00 0.00 26.88
NAPAN000 Napora, Anita Group: 791791
DOB: 06/10/1962 Insured ID: 948790939-01
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
NEWKE000 Newenhouse, Kelsey Group: 783589
DOB: 04/26/1985 Insured ID: 947748800-04
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
NYKJA000 Nykamp, Janet Group: 200026
DOB: 01/04/1961 Insured ID: 948343903-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
NYLKO000 Nyland, Kortney Group: 786773
DOB: 06/28/1984 Insured ID: 947708530-00
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
09/28/22 No 10/03/22 10/03/22 0.00 36.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 36.72 36.00 0.00 0.00 0.00 72.72
NYSLO000 Nys, Lori Group: 773560
DOB: 10/08/1964 Insured ID: 947227253-00
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 12.34 0.00 0.00 0.00 12.34
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 10/20/22 12.34 0.00 0.00 0.00 0.00 12.34
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 12.34 12.34 0.00 0.00 0.00 24.68
OCHYU000 Ochoa, Yuliana Group: 791583
DOB: 07/20/2012 Insured ID: 948508649
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
OLSMI000 Olsen, Michael Group: 786773
DOB: 05/20/1968 Insured ID: 949488514-00
72100 - X-ray
11/01/22 Lumbosacral 2-3 No 11/09/22 11/09/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Samantha J Spooner DC
72040 - X-ray
11/01/22 Cervical Spine - 2-3 No 11/09/22 11/09/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Samantha J Spooner DC
72070 - X-ray
11/01/22 Thoracic Spine - 2-3 No 11/09/22 11/09/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Samantha J Spooner DC
99202-25 - New
11/01/22 Patient Exam - 15- No 11/09/22 11/09/22 65.16 0.00 0.00 0.00 0.00 65.16
29 Min
Provider: Dr Samantha J Spooner DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Samantha J Spooner DC
Patient Totals: 254.39 0.00 0.00 0.00 0.00 254.39
OVEBR000 Overbeek, Bryce Group: 788155
DOB: 11/10/2005 Insured ID: 949075365-02
98941-AT -
07/20/22 Manipulation 3-4 No 07/25/22 10/05/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 36.72 0.00 36.72
OVECH000 Overbeek, Channa Group: 788155
DOB: 01/24/1980 Insured ID: 949075365-01
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/24/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/10/22 10/26/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 11/03/22 46.36 0.00 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/05/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/12/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/05/22 Manipulation 3-4 No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 44.34 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/15/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 44.34 0.00 44.34

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 Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 44.34 44.34
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 10/13/22 0.00 46.36 0.00 0.00 0.00 46.36
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 46.36 139.08 0.00 88.68 175.62 449.74
OVELE000 Overbeek, Levi Group: 788155P
DOB: 05/18/1981 Insured ID: 949075365-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
OVIYV000 Oviedo, Yvonne Group: 567100
DOB: 08/15/1972 Insured ID: 947150283-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 19.06 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/26/22 No 09/29/22 09/29/22 0.00 19.06 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 58.28 38.12 0.00 0.00 0.00 96.40
PAGAB000 Page, Abron Group:
DOB: 07/07/2012 Insured ID: 948522836-03
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
PAGAM000 Page, Amelie Group: 783589
DOB: 05/01/2009 Insured ID: 948522836-03
10/14/22 98941-AT - No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72

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 Manipulation 3-4
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
PEROD000 Perez, Odalis Group: 791568
DOB: 04/18/2005 Insured ID: 948513501-03
98941-AT -
10/05/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
12/15/21 Manipulation 3-4 No 12/21/21 10/20/22 0.00 0.00 0.00 0.00 6.72 6.72
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
04/19/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/15/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 09/26/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 36.72 110.16 0.00 36.72 43.44 227.04
PETLI000 Peterson, Lindsey Group: 733710
DOB: 02/06/1992 Insured ID: 948905944-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
PONCH000 Ponstein, Christopher Group: 762110
DOB: 12/12/1981 Insured ID: 948467779-01
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36,072.00 0.00 0.00 0.00 0.00 36,072.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 36,108.72 0.00 0.00 0.00 0.00 36,108.72
POOLI000 Poortvliet, Lisa Group: 793151
DOB: 03/28/1972 Insured ID: 948871118-01
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
PRIJO000 Prince, Jodi Group: 783589
DOB: 03/02/1978 Insured ID: 948484714-01

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 98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
PRILO000 Prince, Logan Group: 783589
DOB: 11/30/2006 Insured ID: 948484714-03
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
PURJA000 Purdy, Jason Group: 786773
DOB: 02/28/1993 Insured ID: 948845133-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
PURMA000 Purdy, Maggie Group: 786773
DOB: 04/25/1996 Insured ID: 948845133-00
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
RAMRA000 Ramirez, Raquel Group: 733710
DOB: 05/26/1981 Insured ID: 948710496-00
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
11/01/22 No 11/09/22 11/09/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
09/21/22 No 09/22/22 10/20/22 0.00 36.72 0.00 0.00 0.00 36.72
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/05/22 No 10/10/22 10/10/22 0.00 36.72 0.00 0.00 0.00 36.72
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97140-GP-59-97 -
Therapy-Manual
10/19/22 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 109.44 73.44 0.00 0.00 0.00 182.88
REIJO000 Reimink, Joel Group: 786773
DOB: 06/02/1984 Insured ID: 947716220-00
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC

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 97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 122.50 36.72 0.00 0.00 0.00 159.22
REIKA000 Reimink, Katelyn Group: 786773
DOB: 08/17/1987 Insured ID: 947716220-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 110.16 0.00 0.00 0.00 0.00 110.16
RHIJO000 Rhine, Joy Group: 780673
DOB: 06/20/1995 Insured ID: 949434029-00
97140-GP-59-97 -
Therapy-Manual
10/21/22 No 10/26/22 10/26/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr Brian S Parkhurst DC
Patient Totals: 36.00 0.00 0.00 0.00 0.00 36.00
RIDKE000 Ridlington, Kelli Group: 790681
DOB: 04/26/1980 Insured ID: 948734820-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Samantha J Spooner DC
Patient Totals: 33.60 0.00 0.00 0.00 0.00 33.60
RILKE000 Rillema, Keith, D Group: 250210

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364 Garden Ave., Holland, MI 49424-8656
DOB: 07/20/1958 Insured ID: 947052777-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
RITMA000 Ritsema, Mary, A Group: 250210
DOB: 11/10/1970 Insured ID: 948476992-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 16.72 0.00 0.00 0.00 0.00 16.72
ROAKI000 Roach, Kilian Group: 790313
DOB: 05/06/1998 Insured ID: 949395586-00
98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/26/22 0.00 0.00 0.00 11.72 0.00 11.72
Regions
Provider: Dr James Friess DC
98941-AT -
06/22/22 Manipulation 3-4 No 06/28/22 10/26/22 0.00 0.00 0.00 0.00 11.72 11.72
Regions
Provider: Dr James Friess DC
98941-AT -
09/13/22 Manipulation 3-4 No 09/14/22 10/26/22 0.00 11.72 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98942-AT -
02/03/22 Manipulation 5 No 02/08/22 10/26/22 0.00 0.00 0.00 0.00 11.72 11.72
Regions
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
08/04/22 No 08/11/22 10/26/22 0.00 0.00 0.00 24.06 0.00 24.06
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
07/28/22 No 08/04/22 10/26/22 0.00 0.00 0.00 24.06 0.00 24.06
Therapeutic
Exercise
Provider: Dr James Friess DC
Patient Totals: 0.00 11.72 0.00 59.84 23.44 95.00
ROHME000 Rohn, Megan Group: 786773
DOB: 04/12/1996 Insured ID: 948668164-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 110.16 0.00 0.00 0.00 0.00 110.16
RUGEL000 Ruger, Elijah, R Group: 655100
DOB: 02/21/2018 Insured ID: 949166188-02
98940-AT -
12/10/21 Manipulation 1-2 No 02/03/22 10/26/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Russell Sweet DC

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Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
RUSBR000 Rus, Brenda Group: 500100
DOB: 12/02/1958 Insured ID: 947548427-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 21.72 0.00 0.00 0.00 0.00 21.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 21.72 0.00 0.00 0.00 0.00 21.72
RUWKE000 Ruwe, Keo Mallei, S Group: 783589
DOB: 08/27/1988 Insured ID: 947650175-00
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr James Friess DC
Patient Totals: 23.44 0.00 0.00 0.00 0.00 23.44
SANJA000 Santellan, Jaxon Group: 200026
DOB: 08/17/2011 Insured ID: 948307320-02
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
SCHBE000 Schipper, Beth Group: 786895
DOB: 12/14/1968 Insured ID: 947705995-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/18/22 No 10/24/22 10/24/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 36.00 0.00 0.00 0.00 0.00 36.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 182.16 0.00 0.00 0.00 0.00 182.16
SCHKE001 Schneider, Kevin Group: 226510
DOB: 03/01/1965 Insured ID: 949014603-00
97110-GP-97 -
Therapy-
11/01/22 No 11/09/22 11/09/22 19.06 0.00 0.00 0.00 0.00 19.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 19.06 0.00 0.00 0.00 0.00 19.06
SCHBE002 Schrotenboer, Becky, S Group: 501510
DOB: 06/18/1967 Insured ID: 947014616-01
05/13/22 98941-AT - No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72

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 Manipulation 3-4
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/09/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/04/22 Manipulation 3-4 No 05/09/22 10/24/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 183.60 183.60
SCHTO000 Schwartz, Todd Group: 791551
DOB: 02/10/1965 Insured ID: 948521591-00
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 1.72 0.00 0.00 0.00 0.00 1.72
Regions
Provider: Dr James Friess DC
Patient Totals: 3.44 0.00 0.00 0.00 0.00 3.44
SELBE000 Selby, Becky Group: 780403
DOB: 04/09/1970 Insured ID: 949058498-01
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 26.72 0.00 0.00 0.00 0.00 26.72
SELES000 Selby, Esther Group: 780403
DOB: 09/18/2000 Insured ID: 949058498-02
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 53.44 0.00 0.00 0.00 0.00 53.44
SELKI000 Selby, Kim Group: 780403
DOB: 05/10/1966 Insured ID: 949058498-00
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions

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Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 26.72 0.00 0.00 0.00 0.00 26.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 106.88 0.00 0.00 0.00 0.00 106.88
SLECH000 Slenk, Chanda Group: 786773
DOB: 05/14/1978 Insured ID: 947716226-01
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
SLEJO000 Slenk, Joseph Group: 786773
DOB: 05/03/1978 Insured ID: 947716226-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
SLETA000 Slenk, Taryn Group: 786773
DOB: 03/23/2006 Insured ID: 947716226-02
98941-AT -
10/19/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
72100 - X-ray
10/19/22 Lumbosacral 2-3 No 10/26/22 10/26/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Russell Sweet DC
99213-25 -
10/19/22 Established Patient No 10/26/22 10/26/22 41.41 0.00 0.00 0.00 0.00 41.41
Exam - 20-29 Min
Provider: Dr Russell Sweet DC
72070 - X-ray
10/19/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Russell Sweet DC
72040 - X-ray
10/19/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Russell Sweet DC
Patient Totals: 267.36 0.00 0.00 0.00 0.00 267.36
SLUJE000 Sluiter, Jeffery Group: 200026
DOB: 05/24/1962 Insured ID: 948024291-02
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr James Friess DC
Patient Totals: 58.76 0.00 0.00 0.00 0.00 58.76
SMAJA001 Smallegan, Jaxton Group: 181100
DOB: 03/03/2022 Insured ID: 949348058-04
98940-AT -
10/26/22 Manipulation 1-2 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72

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 Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
10/31/22 Manipulation 1-2 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
99203-25 - New
10/26/22 Patient Exam - 30- No 10/31/22 10/31/22 65.16 0.00 0.00 0.00 0.00 65.16
44 Min
Provider: Dr Brian S Parkhurst DC
Patient Totals: 138.60 0.00 0.00 0.00 0.00 138.60
SMAJO000 Smallegan, Jolyn Group: 152210
DOB: 03/23/2000 Insured ID: 947224684-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 29.38 0.00 0.00 0.00 0.00 29.38
SOMZA000 Somsouphanh, Zachary Group: 107310
DOB: 03/23/2003 Insured ID: 948024589-03
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
STEHE000 Steanburg, Helen Group: 783589
DOB: 02/03/1962 Insured ID: 948462499-00
97140-GP-59-97 -
Therapy-Manual
10/26/22 No 10/31/22 10/31/22 11.00 0.00 0.00 0.00 0.00 11.00
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
Patient Totals: 11.00 0.00 0.00 0.00 0.00 11.00
STERE001 Steenwyk, Reese Group: 783589
DOB: 09/08/2006 Insured ID: 947583882-03
99203-25 - New
10/31/22 Patient Exam - 30- No 11/03/22 11/03/22 65.16 0.00 0.00 0.00 0.00 65.16
44 Min
Provider: Dr Brian S Parkhurst DC
72100 - X-ray
10/31/22 Lumbosacral 2-3 No 11/03/22 11/03/22 52.26 0.00 0.00 0.00 0.00 52.26
Views
Provider: Dr Brian S Parkhurst DC
72040 - X-ray
10/31/22 Cervical Spine - 2-3 No 11/03/22 11/03/22 49.59 0.00 0.00 0.00 0.00 49.59
Views
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
10/31/22 Thoracic Spine - 2-3 No 11/03/22 11/03/22 50.66 0.00 0.00 0.00 0.00 50.66
Views
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 229.39 0.00 0.00 0.00 0.00 229.39
TERSC000 Terry, Scott Group: 100100
DOB: 10/08/1985 Insured ID: 947935968-02

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 98941-AT -
07/25/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 11.72 0.00 11.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 11.72 0.00 11.72
TERNI000 Tervoort, Nichole Group: 512910
DOB: 11/13/1982 Insured ID: 947246298-01
97110-GP-97 -
Therapy-
06/28/22 No 07/06/22 09/12/22 0.00 0.00 0.00 0.00 36.72 36.72
Therapeutic
Exercise
Provider: Dr James Friess DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 09/12/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 73.44 110.16
RASHE000 Thias, Heidi Group: 772173
DOB: 07/07/1982 Insured ID: 947775116-00
97140-GP-59-97 -
Therapy-Manual
10/03/22 No 10/10/22 10/10/22 0.00 6.00 0.00 0.00 0.00 6.00
(Trigger Point,
Myofascial Release)
Provider: Dr James Friess DC
Patient Totals: 0.00 6.00 0.00 0.00 0.00 6.00
TIMBE000 Timmer, Beth Group: 152210
DOB: 12/31/1971 Insured ID: 947224684-01
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/17/22 No 10/20/22 10/20/22 33.05 0.00 0.00 0.00 0.00 33.05
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/27/22 No 11/03/22 11/03/22 33.05 0.00 0.00 0.00 0.00 33.05
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 132.20 0.00 0.00 0.00 0.00 132.20
TIMJE000 Timmer, Jenna Group: 152210
DOB: 05/08/2002 Insured ID: 947224684-12
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions

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Provider: Dr Brian S Parkhurst DC
Patient Totals: 99.15 0.00 0.00 0.00 0.00 99.15
TIMKA000 Timmerman, Katherine Group: 777497
DOB: 01/11/1970 Insured ID: 949199045-00
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
TIMKE000 Timmerman, Kevin Group: 777497
DOB: 02/11/1961 Insured ID: 949199045-01
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
TINCH000 Tinney, Christopher, M Group: 786773
DOB: 07/24/1970 Insured ID: 947708526-00
97110-GP-97 -
Therapy-
09/20/22 No 09/26/22 09/26/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/03/22 No 10/10/22 10/10/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/07/22 No 10/13/22 10/13/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/10/22 No 10/13/22 10/13/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/13/22 No 10/20/22 10/20/22 49.06 0.00 0.00 0.00 0.00 49.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/11/22 Manipulation 3-4 No 10/17/22 10/17/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Samantha J Spooner DC
Patient Totals: 134.84 110.16 0.00 0.00 0.00 245.00
TWOCH000 Twork, Christopher Group: 786773
DOB: 01/30/1975 Insured ID: 947710227-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
VANKR000 VanBeek, Kristi Group: 100100
DOB: 11/17/1973 Insured ID: 947816079-00
98941-AT -
10/27/22 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Manipulation 3-4

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 Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
VANCA006 Vandermeulen, Cassandra Group: 256210
DOB: 04/21/1982 Insured ID: 947208392-03
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 29.38 0.00 0.00 0.00 0.00 29.38
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 29.38 0.00 0.00 0.00 0.00 29.38
VANMI000 Vanderschel, Michele, L Group: 786895
DOB: 03/24/1970 Insured ID: 947708492-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 73.44 0.00 0.00 0.00 0.00 73.44
VANCH001 Vandyke, Chad Group: 783589
DOB: 09/20/1988 Insured ID: 948087617-00
97140-GP-59-97 -
Therapy-Manual
10/18/22 No 10/24/22 10/24/22 11.00 0.00 0.00 0.00 0.00 11.00
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
10/07/22 No 10/13/22 10/13/22 0.00 11.00 0.00 0.00 0.00 11.00
(Trigger Point,
Myofascial Release)
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.00 11.00 0.00 0.00 0.00 22.00
VANJO001 Vanhaitsma, Joanne Group: 783589
DOB: 11/12/1959 Insured ID: 947583820-01
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 11.72 0.00 0.00 0.00 0.00 11.72
VANRH000 Vankley, Rhonda Group: 788997
DOB: 08/27/1975 Insured ID: 947918076-01
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 16.72 0.00 0.00 0.00 0.00 16.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 33.44 0.00 0.00 0.00 0.00 33.44
VANJE008 VanWoerkom, Jenifer, K Group: 780779
DOB: 07/30/1993 Insured ID: 949243175-00
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
VASIL000 Vasquez-Ochoa, Iliana Group: 791583
DOB: 07/30/1979 Insured ID: 948508649

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 98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
VINAL000 Vincent, Alexandra Group: 100100
DOB: 06/03/1993 Insured ID: 948589487-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 33.05 0.00 0.00 0.00 0.00 33.05
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 33.05 0.00 0.00 0.00 0.00 33.05
VISSA001 Visser, Sandra Group:
DOB: 08/02/1966 Insured ID: 947728745
97110-GP-97 -
Therapy-
10/19/22 No 10/24/22 10/24/22 24.06 0.00 0.00 0.00 0.00 24.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 24.06 0.00 0.00 0.00 0.00 24.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 24.06 0.00 0.00 0.00 0.00 24.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/25/22 No 10/31/22 10/31/22 24.06 0.00 0.00 0.00 0.00 24.06
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 11.72 0.00 0.00 0.00 0.00 11.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 119.68 0.00 0.00 0.00 0.00 119.68
TWOKA000 Voetberg, Kaylee Group: 786773
DOB: 09/23/1998 Insured ID: 947710227-00
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
VRIJE000 Vriezema, Jeffrey Group: 790681
DOB: 04/06/1979 Insured ID: 948834258-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 13.44 0.00 0.00 0.00 0.00 13.44
VRIRA000 Vriezema, Rachel Group: 790681
DOB: 12/24/1980 Insured ID: 948834258-01

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/20/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
WASRE000 Wassink, Rebecca Group: 786773
DOB: 04/04/1969 Insured ID: 947717265-01
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
WATCA000 Watkins, Catherine Group: 226510
DOB: 04/09/1958 Insured ID: 949025027-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
Patient Totals: 6.72 0.00 0.00 0.00 0.00 6.72
WITCU000 Witteveen, Curtis Group: 567100
DOB: 11/03/1965 Insured ID: 947147141-00
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 6.72 0.00 0.00 0.00 0.00 6.72
Regions
Provider: Dr James Friess DC
Patient Totals: 20.16 0.00 0.00 0.00 0.00 20.16
ZAMDO000 Zamora, Dominque Group: 780514
DOB: 04/22/1994 Insured ID: 948953014-00
97110-GP-97 -
Therapy-
11/01/22 No 11/09/22 11/09/22 29.06 0.00 0.00 0.00 0.00 29.06
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 29.06 0.00 0.00 0.00 0.00 29.06
Carrier Totals: 44,401.96 1,653.97 825.62 904.95 1,829.50 49,616.00
Priority Health Insurance - Medicaid 800-942-4765
AKRLO000 Akridge, Lora Group: 10001
DOB: 04/28/1983 Insured ID: 00555422655
98942-AT -
09/19/22 Manipulation 5 No 09/22/22 10/03/22 0.00 37.46 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
09/21/22 Manipulation 5 No 09/26/22 10/13/22 0.00 37.46 0.00 0.00 0.00 37.46
Regions
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
09/19/22 Thoracic Spine - 2-3 No 09/22/22 10/03/22 0.00 28.63 0.00 0.00 0.00 28.63
Views
Provider: Dr Karla A Parkhurst DC
72100 - X-ray
09/19/22 Lumbosacral 2-3 No 09/22/22 10/03/22 0.00 34.66 0.00 0.00 0.00 34.66
Views
Provider: Dr Karla A Parkhurst DC

Parkhurst Chiropractic Life Center PLC Page 165 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 99203-25 - New
09/19/22 Patient Exam - 30- No 09/22/22 10/03/22 0.00 87.77 0.00 0.00 0.00 87.77
44 Min
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
09/19/22 Cervical Spine - 2-3 No 09/22/22 10/03/22 0.00 33.27 0.00 0.00 0.00 33.27
Views
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 259.25 0.00 0.00 0.00 259.25
BELMA001 Beltran-Pena, Marissa Group: 10001
DOB: 11/06/1990 Insured ID: 0099321243
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 30.11 0.00 0.00 0.00 0.00 30.11
BRUKA000 Bruursema, Kara Group: 10001
DOB: 09/05/1981 Insured ID: 0025344768
98941-AT -
11/24/21 Manipulation 3-4 No 11/30/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
11/11/21 Manipulation 3-4 No 11/16/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/21 Manipulation 3-4 No 11/02/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
11/04/21 Manipulation 3-4 No 11/09/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/14/21 Manipulation 3-4 No 10/26/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/21/21 Manipulation 3-4 No 10/26/21 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 220.32 220.32
CARRA000 Carie, Raquel Group: 10004
DOB: 05/26/1956 Insured ID: 949183130-00
98942-AT -
06/20/22 Manipulation 5 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
06/23/22 Manipulation 5 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
06/16/22 Manipulation 5 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 50.92 50.92
Regions
Provider: Dr Karla A Parkhurst DC
99203-25 - New
06/16/22 Patient Exam - 30- No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 129.00 129.00
44 Min
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 281.76 281.76
CHRDA000 Christiansen, Dawn Group: 10001

Parkhurst Chiropractic Life Center PLC Page 166 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
DOB: 01/14/1977 Insured ID: 1025063488
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
Patient Totals: 45.96 0.00 0.00 0.00 0.00 45.96
CHRNO000 Christiansen, Noelle Group: 10003
DOB: 01/10/2006 Insured ID: 1025060904
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
CLARA001 Cladera, Raquelina Group: 10001
DOB: 03/07/1965 Insured ID: 0074639665
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
COBOL000 Cobos, Olivia Group: 10001
DOB: 11/06/1987 Insured ID: 0068489965
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 45.96 0.00 0.00 0.00 0.00 45.96
DEJTE000 DeJonge, Terry Group: 10004
DOB: 07/13/1961 Insured ID: 949012705-00
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr James Friess DC
98941-AT -
05/10/22 Manipulation 3-4 No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/12/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/16/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 31.04 31.04
DELIS000 Delgado, Ismael Group:
DOB: 07/07/1982 Insured ID: 0062839500
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 36.72 0.00 0.00 0.00 0.00 36.72

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 146.88 0.00 0.00 0.00 0.00 146.88
DUCER000 Ducharme, Erika Group: 10001
DOB: 05/26/2001 Insured ID: 0015489762
98941-AT -
01/13/22 Manipulation 3-4 No 01/20/22 10/20/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
ELLCH001 Elliott, Chelsea Group: 10004
DOB: 07/22/1992 Insured ID: 949031378-00
98941-AT -
10/07/22 Manipulation 3-4 No 10/13/22 10/26/22 0.00 20.00 0.00 0.00 0.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
08/25/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
04/20/22 Manipulation 3-4 No 04/25/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
05/02/22 Manipulation 3-4 No 05/05/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
98941-AT -
04/25/22 Manipulation 3-4 No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr James Friess DC
Patient Totals: 0.00 20.00 20.00 0.00 100.00 140.00
GALEM000 Galicia, Emma Group: 10001
DOB: 02/25/2022 Insured ID: 1270128547
98940-AT -
05/27/22 Manipulation 1-2 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/01/22 Manipulation 1-2 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
05/25/22 Manipulation 1-2 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
 98940-AT -
06/03/22 Manipulation 1-2 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/10/22 Manipulation 1-2 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/06/22 Manipulation 1-2 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/15/22 Manipulation 1-2 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/13/22 Manipulation 1-2 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
07/22/22 Manipulation 1-2 No 07/28/22 10/05/22 0.00 0.00 0.00 30.00 0.00 30.00
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
06/17/22 Manipulation 1-2 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr James Friess DC
98940-AT -
06/20/22 Manipulation 1-2 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/24/22 Manipulation 1-2 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
06/27/22 Manipulation 1-2 No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
07/01/22 Manipulation 1-2 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
07/05/22 Manipulation 1-2 No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Russell Sweet DC
98940-AT -
07/18/22 Manipulation 1-2 No 07/21/22 10/05/22 0.00 0.00 0.00 30.00 0.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98940-AT -
07/11/22 Manipulation 1-2 No 07/18/22 10/05/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Russell Sweet DC
98940-AT -
07/15/22 Manipulation 1-2 No 07/21/22 10/05/22 0.00 0.00 0.00 30.00 0.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 90.00 450.00 540.00
GEITA000 Geister, Taylor Group: 10001
DOB: 07/25/1994 Insured ID: 1217402494

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 45.96 0.00 0.00 0.00 0.00 45.96
GOCSK000 Gochenour, Skyla Group: 10001
DOB: 05/18/2001 Insured ID: 0015397141
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 30.11 0.00 0.00 0.00 0.00 30.11
GONSO000 Gonzalez, Sophia Group: 10001
DOB: 10/12/1972 Insured ID: 0013549950
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/25/22 Manipulation 5 No 10/31/22 10/31/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/18/22 Manipulation 5 No 10/24/22 10/24/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Samantha J Spooner DC
72040 - X-ray
10/18/22 Cervical Spine - 2-3 No 10/24/22 10/24/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Samantha J Spooner DC
99203-25 - New
10/18/22 Patient Exam - 30- No 10/24/22 10/24/22 133.00 0.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr Samantha J Spooner DC
72070 - X-ray
10/18/22 Thoracic Spine - 2-3 No 10/24/22 10/24/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Samantha J Spooner DC
72100 - X-ray
10/18/22 Lumbosacral 2-3 No 10/24/22 10/24/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Samantha J Spooner DC
Patient Totals: 425.33 0.00 0.00 0.00 0.00 425.33
GREVA001 Greathouse, Vanidy Group: 10001
DOB: 08/27/1984 Insured ID: 0057702282
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
HASKY000 Hassevoort, Kylee Group:
DOB: 07/10/1987 Insured ID: 1005078160
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions

Parkhurst Chiropractic Life Center PLC Page 170 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Samantha J Spooner DC
Patient Totals: 113.31 0.00 0.00 0.00 0.00 113.31
HAWAL000 Hawkins, Alayziah, I Group: 10001
DOB: 12/06/2005 Insured ID: 1028064291
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
HUGAL000 Hughes, Alma Group: 10001
DOB: 05/10/1960 Insured ID: 1269542779
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
KJENI000 Kjerstad, Nickolas Group: 10001
DOB: 12/02/1980 Insured ID: 1246434912
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 8.87 0.00 0.00 8.87
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/16/22 Manipulation 3-4 No 08/22/22 09/07/22 0.00 0.00 8.87 0.00 0.00 8.87
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/19/22 Manipulation 3-4 No 08/25/22 09/19/22 0.00 0.00 8.87 0.00 0.00 8.87
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 09/01/22 0.00 0.00 0.00 44.34 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/12/22 Manipulation 3-4 No 08/17/22 09/07/22 0.00 0.00 44.34 0.00 0.00 44.34
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/17/22 Manipulation 3-4 No 05/23/22 10/26/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/13/22 Manipulation 3-4 No 05/19/22 10/26/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/06/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
05/10/22 98941-AT - No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47

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 Manipulation 3-4
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/03/22 Manipulation 3-4 No 05/09/22 10/26/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/03/22 Manipulation 3-4 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
98941-AT -
05/27/22 Manipulation 3-4 No 06/02/22 10/24/22 0.00 0.00 0.00 0.00 43.47 43.47
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 70.95 44.34 391.23 506.52
KOREL000 Koros, Elijah Group: 10001
DOB: 07/18/2010 Insured ID: 1110704202
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
KORIS000 Koros, Isaac Group: 10001
DOB: 05/15/2013 Insured ID: 1110708758
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
KORNE000 Koros, Nehemiah Group: 1001
DOB: 07/29/2018 Insured ID: 1215195863
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
LENSO000 Lentz, Sommer Group: 10001
DOB: 03/29/1994 Insured ID: 0095578614
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
LOOAL000 Looman, Allison Group: 10001
DOB: 05/05/2011 Insured ID: 1057430415
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
LOOLA000 Looman, Lauren Group: 10001
DOB: 09/01/2016 Insured ID: 1181261417
98940-AT -
10/24/22 Manipulation 1-2 No 10/26/22 10/26/22 16.05 0.00 0.00 0.00 0.00 16.05
Regions
Provider: Dr Karla A Parkhurst DC

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Patient Totals: 16.05 0.00 0.00 0.00 0.00 16.05
LOPAN000 Lopez, Aniela Group: 10001
DOB: 06/04/1992 Insured ID: 0082018729
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 60.22 0.00 0.00 0.00 0.00 60.22
MAGKR000 Magennis, Kristin Group: 10004
DOB: 10/30/1974 Insured ID: 948898034-00
98941-AT -
07/15/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/24/22 Manipulation 3-4 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/01/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/19/22 Manipulation 3-4 No 08/25/22 09/12/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/12/22 Manipulation 3-4 No 08/17/22 09/01/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 10/05/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/05/22 0.00 0.00 0.00 20.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/13/22 Manipulation 3-4 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
04/21/22 98941-AT - No 04/28/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
04/15/22 Manipulation 3-4 No 04/21/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/10/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/14/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
04/08/22 Manipulation 3-4 No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
04/01/22 Manipulation 3-4 No 04/07/22 10/26/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
03/25/22 Manipulation 3-4 No 03/31/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
03/18/22 Manipulation 3-4 No 03/25/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
03/11/22 Manipulation 3-4 No 03/17/22 10/21/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/01/21 Manipulation 3-4 No 10/05/21 10/20/22 0.00 0.00 0.00 0.00 20.00 20.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 60.00 80.00 320.00 460.00
MANIR000 Mann, Iris Group: 10001
DOB: 04/12/1959 Insured ID: 1005934906
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 36.72 0.00 0.00 0.00 0.00 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 36.72 0.00 0.00 0.00 0.00 36.72
MANJO000 Mann, John Group: 10001
DOB: 01/08/1961 Insured ID: 1097009254
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
MCDSH000 McDole, Sherman Group: 10001
DOB: 07/21/1986 Insured ID: 1167282088
98941-AT -
04/01/22 Manipulation 3-4 No 04/07/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions

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Provider: Dr Russell Sweet DC
98941-AT -
04/08/22 Manipulation 3-4 No 04/14/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 73.44 73.44
GAMTA000 Mcdole, Tania Group:
DOB: 11/23/1986 Insured ID: 0064419443
98941-AT -
04/11/22 Manipulation 3-4 No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 36.72 36.72
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 36.72 36.72
MCFSA000 McFarland, Sara Group: 10001
DOB: 02/05/1987 Insured ID: 0041840999
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
01/04/22 Manipulation 3-4 No 01/07/22 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 22.98 0.00 0.00 0.00 41.50 64.48
MCQSH000 McQueen, Shauna Group: 10001
DOB: 11/05/1969 Insured ID: 1150347534
72100 - X-ray
10/24/22 Lumbosacral 2-3 No 10/26/22 10/26/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Karla A Parkhurst DC
99213-25 -
10/24/22 Established Patient No 10/26/22 10/26/22 98.00 0.00 0.00 0.00 0.00 98.00
Exam - 20-29 Min
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
10/24/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Karla A Parkhurst DC
72070 - X-ray
10/24/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 30.11 0.00 0.00 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 420.44 0.00 0.00 0.00 0.00 420.44
MELEL001 Melendez, Eleta Group: 10001
DOB: 07/08/1959 Insured ID: 1235892052
10/25/22 98941-AT - No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98

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 Manipulation 3-4
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
MEYCA001 Meyers, Carrie Group: 10004
DOB: 02/25/1976 Insured ID: 948228111-00
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/24/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 09/12/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/01/22 Manipulation 3-4 No 08/04/22 10/24/22 0.00 0.00 0.00 7.00 0.00 7.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
07/11/22 Manipulation 3-4 No 07/18/22 10/05/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 7.00 0.00 7.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 10/03/22 0.00 7.00 0.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 7.00 0.00 0.00 7.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
05/10/22 Manipulation 3-4 No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 35.00 35.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
05/23/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 35.00 35.00
Regions
Provider: Dr Matthew Meiste DC
98941-AT -
06/13/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 14.00 14.00 14.00 91.00 133.00
MORCA001 Moralez, Caleigh Group: 10001
DOB: 02/07/1995 Insured ID: 1211181411
98941-AT -
01/21/22 Manipulation 3-4 No 01/27/22 10/24/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/03/22 Manipulation 3-4 No 01/07/22 10/24/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 83.00 83.00
NIEVE000 Nienhuis, Veejay Group: 10004

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364 Garden Ave., Holland, MI 49424-8656
DOB: 03/23/1958 Insured ID: 949180047-00
98941-AT -
06/27/22 Manipulation 3-4 No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
05/11/22 Manipulation 3-4 No 05/16/22 10/24/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Russell Sweet DC
98940-AT -
06/23/22 Manipulation 1-2 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
06/21/22 Manipulation 1-2 No 06/28/22 10/05/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
07/27/22 Manipulation 1-2 No 08/01/22 10/05/22 0.00 0.00 0.00 5.40 0.00 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
08/01/22 Manipulation 1-2 No 08/04/22 10/05/22 0.00 0.00 0.00 5.40 0.00 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
05/16/22 Manipulation 1-2 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
05/13/22 Manipulation 1-2 No 05/19/22 10/24/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
07/18/22 Manipulation 1-2 No 07/21/22 10/05/22 0.00 0.00 0.00 5.40 0.00 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
07/14/22 Manipulation 1-2 No 07/21/22 10/05/22 0.00 0.00 0.00 5.40 0.00 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
06/29/22 Manipulation 1-2 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
98940-AT -
07/05/22 Manipulation 1-2 No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 5.40 5.40
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 21.60 47.92 69.52
NINMA000 Nino Guerra, Maria Group: 10004
DOB: 09/10/1974 Insured ID: 949012260-00
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/29/22 Manipulation 3-4 No 08/04/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/03/22 Manipulation 3-4 No 08/08/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions

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Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 09/01/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/18/22 Manipulation 3-4 No 02/24/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/25/22 Manipulation 3-4 No 03/03/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/06/22 Manipulation 3-4 No 06/09/22 10/05/22 0.00 0.00 0.00 0.00 25.13 25.13
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 31.04 102.69 133.73
NYHAS000 Nyhof, Ashley Group: 10001
DOB: 04/10/1987 Insured ID: 1040648282
99212-25 -
10/25/22 Established Patient No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Exam - 10-19 Min
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 81.98 0.00 0.00 0.00 0.00 81.98
OLIMA000 Olivares, Maria Group: 10001
DOB: 05/07/1976 Insured ID: 0089322944
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 45.96 0.00 0.00 0.00 0.00 45.96
ORTXA000 Ortiz, Xavier Group: 10001
DOB: 11/20/1993 Insured ID: 1273958801
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 68.94 0.00 0.00 0.00 0.00 68.94
PEDJA000 Pedraza, Jared Group: 10001
DOB: 04/11/2006 Insured ID: 0032644353
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98

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364 Garden Ave., Holland, MI 49424-8656
PEDMA000 Pedraza, Marlene Group: 10001
DOB: 06/30/1983 Insured ID: 0016188790
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
PRIIS001 Prins, Isabelle Group: 10001
DOB: 03/24/2004 Insured ID: 0025839040
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 114.90 0.00 0.00 0.00 0.00 114.90
RAYHO000 Raymond, Holly Group: 10001
DOB: 10/16/1983 Insured ID: 0019697950
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
Patient Totals: 45.96 0.00 0.00 0.00 0.00 45.96
RIVKA000 Rivera, Katelyne Group: 10001
DOB: 09/01/1996 Insured ID: 0095815049
98942-AT -
09/09/22 Manipulation 5 No 09/14/22 09/14/22 0.00 0.00 30.11 0.00 0.00 30.11
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 30.11 0.00 0.00 30.11
RUGEL000 Ruger, Elijah, R Group: 10001
DOB: 02/21/2018 Insured ID: 1213332589
98940-AT -
10/11/22 Manipulation 1-2 No 10/17/22 10/24/22 16.05 0.00 0.00 0.00 0.00 16.05
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 16.05 0.00 0.00 0.00 0.00 16.05
SMISY000 Smith, Sydni Group: 10001
DOB: 10/13/2007 Insured ID: 0037685429
98941-AT -
05/20/22 Manipulation 3-4 No 05/26/22 10/24/22 0.00 0.00 0.00 0.00 30.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 0.00 30.00 30.00

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364 Garden Ave., Holland, MI 49424-8656
STACH002 Stanley, Chad Group: 10001
DOB: 03/01/1979 Insured ID: 948480389-00
98941-AT -
01/20/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 35.00 35.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/28/22 Manipulation 3-4 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/06/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 35.00 35.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/14/22 Manipulation 3-4 No 01/25/22 10/20/22 0.00 0.00 0.00 0.00 35.00 35.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 0.00 0.00 112.00 112.00
STEMA001 Stevens, Mariann Group: 10004
DOB: 01/26/1963 Insured ID: 947842672-00
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/18/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/05/22 Manipulation 3-4 No 10/10/22 10/31/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/18/22 Manipulation 3-4 No 07/21/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/19/22 Manipulation 3-4 No 07/25/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 15.52 0.00 15.52 0.00 31.04
TERSA000 Terry, Sandra Group: 10001
DOB: 03/31/1987 Insured ID: 0065313082
98941-AT -
05/09/22 Manipulation 3-4 No 05/12/22 10/24/22 0.00 0.00 0.00 0.00 25.00 25.00
Regions
Provider: Dr Matthew Meiste DC
Patient Totals: 0.00 0.00 0.00 0.00 25.00 25.00
TREGR000 Trevino, Graciela Group: 10004
DOB: 04/25/1945 Insured ID: 948894183-00
98941-AT -
01/27/22 Manipulation 3-4 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
01/06/22 Manipulation 3-4 No 01/12/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/10/22 Manipulation 3-4 No 02/17/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/03/22 Manipulation 3-4 No 02/08/22 10/20/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Jeremy Lengkeek DC

Parkhurst Chiropractic Life Center PLC Page 180 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
03/08/22 Manipulation 3-4 No 03/14/22 10/21/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
02/24/22 Manipulation 3-4 No 03/03/22 10/20/22 0.00 0.00 0.00 0.00 35.87 35.87
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
03/15/22 Manipulation 3-4 No 03/21/22 10/21/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
04/22/22 Manipulation 3-4 No 04/28/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/26/22 Manipulation 3-4 No 09/01/22 09/12/22 0.00 0.00 7.76 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/29/22 Manipulation 3-4 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
07/08/22 Manipulation 3-4 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 7.76 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Russell Sweet DC
98941-AT -
07/22/22 Manipulation 3-4 No 07/28/22 10/05/22 0.00 0.00 0.00 7.76 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/03/22 Manipulation 3-4 No 10/10/22 10/31/22 0.00 7.76 0.00 0.00 0.00 7.76
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 7.76 7.76 15.52 237.55 268.59
TROAS000 Troutman, Ashley Group: 10001
DOB: 04/09/1987 Insured ID: 0023647168
98941-AT -
06/17/22 Manipulation 3-4 No 06/23/22 10/05/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/13/22 Manipulation 3-4 No 06/16/22 10/05/22 0.00 0.00 0.00 0.00 10.00 10.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
08/19/22 Manipulation 5 No 08/25/22 09/19/22 0.00 0.00 10.00 0.00 0.00 10.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
08/22/22 Manipulation 5 No 08/25/22 09/19/22 0.00 0.00 10.00 0.00 0.00 10.00
Regions
Provider: Dr Russell Sweet DC

Parkhurst Chiropractic Life Center PLC Page 181 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98942-AT -
08/16/22 Manipulation 5 No 08/22/22 09/07/22 0.00 0.00 10.00 0.00 0.00 10.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 30.00 0.00 20.00 50.00
TYESI001 Tye, Silver Group: 10001
DOB: 09/27/2002 Insured ID: 0020493040
98941-AT -
06/22/22 Manipulation 3-4 No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 22.98 22.98
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
99212-25 -
06/22/22 Established Patient No 06/30/22 10/05/22 0.00 0.00 0.00 0.00 55.00 55.00
Exam - 10-19 Min
Provider: Dr James Friess DC
Patient Totals: 22.98 0.00 0.00 0.00 77.98 100.96
VANAR001 Vanhuis, Arielle Group: 10001
DOB: 10/10/2003 Insured ID: 0024242432
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/20/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 91.92 0.00 0.00 0.00 0.00 91.92
VILKR000 Villa, Kristina Group: 10001
DOB: 12/06/1993 Insured ID: 1239922202
98942-AT -
12/02/21 Manipulation 5 No 12/07/21 10/26/22 0.00 0.00 0.00 0.00 37.46 37.46
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 37.46 37.46
WHIRO000 White, Ronda Group: 10001
DOB: 04/20/1969 Insured ID: 1127649358
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/24/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr James Friess DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
WISBR000 Wisniewski, Brian Group: 10001
DOB: 05/07/1981 Insured ID: 0060457043
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 22.98 0.00 0.00 0.00 0.00 22.98
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 22.98 0.00 0.00 0.00 0.00 22.98
ZUNLY000 Zuniga, Lyle Group: 10004
DOB: 04/26/1988 Insured ID: 947953957-00

Parkhurst Chiropractic Life Center PLC Page 182 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
05/20/22 Manipulation 3-4 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 12.50 12.50
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/23/22 Manipulation 3-4 No 06/06/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
05/27/22 Manipulation 3-4 No 06/06/22 10/21/22 0.00 0.00 0.00 0.00 38.78 38.78
Regions
Provider: Dr Brian S Parkhurst DC
99202-25 - New
05/20/22 Patient Exam - 15- No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 91.00 91.00
29 Min
Provider: Dr Brian S Parkhurst DC
72082 - X-Ray Full
05/20/22 No 06/06/22 10/24/22 0.00 0.00 0.00 0.00 118.00 118.00
Spine - 2-3 views
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 299.06 299.06
Carrier Totals: 2,296.40 316.53 232.82 312.02 3,146.39 6,304.16
Priority Health Insurance - Medicare 800-942-4765
ANDST000 Anderson, Stacey Group: 10003
DOB: 05/09/1955 Insured ID: 800265856-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BAULE000 Bauer, Leslie Group: 226510
DOB: 06/07/1947 Insured ID: 947144414-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
BECLO000 Becksford, Lois Group: 226510
DOB: 04/19/1947 Insured ID: 947350083-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/31/22 Cervical Spine - 2-3 No 11/03/22 11/03/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/31/22 Lumbosacral 2-3 No 11/03/22 11/03/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/31/22 Thoracic Spine - 2-3 No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/31/22 Patient Exam - 30- No 11/03/22 11/03/22 133.00 0.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 363.78 0.00 0.00 0.00 0.00 363.78
BERPE000 Berens, Penny Group: 10003
DOB: 05/25/1942 Insured ID: 94758245600
10/26/22 98941-AT - No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78

Parkhurst Chiropractic Life Center PLC Page 183 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
BERBU000 Bergman, Burton Group: 10003
DOB: 06/11/1950 Insured ID: 800119933-00
98940-AT -
10/26/22 Manipulation 1-2 No 10/31/22 10/31/22 6.98 0.00 0.00 0.00 0.00 6.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 6.98 0.00 0.00 0.00 0.00 6.98
BILFR000 Biller, Francis, X Group:
DOB: 10/28/1956 Insured ID: 800278275-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BOELA000 Boeve, Laurie Group: 10003
DOB: 05/21/1957 Insured ID: 800302927-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BOSCI000 Bos, Cindy, L Group: 10003
DOB: 10/18/1957 Insured ID: 800311632-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BOSSH000 Bos, Shirley Group: 387100
DOB: 08/18/1937 Insured ID: 949379899-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BRILI000 Britton-Burnham, Lillian Group: 10003
DOB: 10/09/1938 Insured ID: 948100726-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
BUFJA000 Buffington, Janie Group: 10003
DOB: 11/21/1947 Insured ID: 800303767-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
BUNJA000 Bunker, Jami Group: 10003
DOB: 01/03/1978 Insured ID: 92705451800
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78

Parkhurst Chiropractic Life Center PLC Page 184 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
CHRLE000 Chrisman, Lewis Group: 10003
DOB: 08/22/1951 Insured ID: 800150952-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
DANAR000 Dannenberg, Arlene Group: 10003
DOB: 07/29/1948 Insured ID: 948039207-00
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 30.92 0.00 0.00 0.00 0.00 30.92
DEJCI000 Dejong, Cindy Group: 10003
DOB: 09/11/1957 Insured ID: 800309620-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
DEMLO001 Demaagd, Louis Group: 10003
DOB: 08/06/1955 Insured ID: 800225156-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
DIEMA000 Diekema, Marcia Group: 10003
DOB: 03/01/1951 Insured ID: 947612944-00
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 30.92 0.00 0.00 0.00 0.00 30.92
DILBE000 Dileski, Beverly Group: 10003
DOB: 04/25/1951 Insured ID: 80014768900
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
DOKJA000 Dokter, James Group: 10003
DOB: 11/26/1953 Insured ID: 800172119-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
ELGHA000 Elgersma, Harvey Group: 10003
DOB: 02/13/1954 Insured ID: 800184641-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
FALRO000 Fales, Ronald Group: 226510
DOB: 06/10/1953 Insured ID: 947301389-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions

Parkhurst Chiropractic Life Center PLC Page 185 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 67.56 0.00 0.00 0.00 0.00 67.56
FRESA000 French, Sandra, J Group: 226510
DOB: 11/27/1939 Insured ID: 947144744-01
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/28/22 Patient Exam - 30- No 11/03/22 11/03/22 133.00 0.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/28/22 Thoracic Spine - 2-3 No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/28/22 Lumbosacral 2-3 No 11/03/22 11/03/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/28/22 Cervical Spine - 2-3 No 11/03/22 11/03/22 71.00 0.00 0.00 0.00 0.00 71.00
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 392.56 0.00 0.00 0.00 0.00 392.56
GARJO000 Gargala, John Group: 10003
DOB: 06/15/1957 Insured ID: 800304423-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
GEEMA000 Geerlings, Marlys, J Group: 10003
DOB: 06/03/1957 Insured ID: 800305474-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
GRELA000 Greathouse, Laureen Group: 10003
DOB: 03/26/1950 Insured ID: 948113885-00
98942-AT -
10/25/22 Manipulation 5 No 10/31/22 10/31/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
11/01/22 Manipulation 5 No 11/09/22 11/09/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Samantha J Spooner DC
98942-AT -
10/27/22 Manipulation 5 No 11/03/22 11/03/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Samantha J Spooner DC
Patient Totals: 92.76 0.00 0.00 0.00 0.00 92.76

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364 Garden Ave., Holland, MI 49424-8656
HAMRE000 Hamrick-Glover, Retha, J Group: 10003
DOB: 05/11/1951 Insured ID: 800226843-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
HAREV000 Harris, Evelyn Group: 10003
DOB: 12/13/1946 Insured ID: 947792961-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
HOEBE000 Hoekstra, Betty Group: 10003
DOB: 11/16/1950 Insured ID: 800282502-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
HORJA001 Horgan, James Group: 10003
DOB: 10/06/1947 Insured ID: 948289795-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
HOVPA000 Hoving, Patricia Group: 10003
DOB: 02/20/1947 Insured ID: 947826511-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 37.56 0.00 0.00 0.00 0.00 37.56
JAGCA000 Jager, Carl Group: 10003
DOB: 01/16/1957 Insured ID: 800287052-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
JONGL000 Jones, Gloria Group:
DOB: 04/04/1943 Insured ID: 947790678-00
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 40.92 0.00 0.00 0.00 0.00 40.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 40.92 0.00 0.00 0.00 0.00 40.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 81.84 0.00 0.00 0.00 0.00 81.84
KEAJA000 Keag, James Group: 10003
DOB: 04/08/1953 Insured ID: 800152773-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78

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 Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 37.56 0.00 0.00 0.00 0.00 37.56
KEILO000 Keifer, Lorraine Group: 10003
DOB: 02/03/1950 Insured ID: 948129180-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
KESMI000 Kesterke, Michael Group: 226510
DOB: 04/06/1953 Insured ID: 947541589-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
KLEBA000 Kleis, Barbara Group: 10003
DOB: 11/20/1951 Insured ID: 800118475-00
72100 - X-ray
10/26/22 Lumbosacral 2-3 No 11/03/22 11/03/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr James Friess DC
72040 - X-ray
10/26/22 Cervical Spine - 2-3 No 11/03/22 11/03/22 36.00 0.00 0.00 0.00 0.00 36.00
Views
Provider: Dr James Friess DC
72070 - X-ray
10/26/22 Thoracic Spine - 2-3 No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr James Friess DC
99212-25 -
10/26/22 Established Patient No 11/03/22 11/03/22 59.00 0.00 0.00 0.00 0.00 59.00
Exam - 10-19 Min
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 263.56 0.00 0.00 0.00 0.00 263.56
KLOWI000 Kloosterman, Willard Group: 10003
DOB: 09/22/1932 Insured ID: 947587582-00
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 30.92 0.00 0.00 0.00 0.00 30.92
KOELA000 Koedam, Lavonne, J Group: 10003
DOB: 06/17/1952 Insured ID: 800135663-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78

Parkhurst Chiropractic Life Center PLC Page 188 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
KOLBE000 Kolean, Betty Group: 226510
DOB: 11/09/1942 Insured ID: 947150285-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
KOLMA000 Kolk, Maryellen Group: 10003
DOB: 02/21/1948 Insured ID: 947911783-00
98940-AT -
10/31/22 Manipulation 1-2 No 11/03/22 11/03/22 6.98 0.00 0.00 0.00 0.00 6.98
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 6.98 0.00 0.00 0.00 0.00 6.98
MARMI001 Marble, Mildred Group: 10003
DOB: 10/08/1936 Insured ID: 947597226-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 37.56 0.00 0.00 0.00 0.00 37.56
MEESH000 Meengs, Sharon Group: 10003
DOB: 01/02/1946 Insured ID: 947694618-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
MILKA000 Mills, Kathleen Group: 10003
DOB: 04/29/1944 Insured ID: 947518020-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
MONLE000 Montes, Leandro Group:
DOB: 09/16/1946 Insured ID: 947794705-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 37.56 0.00 0.00 0.00 0.00 37.56
MORDI000 Morgan, Diana Group: 10003
DOB: 06/04/1957 Insured ID: 800305975-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
NALGR000 Nale, Gretchen Group: 10003
DOB: 02/18/1944 Insured ID: 800127710-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
PETHA000 Peters, Harlan Group:
DOB: 02/22/1955 Insured ID: 800215240-00
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 30.92 0.00 0.00 0.00 0.00 30.92
REDRO000 Redmond, Rosemarie Group: 226510
DOB: 10/07/1952 Insured ID: 94887883500
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
REEBE000 Reek, Beverly, J Group: 10003
DOB: 06/29/1946 Insured ID: 947764752-00
98942-AT -
06/30/22 Manipulation 5 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 30.92 30.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
07/01/22 Manipulation 5 No 07/06/22 10/05/22 0.00 0.00 0.00 0.00 30.92 30.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
07/06/22 Manipulation 5 No 07/11/22 10/05/22 0.00 0.00 0.00 0.00 30.92 30.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
07/20/22 Manipulation 5 No 07/25/22 10/05/22 0.00 0.00 0.00 30.92 0.00 30.92
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
07/08/22 Manipulation 5 No 07/13/22 10/05/22 0.00 0.00 0.00 0.00 30.92 30.92
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 30.92 123.68 154.60
REYDE000 Reynolds, Deborah Group:
DOB: 11/27/1954 Insured ID: 800192823-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
RODFR000 Rodriguez, Francisca Group: 10003
DOB: 01/07/1950 Insured ID: 800189131-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
SABRO000 Sabin, Ronald Group: 10003
DOB: 02/17/1948 Insured ID: 947898893-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
11/01/22 98941-AT - No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78

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364 Garden Ave., Holland, MI 49424-8656
 Manipulation 3-4
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 56.34 0.00 0.00 0.00 0.00 56.34
SCHDE000 Schaap, Debra Group: 226510
DOB: 03/07/1954 Insured ID: 948443076-00
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr James Friess DC
Patient Totals: 57.56 0.00 0.00 0.00 0.00 57.56
SCHMA003 Schaap, Marc, J Group: 226510
DOB: 05/13/1954 Insured ID: 948443076-01
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr James Friess DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
SCHCA000 Scholten, Cathryn Group: 10003
DOB: 04/28/1942 Insured ID: 947448251-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
SCHDO000 Scholten, Donald Group: 10003
DOB: 09/08/1950 Insured ID: 800134217-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
ELGJA000 Sheppard-Elgersma, Janet Group: 10003
DOB: 07/07/1949 Insured ID: 948081453-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
SHOCL000 Shosten, Claudia Group: 10003
DOB: 11/09/1946 Insured ID: 947920157-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
SNYLI001 Snyder, Linda Group: 10003
DOB: 06/21/1949 Insured ID: 948022380-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78

Parkhurst Chiropractic Life Center PLC Page 191 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
STEBO000 Stehle, Bonnie Group: 10003
DOB: 09/14/1951 Insured ID: 947707981-00
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 56.34 0.00 0.00 0.00 0.00 56.34
STEMA001 Stevens, Mariann Group: 10003
DOB: 01/26/1963 Insured ID: 800221522-00
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 77.56 0.00 0.00 0.00 0.00 77.56
TERAL000 TerHaar, Allyn Group: 10003
DOB: 09/13/1945 Insured ID: 800129279-00
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
TREGR000 Trevino, Graciela Group: 10003
DOB: 04/25/1945 Insured ID: 800188564-00
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 38.78 0.00 0.00 0.00 38.78
VANSA002 Vandenheuvel, Sandra Group: 10003
DOB: 02/19/1949 Insured ID: 948053946
98941-AT -
08/25/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 09/01/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
08/31/22 Manipulation 3-4 No 09/07/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Regions
Provider: Dr Karla A Parkhurst DC
72040 - X-ray
08/25/22 Cervical Spine - 2-3 No 09/01/22 09/26/22 0.00 0.00 20.00 0.00 0.00 20.00
Views
Provider: Dr Karla A Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 0.00 0.00 100.00 0.00 0.00 100.00
VANKE003 Vanderkooi, Kenneth Group: 10003
DOB: 09/19/1954 Insured ID: 800286209-00
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
VANVI001 Vandersloot, Vicki Group: 226510
DOB: 07/28/1956 Insured ID: 948604772-00
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 28.78 0.00 0.00 0.00 0.00 28.78
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 28.78 0.00 0.00 0.00 0.00 28.78
VANMA007 VanRhee, Marcia Group: 10003
DOB: 12/11/1955 Insured ID: 800249556-00
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr James Friess DC
Patient Totals: 56.34 0.00 0.00 0.00 0.00 56.34
WALDE000 Walburg, Debra Group: 10003
DOB: 12/05/1956 Insured ID: 800279365
98941-AT -
09/16/22 Manipulation 3-4 No 09/22/22 09/22/22 0.00 18.78 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 0.00 18.78 0.00 0.00 0.00 18.78
WOLSH000 Wolters, Sharon Group: 10003
DOB: 02/02/1952 Insured ID: 800132941-00
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 30.92 0.00 0.00 0.00 0.00 30.92
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 30.92 0.00 0.00 0.00 0.00 30.92
Carrier Totals: 2,812.54 57.56 100.00 30.92 123.68 3,124.70
Progressive Michigan Ins Company 888-622-6658
KELCH000 Kellum, Chance Group:
DOB: 09/27/2001 Insured ID: 22-9000873
97110-GP-97 -
Therapy-
08/17/22 No 08/22/22 11/07/22 0.00 0.00 36.72 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/08/22 No 08/22/22 11/07/22 0.00 0.00 0.00 36.72 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/21/22 No 09/26/22 11/07/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise

Parkhurst Chiropractic Life Center PLC Page 193 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/14/22 No 09/22/22 11/07/22 0.00 36.72 0.00 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/31/22 No 09/07/22 11/07/22 0.00 0.00 68.00 0.00 0.00 68.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/28/22 No 10/03/22 11/07/22 0.00 41.41 0.00 0.00 0.00 41.41
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/24/22 No 08/29/22 11/07/22 0.00 0.00 36.72 0.00 0.00 36.72
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/15/22 Manipulation 3-4 No 08/22/22 11/07/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/10/22 Manipulation 3-4 No 08/15/22 11/07/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 11/07/22 0.00 0.00 0.00 50.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/22/22 Manipulation 3-4 No 08/25/22 11/07/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/12/22 Manipulation 3-4 No 09/14/22 11/07/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/03/22 Manipulation 3-4 No 08/08/22 11/07/22 0.00 0.00 0.00 36.72 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 11/07/22 0.00 36.72 0.00 0.00 0.00 36.72
Regions
Provider: Dr Brian S Parkhurst DC
72070 - X-ray
08/03/22 Thoracic Spine - 2-3 No 08/08/22 11/07/22 0.00 0.00 0.00 50.66 0.00 50.66
Views
Provider: Dr Brian S Parkhurst DC
72040 - X-ray
08/03/22 Cervical Spine - 2-3 No 08/08/22 11/07/22 0.00 0.00 0.00 49.59 0.00 49.59
Views
Provider: Dr Brian S Parkhurst DC
99203-25 - New
08/03/22 Patient Exam - 30- No 08/08/22 11/07/22 0.00 0.00 0.00 65.16 0.00 65.16
44 Min
Provider: Dr Brian S Parkhurst DC
72100 - X-ray
08/03/22 Lumbosacral 2-3 No 08/08/22 11/07/22 0.00 0.00 0.00 52.26 0.00 52.26
Views

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 188.29 241.44 391.11 0.00 820.84
Carrier Totals: 0.00 188.29 241.44 391.11 0.00 820.84
Sisco
VANSA001 Franklin, Sanne Group: 276
DOB: 05/26/1996 Insured ID: 992764129
98941-AT -
10/14/22 Manipulation 3-4 No 10/17/22 10/17/22 29.14 0.00 0.00 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
98941-AT -
10/31/22 Manipulation 3-4 No 10/31/22 10/31/22 29.14 0.00 0.00 0.00 0.00 29.14
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 58.28 0.00 0.00 0.00 0.00 58.28
GENLY001 Gentry-Salas, Lynette Group: 276
DOB: 04/17/1966 Insured ID: 992761528
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 37.46 0.00 0.00 0.00 0.00 37.46
Regions
Provider: Dr James Friess DC
Patient Totals: 37.46 0.00 0.00 0.00 0.00 37.46
Carrier Totals: 95.74 0.00 0.00 0.00 0.00 95.74
TIG 858-716-2203
MULBR000 Mulder, Brenda Group:
DOB: 11/22/1966 Insured ID: WM7529
98942-AT -
11/04/22 Manipulation 5 No 11/07/22 11/07/22 47.22 0.00 0.00 0.00 0.00 47.22
Regions
Provider: Dr James Friess DC
Patient Totals: 47.22 0.00 0.00 0.00 0.00 47.22
Carrier Totals: 47.22 0.00 0.00 0.00 0.00 47.22
UHSS 866-913-2641
COMJE000 Compagner, Jeffrey Group: N73
DOB: 04/02/1966 Insured ID: HHN730925
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 30.00 0.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 30.00 0.00 0.00 0.00 0.00 30.00
Carrier Totals: 30.00 0.00 0.00 0.00 0.00 30.00
UMR Harrington 800-826-9781
JOHAD000 Johnston, Adam Group: 76-413588
DOB: 06/21/2003 Insured ID: 20004582
97012-GP -
01/28/22 Therapy- No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 15.38 15.38
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
01/21/22 Therapy- No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 15.38 15.38
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
98941-AT -
01/28/22 Manipulation 3-4 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
01/21/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 41.50 41.50
Regions
Provider: Dr Brian S Parkhurst DC

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364 Garden Ave., Holland, MI 49424-8656
 97110-GP-97 -
Therapy-
01/21/22 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 62.24 62.24
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
01/28/22 No 02/03/22 10/20/22 0.00 0.00 0.00 0.00 62.24 62.24
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 0.00 0.00 238.24 238.24
SPESH000 Speet , Shannon Group: 76-410581
DOB: 10/18/1972 Insured ID: Y16785651
98941-AT -
10/14/22 Manipulation 3-4 No 10/20/22 10/20/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 40.00 0.00 0.00 0.00 0.00 40.00
SPLRE000 Splan, Rebecca Group: 76-412251
DOB: 05/30/1985 Insured ID: 17062896
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
Carrier Totals: 90.00 0.00 0.00 0.00 238.24 328.24
United Healthcare
CISLU000 Cistaro, Luciano Group: 905050
DOB: 04/15/2000 Insured ID: 996974450
98941-AT -
09/02/22 Manipulation 3-4 No 09/07/22 09/07/22 0.00 0.00 45.00 0.00 0.00 45.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 0.00 0.00 45.00 0.00 0.00 45.00
LOSJO000 Lostoski, Joseph, P Group: 204475
DOB: 07/04/1993 Insured ID: 982568548
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 15.00 0.00 0.00 0.00 0.00 15.00
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/21/22 No 10/26/22 10/26/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
TENKA000 Tenbrink, Kathy, J Group: 905754
DOB: 01/08/1976 Insured ID: 934291092
98941-AT -
10/20/22 Manipulation 3-4 No 10/26/22 10/26/22 30.00 0.00 0.00 0.00 0.00 30.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 70.00 0.00 0.00 0.00 0.00 70.00
Carrier Totals: 120.00 0.00 45.00 0.00 0.00 165.00
United Healthcare - Commercial 877-842-3210
HOEKE000 Hoekstra, Kelly-Jo Group: 751948
DOB: 09/07/1980 Insured ID: 966076921

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 35.00 0.00 0.00 0.00 0.00 35.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 35.00 0.00 0.00 0.00 0.00 35.00
MACCL000 Mackenzie, Clara, A Group: 901872
DOB: 08/04/1962 Insured ID: 913557329
97140-GP-59-97 -
Therapy-Manual
10/24/22 No 10/26/22 10/26/22 25.60 0.00 0.00 0.00 0.00 25.60
(Trigger Point,
Myofascial Release)
Provider: Dr Karla A Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 14.40 0.00 0.00 0.00 0.00 14.40
Therapeutic
Exercise
Provider: Dr Karla A Parkhurst DC
Patient Totals: 40.00 0.00 0.00 0.00 0.00 40.00
MEEDE000 Meengs, Deanna Group: 710702
DOB: 11/18/1974 Insured ID: 917960755
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 10.00 0.00 0.00 0.00 0.00 10.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 10.00 0.00 0.00 0.00 0.00 10.00
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 10.00 0.00 0.00 0.00 0.00 10.00
Regions
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
10/19/22 Thoracic Spine - 2-3 No 10/26/22 10/26/22 59.00 0.00 0.00 0.00 0.00 59.00
Views
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
10/19/22 Cervical Spine - 2-3 No 10/26/22 10/26/22 31.00 0.00 0.00 0.00 0.00 31.00
Views
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
10/21/22 Patient Exam - 30- No 10/26/22 10/26/22 133.00 0.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
10/19/22 Lumbosacral 2-3 No 10/26/22 10/26/22 72.00 0.00 0.00 0.00 0.00 72.00
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 325.00 0.00 0.00 0.00 0.00 325.00
VESKI000 Vesper, Kimberly Group: 901872
DOB: 05/21/1972 Insured ID: 904793496
72070 - X-ray
10/13/22 Thoracic Spine - 2-3 No 10/20/22 10/20/22 47.20 0.00 0.00 0.00 0.00 47.20
Views
Provider: Dr Russell Sweet DC
72100 - X-ray
10/13/22 Lumbosacral 2-3 No 10/20/22 10/20/22 57.60 0.00 0.00 0.00 0.00 57.60
Views
Provider: Dr Russell Sweet DC
72040 - X-ray
10/13/22 Cervical Spine - 2-3 No 10/20/22 10/20/22 56.80 0.00 0.00 0.00 0.00 56.80
Views
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 40.00 0.00 0.00 0.00 0.00 40.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 321.60 0.00 0.00 0.00 0.00 321.60
Carrier Totals: 721.60 0.00 0.00 0.00 0.00 721.60
United Healthcare - Community Plan
CHRLA000 Christiansen, Lawrence Group: MIDSNP
DOB: 07/30/1971 Insured ID: 121767921-00
98942-AT -
10/26/22 Manipulation 5 No 10/31/22 10/31/22 29.59 0.00 0.00 0.00 0.00 29.59
Regions
Provider: Dr James Friess DC
98942-AT -
10/19/22 Manipulation 5 No 10/24/22 10/24/22 29.59 0.00 0.00 0.00 0.00 29.59
Regions
Provider: Dr James Friess DC
Patient Totals: 59.18 0.00 0.00 0.00 0.00 59.18
JIPCI000 Jipping, Cindy Group: MPHCP
DOB: 11/11/1975 Insured ID: 120762755
98941-AT -
01/21/22 Manipulation 3-4 No 01/27/22 10/20/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
04/26/22 Manipulation 3-4 No 05/02/22 10/21/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
06/07/22 Manipulation 3-4 No 06/13/22 10/05/22 0.00 0.00 0.00 0.00 7.00 7.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
08/05/22 Manipulation 3-4 No 08/11/22 08/29/22 0.00 0.00 0.00 7.00 0.00 7.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 0.00 0.00 7.00 64.00 71.00
MELPH000 Melendez, Philip Group:
DOB: 07/10/1982 Insured ID: 119251950
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 19.53 0.00 0.00 0.00 0.00 19.53
RICIS000 Richardson, Isabella Group: MIPHCP
DOB: 12/29/2014 Insured ID: 106959844
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 19.53 0.00 0.00 0.00 0.00 19.53
RICTE001 Richardson, Tessa Group: UHCCP
DOB: 06/16/1992 Insured ID: 105442193
98942-AT -
10/25/22 Manipulation 5 No 10/31/22 10/31/22 29.59 0.00 0.00 0.00 0.00 29.59
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 29.59 0.00 0.00 0.00 0.00 29.59
SMISH000 Smith, Shonda, K Group: MIPHCP
DOB: 02/21/1975 Insured ID: 123803097
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Jeremy Lengkeek DC
98941-AT -
10/19/22 Manipulation 3-4 No 10/24/22 10/26/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 19.53 0.00 0.00 0.00 0.00 19.53
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 78.12 0.00 0.00 0.00 0.00 78.12
Carrier Totals: 205.95 0.00 0.00 7.00 64.00 276.95
United Healthcare - Medicare 877-842-3210
DEYGL000 DeYoung, Gloria Group: 16175
DOB: 11/13/1942 Insured ID: 950828020-00
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 46.00 0.00 0.00 0.00 0.00 46.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 46.00 0.00 0.00 0.00 0.00 46.00
FITJO000 Fitzhugh, Joey Group: MIDSNP
DOB: 07/17/1955 Insured ID: 121085367
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 38.78 0.00 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 38.78 0.00 0.00 0.00 0.00 38.78
JOHKI000 Johnson, Kim Group: 12809
DOB: 06/14/1957 Insured ID: 995142308-00
97012-GP -
10/26/22 Therapy- No 10/31/22 10/31/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/17/22 10/17/22 22.78 0.00 0.00 0.00 0.00 22.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/31/22 Manipulation 3-4 No 11/03/22 11/03/22 22.78 0.00 0.00 0.00 0.00 22.78
Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/31/22 10/31/22 22.78 0.00 0.00 0.00 0.00 22.78
Regions
Provider: Dr James Friess DC

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364 Garden Ave., Holland, MI 49424-8656
Patient Totals: 92.34 0.00 0.00 0.00 0.00 92.34
SMISH000 Smith, Shonda, K Group: MIDSNP
DOB: 02/21/1975 Insured ID: 122956930
98941-AT -
08/24/22 Manipulation 3-4 No 08/29/22 09/26/22 0.00 0.00 38.78 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/29/22 09/29/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/21/22 Manipulation 3-4 No 09/26/22 09/26/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/19/22 Manipulation 3-4 No 09/22/22 10/03/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/13/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/28/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/27/22 Manipulation 3-4 No 10/03/22 10/03/22 0.00 38.78 0.00 0.00 0.00 38.78
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 0.00 232.68 38.78 0.00 0.00 271.46
WASKA000 Wassick, Karen, H Group: 13523
DOB: 08/28/1956 Insured ID: 950821042-00
98941-AT -
10/13/22 Manipulation 3-4 No 10/20/22 10/20/22 18.78 0.00 0.00 0.00 0.00 18.78
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 18.78 0.00 0.00 0.00 0.00 18.78
Carrier Totals: 195.90 232.68 38.78 0.00 0.00 467.36
United Healthcare - Medicare 800-826-9781
GARJO003 Garcia, Josefina Group: MIDSNP
DOB: 03/02/1938 Insured ID: 120765822
98942-AT -
10/20/22 Manipulation 5 No 10/26/22 10/26/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Karla A Parkhurst DC
Patient Totals: 61.00 0.00 0.00 0.00 0.00 61.00
JIPCI000 Jipping, Cindy Group: MDSNP
DOB: 11/11/1975 Insured ID: 120696258
98941-AT -
10/25/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/26/22 10/26/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/24/22 10/24/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
11/01/22 Manipulation 3-4 No 11/09/22 11/09/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 250.00 0.00 0.00 0.00 0.00 250.00
Carrier Totals: 311.00 0.00 0.00 0.00 0.00 311.00
VA Community Care - Optum
BIOTR000 Biolette, Travis Group:
DOB: 10/14/1975 Insured ID: 1094761464
98942-AT -
10/10/22 Manipulation 5 No 10/13/22 10/13/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr James Friess DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
10/24/22 Therapy- No 10/26/22 10/26/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/24/22 No 10/26/22 10/26/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr James Friess DC
97110-GP-97 -
Therapy-
10/10/22 No 10/13/22 10/13/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/24/22 Therapeutic No 10/26/22 10/26/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr James Friess DC
97124-59-GP -
10/31/22 Therapeutic No 11/03/22 11/03/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/10/22 Therapeutic No 10/13/22 10/13/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
Patient Totals: 498.00 0.00 0.00 0.00 0.00 498.00
BOEDE000 Boeve, Dennis Group:
DOB: 02/20/1949 Insured ID: 1017700492V568758

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364 Garden Ave., Holland, MI 49424-8656
 98941-AT -
11/01/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
11/01/22 No 11/03/22 11/03/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
Patient Totals: 120.00 0.00 0.00 0.00 0.00 120.00
BOWTI000 Bowes, Timothy, W Group:
DOB: 03/21/1979 Insured ID: 565952132
97110-GP-97 -
Therapy-
10/18/22 No 10/21/22 10/21/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
98941-AT -
10/18/22 Manipulation 3-4 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Russell Sweet DC
98941-AT -
09/16/22 Manipulation 3-4 No 09/19/22 09/19/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/10/22 Manipulation 3-4 No 10/13/22 10/13/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
97124-59-GP -
10/18/22 Therapeutic No 10/21/22 10/21/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Russell Sweet DC
Patient Totals: 189.00 50.00 0.00 0.00 0.00 239.00
BUSMA000 Bussinger, Mark Group:
DOB: 02/15/1965 Insured ID: 386726983
97110-GP-97 -
Therapy-
11/07/22 No 11/07/22 11/07/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/10/22 No 10/26/22 10/26/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/26/22 No 10/26/22 10/26/22 0.00 70.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/12/22 No 10/26/22 10/26/22 0.00 70.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
08/29/22 No 10/26/22 10/26/22 0.00 0.00 70.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98942-AT -
11/07/22 Manipulation 5 No 11/07/22 11/07/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Brian S Parkhurst DC
98941-AT -
08/29/22 Manipulation 3-4 No 10/26/22 10/26/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/12/22 Manipulation 3-4 No 10/26/22 10/26/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
Patient Totals: 201.00 190.00 120.00 0.00 0.00 511.00
CHAMA000 Chartrand, Mark Group:
DOB: 06/27/1966 Insured ID: 371824858
97110-GP-97 -
Therapy-
12/03/21 No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 34.00 34.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
12/03/21 Manipulation 3-4 No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 50.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
12/03/21 Therapeutic No 12/24/21 10/20/22 0.00 0.00 0.00 0.00 54.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/23/22 No 09/26/22 10/21/22 0.00 34.00 0.00 0.00 0.00 34.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/28/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/23/22 Manipulation 3-4 No 09/26/22 10/21/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
09/23/22 Therapeutic No 09/26/22 10/21/22 0.00 54.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/28/22 Therapeutic No 11/03/22 11/03/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
Patient Totals: 139.00 138.00 0.00 0.00 138.00 415.00
CORBE000 Coronado, Belinda Group:
DOB: 06/13/1970 Insured ID: 325620400
98941-AT -
10/12/22 Manipulation 3-4 No 10/13/22 10/13/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 50.00 0.00 0.00 0.00 0.00 50.00
CRIRY000 Crist, Ryan, A Group:
DOB: 03/17/1990 Insured ID: 370113039
98942-AT -
10/07/22 Manipulation 5 No 10/10/22 10/10/22 0.00 61.00 0.00 0.00 0.00 61.00

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr James Friess DC
98942-AT -
10/10/22 Manipulation 5 No 10/10/22 10/10/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr James Friess DC
98942-AT -
10/14/22 Manipulation 5 No 10/17/22 10/17/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr James Friess DC
98942-AT -
10/31/22 Manipulation 5 No 10/31/22 10/31/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr James Friess DC
97012-GP -
11/03/22 Therapy- No 11/07/22 11/07/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/14/22 Therapy- No 10/17/22 10/17/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/17/22 Therapy- No 10/17/22 10/17/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/10/22 Therapy- No 10/10/22 10/10/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/07/22 Therapy- No 10/10/22 10/10/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/12/22 Therapy- No 10/13/22 10/13/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/26/22 Therapy- No 10/26/22 10/26/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/19/22 Therapy- No 10/21/22 10/21/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
10/21/22 Therapy- No 10/21/22 10/21/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
97012-GP -
09/30/22 Therapy- No 10/05/22 10/05/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr James Friess DC
98941-AT -
09/30/22 Manipulation 3-4 No 10/05/22 10/05/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/19/22 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Manipulation 3-4

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364 Garden Ave., Holland, MI 49424-8656
 Regions
Provider: Dr James Friess DC
98941-AT -
10/26/22 Manipulation 3-4 No 10/26/22 10/26/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
11/03/22 Manipulation 3-4 No 11/07/22 11/07/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/17/22 Manipulation 3-4 No 10/17/22 10/17/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/12/22 Manipulation 3-4 No 10/13/22 10/13/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
72040 - X-ray
09/30/22 Cervical Spine - 2-3 No 10/05/22 10/05/22 0.00 71.00 0.00 0.00 0.00 71.00
Views
Provider: Dr James Friess DC
99203-25 - New
09/30/22 Patient Exam - 30- No 10/05/22 10/05/22 0.00 133.00 0.00 0.00 0.00 133.00
44 Min
Provider: Dr James Friess DC
72100 - X-ray
09/30/22 Lumbosacral 2-3 No 10/05/22 10/05/22 0.00 72.00 0.00 0.00 0.00 72.00
Views
Provider: Dr James Friess DC
72070 - X-ray
09/30/22 Thoracic Spine - 2-3 No 10/05/22 10/05/22 0.00 59.00 0.00 0.00 0.00 59.00
Views
Provider: Dr James Friess DC
Patient Totals: 675.00 494.00 0.00 0.00 0.00 1,169.00
ORTJA000 Ortiz, James Group:
DOB: 06/04/1968 Insured ID: 368887263
98942-AT -
10/24/22 Manipulation 5 No 10/26/22 10/26/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Russell Sweet DC
Patient Totals: 61.00 0.00 0.00 0.00 0.00 61.00
RICJA000 Richardson, Jackie, M Group:
DOB: 12/14/1972 Insured ID: 364704823
97110-GP-97 -
Therapy-
10/28/22 No 11/03/22 11/03/22 70.00 0.00 0.00 0.00 0.00 70.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
10/31/22 No 11/03/22 11/03/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
09/21/22 No 09/22/22 09/22/22 0.00 68.00 0.00 0.00 0.00 68.00
Therapeutic
Exercise
Provider: Dr Russell Sweet DC
97110-GP-97 -
Therapy-
09/13/22 No 09/14/22 09/14/22 0.00 68.00 0.00 0.00 0.00 68.00
Therapeutic
Exercise

Parkhurst Chiropractic Life Center PLC Page 205 Insurance Accounts Receivable Report
364 Garden Ave., Holland, MI 49424-8656
Provider: Dr Russell Sweet DC
98942-AT -
10/31/22 Manipulation 5 No 11/03/22 11/03/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
10/28/22 Manipulation 5 No 11/03/22 11/03/22 61.00 0.00 0.00 0.00 0.00 61.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
09/09/22 Manipulation 5 No 09/12/22 09/12/22 0.00 0.00 60.00 0.00 0.00 60.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
09/13/22 Manipulation 5 No 09/14/22 09/14/22 0.00 60.00 0.00 0.00 0.00 60.00
Regions
Provider: Dr Russell Sweet DC
98942-AT -
09/21/22 Manipulation 5 No 09/22/22 09/22/22 0.00 60.00 0.00 0.00 0.00 60.00
Regions
Provider: Dr Russell Sweet DC
97012-GP -
09/21/22 Therapy- No 09/22/22 09/22/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
09/09/22 Therapy- No 09/12/22 09/12/22 0.00 0.00 24.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
09/13/22 Therapy- No 09/14/22 09/14/22 0.00 24.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
10/28/22 Therapy- No 11/03/22 11/03/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Russell Sweet DC
97012-GP -
10/31/22 Therapy- No 11/03/22 11/03/22 24.00 0.00 0.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Russell Sweet DC
Patient Totals: 275.00 304.00 84.00 0.00 0.00 663.00
TARJA000 Tarr, James Group:
DOB: 06/21/1981 Insured ID: 386020633
97012-GP -
08/19/22 Therapy- No 08/25/22 09/14/22 0.00 0.00 24.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
09/02/22 Therapy- No 09/07/22 09/14/22 0.00 0.00 24.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97012-GP -
08/22/22 Therapy- No 08/25/22 09/14/22 0.00 0.00 24.00 0.00 0.00 24.00
Traction/Mechanical
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
10/21/22 No 10/24/22 10/24/22 35.00 0.00 0.00 0.00 0.00 35.00
Therapeutic
Exercise
Provider: Dr Jeremy Lengkeek DC
97110-GP-97 -
08/22/22 Therapy- No 08/25/22 09/14/22 0.00 0.00 34.00 0.00 0.00 34.00
Therapeutic

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364 Garden Ave., Holland, MI 49424-8656
 Exercise
Provider: Dr Brian S Parkhurst DC
97110-GP-97 -
Therapy-
09/02/22 No 09/07/22 09/14/22 0.00 0.00 34.00 0.00 0.00 34.00
Therapeutic
Exercise
Provider: Dr Brian S Parkhurst DC
98942-AT -
08/22/22 Manipulation 5 No 08/25/22 09/14/22 0.00 0.00 60.00 0.00 0.00 60.00
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
09/02/22 Manipulation 5 No 09/07/22 09/14/22 0.00 0.00 60.00 0.00 0.00 60.00
Regions
Provider: Dr Brian S Parkhurst DC
98942-AT -
08/19/22 Manipulation 5 No 08/25/22 09/14/22 0.00 0.00 60.00 0.00 0.00 60.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
10/21/22 Manipulation 3-4 No 10/24/22 10/24/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
97140-GP-59-97 -
Therapy-Manual
08/22/22 No 08/25/22 09/14/22 0.00 0.00 64.00 0.00 0.00 64.00
(Trigger Point,
Myofascial Release)
Provider: Dr Brian S Parkhurst DC
97124-59-GP -
10/21/22 Therapeutic No 10/24/22 10/24/22 54.00 0.00 0.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Jeremy Lengkeek DC
97124-59-GP -
09/02/22 Therapeutic No 09/07/22 09/14/22 0.00 0.00 54.00 0.00 0.00 54.00
Massage w/AIS
Provider: Dr Brian S Parkhurst DC
Patient Totals: 139.00 0.00 438.00 0.00 0.00 577.00
VANGO000 Vanhaitsma, Gordon, L Group:
DOB: 05/26/1948 Insured ID: 382486171
98941-AT -
10/27/22 Manipulation 3-4 No 11/03/22 11/03/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/21/22 10/21/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/06/22 Manipulation 3-4 No 10/10/22 10/10/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
Patient Totals: 100.00 50.00 0.00 0.00 0.00 150.00
Carrier Totals: 2,447.00 1,226.00 642.00 0.00 138.00 4,453.00
Wellcare Health Plans
BOSRO000 Bosley, Rose Group: M139
DOB: 07/03/1965 Insured ID: 34674113
98941-AT -
10/21/22 Manipulation 3-4 No 10/24/22 10/24/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/20/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions

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364 Garden Ave., Holland, MI 49424-8656
Provider: Dr James Friess DC
98941-AT -
10/24/22 Manipulation 3-4 No 10/26/22 10/26/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/14/22 Manipulation 3-4 No 10/17/22 10/17/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
09/29/22 Manipulation 3-4 No 10/03/22 11/03/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
09/01/22 Manipulation 3-4 No 09/02/22 11/03/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Brian S Parkhurst DC
98941-AT -
09/15/22 Manipulation 3-4 No 09/19/22 10/24/22 0.00 50.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
10/28/22 Manipulation 3-4 No 10/31/22 10/31/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98941-AT -
11/04/22 Manipulation 3-4 No 11/07/22 11/07/22 50.00 0.00 0.00 0.00 0.00 50.00
Regions
Provider: Dr James Friess DC
98942-AT -
07/29/22 Manipulation 5 No 08/01/22 10/04/22 0.00 0.00 0.00 60.00 0.00 60.00
Regions
Provider: Dr James Friess DC
Patient Totals: 300.00 100.00 50.00 60.00 0.00 510.00
DAVAN000 Davis, Andrea Group:
DOB: 05/10/1972 Insured ID: 33289817
98941-AT -
08/26/22 Manipulation 3-4 No 09/02/22 11/03/22 0.00 0.00 50.00 0.00 0.00 50.00
Regions
Provider: Dr Jeremy Lengkeek DC
99203-25 - New
08/26/22 Patient Exam - 30- No 09/02/22 11/03/22 0.00 0.00 129.00 0.00 0.00 129.00
44 Min
Provider: Dr Jeremy Lengkeek DC
72070 - X-ray
08/26/22 Thoracic Spine - 2-3 No 09/02/22 11/03/22 0.00 0.00 56.50 0.00 0.00 56.50
Views
Provider: Dr Jeremy Lengkeek DC
72100 - X-ray
08/26/22 Lumbosacral 2-3 No 09/02/22 11/03/22 0.00 0.00 68.50 0.00 0.00 68.50
Views
Provider: Dr Jeremy Lengkeek DC
72040 - X-ray
08/26/22 Cervical Spine - 2-3 No 09/02/22 11/03/22 0.00 0.00 68.00 0.00 0.00 68.00
Views
Provider: Dr Jeremy Lengkeek DC
Patient Totals: 0.00 0.00 372.00 0.00 0.00 372.00
Carrier Totals: 300.00 100.00 422.00 60.00 0.00 882.00
120,275.9
Combined Totals: 80,857.88 9,495.92 6,066.10 4,812.84 19,043.23
7

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