1. Provider Discipline Value # of Appointment
Central Utah Clinic Cardiac Diagnost cardiology $ 2,265.00 7 7
Dr. Marv Allen cardiology $ 1,987.00 9 3
Dr. Chun Hwang cardiology $ 1,027.00 3 0
Dr. David Cragun cardiology $ 673.00 4 1
Dr. Ronald Asay cardiology $ 637.00 4 2
Dr. Aaron Weaver cardiology $ 563.00 3 2
Dr. Charles Dahl cardiology $ 491.00 3 2
NP Rachelle Frost cardiology $ 130.00 1 1
NP Nancy Radle cardiology $ 104.00 1 0
Damien Moreno dental lab $ 490.00 4 1
Angus Dental Lab dental lab $ 390.00 3 2
Dr. Kenneth Molen dentistry $ 7,867.00 50 46
Dr. Joe Winward dentistry $ 7,195.00 10 5
Dr. Donny Allred dentistry $ 6,005.00 5 4
Dr. Kyle Clark dentistry $ 5,899.00 7 5
Dr. L. Craig Rosvall dentistry $ 4,862.00 9 7
Dr. David Nance dentistry $ 4,848.00 9 5
Dr. Quinn Schiffman dentistry $ 4,739.00 10 7
Dr. Garry Brown dentistry $ 4,584.00 5 2
Dr. Renn Flinders dentistry $ 4,318.00 7 4
Dr. Randal Hadfield dentistry $ 4,058.00 4 4
Dr. Keith Dodge dentistry $ 3,936.00 13 8
DMD Robert Baird dentistry $ 3,375.00 3 0
Dr. Devin Davidson dentistry $ 3,088.00 3 2
Dr. J. Chris Crawford dentistry $ 2,592.00 3 2
Dr. Gavin Huntington dentistry $ 2,414.00 6 6
Dr. Albert Clark dentistry $ 2,412.00 7 5
Dr. Scott Stapley dentistry $ 2,384.00 10 8
Dr. Jerel Hill dentistry $ 2,153.00 5 5
Dr. Jeremy White dentistry $ 1,725.00 3 1
Dr. Corbin Matthews dentistry $ 1,590.00 2 2
DMD Ashley Heid dentistry $1,521.00 2 0
Dr. Richard Leishman dentistry $ 1,520.00 3 1
# of Patients
2. Provider Discipline Value # of Appointment
Dr. Gary Wiest dentistry $ 1,502.00 4 2
Dr. Nicholas Young dentistry $ 1,253.00 6 4
Dr. Reed Robinson dentistry $ 1,202.00 4 3
Dr. Glenn Payne dentistry $ 1,168.00 5 2
Dr Stephen Pratt dentistry $ 1,083.00 3 2
Tanya Westmorland dentistry $ 1,037.00 2 1
Bart Gardiner dentistry $ 1,010.00 2 1
Dr. Scott Chandler dentistry $ 635.00 1 1
Alexander Larsen dentistry $ 482.00 1 1
Dr. Ronald Smith dentistry $ 305.00 3 1
David Hansen dentistry $0 1 1
Community Health Connect dentistry - education $ 47.00 52 48
UCDH UCDH dentistry - hygiene $ 4,500.00 46 46
UVU UVU dentistry - hygiene $ 2,100.00 23 22
Dr. Daryn Moody dentistry - kids $ 9,121.00 8 4
Dr. Adam Shepherd dentistry - kids $ 4,491.00 7 5
James Bonny dentistry - kids $ 3,652.00 7 2
Dr. Don Gifford dentistry - kids $ 3,087.03 8 3
Bruce Howell dentistry - kids $ 2,705.00 5 3
Dr. Paul Nielsen dentistry - kids $ 2,318.00 6 2
Dr. Michael Lorscheider dentistry - kids $ 1,576.00 5 3
Dr. Tyler Ashman dentistry - kids $ 1,080.00 2 0
Darren Chamberlain dentistry - kids $ 687.00 2 1
Dr. S. Peterson dermatology $ 23,706.0 8 3
Dr. Mark Donaldson dermatology $ 4,421.00 15 12
Dr. Brad Huber dermatology $ 2,793.00 13 13
NP Christina Linton dermatology $ 2,107.00 13 11
NP Lisa Williams dermatology $ 1,870.00 11 11
Dr. Brian Bradshaw dermatology $ 1,324.00 8 7
NP Nicole Rawle dermatology $ 1,232.00 8 5
Dr. Kraig Jenson dermatology $ 695.00 7 7
Dr. David Myers dermatology $ 395.00 3 2
PA Byron Edwards dermatology $ 192.00 2 1
# of Patients
3. Provider Discipline Value # of Appointment
NP Clarene Hansen endocrinology $ 765.00 4 3
Dr. Soubhi Nizam endocrinology $ 729.00 4 3
Ryan Van Moorlehem endodontics $ 3,855.00 4 3
Dr. Paul Creer endodontics $ 3,048.00 8 6
Dr. Daniel Burr endodontics $ 2,619.00 3 1
Dr. S. Todd Hamilton ENT $ 6,718.00 6 4
Dr. David Darley ENT $ 5,059.00 9 7
Dr Seth Riddle ENT $ 2,647.00 8 6
Dr Kirt Beus ENT $ 1,847.00 7 5
Dr Kipp Robins ENT $ 1,078.00 4 2
Dr Steven Parson ENT $ 937.00 4 3
Dr Randal Gibb ENT $ 467.00 4 4
Dr Scott Shipley ENT $ 459.00 2 1
Dr Douglas Denys ENT $ 390.00 4 3
P.A. Aaron Paxman ENT $ 223.00 1 0
P.A. Scott Summers ENT $ 223.00 2 1
Dr. Kelly Ence ENT $ 120.00 2 0
Dr Heidi Heras ENT $ 95.00 1 0
PA Dawn Ngo gastroenterology $ 1,967.00 13 11
PA Dan Ibarra gastroenterology $ 1,281.00 8 3
Dr. David Fraintz gastroenterology $ 1,136.00 8 5
NP Adrianne Shaver gastroenterology $ 954.00 3 2
Dr Chad Kawa gastroenterology $ 891.00 3 3
Dr Mohammad Alsolaiman gastroenterology $ 776.00 3 3
Dr. Haslem Bryce gastroenterology $ 542.00 3 2
Dr. Tom Dickinson gastroenterology $ 410.00 3 1
Dr. David Frantz gastroenterology $ 340.00 2 2
NP Chris Biesinger gastroenterology $ 170.00 1 1
Dr. Karl Francis general surgery $ 9,205.00 8 7
Dr. Craig Cook general surgery $ 6,484.00 6 3
Dr Lee Peterson general surgery $ 6,380.00 7 5
Dr. Richard Rasmussen general surgery $ 5,410.00 8 5
Dr Brian Gill general surgery $ 4,640.00 5 1
# of Patients
4. Provider Discipline Value # of Appointment
Dr David Garry general surgery $ 4,150.00 4 4
Dr Jennifer Tittensor general surgery $ 3,750.00 4 2
Dr. Clark Sheffield general surgery $ 3,195.00 3 2
Dr Bruce Hill general surgery $ 3,100.00 3 2
Dr. David Watts general surgery $ 2,250.00 2 2
UVRMC UVRMC hospitals $ 77,409.0 13 13
American Fork Hosptial hospitals $ 20,682.1 4 4
Central Utah Surgical hospitals $ 14,460.0 6 5
Revere Health Care Imaging - Provo hospitals $ 12,717.0 0 0
Utah Valley Outpatient Center hospitals $ 8,802.02 3 3
Orem Community Hospital hospitals $ 3,966.12 1 0
Revere Health Imaging - American F hospitals $ 729.00 2 2
Dr. Henry Yeates immunology $ 170.00 1 0
NP Valarie Juarez internal medicine $ 691.00 3 1
Dr. Larry Nobuhara internal medicine $ 359.00 1 0
Dr. Robert Corniea internal medicine $ 244.00 1 1
Revere Health Care Laboratory medical lab $ 983.00 10 10
NP Mark Boyack nephrology $ 1,075.00 7 7
Dr. William Barager nephrology $ 690.00 4 3
Dr. Mariusz Kielar nephrology $ 534.00 1 1
Dr Terry Hammond nephrology $ 310.00 1 0
Dr. Jeff Groves neurology $ 590.00 4 2
Dr. Howard Reichman neurosurgery $ 180.00 2 1
Dr. Scott Rees OB/GYN $ 5,500.00 3 1
Dr Jennifer Booth OB/GYN $ 800.00 2 0
Dr. Christy Jorgensen OB/GYN $ 255.00 2 2
Dr. Scott Jacob OB/GYN $ 220.00 2 1
Dr Donna Bennett OB/GYN $ 160.00 1 1
NP Heidi Mcsweeney OB/GYN $ 160.00 1 1
NP Steve Larsen oncology $ 167.00 1 1
Dr. Mark Nuttall oncology $ 46.00 1 1
Dr. Duane Nelson ophthalmology $ 5,311.00 13 12
Dr. Michael Lloyd ophthalmology $ 4,091.00 19 13
# of Patients
5. Provider Discipline Value # of Appointment
Dr. Jeremy Valentine ophthalmology $ 1,050.00 5 2
Dr. Ryan Isom ophthalmology $ 544.00 1 0
Dr. Scott Yeates ophthalmology $ 431.00 2 2
Dr. Richard Corey ophthalmology $ 394.00 1 1
Dr. John Carver ophthalmology $ 390.00 1 0
Dr. Blaine Bird optometry $ 2,490.00 12 9
Dr. Frank Edmunds optometry $ 1,225.00 5 5
Dr. Joe Haggard optometry $ 930.00 4 2
Provo Lenscrafters optometry $ 340.00 2 2
ShopKo Spanish Fork optometry $ 170.00 1 1
Dr. Paul Olson optometry/opthalmolo $ 1,809.00 5 2
Dr. Kristine Dunn optometry/opthalmolo $ 1,530.00 8 5
Dr. David Nicholls oral surgery $ 5,572.00 7 3
Dr. William McBee oral surgery $ 3,622.00 8 2
Dr. Heath Hendrickson oral surgery $ 3,499.00 3 3
Dr. David Park oral surgery $ 383.00 1 1
Dr. Gary Crawford oral surgery $ 220.00 1 0
Dr. David Christiansen orthodontics $ 9,164.00 7 3
Dr. Kendall Barrowes orthodontics $ 5,549.00 6 6
Dr. Scott Nord orthodontics $ 4,387.00 8 1
Dr. Robert Jackson orthopedics $ 4,946.00 8 5
Dr. Jeff Wallentine orthopedics $ 4,047.00 8 8
Dr. Karl Weenig orthopedics $ 3,116.00 14 8
Dr. John Wells orthopedics $ 1,661.00 4 4
Dr. Richard Jackson orthopedics $ 1,475.00 7 5
Dr. Michael Carlson orthopedics $ 1,178.00 3 1
Dr. Mitch Larsen orthopedics $ 1,027.00 2 2
Dr. Ryan Slater orthopedics $ 462.00 2 2
Dr. William Bacon orthopedics - back $ 266.00 1 0
Dr. Robert Faux orthopedics - foot $ 6,884.00 9 8
Dr Daniel Hoopes orthopedics - foot $ 2,644.00 5 3
Dr. M. Shane Fraizer orthopedics - hand $ 5,366.00 9 3
Dr. Ryan Richards orthopedics - hand $ 3,532.00 7 5
# of Patients
6. Provider Discipline Value # of Appointment
Dr. Curtis Johnson orthopedics - hand $ 2,914.00 4 1
PA David Waldron orthopedics - hand $ 1,257.00 4 4
Dr. Paul Francis periodontics $ 5,343.00 5 5
Von Hill physical therapy $ 14,777.0 71 1
Coleby Clawson physical therapy $ 12,152.0 56 39
Jim Anderson physical therapy $ 9,250.00 51 19
Braden Taylor physical therapy $ 7,834.00 39 9
Brent Butler physical therapy $ 6,602.00 31 9
Doug Bagley physical therapy $ 4,698.00 20 10
Richard Nielsen physical therapy $ 434.00 2 2
Dr. Kelly Gomez podiatry $ 2,556.00 9 5
Dr. Jared Clegg podiatry $ 2,347.00 9 5
Dr. Michael Nelson podiatry $ 70.00 3 1
Dr. Tala-at Al-Shuqairat pulmonology $ 637.00 4 1
Dr. RHC Revere Health Care radiology $ - 1 1
Dr. Steven Call rheumatology $ 170.00 1 1
# of Patients
9. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
12/16/2015 Maria Vazquez 2/10/1958 cardiology Central Utah Clinic Cardiac Diagnostic 93227 - I49.1 - $179
11/20/2015 Jesus Garcia 2/19/1973 cardiology NP Nancy Radle 99213 - I49.9 - $104
10/12/2015 Eva Pinales 6/26/1944 cardiology NP Rachelle Frost 93280 - V53.31 - $130
9/25/2015 Maria Vazquez 2/10/1958 cardiology Central Utah Clinic Cardiac Diagnostic 99204 - 424.1 - $275
8/27/2015 Maria Vazquez 2/10/1958 cardiology Dr. Chun Hwang 99212 - 427.31 - $58
8/20/2015 Wen Li Dong 1/10/1934 cardiology Dr. Marv Allen 93306 - 4280 - $527
8/10/2015 Myriam Licet Salomon 9/2/1965 cardiology Central Utah Clinic Cardiac Diagnostic 99243 - 4019 - $223
6/9/2015 Nubia Pena 12/31/1961 cardiology Dr. Ronald Asay 99213 - 785.59 - $117
5/18/2015 Eva Pinales 6/26/1944 cardiology Dr. Chun Hwang 93280 - V53.31 - $911
4/23/2015 Javier Aguayo 8/6/1954 cardiology Dr. David Cragun 84443, 36415 thyroid stimulating hormone, collection of venous blood by venipuncture 4019 hypertension $49
3/26/2015 Magalis Garces 3/23/1949 cardiology Dr. Ronald Asay 99214 - 2724 - $175
3/5/2015 Ramon Fraustro 5/20/1940 cardiology Dr. Ronald Asay 99214 office visit 4019, 41400 hypertension, CAD $175
11/30/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99024/NC - 226/D34 - $0
11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 15260/58 - C44311 - $3,965
11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 14060/58 - 07810/B079 - $3,965
11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 17110/5979 - - - $3,965
11/17/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application i83.018 Varicose veins of right lower extremity with ulcer o $100
11/12/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 99214 - M5136 - $175
11/10/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application i83.018 Varicose veins of right lower extremity with ulcer o $100
11/4/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99024/NC - 226/D34 - $0
11/3/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application I83.018 Varicose veins of right lower extremity with ulcer o $100
10/30/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 88305 - 226/D34 - $161
10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 12051 - R229 - $1,431
10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 11442/59 - 2382/D485 - $1,431
10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 11310/59 - D229 - $1,431
10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 88305 - - - $1,431
10/27/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 Una boot application - - $100
10/26/2015 Rick Giovanini 4/13/1993 dermatology Dr. Brian Bradshaw 99202 - 7061/L709 - $120
10/26/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99215 - M5136 - $236
10/21/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99213 - 2382/D485 - $117
10/20/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 - I83.018 Varicose veins of right lower extremity with ulcer o $100
10/14/2015 Leticia Casasola 7/21/1981 dermatology Dr. Brad Huber 99202 - 7061/L709 - $120
10/13/2015 Raymundo Madrid 8/30/1965 dermatology Dr. Kraig Jenson 99202 new patient 216.5 Benign neoplasm of skin of trunk except scrotum $110
10/13/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 99201 new patient L08.9 local infection of the skin and subcutaneous tissue $85
10/8/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards 99212 established office visit - - $70
9/15/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99024/NC - V5842 - $0
9/8/2015 Dolores Hurtado 4/13/1961 dermatology NP Christina Linton 99212 - 695.3 - $70
9/1/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 99024/NC - V5832 - $0
8/25/2015 Maurice Kaouk 1/6/1946 dermatology NP Nicole Rawle RECON/NC - 2322 - $182
8/25/2015 Maurice Kaouk 1/6/1946 dermatology NP Nicole Rawle 11310 - 2382 - $182
8/18/2015 Shaira Morralla Estrada 7/18/2000 dermatology NP Christina Linton 99202 - 7061 - $120
8/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99024/NC - V5832 - $0
8/17/2015 Carmen Argueta 3/31/1982 dermatology Dr. Brian Bradshaw 99212 - 757.9 - $70
8/12/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110 - 7810 - $178
8/10/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards 11900 intralesional injections of up to and including seven lesions - - $122
8/10/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards J.3301 intralesional injections of up to and including seven lesions - - $122
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 14061/79 - 173.81 - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 15260/5979 - 173.31 - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 21235/5979 - 173.9 - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 14041/5979 - 702.11 - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 13132/5979 - - - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 17311/79 - - - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 17311/5979 - - - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 17311/5979 - - - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 88331/5979 - - - $16,529
8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99213/57 - - - $16,529
8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17000 - 702 - $505
8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17003 - 7810 - $505
8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17110/59 - 173.31 - $505
8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 99202/25 - - - $505
8/5/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99212 - 7014 - $70
8/3/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 99024/NC - V5832 - $0
7/28/2015 Dolores Hurtado 4/13/1961 dermatology NP Christina Linton 99213 - 695.3 - $117
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 13151 - 17311 - $2,976
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 17311 - 17390 - $2,976
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 17312 - 70211 - $2,976
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 11100/59 - - - $2,976
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 88331/59 - - - $2,976
7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 99213/57 - - - $2,976
7/22/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110 - 7810 - $178
7/17/2015 Norma Farris 5/28/1963 dermatology Dr. Brian Bradshaw 99213 - 17311 - $117
7/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99212 - 7092 - $70
10. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
7/10/2015 Norma Thayne 5/23/1959 dermatology Dr. Brad Huber 99202 - 2168 - $120
7/8/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson A9270 - 709.2 - $1,000
6/24/2015 Bianca Ferreira 6/21/2011 dermatology Dr. Mark Donaldson 99202 - 704.01 - $120
6/19/2015 Mayra Cisneros 9/14/1982 dermatology Dr. Brad Huber 17110 - 78.1 - $178
6/16/2015 Yulissa Buritica 7/24/1988 dermatology NP Nicole Rawle 99202 - 757.39 - $120
6/15/2015 Susana Nunez 1/17/1946 dermatology Dr. Brian Bradshaw 99213 - 702.19 - $117
6/9/2015 Dolores Hurtado 4/13/1961 dermatology NP Christina Linton 99203 - 695.3 - $175
6/8/2015 Yolanda Contreras 2/10/1950 dermatology NP Lisa Williams 17000 - 702 - $248
6/8/2015 Yolanda Contreras 2/10/1950 dermatology NP Lisa Williams 99213 - 216.8 - $248
6/8/2015 Catalina Mora 7/10/1993 dermatology NP Lisa Williams 99202 - 706.1 - $120
6/4/2015 Nohemi Medina 5/18/1996 dermatology Dr. Brian Bradshaw 99212 - 701.4 - $70
5/26/2015 Chengzhen Chen 12/4/1938 dermatology Dr. David Myers 99202 - 705.81 - $110
5/26/2015 Carlos Zegarra 9/18/1957 dermatology Dr. David Myers 99202 - 702.19 - $110
5/26/2015 Carlos Zegarra 9/18/1957 dermatology Dr. David Myers - - 709.8 - $110
5/20/2015 Alma Avila 3/26/1972 dermatology Dr. Brad Huber 99202 - 216.3 - $120
5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 11900 - 709.2 - $276
5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson J3301 - 706.1 - $276
5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99203 - - - $276
4/28/2015 Efrain Del Anda 9/17/1969 dermatology NP Nicole Rawle 11100, 99202 - 782.1, 692.9, 238.2 - $300
4/21/2015 Rosalina Rivera 4/6/1954 dermatology NP Christina Linton 99203 office visit 6929 other disorders of female genital organs $175
4/21/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 99213 office visit 693 dermatitis due to drugs and medicines $117
4/20/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110,11900, J3490 destruction of benign lesions other than skin tags or cutaneous vascular prol 78.1 viral warts, unspecified $275
4/16/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 88305, 88312, 99024 Level IV - Surgical pathology, gross and microscopic examination;Special stai 692.9, V58.32 dermatitis due to unspecified cause; encounter for $303
4/14/2015 Carmen Argueta 3/31/1982 dermatology Dr. Brian Bradshaw 992,028,444,336,415 office visit, Thyroid stimulating hormone, Collection of venous blood by veni 709.01 vitiligo $169
4/9/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 11100 biopsy of skin 7821, 6929 rash and other nonspecific skin eruption; dermatiti $180
3/20/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 99212 exam 692.9 dermatitis due to unspecified cause $70
3/18/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 99212 exam 692.9 dermatitis due to unspecified cause $70
3/16/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 95044 patch or application test 692.9 dermatitis due to unspecified cause $975
3/13/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 99202 exam 692.9 dermatitis due to unspecified cause $120
3/12/2015 Madeleine Cortes 7/30/1993 dermatology Dr. Mark Donaldson 17106, 99203 destruction of cutaneous vascular proliferative lesions, office visit 448.9, 216.8 other and unspecified capillary diseases, benign ne $836
3/10/2015 Maria Moreno 9/15/1967 dermatology NP Nicole Rawle 99202 office visit 692.9 dermatitis due to unspecified cause $120
3/4/2015 Marcos Calderon 2/12/1957 dermatology NP Lisa Williams 99203 office visit 110.1 Dermatophytosis of nail $175
3/2/2015 Rafael Vizcarra 10/24/1970 dermatology Dr. Brian Bradshaw 99024 New patient office visit 696.1 Generalized pustular psoriasis $661
5/7/2015 Patricia Herrera 8/31/1974 endocrinology Dr. Soubhi Nizam 99215 - 193 - $236
4/2/2015 Patricia Herrera 8/31/1974 endocrinology Dr. Soubhi Nizam 99215 office visit 193 malign neopl thyroid $236
3/31/2015 Erika Lugo 1/10/1988 endocrinology NP Clarene Hansen 99214 office vist 701.2 Acquired acanthosis nigricans $175
3/26/2015 Elvira Orozco 2/18/1973 endocrinology NP Clarene Hansen 99213 office visit 245.9 Thyroiditis, unspecified $117
3/24/2015 Erika Lugo 1/10/1988 endocrinology NP Clarene Hansen 80053, 36415, 83036, 83525, 84439, 84443 Comprehensive metabolic panel; Collection of venous blood by venipunctur 277.7, 244.9 Dysmetabolic syndrome X; Unspecified hypothyroi $141
3/17/2015 Marisa Rodriguez 3/17/1973 endocrinology NP Clarene Hansen 99214, 80048, 36415, 84439, 84443, 82306 office visit; Basic metabolic panel (Calcium, total); Collection of venous bloo 275.41, 244.0 Disorders of calcium metabolism; hypocalcemia; P $332
3/11/2015 Kenny Lemus 4/13/1985 endocrinology Dr. Soubhi Nizam - - 701.2, 255.0, 277.7, 241.0 - $82
11/19/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 99024 4731/J321 - - $450
11/19/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 31231 4731/J321 - - $450
11/10/2015 Silverio Gonzalez 2/14/1932 ENT P.A. Aaron Paxman 76536 R221 - - $223
11/9/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4731/J321 - - - $5,584
11/9/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4732/J322 - - - $5,584
11/9/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4730/J320 - - - $5,584
11/6/2015 Kristi Alvey 11/20/1961 ENT Dr Randal Gibb 99203 2411/E042 - - $175
11/4/2015 Cristabel Cabrales 11/27/1978 ENT P.A. Scott Summers H9192 - - - $223
11/2/2015 Luz Ramirez 3/15/1979 ENT Dr Douglas Denys 99204 - - - $295
10/28/2015 Magalis Garces 3/23/1949 ENT Dr Kipp Robins 47830/J3800 99203/25, 31505 - - $354
10/20/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4719/J339 - - - $175
10/13/2015 Jesus Gutierrez 4/21/1972 ENT Dr. S. Todd Hamilton 99203 6989/L299 - - $175
10/7/2015 Rita Rodriguez 5/23/1955 ENT Dr. Kelly Ence 2411/E042 - - - $120
9/15/2015 Tila Rosado 5/28/1970 ENT Dr. David Darley 99214 - - - $370
9/15/2015 Tila Rosado 5/28/1970 ENT Dr. David Darley 92504 - - - $370
9/15/2015 Tila Rosado 5/28/1970 ENT Dr. David Darley 92557 - - - $370
9/15/2015 Tila Rosado 5/28/1970 ENT Dr. David Darley 92567 - - - $370
3/11/2015 Laura Valenzuela 6/1/1960 ENT Dr. S. Todd Hamilton 99213 - 338.70, 384.21 - $117
12/30/2015 Gabriela Salas 3/24/1960 gastroenterology Dr Mohammad Alsolaiman 99243 25000/R1031 - - $223
12/29/2015 Sandra Robles 9/26/1970 gastroenterology Dr Chad Kawa 99214 - R12 - $175
12/22/2015 Saul Flores 6/2/1972 gastroenterology PA Dawn Ngo 99203 R0789 - - $175
12/10/2015 Jania Pedro 12/19/1950 gastroenterology Dr Chad Kawa 83014 R1013 (2), 56400/ R1013 - - $445
12/10/2015 Jania Pedro 12/19/1950 gastroenterology Dr Chad Kawa 83013 R1013 (2), 56400/ R1013 - - $445
12/10/2015 Jania Pedro 12/19/1950 gastroenterology Dr Chad Kawa 99204 R1013 (2), 56400/ R1013 - - $445
12/9/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 83014 R1011 (2), 53081/R1011 - - $291
12/9/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 83013 R1011 (2), 53081/R1011 - - $291
12/9/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 99213 R1011 (2), 53081/R1011 - - $291
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 36415 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 82728 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 83540 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 83550 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 85610 07054/B182 - - $508
11. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 99204/25 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 90471 07054/B182 - - $508
12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 90636 07054/B182 - - $508
12/7/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman 99214 R1011 - - $175
11/19/2015 Eloisa Landin 6/1/1969 gastroenterology PA Dan Ibarra 99204 7242/R109 - - $271
11/13/2015 Sandra Robles 9/26/1970 gastroenterology Dr Chad Kawa R12 99204 - - $271
11/13/2015 Teresa Esparza 12/26/1951 gastroenterology PA Dan Ibarra 99204 5368/K30 - - $271
11/6/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 56400/K589 99213 - - $117
11/4/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 99204 53081/R760 - - $271
11/4/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman R740 3,641,580,076,830,140,000,000,000 - - $378
11/4/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman 53081/R109 3,641,580,076,830,140,000,000,000 - - $378
11/3/2015 Luz Alvarez 11/6/1955 gastroenterology Dr. Haslem Bryce 99204 R1032 - - $271
11/3/2015 Claudia Masso 8/23/1972 gastroenterology Dr. Haslem Bryce 99204 K5792 - - $271
10/6/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 56400/R110 99213 - - $117
9/23/2015 Marcela Ramos 11/21/1968 gastroenterology PA Dawn Ngo 99203 - 5781 - $117
9/3/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99213 - 5715 - $117
8/21/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99214 - 5715 - $175
7/23/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99213 - 5715 - $117
7/17/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99214 - 5715 - $175
7/10/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99214 - 5715 - $175
7/9/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99213 - - - $117
7/2/2015 Emigdio Mariluz 8/4/1952 gastroenterology PA Dawn Ngo 99203 - - - $175
7/2/2015 Marcela Ramos 11/21/1968 gastroenterology PA Dawn Ngo 99203 - 5781 - $175
7/2/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99204 - 78959 - $271
6/30/2015 Travis Clements 10/25/1985 gastroenterology Dr. David Fraintz 99213 7054 - - $117
5/28/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99213 - - - $117
5/5/2015 Judy Hardman 1/7/1964 gastroenterology PA Dawn Ngo 99214 - 211.3 - $175
4/29/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99204 - 789 - $271
3/4/2015 Sarantsetseg Dulamjav 3/5/1973 gastroenterology PA Dawn Ngo 43235 Esophagogastroduodenoscopy 536.8, 789.06 Abdominal pain, epigastric $120
2/23/2015 Travis Clements 10/25/1985 gastroenterology NP Adrianne Shaver 99214 07054, V053, V053 - - $326
2/23/2015 Travis Clements 10/25/1985 gastroenterology NP Adrianne Shaver 90471 07054, V053, V053 - - $326
2/23/2015 Travis Clements 10/25/1985 gastroenterology NP Adrianne Shaver 90636 07054, V053, V053 - - $326
12/30/2015 Saribek Danilyan 1/5/1951 general surgery Dr. Karl Francis 49650 K40.20 - - - $2,200
12/28/2015 Seda Danilyan 9/9/1954 general surgery Dr. Craig Cook 49585 K42.9 - - - $950
12/15/2015 Javier Alemandi 7/11/1970 general surgery Dr Brian Gill 99203 - 553.1 - $200
12/15/2015 Saribek Danilyan 1/5/1951 general surgery Dr. Karl Francis 99204 K40.20 - - - $250
12/10/2015 Olga Catherine Pena Aguiar 1/10/1979 general surgery Dr Bruce Hill 99203 R10.84 - - - $200
11/24/2015 Rita Rosales 6/21/1958 general surgery Dr Lee Peterson 99202 F10.13 - - - $150
11/23/2015 Leonel Esqueda 7/30/1971 general surgery Dr Bruce Hill 49587 - 552.1 - $1,450
11/3/2015 David Ulbrich 9/12/1986 general surgery Dr. Richard Rasmussen 99203 - 550.9 - $200
10/29/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 49568 - 553.2 - $500
10/27/2015 Sandra Rodriguez 6/19/1983 general surgery Dr Brian Gill 47563 K81.0 - - - $1,970
10/7/2015 Yarelly Ovalle 7/19/1988 general surgery Dr David Garry 21554 - 782.2 - $2,150
9/30/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 49565 - 553.2 - $1,500
9/30/2015 Stan Johnson 11/28/1956 general surgery Dr. David Watts 49650-50 - - - $2,050
9/30/2015 Stan Johnson 11/28/1956 general surgery Dr. David Watts K40.20 - - - $2,050
9/24/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 99203 - 553.2 - $200
9/22/2015 Erika Nava 8/24/1984 general surgery Dr David Garry 99203 - 553.1 - $200
9/15/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 99204 - 782.2 - $250
9/4/2015 Jorge Serrano 9/24/1962 general surgery Dr. Richard Rasmussen 49585 - 552.1 - $1,450
8/31/2015 Araceli Mendoza 6/3/1975 general surgery Dr. Clark Sheffield 47563 - 574.1 - $1,970
8/28/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 47563 - 574.1 - $1,970
8/27/2015 Dolores Hurtado 4/13/1961 general surgery Dr Lee Peterson 47563 - 574.1 - $1,970
8/25/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 99204 - 574.2 - $250
8/25/2015 Jorge Serrano 9/24/1962 general surgery Dr. Richard Rasmussen 99203 - 552.1 - $200
8/21/2015 Dolores Hurtado 4/13/1961 general surgery Dr Lee Peterson 99203 - 574.1 - $200
8/21/2015 Araceli Mendoza 6/3/1975 general surgery Dr. Clark Sheffield 99203 - 574.1 - $200
8/4/2015 Luis Orozco 5/1/1953 general surgery Dr. Richard Rasmussen 49507 - 550.1 - $1,610
7/29/2015 Abdiel Gaxiola 7/2/1999 general surgery Dr Jennifer Tittensor 47563 - 574.2 - $1,970
7/20/2015 David Rocha 7/5/1973 general surgery Dr David Garry 21554 - 784.2 - $1,800
7/15/2015 Oscar Ceballos 5/27/1970 general surgery Dr Jennifer Tittensor 49585 - 553.1 - $1,150
7/14/2015 Rob Larsen 7/23/1963 general surgery Dr. Craig Cook 49585 - 553.1 - $1,150
7/14/2015 Shaun Murphy 10/20/1962 general surgery Dr Lee Peterson 49650 - 550.9 - $1,350
7/7/2015 Abdiel Gaxiola 7/2/1999 general surgery Dr Jennifer Tittensor 99204 - 574.2 - $250
6/29/2015 Shaun Murphy 10/20/1962 general surgery Dr Lee Peterson 9920 - 550.9 - $250
6/29/2015 Rob Larsen 7/23/1963 general surgery Dr. Craig Cook 99204 - 553.1 - $250
6/25/2015 Eloisa Landin 6/1/1969 general surgery Dr. Karl Francis 47563 - 574.1 - $1,970
6/16/2015 Oscar Ceballos 5/27/1970 general surgery Dr Jennifer Tittensor 99203 - 553.1 - $200
5/19/2015 Luis Orozco 5/1/1953 general surgery Dr. Richard Rasmussen 99204 - 550.1 - $250
5/15/2015 Wilford Harris 3/23/1968 general surgery Dr. Clark Sheffield 49650 - 550.9 - $1,025
5/14/2015 Lennin Santos 11/3/1982 general surgery Dr Bruce Hill 49587 - 552.1 - $1,450
4/27/2015 Sergio Leiva 1/8/1973 general surgery Dr. Craig Cook 49585 - 553.1 - $1,150
12. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
4/24/2015 Alejandro DaSilva 10/7/1961 general surgery Dr Lee Peterson 49650 - 550.92 - $2,460
4/23/2015 Julio Nolasco 6/28/1998 general surgery Dr. Karl Francis 49650 - 550.92 - $2,460
4/22/2015 Jacob Miller 5/25/1987 general surgery Dr. David Watts 99203 - 229 - $200
3/25/2015 Maria Barrionuevo 7/15/1941 general surgery Dr. Craig Cook 49566 - 552.2 - $2,300
3/24/2015 Jose Servin 9/19/1972 general surgery Dr. Richard Rasmussen 49651 - 550.91 - $1,450
2/26/2015 Jose Servin 9/19/1972 general surgery Dr. Richard Rasmussen 99204 - 550.91 - $250
11/19/2015 Eloisa Landin 6/1/1969 hospitals Revere Health Imaging - American Fork 74000 56400/K5900 - - $65
11/16/2015 Silverio Gonzalez 2/14/1932 hospitals Revere Health Care Imaging - Provo 76536 2411/E042 - - $317
11/13/2015 Kristi Alvey 11/20/1961 hospitals Revere Health Imaging - American Fork 10022 2411/E042 - - $664
11/13/2015 Kristi Alvey 11/20/1961 hospitals Revere Health Imaging - American Fork 76942 2411/E042 - - $664
11/13/2015 Kristi Alvey 11/20/1961 hospitals Revere Health Imaging - American Fork 36415 2411/E042 - - $664
11/13/2015 Kristi Alvey 11/20/1961 hospitals Revere Health Imaging - American Fork 84443 2411/E042 - - $664
10/28/2015 Maria Lee 4/2/1964 hospitals UVRMC UVRMC 5589/K529 45380, 43239 - - $2,162
10/28/2015 Maria Lee 4/2/1964 hospitals UVRMC UVRMC 53520/K2960 45380, 43239 - - $2,162
9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 72132 - 722.1 - $2,006
9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 62290 - 724.2 - $2,006
9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 72295 - - - $2,006
9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo Q9966 - - - $2,006
8/10/2015 Alejandra Hermoso 7/17/1982 hospitals Central Utah Surgical 65426 Pterygium surgery - - $3,624
7/27/2015 Felicitas Mendoza 3/11/1939 hospitals Central Utah Surgical 66984 cataract removal - - $3,743
7/6/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 72158 - 722.1 - $1,936
7/6/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo A9579 - - - $1,936
6/15/2015 Erika Escareno 9/19/2002 hospitals Central Utah Surgical 20680 - V54.01 - $4,099
6/4/2015 Janet Talbot 5/11/1959 hospitals UVRMC UVRMC 64721 - 354 - $3,634.3
5/8/2015 Maria Lee 4/2/1964 hospitals Revere Health Care Imaging - Provo 76700 - 573.9 - $337
4/15/2015 Chengzhen Chen 12/4/1938 hospitals UVRMC UVRMC 96365 - 733 - $824.44
4/15/2015 Chengzhen Chen 12/4/1938 hospitals UVRMC UVRMC 80053 - - - $824.44
4/14/2015 Maria Rodriguez (youth) 5/25/1999 hospitals UVRMC UVRMC 27422 - 718.36 - $22
4/14/2015 Maria Rodriguez (youth) 5/25/1999 hospitals UVRMC UVRMC 29873 - - - $22
4/8/2015 Maria Garrido 1/20/1958 hospitals Revere Health Care Imaging - Provo 76770 - 5939 - $310
2/23/2015 Leticia Escareno 8/30/1975 hospitals Central Utah Surgical 65855 - 365.9 - $1,210
12/31/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 99214 - 29632/M1A9XX0 - $175
12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 99214 - 4019/E1149 - $244
12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 84443 - 2449/E039 - $244
12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 80048 - - - $244
12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 36415 - - - $244
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 80061 - 2724/E785 - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 80050 - 2449/E039 - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 36415 - E1149 - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 86140 - M8580 - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 85652 - 71590/M1990 - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 84439 - - - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 83036 - - - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 82570 - - - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 82043 - - - $289
12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 82306 - - - $289
11/19/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 99397 - Z0000 - $227
11/19/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 36415 - Z5189 - $227
3/9/2015 Magalis Garces 3/23/1949 internal medicine Dr. Larry Nobuhara 99214, 80050, 36415, 82150, 84439, 83036, 81001, 82570, 8204 office visit; General health panel; Collection of venous blood by venipunctur 78900, 25060, 2449, 25060 abdominal pain, unspecified site; Diabetes with ne $359
8/14/2015 Julia Lopez 7/4/1974 medical lab Revere Health Care Laboratory 80069, 36415 renal function panel; Collection of venous blood by venipuncture 583.9 Nephritis and nephropathy, not acute or chronic $30
5/7/2015 Patricia Herrera 8/31/1974 medical lab Revere Health Care Laboratory 80069, 36415 - 193 - $30
5/4/2015 Chris Missett 12/28/1958 medical lab Revere Health Care Laboratory 36415 - 586 - $10
4/16/2015 Adriana Armenta 9/29/1974 medical lab Revere Health Care Laboratory 80069, 82570, 82043, 36415 Renal function panel; Creatinine; Albumin; urine, microalbumin, quantitativ 791 Nonspecific findings; proteinuria $53
3/24/2015 Magalis Garces 3/23/1949 medical lab Revere Health Care Laboratory 80069, 36415, 81001, 82340, 83986, 81050 renal function panel; Collection of venous blood by venipuncture; urinalysis; 275.41 Disorders of calcium metabolism; hypocalcemia $64
9/2/2015 Carlos San Juan 9/27/1991 nephrology Dr. William Barager 99214 - - - $175
5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 85025 - 586 - $214
5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 80069 - - - $214
5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 80076/59 - - - $214
5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 83970 - - - $214
5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 82306 - - - $214
5/7/2015 Chris Missett 12/28/1958 nephrology Dr Terry Hammond 76770 - 593.9 - $310
4/17/2015 Julia Lopez 7/4/1974 nephrology NP Mark Boyack 99213 office visit 401.9 Essential hypertension; unspecified $117
4/16/2015 Adriana Armenta 9/29/1974 nephrology Dr. William Barager 99214 office visit 585.1 Chronic kidney disease, Stage I $175
4/3/2015 Paul Dalley 4/2/1957 nephrology NP Mark Boyack 99213 office visit 5849 acute kidney failure $117
3/30/2015 Magalis Garces 3/23/1949 nephrology NP Mark Boyack 99213 office visit 592 Stone in kidney $117
3/3/2015 Debrah Lewis 6/14/1956 nephrology Dr. Mariusz Kielar 84443, 36415, 99214, 76770 hypertension, venipuncture, chronic kidney, ultrasound on kidney and bladd 4019, 5853 hypertension NOS, chronic kidney disease stage III $534
4/9/2015 Magalis Garces 3/23/1949 neurology Dr. Jeff Groves 99215 office visit 340 multiple sclerosis $236
3/6/2015 Julio Ruiz 9/12/1987 neurology Dr. Jeff Groves 99214 - 345.4 epilepsy and epileptic syndromes w/ complex parti $118
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 99213 - - - $5,210
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 99214 - - - $5,210
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 58571 - - - $5,210
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 58662 - - - $5,210
13. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 52000 - - - $5,210
7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 58662 - - - $5,210
4/16/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 99213 - - - $370
4/16/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 76817 - - - $370
4/10/2015 Mayra Cisneros 9/14/1982 OB/GYN NP Heidi Mcsweeney 99203 - - - $160
4/9/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 99211 - - - $430
4/9/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 99213 - - - $430
4/9/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 76817 - - - $430
3/31/2015 Refugio Basilio 11/24/1957 OB/GYN Dr. Scott Jacob 99203 - 618.02, 553.9, 627.3 - $110
3/25/2015 Margarita Posadas 2/22/1944 OB/GYN Dr. Scott Rees 99213 - 625.6, 618.84 stress incontinence, cervical stump prolapse $145
3/24/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 99214 - 626.9, 625.9, 218.9 Abrnormal uterine bleeding, pelvic pain, uterine fib $145
3/5/2015 Maribel Gonzalez 7/17/1980 OB/GYN Dr. Christy Jorgensen 99214 - 611.71, 625.5 Mastodynia, pelvic congestion syndrome $145
2/3/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Christy Jorgensen 99213 - 626.9 Abnormal uterine bleeding $110
11/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - - - $205
11/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92133 - - - $205
10/12/2015 Rosibel Attentio 10/7/1944 ophthalmology Dr. Jeremy Valentine 92014 - H04123 - $225
10/12/2015 Rosibel Attentio 10/7/1944 ophthalmology Dr. Jeremy Valentine 92015 - - - $225
10/9/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92012 - - - $205
10/9/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92134 - - - $205
10/7/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd 92012 - H40.11 - $120
10/7/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd - - E11.359 - $120
9/18/2015 Narcisa Barcia 10/26/1956 ophthalmology Dr. Duane Nelson 92002 - 375.15 - $130
9/18/2015 Narcisa Barcia 10/26/1956 ophthalmology Dr. Duane Nelson - - 379.91 - $130
9/16/2015 Margarita Calderon 1/1/1945 ophthalmology Dr. Michael Lloyd 92004 - 366.16 - $295
9/16/2015 Margarita Calderon 1/1/1945 ophthalmology Dr. Michael Lloyd 92015 - - - $295
9/14/2015 Eloisa Alvarez 6/13/1949 ophthalmology Dr. Paul Olson 92004 - 366.18 - $295
9/14/2015 Eloisa Alvarez 6/13/1949 ophthalmology Dr. Paul Olson 92015 - - - $295
8/25/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92024 - - - $0
8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92014 - 366.16 - $350
8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92015 - - - $350
8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92134 - - - $350
8/18/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92024 - - - $0
8/14/2015 Mayra Villalpando 11/2/1998 ophthalmology Dr. Duane Nelson 92004 - V72.0 - $295
8/14/2015 Mayra Villalpando 11/2/1998 ophthalmology Dr. Duane Nelson 92015 - - - $295
8/11/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92024 - - - $0
8/10/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 65426 - 372.41 - $925
7/27/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 66984 - 366.16 - $1,200
7/21/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 99203 - 372.41 - $180
7/21/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd - - 375.15 - $180
7/15/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - 365.11 - $260
7/15/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92083 - - - $260
7/15/2015 Maria Romero 1/21/1979 ophthalmology Dr. Jeremy Valentine 92004 - 37240 - $275
7/15/2015 Maria Romero 1/21/1979 ophthalmology Dr. Jeremy Valentine 92015 - - - $275
7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92004 - 366.16 - $670
7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92015 - - - $670
7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92134 - - - $670
7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92136 - - - $670
6/26/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92014 - V72.0 - $329
6/26/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92015 - - - $329
6/26/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92025 - - - $329
6/25/2015 Maria Romero 1/21/1979 ophthalmology Dr. John Carver 99204 new office visit, posterior segment imaging (eye 1), posterior segment imagi - - $390
6/25/2015 Maria Romero 1/21/1979 ophthalmology Dr. John Carver 92226 new office visit, posterior segment imaging (eye 1), posterior segment imagi - - $390
6/25/2015 Maria Romero 1/21/1979 ophthalmology Dr. John Carver 92226 new office visit, posterior segment imaging (eye 1), posterior segment imagi - - $390
6/24/2015 Rosa Estrada 2/19/1966 ophthalmology Dr. Jeremy Valentine 92004 - 37515 - $275
6/24/2015 Rosa Estrada 2/19/1966 ophthalmology Dr. Jeremy Valentine 92015 - 37515 - $275
6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson 92004 - V72.0 - $295
6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson 92015 - 372.4 - $295
6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson - - 372.51 - $295
6/20/2015 Nancy Rios 7/21/1953 ophthalmology Dr. Paul Olson 92014 - 375.15 - $265
6/20/2015 Nancy Rios 7/21/1953 ophthalmology Dr. Paul Olson 92015 - 366.16 - $265
6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson 92014 - 351 - $265
6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson 92015 - 375.15 - $265
6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson - - 366.16 - $265
6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson - - 379.24 - $265
5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 99204 - 372.4 - $394
5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92250 - - - $394
5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92225R - - - $394
5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92225L - - - $394
5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 92004 - 372.41 - $585
5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 92015 - 366.06 - $585
5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 92136 - 372.51 - $585
5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson - - 250.01 - $585
14. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
5/13/2015 Rita Rosales 6/21/1958 ophthalmology Dr. Jeremy Valentine 92004 - 36616 - $275
5/13/2015 Rita Rosales 6/21/1958 ophthalmology Dr. Jeremy Valentine 92015 - 36616 - $275
5/5/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - 365.11 - $120
5/4/2015 Maritza Leyva Garcia 12/18/2007 ophthalmology Dr. Scott Yeates 92012 - 368 - $138
5/4/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 66984 - 366.16; 366.02 - $1,200
4/13/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Ryan Isom 99204, 92250, 92225R, 92225L - 362.01; 362.07; 366.16 - $544
4/13/2015 Aurelia Polar 9/20/1934 ophthalmology Dr. Paul Olson 92014; 92015; 66821 - 379.39; 366.53; 375.15 - $865
4/7/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92004; 92015; 92134; 92136 - 366.16; 362.01; 374.33; 366.0 - $670
4/2/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd 92012 - 365.11; 250.50 - $120
3/5/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92012; 92083 - 365.11 - $260
3/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd - - 365.11 - $1
3/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 99024 - 365.11 - $1
2/23/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 65855-LT - 365.11 - $600
1/8/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - 365.11 - $120
8/21/2015 Regina King 1/17/1935 optometry Dr. Kristine Dunn 92012 - 375.15 - $120
8/21/2015 Regina King 1/17/1935 optometry Dr. Kristine Dunn - - 379.91 - $120
8/18/2015 Valeria Perez 11/30/2003 optometry Dr. Frank Edmunds 92004 - V72.0 - $295
8/18/2015 Valeria Perez 11/30/2003 optometry Dr. Frank Edmunds 92015 - - - $295
8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird 92004 - V72.0 - $295
8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird 92015 - 367.9 - $295
8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird - - 367.4 - $295
8/12/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92020 - 365.52 - $170
8/12/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird - - 366.16 - $170
7/10/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92012 - 365.52 - $205
7/10/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92133 - 366.16 - $205
7/10/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird - - 372.41 - $205
7/7/2015 Rosario Rabi 11/22/1971 optometry Dr. Blaine Bird 92004 - V72.0 - $295
7/7/2015 Rosario Rabi 11/22/1971 optometry Dr. Blaine Bird 92015 - - - $295
6/17/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92014 - 372.41 - $345
6/17/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92250 - 365.31 - $345
6/17/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 76514 - - - $345
6/15/2015 Daniela Olaya 7/25/1998 optometry Dr. Kristine Dunn 92014 - V72.0 - $265
6/15/2015 Daniela Olaya 7/25/1998 optometry Dr. Kristine Dunn 92015 - - - $265
6/12/2015 Alejandro Rios 1/6/1990 optometry Dr. Blaine Bird 92004 - - - $295
6/12/2015 Alejandro Rios 1/6/1990 optometry Dr. Blaine Bird 92015 - - - $295
6/3/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92012 - 372.41 - $120
4/4/2015 Marga Turner 12/10/1969 optometry Dr. Kristine Dunn 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati V72.0, 367.9, 372.51 Examination of eyes and vision; Unspecified disord $295
3/17/2015 Ezequiel Ruiz 11/30/1972 optometry Dr. Frank Edmunds 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati 366.16, 372.41 nuclear sclerosis, cataracta brunescens, nuclear cat $295
3/10/2015 Salvador Lopez 7/28/1966 optometry Dr. Blaine Bird 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati V72.0, 367.9 Examination of eyes and vision, Unspecified disord $295
12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn 92014 - Z01.00 - $265
12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn 92015 - H16.223 - $265
12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn - - H25.13 - $265
11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson 92004 - H25.13 - $295
11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson 92015 - H11.053 - $295
11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson - - H16.233 - $295
10/14/2015 Alejandra Hermoso 7/17/1982 optometry/opthalmology Dr. Kristine Dunn 92012 - - - $120
11/21/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - Z471 - $316
11/21/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 27570/78LT - S80242A - $316
10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - Z471 - $93
10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 73562/LT - - - $93
10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - - - $93
10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 99212 - M170 - $288
10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 73564/LT - - - $288
10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 73564/RT - - - $288
10/20/2015 Magalis Garces 3/23/1949 orthopedics Dr. Robert Jackson 99024/NC - Z471 - $0
10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 99212/25 - M170 - $410
10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/LT - - - $410
10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/RT - - - $410
10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson J3301 - - - $410
10/8/2015 Franco Bianchetti 8/31/1999 orthopedics Dr. Ryan Slater 99213 - M222X1 - $117
10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 99203/25 - M1711 - $614
10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 20610/RT - - - $614
10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig J3301 - - - $614
10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 73564 - - - $614
10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig L1820/RT - - - $614
10/7/2015 Magalis Garces 3/23/1949 orthopedics Dr. Robert Jackson 27447/LT - M1712 - $4,131
9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 99203 - 715.16 - $335
9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 73560/RT - - - $335
9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 73560/LT - - - $335
9/21/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 724.2 - $213
9/21/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 72100 - - - $213
8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 99213 - 722.4 - $287
15. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 72040 - 726.2 - $287
8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 73030 - - - $287
7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater 99203/25 - 715.96 - $345
7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater 20610/LT - - - $345
7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater J3301 - - - $345
7/9/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 724.2 - $117
6/17/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 99024/NC - V5489 - $0
6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson 99212/25 - 71946 - $240
6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson 20610/RT - 71946 - $240
6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson J3301 - 71946 - $240
6/8/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 7242 - $213
6/8/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 72100 - 7242 - $213
6/4/2015 Maria Ruelas 12/10/1969 orthopedics Dr. Karl Weenig 99213 - 7242 - $117
5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 99213/25 - 71516 - $528
5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/RT - 71516 - $528
5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson J3301 - 71516 - $528
5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/LT - 71516 - $528
5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 73030/LT - 71941 - $528
5/20/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 99024/NC - V5489 - $1
5/20/2015 Cheryl Tarnuev 5/22/1966 orthopedics Dr. Jeff Wallentine 99212 - 72252 - $166
5/20/2015 Cheryl Tarnuev 5/22/1966 orthopedics Dr. Jeff Wallentine 72100 - 72252 - $166
5/6/2015 Robert Baggett 6/13/1980 orthopedics Dr. Mitch Larsen 99203 - 71946 - $175
4/29/2015 DeAnna Alexander 5/27/1955 orthopedics Dr. Jeff Wallentine 20610/RT; J3301; 73564/LT; 73564/RT - 71596 - $388
4/22/2015 Maria Abrego 10/27/1974 orthopedics Dr. John Wells 99024/NC - V5878 - $1
4/22/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 99024/NC - V5489 - $1
4/16/2015 Maria Abrego 10/27/1974 orthopedics Dr. John Wells 29873/LT - 7179 - $1,105
4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 99202/25 - 71596 - $534
4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 20610/RT - 71595 - $534
4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson J3301 - 71595 - $534
4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 72170 - 71695 - $534
4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 73565 - 71695 - $534
4/16/2015 Maritza Gonzalez 8/15/1987 orthopedics Dr. Robert Jackson 99211 - V5489 - $34
4/14/2015 Maria Lopez 3/24/1947 orthopedics Dr. Richard Jackson 72170; 73500; 99213 - 71595 - $264
4/14/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 27427; 29876; 27427/AS - 71836 - $3,374
4/13/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 7242 - $117
4/13/2015 Nubia Pena 12/31/1961 orthopedics Dr. Karl Weenig 99213 - 7265 - $117
2/18/2015 Sandra Zavala 11/10/1972 orthopedics Dr. Jeff Wallentine RECON/NC - 71945 - $0
11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - S82851D - $126
11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes A4466 - - - $126
11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 73610/RT - - - $126
11/9/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - Z478.9 - $86
11/9/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 73610/RT - - - $86
10/12/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - S82852D - $377
10/12/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes L4361/RT - - - $377
10/12/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 73610/RT - - - $377
10/8/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - Z478.9 - $86
10/8/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 73610/RT - - - $86
9/3/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - V548.9 - $86
9/3/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 73610/RT - - - $86
8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 99212/25 - 71527 - $200
8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux J3301 - - - $200
8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 20605/LT - - - $200
8/31/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - V548.9 - $0
8/20/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 27814/RT - 824.4 - $1,784
8/20/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 77071 - - - $1,784
8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 28446/RT - 84500 - $5,738
8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 29898/RT - 73390 - $5,738
8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 28446/ASRT - 84500 - $5,738
8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 29898/ASRT - 73390 - $5,738
8/17/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99204 - 824.6 - $357
8/17/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 73610/RT - - - $357
8/4/2015 Angela Estrada 9/4/1967 orthopedics - foot Dr. Robert Faux 99213 - 782.2 - $196
8/4/2015 Angela Estrada 9/4/1967 orthopedics - foot Dr. Robert Faux 73630/RT - - - $196
6/18/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99214 - 73390 - $175
4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 99212/25 - 71597 - $200
4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 20605/LT - 71597 - $200
4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux J3301 - 71597 - $200
3/19/2015 Magalis Garces 3/23/1949 orthopedics - foot Dr. Robert Faux 99213 - 7350 - $117
12/9/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 64721/RT - G5601 - $2,256
12/9/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 64721/LT - G5602 - $2,256
11/30/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99213 - S62635D - $201
11/30/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 73140/F3 - - - $201
16. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
11/5/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - Z4789 - $0
10/29/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 99203 - G5602 - $175
10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron L3933?LT - M20014 - $405
10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99213 - S62635D - $405
10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 73140/F3 - - - $405
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 99202/25 - M65341 - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F8 - M65322 - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F6 - - - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F1 - - - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson J3301 - - - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 73140/RT - - - $657
10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 73140/LT - - - $657
10/7/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99202 - S62635A - $154
10/7/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron L3927/LT - - - $154
9/22/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - V5489 - $0
8/25/2015 Jose Correa 10/7/1968 orthopedics - hand Dr. M. Shane Fraizer 99203 - 727.41 - $271
8/25/2015 Jose Correa 10/7/1968 orthopedics - hand Dr. M. Shane Fraizer 73110/LT - - - $271
8/25/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - V5489 - $0
8/12/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 26055/F6 - 72703 - $2,454
8/12/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 26055/XSF8 - - - $2,454
8/5/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 99204/NC - V548.9 - $70
8/5/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 73090/RT - - - $70
7/28/2015 Elsa Martinez 3/23/1954 orthopedics - hand Dr. Ryan Richards 99203 - 715.94 - $246
7/28/2015 Elsa Martinez 3/23/1954 orthopedics - hand Dr. Ryan Richards 73120/RT - - - $246
7/16/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99202 - 72703 - $120
7/7/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 20682/RT - V5401 - $1,267
6/15/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 20680/RT - V5401 - $1,267
6/4/2015 Janet Talbot 5/11/1959 orthopedics - hand Dr. Curtis Johnson 64721/RT - 3540 - $2,256
6/4/2015 Janet Talbot 5/11/1959 orthopedics - hand Dr. Curtis Johnson 64721/LT - 3540 - $2,256
6/3/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 99213 - 996.78 - $197
6/3/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 73100/RT - - - $197
4/22/2015 Janet Talbot 5/11/1959 orthopedics - hand PA David Waldron 99214/25; 20526/LT; 20526/RT; J3301 - 3540 - $497
12/17/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - Z5189 - $154
12/17/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97124 - - - $154
12/17/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - - - $154
12/14/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - 72887/Z5189 - $210
12/14/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97140 - - - $210
12/14/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - - - $210
12/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - 72887/M25661 - $210
12/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $210
12/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $210
12/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - 72887/M25661 - $210
12/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $210
12/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $210
12/9/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - 72887/Z5189 - $154
12/9/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97124 - - - $154
12/9/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - - - $154
12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - M25661 - $265
12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97530/XU - - - $265
12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $265
12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $265
12/7/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - Z5189 - $214
12/7/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - - - $214
12/4/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - M25661 - $265
12/4/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97530/XU - - - $265
12/4/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $265
12/4/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $265
12/2/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - M25661 - $174
12/2/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $174
12/2/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - - - $174
12/1/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - 72887/Z5189 - $255
12/1/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97016/XU - - - $255
12/1/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - - - $255
12/1/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $255
12/1/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - 72887/Z5189 - $169
12/1/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97124 - - - $169
12/1/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97014 - - - $169
11/25/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - 72887/Z5189 - $204
11/25/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97016/XU - - - $204
11/25/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - - - $204
11/25/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $204
11/24/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - Z5189 - $255
17. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
11/24/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - - - $255
11/24/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97016/XU - - - $255
11/24/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $255
11/24/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - 72887/Z5189 - $184
11/24/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97014 - - - $184
11/24/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97140 - - - $184
11/24/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - - - $184
11/23/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - Z5189 - $235
11/23/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $235
11/23/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - - - $235
11/23/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $235
11/20/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97010 - Z5189 - $184
11/20/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97014 - - - $184
11/20/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97140 - - - $184
11/20/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - - - $184
11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/z5189 - $153
11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153
11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $153
11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $153
11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 99213 - - - $153
11/16/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97001 - 72887/Z5189 - $275
11/16/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - - - $275
11/16/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - 72887/Z5189 - $178
11/16/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97039 - - - $178
11/16/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $178
11/16/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $178
11/13/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - 72887/Z5189 - $178
11/13/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97039 - - - $178
11/13/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $178
11/13/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $178
11/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - 72887/Z5189 - $159
11/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $159
11/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $159
11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/Z5189 - $153
11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153
11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $153
11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $153
11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $153
11/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - 72887/Z5189 - $251
11/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $251
11/6/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97001 - M25662 - $281
11/6/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97010 - - - $281
11/6/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $281
11/6/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - - - $281
11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 99211/25 - 6960/L4050 - $226
11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 96401 - - - $226
11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor J3357 - - - $226
11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/z5189 - $153
11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153
11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $153
11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $153
11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $153
10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887-z5189 - $153
10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $153
10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153
10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $153
10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $153
10/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - 72887/Z5189 - $153
10/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $153
10/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $153
10/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $153
10/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153
10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/20/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $219
10/20/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $219
10/20/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97140 - - - $219
10/20/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97039 - - - $219
10/19/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/Z5189 - $157
18. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
10/19/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $157
10/19/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $157
10/19/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $157
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252
10/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - Z5189 - $128
10/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
10/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
10/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $128
10/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/13/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $219
10/13/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $219
10/13/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97140 - - - $219
10/13/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97022 - - - $219
10/12/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - z5189 - $159
10/12/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $159
10/12/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $159
10/9/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - 72887/Z5189 - $157
10/9/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $157
10/9/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $157
10/9/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $157
10/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182
10/7/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/Z5189 - $128
10/7/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
10/7/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
10/7/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - - - $128
10/6/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $185
10/6/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $185
10/6/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97140 - - - $185
10/6/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97022 - - - $185
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley L3908 - - - $412
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97001 - - - $412
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $412
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97140 - - - $412
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97002 - - - $412
9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley A9300 - - - $412
9/29/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, therapeutic massage, electrical stim, ultrasound - - $112
9/29/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 aquatic therapy, therapeutic massage, electrical stim, ultrasound - - $112
9/29/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 aquatic therapy, therapeutic massage, electrical stim, ultrasound - - $112
9/29/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 aquatic therapy, therapeutic massage, electrical stim, ultrasound - - $112
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252
9/22/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 - - - $112
9/22/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 - - - $112
9/22/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 - - - $112
9/22/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 - - - $112
9/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy,manual therapy - - $120
9/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 aquatic therapy,manual therapy - - $120
9/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128
9/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
19. ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value
9/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
9/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $128
9/12/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy - - $50
9/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128
9/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
9/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
9/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $128
9/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 electrical stimulation, aquatic therapy - - $66
9/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 electrical stimulation, aquatic therapy - - $66
9/4/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128
9/4/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
9/4/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
9/4/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $128
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252
9/2/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128
9/2/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
9/2/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
9/2/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $128
9/1/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97110 - V57.1 - $159
9/1/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97140 - - - $159
9/1/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97010 - - - $159
8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97110 - V57.1 - $226
8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97140 - - - $226
8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97035 - - - $226
8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97010 - - - $226
8/26/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128
8/26/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - - - $128
8/26/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $128
8/26/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $128
8/25/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97110 - V57.1 - $184
8/25/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97140 - - - $184
8/25/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97014 - - - $184
8/25/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97010 - - - $184
8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97110 - V57.1 - $226
8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97140 - - - $226
8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97035 - - - $226
8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97010 - - - $226
8/24/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $123
8/24/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97124 - - - $123
8/24/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97035 - - - $123
8/24/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - - - $123
8/20/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97110 - V57.1 - $225
8/20/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97124 - - - $225
8/20/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97035 - - - $225
8/20/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97010 - - - $225
8/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, aquatic therapy - - $100
8/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, aquatic therapy - - $100
8/18/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97110 - V57.1 - $158
8/18/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97140 - - - $158
8/18/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97010 - - - $158
8/18/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97010 - V57.1 - $128
8/18/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97035 - - - $128
8/18/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97140 - - - $128
8/18/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97110 - - - $128
8/17/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 97110 - V57.1 - $214
8/17/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 97010 - - - $214
8/14/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97110 - V57.1 - $226
8/14/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97140 - - - $226
8/14/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97035 - - - $226
8/14/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97010 - - - $226
8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222
8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222
8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222
8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97035 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222
8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222
8/12/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97001 - V57.1 - $250
8/12/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97010 - - - $250
