Service Date(s) Patient Staff Member Invoice #

7/11/2024 Abbigail Shaver Tessa Turner 6616-C01

7/12/2024 Abbigail Shaver Tessa Turner 6618-C01
7/12/2024 Abbigail Shaver Tessa Turner 6615-C01
7/16/2024 Abbigail Shaver Tessa Turner 6668-C01
7/17/2024 Abbigail Shaver Tessa Turner 6682-C01
7/26/2024 Abbigail Shaver Tessa Turner 6848-C01
7/30/2024 Abbigail Shaver Tessa Turner 6895-C01
8/2/2024 Abbigail Shaver Tessa Turner 6952-C01
8/5/2024 Abbigail Shaver Tessa Turner 6991-C01
8/9/2024 Abbigail Shaver Tessa Turner 7064-C01
8/16/2024 Abbigail Shaver Tessa Turner 7161-C01
8/20/2024 Abbigail Shaver Tessa Turner 7202-C01
8/23/2024 Abbigail Shaver Tessa Turner 7272-C01
8/27/2024 Abbigail Shaver Tessa Turner 7319-C01
8/30/2024 Abbigail Shaver Tessa Turner 7388-C01
7/15/2024 Airamay Rise Adrienne Jeannerat 6647-C01
7/15/2024 Airamay Rise Adrienne Jeannerat 6646-C01
7/18/2024 Airamay Rise Adrienne Jeannerat 6717-C01
7/16/2024 Alexander Gross Ash Di Meo 6664-C01
8/27/2024 Alexander Gross Ash Di Meo 7320-C01
7/16/2024 Alexandra Benderly Melissa Dawn Ackley 6677-C01
7/16/2024 Alexi Slater Ash Di Meo 6659-C01
7/30/2024 Alexi Slater Ash Di Meo 6886-C01
7/11/2024 Alison Armstrong Joann Lundberg 6609-C01
7/11/2024 Alison Armstrong Joann Lundberg 6609-C02
7/12/2024 Alison Armstrong Joann Lundberg 6626-C01
7/12/2024 Alison Armstrong Joann Lundberg 6626-C02
7/18/2024 Alison Armstrong Joann Lundberg 6728-C01
7/18/2024 Alison Armstrong Joann Lundberg 6728-C02
7/19/2024 Alison Armstrong Joann Lundberg 6759-C01
7/19/2024 Alison Armstrong Joann Lundberg 6759-C02
7/25/2024 Alison Armstrong Joann Lundberg 6838-C01
7/25/2024 Alison Armstrong Joann Lundberg 6838-C02
7/30/2024 Alison Armstrong Joann Lundberg 6918-C01
7/30/2024 Alison Armstrong Joann Lundberg 6918-C02
8/2/2024 Alison Armstrong Joann Lundberg 6958-C01
8/2/2024 Alison Armstrong Joann Lundberg 6958-C02
8/8/2024 Alison Armstrong Joann Lundberg 7058-C01
8/8/2024 Alison Armstrong Joann Lundberg 7058-C02
8/8/2024 Alison Armstrong Joann Lundberg 7056-C01
8/8/2024 Alison Armstrong Joann Lundberg 7056-C02
8/9/2024 Alison Armstrong Joann Lundberg 7075-C01
8/9/2024 Alison Armstrong Joann Lundberg 7075-C02
8/16/2024 Alison Armstrong Joann Lundberg 7166-C01
8/16/2024 Alison Armstrong Joann Lundberg 7166-C02
8/22/2024 Alison Armstrong Joann Lundberg 7260-C01
8/22/2024 Alison Armstrong Joann Lundberg 7260-C02
8/23/2024 Alison Armstrong Joann Lundberg 7276-C01
8/30/2024 Alison Armstrong Joann Lundberg 7399-C03
7/15/2024 Aliyah Sieler Tessa Turner 6648-C01
7/19/2024 Aliyah Sieler Tessa Turner 6736-C01
7/24/2024 Aliyah Sieler Tessa Turner 6803-C01
7/30/2024 Aliyah Sieler Tessa Turner 6883-C01
7/31/2024 Aliyah Sieler Tessa Turner 6932-C01
8/5/2024 Aliyah Sieler Tessa Turner 6983-C01
8/14/2024 Aliyah Sieler Tessa Turner 7113-C01
8/14/2024 Aliyah Sieler Tessa Turner 7135-C01
8/21/2024 Aliyah Sieler Tessa Turner 7237-C01
8/23/2024 Aliyah Sieler Tessa Turner 7268-C01
8/30/2024 Aliyah Sieler Tessa Turner 7391-C01
7/22/2024 Allene Lowsley Ash Di Meo 6762-C01
8/5/2024 Allene Lowsley Ash Di Meo 6975-C01
9/2/2024 Allene Lowsley Ash Di Meo 7415-C01
8/9/2024 Amelia Garrison Joann Lundberg 7066-C01
8/29/2024 Anahi Moreno Salcedo Amanda Sanabria 7379-C01
8/1/2024 Andrew Anastasia Ash Di Meo 6933-C01
8/29/2024 Andrew Anastasia Ash Di Meo 7363-C01
7/30/2024 Angela McDonald-Wilkins Ash Di Meo 6887-C01
8/6/2024 Angela McDonald-Wilkins Ash Di Meo 7000-C01
7/11/2024 Angelo Lucero Jordan Grant 6604-C01
8/9/2024 Angelo Lucero Jordan Grant 7069-C01
7/15/2024 Annie Nguyen Ash Di Meo 6635-C01
7/31/2024 Annie Zigman Ash Di Meo 6911-C01
8/24/2024 Annie Zigman Ash Di Meo 7282-C01
8/31/2024 Anthony Cull-whitllock Amanda Sanabria 7407-C01
7/13/2024 Antonio Ricciardi Joann Lundberg 6630-C01
7/20/2024 Antonio Ricciardi Joann Lundberg 6748-C01
7/27/2024 Antonio Ricciardi Joann Lundberg 6859-C01
8/10/2024 Antonio Ricciardi Joann Lundberg 7076-C01
8/17/2024 Antonio Ricciardi Joann Lundberg 7169-C01
8/17/2024 Antonio Ricciardi Joann Lundberg 7168-C01
8/24/2024 Antonio Ricciardi Joann Lundberg 7278-C01
8/27/2024 Antonio Ricciardi Joann Lundberg 7323-C01
8/28/2024 Antonio Ricciardi Joann Lundberg 7343-C01
8/31/2024 Antonio Ricciardi Joann Lundberg 7412-C01
8/31/2024 Antonio Ricciardi Joann Lundberg 7405-C01
9/3/2024 Antonio Ricciardi Joann Lundberg 7423-C01
7/10/2024 Arabella Linden Tessa Turner 6596-C01
8/5/2024 Arabella Linden Tessa Turner 6985-C01
8/19/2024 Arabella Linden Tessa Turner 7181-C01
8/30/2024 Arabella Linden Tessa Turner 7389-C01
7/19/2024 Arjon Nance Ash Di Meo 6734-C01
8/2/2024 Arjon Nance Ash Di Meo 6945-C01
8/23/2024 Arjon Nance Ash Di Meo 7269-C01
8/30/2024 Arjon Nance Ash Di Meo 7384-C01
8/28/2024 Aspen Sheehan Ash Di Meo 7333-C01
7/15/2024 Audrey Feuerborn Tessa Turner 6643-C01
8/19/2024 August Gwin Emery Tessa Turner 7179-C01
8/20/2024 August Gwin Emery Tessa Turner 7193-C01
8/27/2024 August Gwin Emery Tessa Turner 7330-C01
7/18/2024 Aurelia Philo Tiffany Merchant 6723-C02
8/1/2024 Aurelia Philo Tiffany Merchant 6941-C01
8/19/2024 Aurelia Philo Tiffany Merchant 7175-C01
8/29/2024 Aurelia Philo Tiffany Merchant 7376-C01
7/18/2024 Brianna Costello Ash Di Meo 6712-C01
8/1/2024 Brianna Costello Ash Di Meo 6937-C01
8/22/2024 Brianna Costello Ash Di Meo 7250-C01
7/10/2024 Cailin Urzua Tiffany Merchant 6588-C01
7/24/2024 Cailin Urzua Tiffany Merchant 6819-C01
8/7/2024 Cailin Urzua Tiffany Merchant 7044-C01
8/8/2024 Cailin Urzua Tiffany Merchant 7082-C01
7/10/2024 Caleb Thomas Joann Lundberg 6573-C01
7/18/2024 Caleb Thomas Joann Lundberg 6724-C01
8/7/2024 Caleb Thomas Joann Lundberg 7027-C01
8/15/2024 Caleb Thomas Joann Lundberg 7145-C01
8/22/2024 Caleb Thomas Joann Lundberg 7256-C01
8/29/2024 Caleb Thomas Joann Lundberg 7369-C01
7/10/2024 Candice Miller Tiffany Merchant 6571-C01
7/10/2024 Candice Miller Tiffany Merchant 6572-C01
7/17/2024 Candice Miller Tiffany Merchant 6678-C01
7/17/2024 Carly Cusack Tiffany Merchant 6681-C01
7/24/2024 Carly Cusack Tiffany Merchant 6821-C01
7/31/2024 Carly Cusack Tiffany Merchant 6907-C02
8/20/2024 Carly Cusack Tiffany Merchant 7194-C01
8/28/2024 Carly Cusack Tiffany Merchant 7340-C01
7/17/2024 Carter Benson Melissa Dawn Ackley 6689-C01
7/30/2024 Carter Benson Melissa Dawn Ackley 6913-C01
8/13/2024 Carter Benson Melissa Dawn Ackley 7097-C01
8/30/2024 Carter Benson Melissa Dawn Ackley 7403-C01
7/10/2024 Casey Clark Ash Di Meo 6569-C01
7/17/2024 Casey Clark Ash Di Meo 6672-C01
7/31/2024 Casey Clark Ash Di Meo 6904-C01
8/7/2024 Casey Clark Ash Di Meo 7021-C01
8/21/2024 Casey Clark Ash Di Meo 7214-C01
8/28/2024 Casey Clark Ash Di Meo 7331-C01
8/27/2024 Cassandra Perez Ortiz Adrienne Jeannerat 7316-C01
8/24/2024 Charlie White Ash Di Meo 7284-C01
8/27/2024 Charlie White Ash Di Meo 7317-C01
7/20/2024 Christine Decroos Ash Di Meo 6753-C01
8/6/2024 Christine Decroos Ash Di Meo 6998-C01
8/20/2024 Christine Decroos Ash Di Meo 7190-C01
7/18/2024 Christopher Trejo Jordan Grant 6720-C01
8/6/2024 Christopher Trejo Jordan Grant 7001-C01
8/28/2024 Christopher Trejo Jordan Grant 7375-C01
7/11/2024 Claire Emerson Frame Jordan Grant 6597-C01
7/23/2024 Claire Emerson Frame Jordan Grant 6812-C01
7/26/2024 Claire Emerson Frame Jordan Grant 6857-C01
8/8/2024 Claire Emerson Frame Jordan Grant 7068-C02
8/22/2024 Claire Emerson Frame Jordan Grant 7252-C01
8/14/2024 Crystal Stonebreaker Tiffany Merchant 7128-C01
8/15/2024 Crystal Stonebreaker 7136-C01
8/28/2024 Crystal Stonebreaker Tiffany Merchant 7377-C01
7/16/2024 Daniel Parker Ash Di Meo 6665-C01
7/17/2024 Daniel Parker Joann Lundberg 6716-C01
7/17/2024 Daniel Parker Tiffany Merchant 6711-C01
7/23/2024 Daniel Parker Tiffany Merchant 6785-C02
8/2/2024 Danielle Hines Melissa Dawn Ackley 7052-C01
7/19/2024 Devyn Richardson Joann Lundberg 6740-C01
8/2/2024 Devyn Richardson Joann Lundberg 6957-C01
8/2/2024 Devyn Richardson Joann Lundberg 6966-C01
8/4/2024 Devyn Richardson Joann Lundberg 6994-C01
8/6/2024 Devyn Richardson Joann Lundberg 7007-C01
8/9/2024 Devyn Richardson Joann Lundberg 7065-C01
8/30/2024 Devyn Richardson Joann Lundberg 7394-C02
7/22/2024 Eliza Eckert Ash Di Meo 6766-C01
7/25/2024 Eliza Eckert Melissa Dawn Ackley 6836-C01
8/2/2024 Eliza Eckert Melissa Dawn Ackley 6951-C01
8/7/2024 Eliza Eckert Melissa Dawn Ackley 7023-C01
7/17/2024 Elliana Blough Adrienne Jeannerat 6697-C01
7/24/2024 Elliana Blough Adrienne Jeannerat 6814-C01
7/31/2024 Elliana Blough Adrienne Jeannerat 6928-C01
8/7/2024 Elliana Blough Adrienne Jeannerat 7040-C01
8/21/2024 Elliana Blough Adrienne Jeannerat 7232-C01
8/21/2024 Elliana Blough Adrienne Jeannerat 7213-C01
8/28/2024 Elliana Blough Adrienne Jeannerat 7353-C01
7/22/2024 Elvy Svensson-Nilsson Tessa Turner 6773-C01
8/5/2024 Elvy Svensson-Nilsson Tessa Turner 6982-C01
8/12/2024 Elvy Svensson-Nilsson Tessa Turner 7086-C02
8/19/2024 Elvy Svensson-Nilsson Tessa Turner 7182-C01
8/26/2024 Elvy Svensson-Nilsson Tessa Turner 7299-C01
7/16/2024 Esme Konsor Tiffany Merchant 6670-C02
7/30/2024 Esme Konsor Tiffany Merchant 6899-C01
8/13/2024 Esme Konsor Tiffany Merchant 7102-C01
8/27/2024 Esme Konsor Tiffany Merchant 7326-C01
8/16/2024 Everett Armstrong Melissa Dawn Ackley 7167-C01
8/30/2024 Everett Armstrong Melissa Dawn Ackley 7404-C01
7/11/2024 Ezme Wilkin Tiffany Merchant 6607-C01
8/8/2024 Ezme Wilkin Tiffany Merchant 7057-C01
8/22/2024 Ezme Wilkin Tiffany Merchant 7257-C01
7/16/2024 Felicia Ortega Tiffany Merchant 6657-C01
7/25/2024 Felicia Ortega Tiffany Merchant 6820-C01
7/30/2024 Felicia Ortega Tiffany Merchant 6884-C01
8/6/2024 Felicia Ortega Tiffany Merchant 6995-C01
8/13/2024 Felicia Ortega Tiffany Merchant 7095-C01
8/20/2024 Felicia Ortega Tiffany Merchant 7188-C01
9/3/2024 Felicia Ortega Tiffany Merchant 7421-C01
7/19/2024 Finn Raphael Melissa Dawn Ackley 6739-C01
8/6/2024 Finn Raphael Melissa Dawn Ackley 7002-C01
8/2/2024 Gabriella Thompson Melissa Dawn Ackley 6962-C01
8/15/2024 Gabriella Thompson Melissa Dawn Ackley 7150-C01
8/22/2024 Gabriella Thompson Melissa Dawn Ackley 7264-C01
8/27/2024 Gabriella Thompson Melissa Dawn Ackley 7310-C01
9/3/2024 Gabriella Thompson Melissa Dawn Ackley 7422-C01
7/10/2024 Georgia Guzman Tiffany Merchant 6577-C01
8/1/2024 Georgia Guzman Tiffany Merchant 6935-C01
8/8/2024 Georgia Guzman Tiffany Merchant 7051-C01
8/15/2024 Georgia Guzman Tiffany Merchant 7138-C02
8/22/2024 Georgia Guzman Tiffany Merchant 7248-C01
8/29/2024 Georgia Guzman Tiffany Merchant 7368-C01
7/22/2024 Hannah Frey Tiffany Merchant 6761-C02
8/5/2024 Hannah Frey Tiffany Merchant 6976-C01
8/12/2024 Hannah Frey Tiffany Merchant 7079-C01
8/19/2024 Hannah Frey Tiffany Merchant 7174-C02
8/26/2024 Hannah Frey Tiffany Merchant 7293-C02
7/10/2024 Hannah Reardon Ash Di Meo 6570-C01
7/17/2024 Hannah Reardon Ash Di Meo 6684-C01
8/21/2024 Hannah Reardon Ash Di Meo 7215-C01
7/15/2024 Heather Garrison Adrienne Jeannerat 6653-C01
8/19/2024 Heather Garrison Adrienne Jeannerat 7183-C01
8/26/2024 Heather Garrison Adrienne Jeannerat 7305-C01
8/14/2024 Hector Toro Santana Leocadia Hainley 7132-C01
8/22/2024 Hector Toro Santana Leocadia Hainley 7262-C01
8/28/2024 Hector Toro Santana Amanda Sanabria 7351-C01
8/28/2024 Hector Toro Santana Leocadia Hainley 7361-C01
8/29/2024 Helena Wren Wooten Ash Di Meo 7381-C01
7/29/2024 Hope O'Connor Tiffany Merchant 6874-C01
8/12/2024 Hope O'Connor Tiffany Merchant 7088-C01
8/26/2024 Hope O'Connor Tiffany Merchant 7303-C01
7/11/2024 Ian Kirkpatrick Joann Lundberg 6598-C01
7/13/2024 Ian Kirkpatrick Joann Lundberg 6633-C01
7/18/2024 Ian Kirkpatrick Joann Lundberg 6707-C01
7/19/2024 Ian Kirkpatrick Joann Lundberg 6733-C01
7/25/2024 Ian Kirkpatrick Joann Lundberg 6828-C01
7/27/2024 Ian Kirkpatrick Joann Lundberg 6861-C02
7/30/2024 Ian Kirkpatrick Joann Lundberg 6885-C01
8/1/2024 Ian Kirkpatrick Melissa Dawn Ackley 6949-C02
8/3/2024 Ian Kirkpatrick Joann Lundberg 6964-C02
8/3/2024 Ian Kirkpatrick Joann Lundberg 6967-C01
8/8/2024 Ian Kirkpatrick Joann Lundberg 7053-C01
8/15/2024 Ian Kirkpatrick Joann Lundberg 7144-C01
8/16/2024 Ian Kirkpatrick Joann Lundberg 7159-C01
8/17/2024 Ian Kirkpatrick Joann Lundberg 7171-C02
8/22/2024 Ian Kirkpatrick Joann Lundberg 7253-C01
8/24/2024 Ian Kirkpatrick Joann Lundberg 7285-C01
8/26/2024 Ian Kirkpatrick Joann Lundberg 7292-C01
8/29/2024 Ian Kirkpatrick Joann Lundberg 7372-C01
8/31/2024 Ian Kirkpatrick Joann Lundberg 7409-C02
7/29/2024 Isabelle Cordova Tiffany Merchant 6872-C01
8/13/2024 Isabelle Cordova Tiffany Merchant 7099-C01
8/27/2024 Isabelle Cordova Tiffany Merchant 7321-C01
7/11/2024 Isaiah Lucero Tiffany Merchant 6601-C01
7/12/2024 Isaiah Lucero Tessa Turner 6628-C01
7/15/2024 Isaiah Lucero Tessa Turner 6649-C01
7/24/2024 Isaiah Lucero Tiffany Merchant 6799-C01
7/26/2024 Isaiah Lucero Tessa Turner 6854-C01
7/31/2024 Isaiah Lucero Tessa Turner 6908-C01
8/2/2024 Isaiah Lucero Tessa Turner 6960-C01
8/7/2024 Isaiah Lucero Tiffany Merchant 7034-C01
8/9/2024 Isaiah Lucero Tiffany Merchant 7077-C01
8/12/2024 Isaiah Lucero Tessa Turner 7085-C01
8/14/2024 Isaiah Lucero Tessa Turner 7115-C01
8/20/2024 Isaiah Lucero Tessa Turner 7206-C01
8/21/2024 Isaiah Lucero Tiffany Merchant 7228-C01
8/28/2024 Isaiah Lucero Tessa Turner 7350-C01
7/16/2024 Israel Valentin Adrienne Jeannerat 6671-C01
7/23/2024 Israel Valentin Adrienne Jeannerat 6795-C01
7/30/2024 Israel Valentin Adrienne Jeannerat 6902-C01
8/6/2024 Israel Valentin Adrienne Jeannerat 7016-C01
8/20/2024 Israel Valentin Adrienne Jeannerat 7211-C01
8/27/2024 Israel Valentin Adrienne Jeannerat 7329-C01
8/22/2024 Jack Bowen Ash Di Meo 7239-C01
7/15/2024 Jack Burke Tiffany Merchant 6636-C01
7/15/2024 Jack Burke Tiffany Merchant 6636-C02
7/29/2024 Jack Burke Tiffany Merchant 6864-C01
7/29/2024 Jack Burke Tiffany Merchant 6864-C02
8/26/2024 Jack Burke Tiffany Merchant 7306-C01
8/26/2024 Jack Burke Tiffany Merchant 7306-C02
7/22/2024 Jack Farley Tiffany Merchant 6768-C01
8/6/2024 Jack Farley Tiffany Merchant 7015-C01
8/29/2024 Jack Farley Tiffany Merchant 7380-C01
7/10/2024 Jada Ibarra Thompson Joann Lundberg 6582-C01
7/11/2024 Jada Ibarra Thompson Joann Lundberg 6602-C01
7/18/2024 Jada Ibarra Thompson Joann Lundberg 6718-C03
7/19/2024 Jada Ibarra Thompson Joann Lundberg 6743-C01
7/24/2024 Jada Ibarra Thompson Joann Lundberg 6810-C01
7/24/2024 Jada Ibarra Thompson Joann Lundberg 6805-C01
7/25/2024 Jada Ibarra Thompson Joann Lundberg 6839-C01
7/31/2024 Jada Ibarra Thompson Joann Lundberg 6927-C01
7/31/2024 Jada Ibarra Thompson Joann Lundberg 6917-C01
8/7/2024 Jada Ibarra Thompson Joann Lundberg 7036-C01
8/14/2024 Jada Ibarra Thompson Joann Lundberg 7117-C01
8/21/2024 Jada Ibarra Thompson Joann Lundberg 7226-C01
8/28/2024 Jada Ibarra Thompson Joann Lundberg 7344-C01
7/23/2024 Jade Benson Melissa Dawn Ackley 6782-C01
7/30/2024 Jade Benson Melissa Dawn Ackley 6894-C01
8/13/2024 Jade Benson Melissa Dawn Ackley 7098-C01
8/7/2024 Jakob Levin Adrienne Jeannerat 7041-C01
8/14/2024 Jakob Levin Adrienne Jeannerat 7131-C01
8/21/2024 Jakob Levin Adrienne Jeannerat 7231-C01
8/22/2024 Jakob Levin Tiffany Merchant 7259-C01
8/14/2024 James Holland Tiffany Merchant 7124-C01
8/28/2024 James Holland Tiffany Merchant 7356-C01
8/29/2024 James Holland Tiffany Merchant 7378-C01
9/3/2024 James Holland Tiffany Merchant 7420-C01
7/12/2024 Jamie Arcelay Tessa Turner 6585-C01
7/26/2024 Jamie Arcelay Tessa Turner 6840-C01
7/29/2024 Jamie Arcelay Adrienne Jeannerat 6873-C01
8/2/2024 Jamie Arcelay Tessa Turner 6946-C01
8/5/2024 Jamie Arcelay Tessa Turner 6986-C01
8/9/2024 Jamie Arcelay Tessa Turner 7062-C01
8/12/2024 Jamie Arcelay Adrienne Jeannerat 7090-C01
8/16/2024 Jamie Arcelay Tessa Turner 7153-C01
8/21/2024 Jamie Arcelay Tessa Turner 7236-C01
8/28/2024 Jamie Arcelay Adrienne Jeannerat 7354-C01
7/24/2024 Jamie Armstrong Tiffany Merchant 6811-C01
8/15/2024 Jamie Armstrong Tiffany Merchant 7148-C01
8/12/2024 Jasper Hodges Tiffany Merchant 7084-C01
8/26/2024 Jasper Hodges Tiffany Merchant 7301-C01
8/6/2024 Jaxson Fromdahl Tessa Turner 7013-C01
7/16/2024 Jenna Devlin Adrienne Jeannerat 6663-C01
7/22/2024 Jenna Devlin Adrienne Jeannerat 6771-C01
7/11/2024 Jennifer Sonntag Tiffany Merchant 6590-C01
7/25/2024 Jennifer Sonntag Tiffany Merchant 6823-C01
8/8/2024 Jennifer Sonntag Tiffany Merchant 7047-C02
8/22/2024 Jennifer Sonntag Tiffany Merchant 7241-C01
7/10/2024 Jeremiah Bennett Tiffany Merchant 6581-C01
7/11/2024 Jeremiah Bennett Tiffany Merchant 6608-C01
7/18/2024 Jeremiah Bennett Tiffany Merchant 6709-C01
8/1/2024 Jeremiah Bennett Tiffany Merchant 6936-C01
8/8/2024 Jeremiah Bennett Tiffany Merchant 7050-C01
8/22/2024 Jeremiah Bennett Tiffany Merchant 7249-C01
9/2/2024 Jerram Harte Ash Di Meo 7417-C01
7/23/2024 Jessica Hanna Adrienne Jeannerat 6787-C01
7/30/2024 Jessica Hanna Adrienne Jeannerat 6900-C01
8/14/2024 Jessica Hanna Adrienne Jeannerat 7130-C01
8/20/2024 Jessica Hanna Adrienne Jeannerat 7197-C01
8/29/2024 Jessica Hanna Adrienne Jeannerat 7364-C01
8/20/2024 Jesus Alvarez Tiffany Merchant 7205-C02
7/12/2024 Jillian Johnson Joann Lundberg 6614-C03
7/12/2024 Jillian Johnson Joann Lundberg 6614-C02
7/19/2024 Jillian Johnson Joann Lundberg 6744-C04
7/19/2024 Jillian Johnson Joann Lundberg 6744-C03
7/25/2024 Jillian Johnson Joann Lundberg 6835-C01
7/25/2024 Jillian Johnson Joann Lundberg 6835-C02
8/7/2024 Jillian Johnson Joann Lundberg 7024-C01
8/7/2024 Jillian Johnson Joann Lundberg 7024-C02
8/21/2024 Jillian Johnson Joann Lundberg 7223-C01
8/28/2024 Jillian Johnson Joann Lundberg 7334-C01
7/18/2024 Joneen Odermann Tiffany Merchant 6719-C01
7/30/2024 Joneen Odermann Tiffany Merchant 6798-C02
8/13/2024 Joneen Odermann Tiffany Merchant 7103-C01
8/27/2024 Joneen Odermann Tiffany Merchant 7328-C01
7/10/2024 Jorden LaMar Tessa Turner 6575-C01
7/17/2024 Jorden LaMar Tessa Turner 6687-C01
7/26/2024 Jorden LaMar Tessa Turner 6841-C01
7/31/2024 Jorden LaMar Tessa Turner 6916-C01
7/29/2024 Joseph Rostochil Ash Di Meo 6871-C01
8/26/2024 Joseph Rostochil Ash Di Meo 7291-C01
7/25/2024 Joshua Olinger Melissa Dawn Ackley 6837-C01
8/6/2024 Joshua Olinger Melissa Dawn Ackley 6999-C01
8/20/2024 Joshua Olinger Melissa Dawn Ackley 7242-C01
7/25/2024 Joy Teragli Tiffany Merchant 6832-C02
7/23/2024 Justin Martin Tiffany Merchant 6786-C01
8/6/2024 Justin Martin Tiffany Merchant 7008-C01
8/20/2024 Justin Martin Tiffany Merchant 7200-C01
7/22/2024 Kaden Collins Tiffany Merchant 6769-C01
8/5/2024 Kaden Collins Tiffany Merchant 6980-C02
8/20/2024 Kaden Collins Tiffany Merchant 7208-C01
7/16/2024 Kai Cade Tessa Turner 6669-C01
7/25/2024 Kailyn Bakken Joann Lundberg 6830-C01
8/15/2024 Kailyn Bakken Joann Lundberg 7142-C01
8/28/2024 Kailyn Bakken Joann Lundberg 7347-C01
8/2/2024 Kaitlin Romano Ash Di Meo 6942-C01
7/10/2024 Kaitlyn Lathrop Jordan Grant 6579-C01
7/17/2024 Kaitlyn Lathrop Jordan Grant 6693-C01
7/24/2024 Kaitlyn Lathrop Jordan Grant 6807-C01
7/26/2024 Kaitlyn Lathrop Jordan Grant 6856-C01
7/31/2024 Kaitlyn Lathrop Jordan Grant 6919-C01
8/7/2024 Kaitlyn Lathrop Jordan Grant 7032-C01
8/14/2024 Kaitlyn Lathrop Jordan Grant 7118-C01
8/21/2024 Kaitlyn Lathrop Jordan Grant 7224-C01
8/28/2024 Kaitlyn Lathrop Jordan Grant 7346-C01
7/12/2024 Kalani Karington Joann Lundberg 6611-C01
7/24/2024 Kalani Karington Joann Lundberg 6801-C01
8/16/2024 Kalani Karington Joann Lundberg 7162-C01
8/20/2024 Kalani Karington Joann Lundberg 7187-C01
8/22/2024 Kalani Karington Joann Lundberg 7255-C01
8/28/2024 Kalani Karington Joann Lundberg 7338-C01
8/1/2024 Kaleb Kroeger Tiffany Merchant 6938-C01
8/15/2024 Kaleb Kroeger Tiffany Merchant 7140-C01
8/29/2024 Kaleb Kroeger Tiffany Merchant 7371-C01
8/7/2024 Kamana O Kala Keanaaina Tiffany Merchant 7035-C02
8/12/2024 Kamana O Kala Keanaaina Tiffany Merchant 7091-C01
8/7/2024 Karen George Tiffany Merchant 7030-C01
8/21/2024 Karen George Tiffany Merchant 7221-C01
8/28/2024 Karen George Tiffany Merchant 7348-C01
7/23/2024 Kaysi Whelan Tiffany Merchant 6784-C01
8/6/2024 Kaysi Whelan Tiffany Merchant 7006-C01
8/27/2024 Kaysi Whelan Tiffany Merchant 7311-C01
7/30/2024 Kelli Kappler Ash Di Meo 6893-C01
7/17/2024 Kimberly Vargas Jordan Grant 6703-C01
7/24/2024 Kimberly Vargas Jordan Grant 6833-C01
8/7/2024 Kimberly Vargas Jordan Grant 7045-C01
8/12/2024 Kimberly Vargas Jordan Grant 7096-C01
8/22/2024 Kimberly Vargas Jordan Grant 7247-C01
7/18/2024 Kiro Kelly Jordan Grant 6730-C01
7/18/2024 Kiro Kelly Jordan Grant 6725-C01
7/30/2024 Kiro Kelly Jordan Grant 6898-C01
8/8/2024 Kiro Kelly Jordan Grant 7067-C01
8/27/2024 Kiro Kelly Jordan Grant 7327-C01
7/19/2024 Kora Marsh Tessa Turner 6745-C01
7/26/2024 Kora Marsh Tessa Turner 6853-C01
8/9/2024 Kora Marsh Tessa Turner 7073-C01
8/27/2024 Lane Brown Ash Di Meo 7313-C01
7/10/2024 Leland Lucero Tessa Turner 6584-C01
7/11/2024 Leland Lucero Tessa Turner 6600-C01
7/11/2024 Leland Lucero Tessa Turner 6600-C02
7/11/2024 Leland Lucero Tessa Turner 6600-C03
7/11/2024 Leland Lucero Jordan Grant 6606-C01
7/31/2024 Leland Lucero Tessa Turner 6925-C01
8/7/2024 Leland Lucero Tessa Turner 7037-C01
8/9/2024 Leland Lucero Tessa Turner 7072-C01
8/21/2024 Leland Lucero Tessa Turner 7234-C01
7/23/2024 Liam Cusack Tessa Turner 6790-C01
7/29/2024 Liam Cusack Tessa Turner 6876-C01
8/2/2024 Liam Cusack Tessa Turner 6961-C01
8/16/2024 Liam Cusack Tessa Turner 7163-C01
8/23/2024 Liam Cusack Tessa Turner 7275-C01
8/7/2024 Lila Mcnerlin Tiffany Merchant 7022-C02
8/20/2024 Lila Mcnerlin Tiffany Merchant 7191-C01
8/20/2024 Lila Mcnerlin Tiffany Merchant 7191-C02
7/23/2024 Lisa Walter Tessa Turner 6792-C01
8/6/2024 Lisa Walter Tessa Turner 7012-C01
8/20/2024 Lisa Walter Tessa Turner 7203-C02
8/21/2024 Lisa Walter Tiffany Merchant 7230-C01
7/17/2024 Lucy Benson Melissa Dawn Ackley 6694-C01
7/30/2024 Lucy Benson Melissa Dawn Ackley 6914-C01
8/21/2024 Lucy Benson Melissa Dawn Ackley 7246-C01
7/22/2024 Luis Araiza Tiffany Merchant 6775-C01
8/5/2024 Luis Araiza Tiffany Merchant 6987-C01
8/19/2024 Luis Araiza Tiffany Merchant 7184-C01
7/18/2024 Malcolm Ellis Tessa Turner 6722-C01
7/23/2024 Malcolm Ellis Tessa Turner 6791-C01
7/30/2024 Malcolm Ellis Tessa Turner 6889-C01
8/7/2024 Malcolm Ellis Tessa Turner 7043-C01
8/16/2024 Malcolm Ellis Tessa Turner 7152-C01
8/21/2024 Malcolm Ellis Tessa Turner 7216-C01
8/30/2024 Malcolm Ellis Tessa Turner 7390-C01
7/18/2024 Mara Reynolds Tessa Turner 6729-C02
8/2/2024 Mara Reynolds Tessa Turner 6954-C02
8/16/2024 Mara Reynolds Tessa Turner 7164-C02
8/26/2024 Mara Reynolds Tessa Turner 7309-C02
7/24/2024 Margaret Bowen Tessa Turner 6815-C01
8/14/2024 Margaret Bowen Tessa Turner 7134-C01
8/21/2024 Margaret Bowen Tessa Turner 7235-C01
8/28/2024 Margaret Bowen Tessa Turner 7357-C01
7/12/2024 Maricruz Martinez Tessa Turner 6627-C01
7/17/2024 Maricruz Martinez Tessa Turner 6696-C01
7/24/2024 Maricruz Martinez Tessa Turner 6809-C01
7/31/2024 Maricruz Martinez Tessa Turner 6921-C01
8/14/2024 Maricruz Martinez Tessa Turner 7122-C01
8/21/2024 Maricruz Martinez Tessa Turner 7227-C01
7/15/2024 Marisa Margolis Ash Di Meo 6638-C01
7/22/2024 Marisa Margolis Ash Di Meo 6763-C01
7/29/2024 Marisa Margolis Ash Di Meo 6865-C01
8/5/2024 Marisa Margolis Ash Di Meo 6977-C01
8/26/2024 Marisa Margolis Ash Di Meo 7296-C01
9/2/2024 Marisa Margolis Ash Di Meo 7416-C01
7/18/2024 Matthew Maguire Ash Di Meo 6704-C01
7/22/2024 Matthew Maguire Ash Di Meo 6764-C01
7/29/2024 Matthew Maguire Ash Di Meo 6868-C01
8/7/2024 Matthew Maguire Ash Di Meo 7020-C01
8/22/2024 Matthew Maguire Ash Di Meo 7238-C01
9/2/2024 Matthew Maguire Ash Di Meo 7418-C01
7/23/2024 Maureen Jay Matis Tiffany Merchant 6783-C01
7/24/2024 Maureen Jay Matis Tessa Turner 6818-C01
7/29/2024 Maureen Jay Matis Tiffany Merchant 6869-C01
8/2/2024 Maureen Jay Matis Tessa Turner 6959-C01
8/5/2024 Maureen Jay Matis Tiffany Merchant 6990-C01
 8/5/2024 Maureen Jay Matis Tessa Turner 6989-C01
8/12/2024 Maureen Jay Matis Tiffany Merchant 7083-C01
8/21/2024 Maureen Jay Matis Tiffany Merchant 7217-C01
8/26/2024 Maureen Jay Matis Tiffany Merchant 7298-C01
8/30/2024 Maureen Jay Matis Tessa Turner 7397-C01
7/12/2024 Meghan Andrews Ash Di Meo 6610-C01
7/19/2024 Meghan Andrews Ash Di Meo 6731-C01
8/2/2024 Meghan Andrews Ash Di Meo 6943-C01
8/23/2024 Meghan Andrews Ash Di Meo 7263-C01
8/30/2024 Meghan Andrews Ash Di Meo 7382-C01
8/6/2024 Melody Bliege Tiffany Merchant 7014-C01
8/14/2024 Melody Bliege Tiffany Merchant 7120-C01
7/18/2024 Mikaela Mihaylov Jordan Grant 6721-C01
8/1/2024 Mikaela Mihaylov Jordan Grant 6953-C01
8/13/2024 Mikaela Mihaylov Jordan Grant 7106-C01
8/5/2024 Miles Benson Tiffany Merchant 6978-C01
8/19/2024 Miles Benson Tiffany Merchant 7176-C01
7/12/2024 Morgan McFadden Ash Di Meo 6612-C01
7/22/2024 Morgan McFadden Ash Di Meo 6760-C01
8/5/2024 Morgan McFadden Ash Di Meo 6974-C01
8/24/2024 Morgan McFadden Ash Di Meo 7281-C01
7/15/2024 Nami Bowser Tessa Turner 6655-C01
7/22/2024 Nami Bowser Tessa Turner 6777-C01
7/23/2024 Nami Bowser Tessa Turner 6793-C01
8/12/2024 Nami Bowser Tessa Turner 7092-C01
8/19/2024 Nami Bowser Tessa Turner 7186-C01
8/26/2024 Nami Bowser Tessa Turner 7308-C01
8/27/2024 Nami Bowser Tessa Turner 7324-C01
7/11/2024 Naomi Thomas Jordan Grant 6625-C01
7/11/2024 Naomi Thomas Jordan Grant 6605-C02
7/17/2024 Naomi Thomas Jordan Grant 6695-C01
8/7/2024 Naomi Thomas Jordan Grant 7046-C01
8/7/2024 Naomi Thomas Jordan Grant 7107-C01
8/14/2024 Naomi Thomas Jordan Grant 7274-C01
8/14/2024 Naomi Thomas Jordan Grant 7119-C01
8/21/2024 Naomi Thomas Jordan Grant 7225-C01
8/28/2024 Naomi Thomas Jordan Grant 7359-C01
7/17/2024 Nicole Henry Tiffany Merchant 6698-C01
8/14/2024 Nicole Henry Tiffany Merchant 7116-C02
7/16/2024 Nikolas Tidwell Adrienne Jeannerat 6667-C01
7/23/2024 Nikolas Tidwell Adrienne Jeannerat 6788-C01
8/6/2024 Nikolas Tidwell Adrienne Jeannerat 7010-C01
8/13/2024 Nikolas Tidwell Adrienne Jeannerat 7101-C01
8/20/2024 Nikolas Tidwell Adrienne Jeannerat 7207-C01
8/27/2024 Nikolas Tidwell Adrienne Jeannerat 7325-C01
7/15/2024 Noah Feuerborn Tessa Turner 6644-C02
8/15/2024 Oliver Mora Martinez Joann Lundberg 7151-C01
8/31/2024 Onyx Serna Amanda Sanabria 7414-C01
7/11/2024 Paula Bancolita Ash Di Meo 6595-C01
7/18/2024 Paula Bancolita Ash Di Meo 6705-C01
8/1/2024 Paula Bancolita Ash Di Meo 6934-C01
8/22/2024 Paula Bancolita Ash Di Meo 7240-C01
8/27/2024 Paula Bancolita Ash Di Meo 7318-C01
8/29/2024 Paula Bancolita Ash Di Meo 7367-C01
7/12/2024 Penelope Oxendine Tessa Turner 6629-C01
7/30/2024 Penelope Oxendine Tessa Turner 6901-C01
7/12/2024 Phoebe Geraghty Ash Di Meo 6613-C01
7/19/2024 Phoebe Geraghty Ash Di Meo 6747-C01
8/2/2024 Phoebe Geraghty Ash Di Meo 6947-C01
8/23/2024 Phoebe Geraghty Ash Di Meo 7270-C01
8/30/2024 Phoebe Geraghty Ash Di Meo 7387-C01
7/16/2024 Phoenix Lyle Melissa Dawn Ackley 6676-C01
7/23/2024 Phoenix Lyle Melissa Dawn Ackley 6797-C01
7/31/2024 Phoenix Lyle Melissa Dawn Ackley 6909-C01
8/6/2024 Phoenix Lyle Melissa Dawn Ackley 7018-C01
8/13/2024 Phoenix Lyle Melissa Dawn Ackley 7111-C01
8/14/2024 Phoenix Lyle Melissa Dawn Ackley 7112-C01
8/20/2024 Phoenix Lyle Melissa Dawn Ackley 7244-C01
8/27/2024 Phoenix Lyle Melissa Dawn Ackley 7337-C01
7/19/2024 Polly Bledsoe Ash Di Meo 6732-C01
8/2/2024 Polly Bledsoe Ash Di Meo 6944-C01
8/23/2024 Polly Bledsoe Ash Di Meo 7265-C01
7/20/2024 Race Rugh Ash Di Meo 6751-C01
7/30/2024 Race Rugh Ash Di Meo 6903-C01
8/6/2024 Race Rugh Ash Di Meo 7019-C01
8/20/2024 Race Rugh Ash Di Meo 7199-C01
8/27/2024 Race Rugh Ash Di Meo 7322-C01
7/10/2024 Rachel Schley-Smith Ash Di Meo 6589-C01
7/17/2024 Rachel Schley-Smith Ash Di Meo 6690-C01
7/31/2024 Rachel Schley-Smith Ash Di Meo 6912-C01
8/21/2024 Rachel Schley-Smith Ash Di Meo 7219-C01
8/28/2024 Rachel Schley-Smith Ash Di Meo 7341-C01
7/10/2024 Raymond Garrison Leocadia Hainley 6574-C01
8/14/2024 Raymond Garrison Leocadia Hainley 7133-C01
8/21/2024 Raymond Garrison Leocadia Hainley 7222-C01
8/28/2024 Raymond Garrison Leocadia Hainley 7339-C01
7/17/2024 Rayna Elise Brigham Adrienne Jeannerat 6692-C01
7/24/2024 Rayna Elise Brigham Adrienne Jeannerat 6813-C01
8/21/2024 Rayna Elise Brigham Adrienne Jeannerat 7233-C01
8/28/2024 Rayna Elise Brigham Adrienne Jeannerat 7396-C01
7/16/2024 Reagan Stephenson Ash Di Meo 6656-C01
7/30/2024 Reagan Stephenson Ash Di Meo 6880-C01
8/6/2024 Reagan Stephenson Ash Di Meo 6997-C01
8/20/2024 Reagan Stephenson Ash Di Meo 7189-C01
9/3/2024 Reagan Stephenson Ash Di Meo 7424-C01
7/15/2024 Renae Hardy Tessa Turner 6654-C01
7/29/2024 Renae Hardy Tessa Turner 6878-C01
8/12/2024 Renae Hardy Tessa Turner 7093-C01
7/10/2024 Sabrina Teragli Tiffany Merchant 6583-C03
7/15/2024 Sabrina Teragli Tiffany Merchant 6641-C02
7/24/2024 Sabrina Teragli Tiffany Merchant 6817-C04
8/8/2024 Sabrina Teragli Tiffany Merchant 7055-C02
8/19/2024 Sabrina Teragli Tiffany Merchant 7254-C01
8/19/2024 Sabrina Teragli Tiffany Merchant 7254-C02
8/22/2024 Sabrina Teragli Tiffany Merchant 7258-C01
8/22/2024 Sabrina Teragli Tiffany Merchant 7258-C02
8/22/2024 Sabrina Teragli Tiffany Merchant 7312-C01
8/22/2024 Sabrina Teragli Tiffany Merchant 7312-C02
7/12/2024 Sage Clementine Joann Lundberg 6621-C01
7/26/2024 Sage Clementine Joann Lundberg 6852-C01
8/9/2024 Sage Clementine Joann Lundberg 7071-C01
8/30/2024 Sage Clementine Joann Lundberg 7395-C01
8/5/2024 Samantha Galan Tiffany Merchant 6981-C01
8/19/2024 Samantha Galan Tiffany Merchant 7180-C01
7/17/2024 Santiago Angel Gaytan Joann Lundberg 6701-C01
7/31/2024 Santiago Angel Gaytan Joann Lundberg 6930-C01
8/14/2024 Santiago Angel Gaytan Joann Lundberg 7129-C01
8/20/2024 Santiago Angel Gaytan Joann Lundberg 7198-C01
7/31/2024 Sarah Mouktabis Melissa Dawn Ackley 6931-C01
7/25/2024 Saraya Ayala Jordan Grant 6834-C01
8/6/2024 Saraya Ayala Jordan Grant 7003-C01
7/23/2024 Savannah Dougherty Tessa Turner 6780-C01
7/30/2024 Savannah Dougherty Tessa Turner 6890-C01
8/6/2024 Savannah Dougherty Tessa Turner 7011-C01
8/20/2024 Savannah Dougherty Tessa Turner 7210-C01
8/23/2024 Savannah Dougherty Tessa Turner 7209-C02
8/26/2024 Savannah Dougherty Tessa Turner 7302-C01
7/12/2024 Sebastian Toro-Santana Joann Lundberg 6617-C01
7/19/2024 Sebastian Toro-Santana Joann Lundberg 6735-C01
7/26/2024 Sebastian Toro-Santana Joann Lundberg 6843-C01
8/2/2024 Sebastian Toro-Santana Joann Lundberg 6948-C01
8/9/2024 Sebastian Toro-Santana Joann Lundberg 7063-C01
8/16/2024 Sebastian Toro-Santana Joann Lundberg 7160-C01
8/23/2024 Sebastian Toro-Santana Joann Lundberg 7271-C01
7/18/2024 Seven Miller-Osborne Jordan Grant 6726-C01
7/31/2024 Seven Miller-Osborne Jordan Grant 6924-C01
8/14/2024 Seven Miller-Osborne Jordan Grant 7127-C01
8/15/2024 Seven Miller-Osborne Joann Lundberg 7149-C01
8/28/2024 Seven Miller-Osborne Jordan Grant 7358-C01
8/3/2024 Shaun Armstrong Joann Lundberg 6968-C01
8/17/2024 Shaun Armstrong Joann Lundberg 7172-C01
8/30/2024 Shaun Armstrong Joann Lundberg 7401-C01
8/31/2024 Shaun Armstrong Joann Lundberg 7411-C02
8/26/2024 Shoshana Retzkin Ash Di Meo 7290-C01
7/17/2024 Sommer Smith Tiffany Merchant 6691-C01
7/24/2024 Sommer Smith Tiffany Merchant 6804-C01
7/31/2024 Sommer Smith Tiffany Merchant 6915-C01
8/7/2024 Sommer Smith Tiffany Merchant 7029-C01
8/14/2024 Sommer Smith Tiffany Merchant 7114-C01
7/21/2024 Sophia Kerr-Davis Ash Di Meo 6756-C01
8/4/2024 Sophia Kerr-Davis Ash Di Meo 6972-C01
8/25/2024 Sophia Kerr-Davis Ash Di Meo 7288-C01
7/13/2024 Sophia Kirkpatrick Joann Lundberg 6631-C01
7/16/2024 Sophia Kirkpatrick Tiffany Merchant 6661-C01
7/20/2024 Sophia Kirkpatrick Joann Lundberg 6750-C01
7/25/2024 Sophia Kirkpatrick Joann Lundberg 6829-C01
7/27/2024 Sophia Kirkpatrick Joann Lundberg 6860-C01
7/30/2024 Sophia Kirkpatrick Joann Lundberg 6891-C01
7/30/2024 Sophia Kirkpatrick Tiffany Merchant 6897-C02
8/3/2024 Sophia Kirkpatrick Joann Lundberg 6963-C01
8/3/2024 Sophia Kirkpatrick Joann Lundberg 6965-C02
8/8/2024 Sophia Kirkpatrick Joann Lundberg 7059-C01
8/13/2024 Sophia Kirkpatrick Tiffany Merchant 7100-C01
8/17/2024 Sophia Kirkpatrick Joann Lundberg 7170-C02
8/22/2024 Sophia Kirkpatrick Joann Lundberg 7261-C01
8/24/2024 Sophia Kirkpatrick Joann Lundberg 7279-C02
8/29/2024 Sophia Kirkpatrick Joann Lundberg 7374-C01
8/31/2024 Sophia Kirkpatrick Joann Lundberg 7408-C01
8/31/2024 Sophia Kirkpatrick Joann Lundberg 7419-C01
7/22/2024 Steven Turner Tiffany Merchant 6776-C01
8/23/2024 Tabitha Garrison Joann Lundberg 7273-C02
7/20/2024 Talia Ruehr Ash Di Meo 6752-C01
8/3/2024 Talia Ruehr Ash Di Meo 6969-C01
8/24/2024 Talia Ruehr Ash Di Meo 7283-C01
7/15/2024 Tatiana Williams Adrienne Jeannerat 6640-C01
7/22/2024 Tatiana Williams Adrienne Jeannerat 6765-C01
7/29/2024 Tatiana Williams Adrienne Jeannerat 6867-C01
8/5/2024 Tatiana Williams Adrienne Jeannerat 6979-C03
8/12/2024 Tatiana Williams Adrienne Jeannerat 7081-C01
8/19/2024 Tatiana Williams Adrienne Jeannerat 7178-C02
8/26/2024 Tatiana Williams Adrienne Jeannerat 7295-C01
8/31/2024 Theodore Cull-whitllock Amanda Sanabria 7406-C01
7/18/2024 Theodore Nagengast Melissa Dawn Ackley 6713-C01
7/26/2024 Theodore Nagengast Melissa Dawn Ackley 6842-C01
8/2/2024 Theodore Nagengast Melissa Dawn Ackley 6950-C01
8/23/2024 Theodore Nagengast Melissa Dawn Ackley 7266-C01
8/30/2024 Theodore Nagengast Melissa Dawn Ackley 7402-C01
7/21/2024 Thomas McGifford Ash Di Meo 6757-C01
8/4/2024 Thomas McGifford Ash Di Meo 6973-C01
8/25/2024 Thomas McGifford Ash Di Meo 7289-C01
7/16/2024 Tora Lyle Melissa Dawn Ackley 6675-C01
7/17/2024 Tora Lyle Melissa Dawn Ackley 6700-C01
7/23/2024 Tora Lyle Melissa Dawn Ackley 6796-C01
7/30/2024 Tora Lyle Melissa Dawn Ackley 6888-C01
7/31/2024 Tora Lyle Melissa Dawn Ackley 6910-C01
8/6/2024 Tora Lyle Melissa Dawn Ackley 7017-C01
8/7/2024 Tora Lyle Melissa Dawn Ackley 7048-C01
8/13/2024 Tora Lyle Melissa Dawn Ackley 7109-C01
8/20/2024 Tora Lyle Melissa Dawn Ackley 7243-C01
8/27/2024 Tora Lyle Melissa Dawn Ackley 7336-C01
7/21/2024 Trynne Volante Ash Di Meo 6755-C01
8/4/2024 Trynne Volante Ash Di Meo 6971-C01
8/25/2024 Trynne Volante Ash Di Meo 7287-C02
8/1/2024 Tyden Williams-Allen Melissa Dawn Ackley 6940-C01
8/9/2024 Tyden Williams-Allen Melissa Dawn Ackley 7080-C01
8/14/2024 Tyden Williams-Allen Melissa Dawn Ackley 7143-C01
8/23/2024 Tyden Williams-Allen Melissa Dawn Ackley 7307-C01
8/15/2024 Tylyn Frank Tiffany Merchant 7141-C01
8/26/2024 Tylyn Frank Tiffany Merchant 7294-C01
7/29/2024 Vivienne Costa Tiffany Merchant 6875-C01
8/12/2024 Vivienne Costa Tiffany Merchant 7089-C01
8/26/2024 Vivienne Costa Tiffany Merchant 7304-C01
7/21/2024 Willamina Macpherson Ash Di Meo 6754-C01
8/4/2024 Willamina Macpherson Ash Di Meo 6970-C01
8/25/2024 Willamina Macpherson Ash Di Meo 7286-C01
7/22/2024 Wyatt Walton Tiffany Merchant 6774-C01
8/5/2024 Wyatt Walton Tiffany Merchant 6984-C01
8/7/2024 Xavier Rosoury Tiffany Merchant 7038-C01
7/26/2024 Yeshuah Jesus Briceno Camejo Melissa Dawn Ackley 6858-C01
8/15/2024 Yeshuah Jesus Briceno Camejo Melissa Dawn Ackley 7155-C01
7/30/2024 Zackery Davis Ash Di Meo 6881-C01
7/17/2024 Zeiah Margolis Ash Di Meo 6685-C01
8/21/2024 Zeiah Margolis Ash Di Meo 7218-C01
8/2/2024 Zion Kiyan Melissa Dawn Ackley 6955-C02
Detail
Claim # 24199E20458 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24204E26326 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24199E23224 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24204E27709 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24204E27867 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24215E35637 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Claim # 24218E19617 Correct billing provider NPI must appear in box 33
Claim # 24220E08718 The Medicaid state requires provider to be enrolled in the members Medicaid state program
Paid
Paid
Paid
Paid
Paid
Paid

Paid
Paid
Paid

Not on file
Not on file
Paid
Paid
Paid
Paid
Paid
Paid
Paid 24232E35882
Paid 24234E14843 In process
Paid
Paid

Claim # 118260032

Not on file
In process 242461107500

Paid
Paid
Paid

Paid
Paid
Paid
Paid
In process
Paid
Paid
In process
Paid
In process
In process
In process
paid
paid
In process

Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Claim # 24232116596 In process
Paid

Not on file
Not on file
Not on file
Paid
In process
In process

Paid
Paid
Paid
Paid
Paid
Paid
Paid

Paid
Paid
Paid
Paid
Paid
Paid
In process
paid
paid
paid
paid
paid
paid
paid
paid
paid
paid
paid

Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
In process

Paid
Paid
Paid
Paid
In process

Paid
In process
In process
In process

Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
In process
In process

Paid
Claim # 24199E20937
Claim # 24200E08713
Paid
Claim # 24215E36573
Claim # 24218E18992
Claim # 24220E08193
Claim # 24232E35978
Paid
Paid
Paid
Paid
Paid
Paid

Paid

Paid
Paid
Paid
Paid
Mutually exclusive procedures cannot be done in the same day/setting.
Paid
Paid
Paid
Paid
Paid
In process
Paid
In process

Claim # 24199E21406
Claim # 24212E09648
Paid
Claim # 24220E08584
Paid
Paid
Paid
Paid
Paid
Paid

Paid
Paid
Paid
Paid
Paid
Paid
In process
Paid
Paid

Paid
Paid

Paid
Paid
Paid
Paid
Paid
Paid
claim # 24204E27220
Paid
Paid
Paid

Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
In process
Paid
Paid
Paid
Paid
Paid

Claim # 24197E11268

Paid
Claim # 24212E11694
Paid
Paid
Paid

Claim # 24212E11047
Claim # 24212E12584
Claim # 24218E21244
Paid
Paid
Paid
in process
Paid
Paid
Paid
Paid

Claim # 24199E21096
Claim # 24204E28348
Claim # 24218E18362
Claim # 24212E10016
Paid
Paid

Paid
Paid
Not on file
Paid
in process
in process
Paid
Claim # 24212E09460
Paid
Claim # 24220E07720
Paid
Paid
Paid
Paid
Paid
in process

Paid
Paid
Paid
Paid
in process
Paid
Paid
Paid
in process
paid
In process
paid
paid
paid
In process

paid
paid
paid
paid
In process

paid
paid
paid
Paid
Paid
Paid
Paid
Claim E66843128600 In process

paid

In process
Paid
Paid
Paid
In process
paid
paid
paid
paid

paid
paid

Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
Paid
In process
In process
In process

Paid
Paid
Paid
Paid
Paid
Paid
Paid

Paid
Paid
Claim # 24212E12444
Claim # 24220E07371
Claim # 24220E09667
Claim # 24232E35661 Claim/service not covered by this payer/contractor. You must send the claim/service t
Claim # 24228E10485 Claim/service not covered by this payer/contractor. You must send the claim/service t
Claim # 24232E36791 Claim/service not covered by this payer/contractor. You must send the claim/service t
Claim # 24241E08177 Claim/service not covered by this payer/contractor. You must send the claim/service to
In process

paid

Not on file

paid
Status Action Charges Paid Date
Wrong NPI 35 0 9/4/2024
Wrong NPI 180 0 9/4/2024
Wrong NPI 70 0 9/4/2024
Wrong NPI 200 0 9/4/2024
Wrong NPI 130 0 9/4/2024
Wrong NPI 180 0 9/4/2024
Wrong NPI 175 0 9/4/2024
Wrong NPI 180 0 9/4/2024
Paid 200 179 9/4/2024
Paid 180 159 9/4/2024
Paid 180 159 9/4/2024
Paid 175 175 9/4/2024
Paid 130 107 9/4/2024
Paid 70 70 9/4/2024

Paid 105 105 9/4/2024

Paid 225 199 9/4/2024
Paid 140 140 9/4/2024

Not on file 9/6/2024

Not on file 9/6/2024
Paid 215 179 9/4/2024
Paid 250 214 9/4/2024
Paid 225 199 9/4/2024
Paid 225 199 9/4/2024
Paid 215 200 9/4/2024
Paid 225 199 9/4/2024
Paid 225 199 9/4/2024
In process 200 0 9/4/2024
Paid 35 35 9/4/2024
Paid 240 214 9/4/2024

Wrong NPI Rebilled 225 0 9/6/2024

Not on file Rebilled 250 9/6/2024

In process 250 9/6/2024

Paid 140 140 9/4/2024

Paid 175 175 9/4/2024
Paid 250 250 9/4/2024

Paid 200 200 9/4/2024

Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
In process 9/9/2024
Paid 200 200 9/9/2024
Paid 450 398 9/9/2024
In process 9/9/2024
Paid 70 70 9/9/2024
In process 9/9/2024
In process 9/9/2024
In process 9/9/2024
paid 250 135.06 9/12/2024
paid 200 86.19 9/12/2024
In process 250 9/12/2024

Paid 200 179 9/4/2024

Paid 200 179 9/4/2024
Paid 200 179 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Paid 200 200 9/4/2024
Pending 200 0 9/4/2024
Paid 35 35 9/4/2024

not on file rebilled 225 0 9/4/2024

not on file rebilled 225 0 9/4/2024
not on file rebilled 225 0 9/4/2024
Paid 225 123.3 9/4/2024
in process 225 0 9/4/2024
in process 225 0 9/4/2024

Paid 225 199 9/4/2024

Paid 35 35 9/4/2024
Paid 225 199 9/4/2024
Paid 225 199 9/4/2024
Paid 105 105 9/4/2024
Paid 225 199 9/4/2024
Paid 225 199 9/4/2024

Paid 130 107 9/4/2024

Paid 130 107 9/4/2024
Paid 70 70 9/4/2024
Paid 35 35 9/4/2024
Paid 35 35 9/4/2024
Paid 250 214 9/4/2024
In process 10/4/2024
paid 180 159 10/4/2024
paid 250 250 10/4/2024
paid 250 250 10/4/2024
paid 140 140 10/4/2024
paid 225 199 10/4/2024
paid 225 199 10/4/2024
paid 225 199 10/4/2024
paid 225 199 10/4/2024
paid 225 199 10/4/2024
paid 35 35 10/4/2024
paid 225 199 10/4/2024

Paid 250 146.91 9/12/2024

Paid 225 122.33 9/12/2024
Paid 130 107 9/9/2024
Paid 200 200 9/9/2024
Paid 200 200 9/9/2024
Paid 180 159 9/9/2024
Paid 130 107 9/9/2024
Paid 180 159 9/9/2024
Paid 180 159 9/9/2024
Paid 180 159 9/9/2024
Paid 180 159 9/9/2024
In process 9/9/2024

Paid 250 250 9/9/2024

Paid 250 250 9/9/2024
Paid 250 250 9/9/2024
Paid 250 250 9/9/2024
In process 9/9/2024

Paid 200 200 9/9/2024

In process 9/9/2024
In process 9/9/2024
In process 9/9/2024

Paid 105 105 9/9/2024

Paid 225 199 9/9/2024
Paid 70 70 9/9/2024
Paid 350 350 9/9/2024
Paid 200 179 9/9/2024
Paid 225 199 9/9/2024
Paid 210 210 9/9/2024
Paid 100 61 9/9/2024
Paid 105 105 9/9/2024
Paid 180 159 9/9/2024
Paid 200 179 9/9/2024
Paid 200 179 9/9/2024
Paid 35 35 9/9/2024
Paid 225 199 9/9/2024
Paid 225 199 9/9/2024
Paid 180 159 9/9/2024
Paid 35 35 9/9/2024
In process 9/9/2024
In process 9/9/2024

Paid 140 140 9/9/2024

Wrong NPI Rebilled 130 0 9/9/2024
Wrong NPI Rebilled 70 0 9/9/2024
Paid 35 35 9/9/2024
Wrong NPI Rebilled 130 0 9/9/2024
Wrong NPI Rebilled 70 0 9/9/2024
Wrong NPI Rebilled 180 0 9/9/2024
Wrong NPI Rebilled
Paid 70 70 9/9/2024
Paid 180 159 9/9/2024
Paid 225 199 9/9/2024
Paid 225 199 9/9/2024
Paid 200 179 9/9/2024
225 199 9/9/2024

Paid 250 135.06 9/12/2024

Paid 200 179 9/9/2024

Paid 225 199 9/9/2024
Paid 130 107 9/9/2024
Paid 105 105 9/9/2024
9/9/2024
Paid 200 200 9/9/2024
Paid 70 70 9/9/2024
Paid 225 199 9/9/2024
Paid 35 35 9/9/2024
Paid 200 179 9/9/2024
In process 9/9/2024
Paid 200 179 9/9/2024
In process 9/9/2024

Wrong NPI Rebilled 180 0 9/9/2024

Wrong NPI Rebilled 225 0 9/9/2024
Paid 225 199 9/9/2024
Wrong NPI Rebilled 130 0 9/9/2024
Paid 180 159 9/9/2024
Paid 195 174 9/9/2024
Paid 225 199 9/9/2024
Paid 180 159 9/9/2024
Paid 225 199 9/9/2024
Paid 225 199 9/9/2024

Paid 70 70 9/9/2024
Paid 35 35 9/9/2024
Paid 105 105 9/9/2024
Paid 225 199 9/9/2024
Paid 225 199 9/9/2024
Paid 225 199 9/9/2024
In process 250 0 9/4/2024
Paid 225 106.54 9/12/2024
Paid 225 106.54 9/12/2024

Paid 180 159 9/4/2024

Paid 180 159 9/4/2024

Paid 180 159 9/4/2024

Paid 180 159 9/4/2024
Paid 130 107 9/4/2024
Paid 130 107 9/4/2024
Paid 130 107 9/4/2024
Paid 130 107 9/4/2024
Wrong NPI Rebilled 200 0 9/4/2024
Paid 130 107 9/4/2024
Paid 130 107 9/4/2024
Paid 130 107 9/4/2024

Paid 180 159 9/4/2024

Paid 180 159 9/4/2024
Paid 225 199 9/4/2024
Paid 35 35 9/4/2024
Paid 225 199 9/4/2024
Paid 130 107 9/4/2024
Paid 225 199 9/4/2024
Paid 225 199 9/4/2024
In process 9/4/2024
Paid 225 199 9/10/2024
Paid 225 199 9/10/2024
Paid 225 199 9/10/2024
Paid 140 140 9/10/2024
Paid 225 199 9/10/2024

Wrong NPI Rebilled 225 0 9/10/2024

Paid 200 200 9/10/2024

Wrong NPI Rebilled 200 0 9/10/2024
Paid 200 200 9/10/2024
Paid 70 70 9/10/2024
Paid 35 35 9/10/2024

Wrong NPI Rebilled 180 9/10/2024

Wrong NPI Rebilled 180 9/10/2024
Wrong NPI Rebilled 130 9/10/2024
Paid 130 107 9/10/2024
Paid 180 159 9/10/2024
Paid 180 159 9/10/2024
In process 70 9/10/2024
Paid 225 199 9/10/2024
Paid 225 199 9/10/2024
Paid 180 159 9/10/2024
Paid 225 199 9/10/2024

Wrong NPI Rebilled 225 9/10/2024

Wrong NPI Rebilled 225 9/10/2024
Wrong NPI Rebilled 180 9/10/2024
Wrong NPI Rebilled 9/10/2024
Paid 225 199 9/10/2024
Paid 225 199 9/10/2024

Paid 225 117 9/4/2024

Paid 225 117 9/4/2024
Not on file Rebilled 225 0 9/4/2024
Paid 225 117 9/4/2024
In process 225 9/4/2024
In process 225 9/4/2024
Paid 200 179 9/10/2024
Wrong NPI Rebilled 200 9/10/2024
Paid 215 179 9/10/2024
Wrong NPI Rebilled 140 9/10/2024
Paid 215 179 9/10/2024
Paid 35 35 9/10/2024
Paid 215 179 9/10/2024
Paid 215 179 9/10/2024
Paid 215 179 9/10/2024
In process 9/10/2024

Paid 70 70 9/11/2024
Paid 225 199 9/11/2024
Paid 225 199 9/11/2024
Paid 180 159 9/11/2024
In process 200 9/11/2024
Paid 70 70 9/11/2024
Paid 225 199 9/11/2024
Paid 200 200 9/11/2024
In process 9/11/2024
paid 225 199 9/6/2024
In process 225 9/6/2024
paid 225 199 9/6/2024
paid 225 199 9/6/2024
paid 35 35 9/6/2024
in process 225 9/6/2024

paid 225 199 9/6/2024

paid 225 199 9/6/2024
paid 180 159 9/6/2024
paid 180 159 9/6/2024
In process 9/6/2024

paid 225 199 9/6/2024

paid 225 199 9/6/2024
paid 225 199 9/6/2024
Paid 225 109.6 9/6/2024
Paid 225 109.6 9/6/2024
Paid 225 109.6 9/6/2024
paid 225 225 9/6/2024
In process 225 0 9/6/2024

paid 225 132.33 9/12/2024

In process 225 9/6/2024

Paid 225 199 9/6/2024
Paid 225 199 9/6/2024
Paid 225 199 9/6/2024
In process 9/6/2024
paid 200 200 9/11/2024
paid 200 200 9/11/2024
paid 200 200 9/11/2024
paid 200 200 9/11/2024

paid 225 199 9/11/2024

paid 225 199 9/11/2024

Paid 200 200 9/11/2024

Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 200 200 9/11/2024
Paid 250 214 9/11/2024
Paid 200 200 9/11/2024
Paid 225 199 9/11/2024
Paid 200 200 9/11/2024
Paid 180 159 9/11/2024
Paid 70 70 9/11/2024
Paid 225 199 9/11/2024
Paid 35 35 9/11/2024
Paid 200 200 9/11/2024
Paid 105 105 9/11/2024
Paid 225 199 9/11/2024
Paid 35 35 9/11/2024
Paid 200 200 9/11/2024
Paid 225 199 9/11/2024
Paid 35 35 9/11/2024
Paid 180 159 9/11/2024
In process 9/11/2024
In process 9/11/2024
In process 9/11/2024

Paid 225 199 9/11/2024

Paid 225 199 9/11/2024
Paid 225 199 9/11/2024
Paid 240 214 9/11/2024
Paid 225 199 9/11/2024
Paid 240 214 9/11/2024
Paid 510 474 9/11/2024

Paid 25 250 9/11/2024

Paid 105 105 9/11/2024
Wrong NPI Rebilled 250 9/11/2024
Wrong NPI Rebilled 105 9/11/2024
Wrong NPI Rebilled 225 9/11/2024
250 9/11/2024
140 9/11/2024
225 9/11/2024
225 9/11/2024
9/11/2024

paid 225 106.54 9/12/2024

Not on file 225 9/6/2024

paid 225 106.5 9/12/2024

Claim
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #DP501L9A
CareOregon #WS100V8U
CareOregon #WS100V8U
CareOregon #WS100V8U
Aetna #W205410833 / 083510301400006
Aetna #W205410833 / 083510301400006
Blue Cross of Oregon Regence (ORBLS) #VPC160233050-02 / 10028583
Blue Cross of Oregon Regence (ORBLS) #TGO201106232 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO201106232 / 83519800
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
First Choice #97230000702 / 21719723
CareOregon #PI401T3E
CareOregon #PI401T3E
CareOregon #PI401T3E
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
CareOregon #SC001F8F
Kaiser NW #54019749
Kaiser NW #54019749
Kaiser NW #54019749
Blue Cross of Oregon Regence (ORBLS) #R60107606
CareOregon #DK901L6X
Blue Cross of Oregon Regence (ORBLS) #YSW101259567
Blue Cross of Oregon Regence (ORBLS) #YSW101259567
Providence Behavioral Health #10093660601 / 106528
Providence Behavioral Health #10093660601 / 106528
CareOregon #ES101C3S
CareOregon #ES101C3S
CareOregon #KV400P8O
Kaiser NW #62277174
Kaiser NW #62277174
Blue Cross of Oregon Regence (ORBLS) #UDWW770394869
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
CareOregon #FL501A0U
Blue Cross of Oregon Regence (ORBLS) #NZS210250864 / 68000749
Blue Cross of Oregon Regence (ORBLS) #NZS210250864 / 68000749
Blue Cross of Oregon Regence (ORBLS) #NZS210250864 / 68000749
Blue Cross of Oregon Regence (ORBLS) #NZS210250864 / 68000749
Kaiser NW #53672599
Kaiser NW #53672599
Kaiser NW #53672599
Kaiser NW #53672599
CareOregon #DT900I2C
Providence Behavioral Health #11317114402 / 106135
Providence Behavioral Health #11349315002 / 106528
Providence Behavioral Health #11349315002 / 106528
Providence Behavioral Health #11349315002 / 106528
Kaiser NW #04084389 / KP007
Kaiser NW #04084389 / KP007
Kaiser NW #04084389 / KP007
Kaiser NW #04084389 / KP007
Kaiser NW #94110888
Kaiser NW #94110888
Kaiser NW #94110888
CareOregon #WW701D5H
CareOregon #WW701D5H
CareOregon #WW701D5H
CareOregon #WW701D5H
CareOregon #EP701M4C
CareOregon #EP701M4C
CareOregon #EP701M4C
CareOregon #EP701M4C
CareOregon #EP701M4C
CareOregon #EP701M4C
CareOregon #AF79323B
CareOregon #AF79323B
DMAP OPEN CARD #AF79323B
Blue Cross of Oregon Regence (ORBLS) #O2F220187681 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F220187681 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F220187681 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F220187681 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F220187681 / 37000201
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / 270142m3af
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / 270142m3af
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / 270142m3af
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / 270142m3af
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
Blue Cross of Oregon Regence (ORBLS) #G6F230196426
CareOregon #YM700U9O
CareOregon #MO800K1V
CareOregon #MO800K1V
Kaiser NW #64221934
Kaiser NW #64221934
Kaiser NW #64221934
CareOregon #RA201B2A
CareOregon #RA201B2A
CareOregon #RA201B2A
CareOregon #JR201I8U
CareOregon #JR201I8U
CareOregon #JR201I8U
CareOregon #JR201I8U
CareOregon #JR201I8U
Aetna #W2854 44447 / 881703-012-00001
Aetna #W285444447 / 881703-012-00001
Aetna #W285444447 / 881703-012-00001
CareOregon #MG800WOA / Health share of Oregon
CareOregon #MG800WOA / Health share of Oregon
CareOregon #MG800WOA / Health share of Oregon
CareOregon #MG800WOA / Health share of Oregon
Trillium Community Health Plan #402358637 / 402358637
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CB200V0I
CareOregon #CP501L0X
CareOregon #CP501L0X
CareOregon #CP501L0X
CareOregon #CP501L0X
CareOregon #SV701I0S
CareOregon #SV701I0S
CareOregon #SV701I0S
CareOregon #SV701I0S
CareOregon #SV701I0S
CareOregon #SV701I0S
CareOregon #SV701I0S
UHC #13341771800 / Group 1652301 (
UHC #13341771800 / Group 1652301 (
UHC #13341771800 / Group 1652301 (
UHC #13341771800 / Group 1652301 (
UHC #13341771800 / Group 1652301 (
Blue Cross of Oregon Regence (ORBLS) #ILY979A24904 / 174056MEA1
Blue Cross of Oregon Regence (ORBLS) #ILY979A24904 / 174056MEA1
Blue Cross of Oregon Regence (ORBLS) #ILY979A24904 / 174056MEA1
Blue Cross of Oregon Regence (ORBLS) #ILY979A24904 / 174056MEA1
Providence Behavioral Health #11310967002 / 106528
Providence Behavioral Health #11310967002 / 106528
CareOregon #ID901I4L
CareOregon #ID901I4L
CareOregon #ID901I4L
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
CareOregon #BK98172B / Care Oregon
Blue Cross of Oregon Regence (ORBLS) #YVA230325983 / 10059312
Blue Cross of Oregon Regence (ORBLS) #YVA230325983 / 10059312
CareOregon #DG27202A / Health share of Oregon DG27202A
CareOregon #DG27202A / Health share of Oregon DG27202A
CareOregon #DG27202A / Health share of Oregon DG27202A
CareOregon #DG27202A / Health share of Oregon DG27202A
CareOregon #DG27202A / Health share of Oregon DG27202A
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #XEA910008665 / W0088914
Blue Cross of Oregon Regence (ORBLS) #YVA190150050
Blue Cross of Oregon Regence (ORBLS) #YVA190150050
Blue Cross of Oregon Regence (ORBLS) #YVA190150050
Blue Cross of Oregon Regence (ORBLS) #YVA190150050
Blue Cross of Oregon Regence (ORBLS) #YVA190150050
Kaiser NW #54406018
Kaiser NW #54406018
Kaiser NW #54406018
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
CareOregon #HA900U3O
CareOregon #HA900U3O
CareOregon #HA900U3O
CareOregon #HA900U3O
Providence Behavioral Health #10068231503
MODA #T04027255 / 10001684
MODA #T04027255 / 10001684
MODA #T04027255 / 10001684
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
CareOregon #BR600X8C
Kaiser NW #03015037
Kaiser NW #03015037
Kaiser NW #03015037
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
CareOregon #XP400V3I
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Blue Cross of Oregon Regence (ORBLS) #vqa665w18323 / l09105m001
Providence Behavioral Health #10071481602 / 108601
Blue Cross of Oregon Regence (ORBLS) #TGO190048671 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO201106232 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO190048671 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO201106232 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO190048671 / 83519800
Blue Cross of Oregon Regence (ORBLS) #TGO201106232 / 83519800
DMAP OPEN CARD #MN701I8K
DMAP OPEN CARD #MN701I8K
DMAP OPEN CARD #MN701I8K
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
CareOregon #NV101M4X
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / DTU514M91026
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / DTU514M91026
Blue Cross of Oregon Regence (ORBLS) #dtu514m91026 / DTU514M91026
Blue Cross of Oregon Regence (ORBLS) #XJBH79409288 / Group 59383
Blue Cross of Oregon Regence (ORBLS) #XJBH79409288 / Group 59383
Blue Cross of Oregon Regence (ORBLS) #XJBH79409288 / Group 59383
Blue Cross of Oregon Regence (ORBLS) #XJBH79409288 / Group 59383
Blue Cross of Oregon Regence (ORBLS) #YVA230331656 / 10059492
Blue Cross of Oregon Regence (ORBLS) #YVA230331656 / 10059492
Blue Cross of Oregon Regence (ORBLS) #YVA230331656 / 10059492
Blue Cross of Oregon Regence (ORBLS) #YVA230331656 / 10059492
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
CareOregon #EO101P5S / CORMCAID
First Choice #972300007 / 21719723
First Choice #972300007 / 21719723
Providence Behavioral Health #11329529402 / 100108
Providence Behavioral Health #11329529402 / 100108
CareOregon #FR600W6H / FR600W6H
Blue Cross of Oregon Regence (ORBLS) #MSJ60242803401 / 1000010
Blue Cross of Oregon Regence (ORBLS) #MSJ60242803401 / 1000010
Trillium Community Health Plan #VJ701J3U
Trillium Community Health Plan #VJ701J3U
Trillium Community Health Plan #VJ701J3U
Trillium Community Health Plan #VJ701J3U
CareOregon #SB101R3J
CareOregon #SB101R3J
CareOregon #SB101R3J
CareOregon #SB101R3J
CareOregon #SB101R3J
CareOregon #SB101R3J
Blue Cross of Oregon Regence (ORBLS) #TJV912108188 / W0069783
Providence Behavioral Health #11367537000 / 104325
Providence Behavioral Health #11367537000 / 104325
Providence Behavioral Health #11367537000 / 104325
Providence Behavioral Health #11367537000 / 104325
Providence Behavioral Health #11367537000 / 104325
Blue Cross of Oregon Regence (ORBLS) #I2W210214828 / 71318001
CareOregon #XH601P4N
Cigna Behavioral Health #U0264840403 / 3344700
CareOregon #XH601P4N
Cigna Behavioral Health #U0264840403 / 3344700
Cigna Behavioral Health #U0264840403 / 3344700
CareOregon #XH601P4N
Cigna Behavioral Health #U0264840403 / 3344700
CareOregon #XH601P4N
Cigna Behavioral Health #U0264840403 / 3344700
Cigna Behavioral Health #U0264840403 / 3344700
Blue Cross of Oregon Regence (ORBLS) #YVA190082748 / 10018023
Blue Cross of Oregon Regence (ORBLS) #YVA190082748 / 10018023
Blue Cross of Oregon Regence (ORBLS) #YVA190082748 / 10018023
Blue Cross of Oregon Regence (ORBLS) #YVA190082748 / 10018023
CareOregon #KP701E4Y
CareOregon #KP701E4Y
CareOregon #KP701E4Y
CareOregon #KP701E4Y
CareOregon #TM701F8P
CareOregon #TM701F8P
Blue Cross of Oregon Regence (ORBLS) #O2F240056445 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F240056445 / 37000201
Blue Cross of Oregon Regence (ORBLS) #O2F240056445 / 37000201
Cigna Behavioral Health #000025463 / 3345220
CareOregon #KC901P7T
CareOregon #KC901P7T
CareOregon #KC901P7T
CareOregon #OF901D3V
CareOregon #OF901D3V
CareOregon #OF901D3V
CareOregon #ND801B4N / ND801B4N
CareOregon #OJ300S5Y
CareOregon #OJ300S5Y
CareOregon #OJ300S5Y
Kaiser NW #04252627
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
CareOregon #UB100X6F / OHP
PacificSource-Medicaid #810362708
PacificSource-Medicaid #810362708
PacificSource-Medicaid #810362708
PacificSource-Medicaid #810362708
PacificSource-Medicaid #810362708
PacificSource-Medicaid #810362708
Aetna #John M. Kroeger/13351152W / 895530-010-00304
Aetna #John M. Kroeger/13351152W / 895530-010-00304
Aetna #John M. Kroeger/13351152W / 895530-010-00304
Pacific Source Health Plans #201074246 / G0045175
Pacific Source Health Plans #201074246 / G0045175
Kaiser NW #63305425
Kaiser NW #63305425
Kaiser NW #63305425
Blue Cross of Oregon Regence (ORBLS) #CPR356A52023
Blue Cross of Oregon Regence (ORBLS) #CPR356A52023
Blue Cross of Oregon Regence (ORBLS) #CPR356A52023
CareOregon #ML201K3F
CareOregon #BG000P8D / Health Share of Oregon
CareOregon #BG000P8D / Health Share of Oregon
CareOregon #BG000P8D / Health Share of Oregon
CareOregon #BG000P8D / Health Share of Oregon
CareOregon #BG000P8D / Health Share of Oregon
CareOregon #GC800M1W
CareOregon #GC800M1W
CareOregon #GC800M1W
CareOregon #GC800M1W
CareOregon #GC800M1W
Providence Behavioral Health #11352835902 / 100315
Providence Behavioral Health #11352835902 / 100315
Providence Behavioral Health #11352835902 / 100315
UnitedHealthcare / Oxford #23572911 / 76-414571
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #XV101J8Y
CareOregon #FE201S6H
CareOregon #FE201S6H
CareOregon #FE201S6H
CareOregon #FE201S6H
CareOregon #FE201S6H
DMAP OPEN CARD #PL001J4W
Blue Cross of Oregon Regence (ORBLS) #R60622375 / Basic
DMAP OPEN CARD #PL001J4W
CareOregon #FF101N8V
CareOregon #FF101N8V
CareOregon #FF101N8V
CareOregon #FF101N8V
Blue Cross of Oregon Regence (ORBLS) #DTU514M91026 / 270142M3AF
Blue Cross of Oregon Regence (ORBLS) #DTU514M91026 / 270142M3AF
Blue Cross of Oregon Regence (ORBLS) #DTU514M91026 / 270142M3AF
Blue Cross of Oregon Regence (ORBLS) #FHNM63069384 / 0000713521000013
Blue Cross of Oregon Regence (ORBLS) #FHNM63069384 / 0000713521000013
Blue Cross of Oregon Regence (ORBLS) #FHNM63069384 / 0000713521000013
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #GI501E7L / Health Share of Oregon
CareOregon #AO701A6S
CareOregon #AO701A6S
CareOregon #AO701A6S
CareOregon #AO701A6S
Providence Behavioral Health #10071481603 / 108602
Providence Behavioral Health #10071481603 / 108602
Providence Behavioral Health #10071481603 / 108602
Providence Behavioral Health #10071481603 / 108602
CareOregon #TS401A6R / Health share oregon
CareOregon #TS401A6R / Health share oregon
CareOregon #TS401A6R / Health share oregon
CareOregon #TS401A6R / Health share oregon
CareOregon #TS401A6R / Health share oregon
CareOregon #TS401A6R / Health share oregon
Providence Behavioral Health #100694906-03
Providence Behavioral Health #100694906-03
Providence Behavioral Health #100694906-03
Providence Behavioral Health #100694906-03
Providence Behavioral Health #100694906-03
Providence Behavioral Health #100694906-03
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
Blue Cross of Oregon Regence (ORBLS) #YVA220316745
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
CareOregon #HO301M7G / CORMCAID
Kaiser NW #84329764
Kaiser NW #84329764
Kaiser NW #84329764
Kaiser NW #84329764
Kaiser NW #84329764
Kaiser NW #34169179
Kaiser NW #34169179
Yamhill #SA901E5S
Yamhill #SA901E5S
Yamhill #SA901E5S
Blue Cross of Oregon Regence (ORBLS) #DTU514M91026
Blue Cross of Oregon Regence (ORBLS) #DTU514M91026
Kaiser NW #23562738
Kaiser NW #23562738
Kaiser NW #23562738
Kaiser NW #23562738
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
Providence Behavioral Health #11361437203 / 121899
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #LO301I1R
CareOregon #CN43964B
CareOregon #CN43964B
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Blue Cross of Oregon Regence (ORBLS) #XYQM64857795 / 0070272140000002
Providence Behavioral Health #11317114403 / 106135
CareOregon #IY301B6T
CareOregon #WT101N6D
CareOregon #XF401B1J
CareOregon #XF401B1J
CareOregon #XF401B1J
CareOregon #XF401B1J
CareOregon #XF401B1J
CareOregon #XF401B1J
CareOregon #YG901H0H
CareOregon #YG901H0H
CareOregon #UE301T5N
CareOregon #UE301T5N
CareOregon #UE301T5N
CareOregon #UE301T5N
CareOregon #UE301T5N
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #KY801I3H
CareOregon #CU201J4V / N\A
CareOregon #CU201J4V / N\A
CareOregon #CU201J4V / N\A
Blue Cross of Oregon Regence (ORBLS) #V6D249W16954 / 174315M3A4
Blue Cross of Oregon Regence (ORBLS) #V6D249W16954 / 174315M3A4
Blue Cross of Oregon Regence (ORBLS) #V6D249W16954 / 174315M3A4
Blue Cross of Oregon Regence (ORBLS) #V6D249W16954 / 174315M3A4
Blue Cross of Oregon Regence (ORBLS) #V6D249W16954 / 174315M3A4
Kaiser NW #34012253
Kaiser NW #34012253
Kaiser NW #34012253
Kaiser NW #34012253
Kaiser NW #34012253
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Blue Cross of Oregon Regence (ORBLS) #R60107606 / 105
Providence Behavioral Health #11295805801
Providence Behavioral Health #11295805801
Providence Behavioral Health #11295805801
Providence Behavioral Health #11295805801
CareOregon #RB201S0W
CareOregon #RB201S0W
CareOregon #RB201S0W
CareOregon #RB201S0W
CareOregon #RB201S0W
Blue Cross of Oregon Regence (ORBLS) #NWC230173931 / 10057623
Blue Cross of Oregon Regence (ORBLS) #NWC230173931 / 10057623
Blue Cross of Oregon Regence (ORBLS) #NWC230173931 / 10057623
Columbia Pacific CCO #YX101L9Y
Columbia Pacific CCO #YX101L9Y
Columbia Pacific CCO #YX101L9Y
Columbia Pacific CCO #YX101L9Y
Cigna Behavioral Health #3942062534 / PD00
Columbia Pacific CCO #YX101L9Y
Cigna Behavioral Health #3942062534 / PD00
Columbia Pacific CCO #YX101L9Y
Cigna Behavioral Health #3942062534 / PD00
Columbia Pacific CCO #YX101L9Y
Cascade Health Alliance #NC500K0X
Cascade Health Alliance #NC500K0X
Cascade Health Alliance #NC500K0X
Cascade Health Alliance #NC500K0X
CareOregon #KC201H2S00 / KC201H2S00
CareOregon #KC201H2S00 / KC201H2S00
CareOregon #BJ401A9C
CareOregon #BJ401A9C
CareOregon #BJ401A9C
CareOregon #BJ401A9C
CareOregon #XK501L7J
CareOregon #OS800P7E
CareOregon #OS800P7E
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
Blue Cross of Oregon Regence (ORBLS) #YVA190206738 / 10044602
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #TE201N2C / OHP Plus
CareOregon #IU801L8G
CareOregon #IU801L8G
CareOregon #IU801L8G
CareOregon #IU801L8G
CareOregon #IU801L8G
Kaiser NW #14451188
Kaiser NW #14451188
Kaiser NW #14451188
Kaiser NW #14451188
CareOregon #401760474
Headway #13351152W
Headway #13351152W
Headway #13351152W
Headway #13351152W
Headway #13351152W
Kaiser NW #14277108
Kaiser NW #14277108
Kaiser NW #14277108
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
CareOregon #CY101B4W
Aetna #W461943435 / 144115-010-00001
Blue Cross of Oregon Regence (ORBLS) #R60107606
Kaiser NW #93810074
Kaiser NW #93810074
Kaiser NW #93810074
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
CareOregon #HC601R0U / HC601R0U
Blue Cross of Oregon Regence (ORBLS) #UDWW770394869
Blue Cross of Oregon Regence (ORBLS) #R60197487
Blue Cross of Oregon Regence (ORBLS) #R60197487
Blue Cross of Oregon Regence (ORBLS) #R60197487
Blue Cross of Oregon Regence (ORBLS) #R60197487
Blue Cross of Oregon Regence (ORBLS) #R60197487
Kaiser NW #11821342
Kaiser NW #11821342
Kaiser NW #11821342
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
CareOregon #KM701L6S
Kaiser NW #63632200
Kaiser NW #63632200
Kaiser NW #63632200
CareOregon #WE401L2I
CareOregon #WE401L2I
CareOregon #WE401L2I
CareOregon #WE401L2I
Kaiser NW #34174109
Kaiser NW #34174109
Blue Cross of Oregon Regence (ORBLS) #YVA220142235 / 10054214
Blue Cross of Oregon Regence (ORBLS) #YVA220142235 / 10054214
Blue Cross of Oregon Regence (ORBLS) #YVA220142235 / 10054214
Providence Behavioral Health #11352247102
Providence Behavioral Health #11352247102
Providence Behavioral Health #11352247102
Kaiser NW #08104118 / 08104118
Kaiser NW #08104118 / 08104118
CareOregon #WR101H6V
CareOregon #XJ701M5O / OHP / Health share of Oregon/ Care Oregon
CareOregon #XJ701M5O / OHP / Health share of Oregon/ Care Oregon
Blue Cross of Oregon Regence (ORBLS) #BHP822375790 / 7IM120
Providence Behavioral Health #11361368101 / 121899
Providence Behavioral Health #11361368101 / 121899
Trillium Community Health Plan #JV401U5R
Description
1x T1016 - Case management ($35.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
2x T1016 - Case management ($70.00)
F43.12
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
5x T1016 - Case management ($175.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
5x T1016 - Case management ($175.00)
F43.12
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F43.12
2x T1016 - (Telehealth) Case Management ($70.00)
F43.12
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F43.12
3x T1016 - (Telehealth) Case Management ($105.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
4x T1016 - (Telehealth) Case Management ($140.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.1
1x 90791 - Diagnostic Evaluation ($250.00)
F43.21
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F41.1
F32.1
Co 90837
1x Pay: $35.00
- Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
Co 90837
1x Pay: $35.00
- Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
1x T1016 - Case management ($35.00)
F33.1
1x T1016 - Case management ($35.00)
F33.1
F32.1
Co Pay: $35.00
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
Co Pay: $35.00
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.1
Co T1016
2x Pay: $35.00
- Case management ($70.00)
F32.1
F33.1
Co 90837
1x Pay: $35.00
- Telehealth psychotherapy 60 minutes ($225.00)
F33.1
Co Pay: $35.00
1x 90785 - Interactive Complexity ($15.00)
F33.1
Co Pay: $35.00
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.1
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F33.1
1x 90785 - Interactive Complexity ($15.00)
F43.11,
1x 90839F32.1, F41.1 Crisis 60 minutes ($250.00)
- Telehealth
F43.11,
1x 90837F32.1, F41.1 therapy ($225.00)
- 60 minute
F43.11,
1x 90837F32.1, F41.1 therapy ($225.00)
- 60 minute
F43.11,
1x 90785F32.1, F41.1 Complexity ($15.00)
- Interactive
F43.11, F32.1, F41.1 therapy ($225.00)
1x 90837 - 60 minute
F43.11,
1x 90837F32.1, F41.1 therapy ($225.00)
- 60 minute
F43.11,
1x 90847F32.1, F41.1
- Family psychotherapy ($200.00)
F43.11, F32.1, F41.1
1x T1016 - (Telehealth) Case Management ($35.00)
F43.11,
1x 90785F32.1, F41.1
- Psytx complex interactive (Telehealth) ($15.00)
F43.11,
1x 90834F32.1, F41.1 Psychotherapy 45 min ($180.00)
- (Telehealth)
F43.11,
1x 90837F32.1, F41.1 psychotherapy 60 minutes ($225.00)
- Telehealth
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
F41.1
Co T1016
1x Pay: $25.00
- Case management ($35.00)
F43.10
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F41.1,
1x F33.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
4x F33.1
T1016 - Case management ($140.00)
F43.89, F90.2
5x T1016 - (Telehealth) Case Management ($175.00)
F43.89,
1x 90791F90.2
- Telehealth Diagnostic Evaluation ($250.00)
F33.1,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.0
Blue Cross of Oregon Regence (ORBLS) #UDWW770394869
90791 - Family
1x 90847 Diagnostic Evaluation ($250.00)
psychotherapy ($200.00)
F90.2
1x 90847 - Family psychotherapy ($200.00)
F90.2
1x 90847 - Family psychotherapy ($200.00)
F90.2
1x 90847 - Family psychotherapy ($200.00)
F90.2
2x T1016 - Case management ($70.00)
F90.2
1x 90847 - Family psychotherapy ($200.00)
F90.2
2x 90837 - Telehealth psychotherapy 60 minutes ($450.00)
F90.2
1x T1016 - Case management ($35.00)
F90.2
2x T1016 - Case management ($70.00)
F90.2
2x T1016 - (Telehealth) Case Management ($70.00)
F90.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F90.2
2x T1016 - (Telehealth) Case Management ($70.00)
F90.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.89
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.89
1x 90791 - Diagnostic Evaluation ($250.00)
F43.10
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.22,
1x 90834F84.0
- Psychotherapy 45 min ($180.00)
F43.22, F84.0
1x 90847 - Family psychotherapy ($200.00)
F43.22,
1x 90834F84.0
- Psychotherapy 45 min ($180.00)
F43.22,
1x 90837F84.0
- Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.10,
1x 90846F90.2
- (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.10,
1x 90846F90.2
- 50 minutes of family psychotherapy without the patient present ($200.00)
F43.10, F90.2
1x 90847 - Family psychotherapy ($200.00)
F43.10,
1x 90847F90.2
- (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.10,
1x T1016F41.1
- (Telehealth) Case Management ($35.00)
F43.10,
1x 90832F41.1
- telehealth 30 min psychotherapy ($130.00)
F43.10,
1x 90834F41.1
- Telehealth psychotherapy 45 min ($180.00)
F41.1, F43.12
1x 90834 - Psychotherapy 45 min ($180.00)
F41.1,
1x F43.12
90837 - 60 minute therapy ($225.00)
F41.1,
1x F43.12
90834 - Psychotherapy 45 min ($180.00)
F41.1,
1x F43.12
90834 - Psychotherapy 45 min ($180.00)
F41.1,
1x F43.12
90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x T1016 - Case management ($35.00)
F43.20
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x T1016 - Case management ($35.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1
1x 90837 - 60 minute therapy ($225.00)
F84.0
1x 90837 - 60 minute therapy ($225.00)
F84.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F84.0
1x 90837 - 60 minute therapy ($225.00)
F43.89
1x 90837 - 60 minute therapy ($225.00)
F43.89
3x T1016 - Case management ($105.00)
F43.89
1x 90837 - 60 minute therapy ($225.00)
F43.89
1x 90837 - 60 minute therapy ($225.00)
F43.89
F43.22
Coinsurance: $40.00 / 881703-012-00001
Aetna #W285444447
90791 - Family
1x 90847 Diagnostic Evaluation ($250.00)
psychotherapy ($200.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
3x T1016 - Case management ($105.00)
F42.2
2x T1016 - (Telehealth) Case Management ($70.00)
F42.2
2x T1016 - Case management ($70.00)
F42.2
Trillium
1x 90832Community Health
- telehealth Plan
30 min #402358637($130.00)
psychotherapy / 402358637
F43.23, F90.0
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.23,
2x T1016F90.0
- Case management ($70.00)
F43.23,
1x T1016F90.0
- Case management ($35.00)
F43.23, F90.0
1x T1016 - Case management ($35.00)
F43.23,
1x 90839F90.0
- Telehealth Crisis 60 minutes ($250.00)
F43.23,
1x 90837F90.0
- Telehealth psychotherapy 60 minutes ($225.00)
F43.23,
1x 90834F90.0
- Telehealth psychotherapy 45 min ($180.00)
F41.1,
1x F34.1
90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.23
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.23
4x T1016 - (Telehealth) Case Management ($140.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.10,
1x 90837T14.91XD
- 60 minute therapy ($225.00)
F43.10,
1x 90837T14.91XD
- 60 minute therapy ($225.00)
F43.10,
1x 90837T14.91XD
- 60 minute therapy ($225.00)
F43.10,
1x 90837T14.91XD
- 60 minute therapy ($225.00)
F43.10,
1x T1016T14.91XD
- Case management ($35.00)
F43.10, T14.91XD
1x 90837 - 60 minute therapy ($225.00)
F43.10,
1x 90837T14.91XD
- 60 minute therapy ($225.00)
F43.12,
1x 90834F90.8
- Psychotherapy 45 min ($180.00)
F43.12, F90.8
1x 90834 - Psychotherapy 45 min ($180.00)
F43.12,
1x 90837F90.8
- 60 minute therapy ($225.00)
F43.12,
1x 90832F90.8, F84.0 30 min psychotherapy ($130.00)
- (Telehealth)
F43.12, F90.8, F84.0 30 min psychotherapy ($130.00)
1x 90832 - telehealth
F41.1,
1x F42.2
90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1, F42.2
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F41.1,
1x F42.2
90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1,
1x F42.2
90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90832 - 30 minute psychotherapy ($130.00)
F43.23
1x 90847 - Family psychotherapy ($200.00)
F43.23
1x 90847 - Family psychotherapy ($200.00)
F43.23
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F41.1
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
CareOregon
1x #BK98172B
90791 - Telehealth / Care Oregon
Diagnostic Evaluation ($250.00)
F43.23
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.23
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.20
CareOregon
1x #DG27202A
90834 - Telehealth / Health share
psychotherapy 45 of
minOregon DG27202A
($180.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.22
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.22
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.22
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F34.1,
1x F90.2
90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F34.1,
1x F90.2
90832 - (Telehealth) 30 min psychotherapy ($130.00)
F34.1,
1x F90.2
90832 - (Telehealth) 30 min psychotherapy ($130.00)
F34.1, F90.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F40.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F40.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F40.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.2
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
4x T1016 - Case management ($140.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F42.2
1x 90834 - Psychotherapy 45 min ($180.00)
F43.23
1x 90834 - Psychotherapy 45 min ($180.00)
F43.23
1x 90834 - Psychotherapy 45 min ($180.00)
F43.23
3x T1016 - Case management ($105.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
2x T1016 - Case management ($70.00)
F43.12
10x T1016 - Case management ($350.00)
F43.12
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
6x T1016 - Case management ($210.00)
F43.12
1x 90853 - Group Therapy ($100.00)
F43.12
3x T1016 - Case management ($105.00)
F43.12
1x 90834 - Psychotherapy 45 min ($180.00)
F43.12
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12
1x T1016 - Case management ($35.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x T1016 - Case management ($35.00)
F43.12
2x T1016 - Case management ($70.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.10,
1x 90834F90.2
- (Telehealth) Psychotherapy 45 min ($180.00)
F43.10, F90.2
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.10,
4x T1016F90.2
- (Telehealth) Case Management ($140.00)
F43.89
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.89
2x T1016 - Case management ($70.00)
F43.89
1x T1016 - Case management ($35.00)
F43.89
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.89
2x T1016 - (Telehealth) Case Management ($70.00)
F43.89
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
4x 90847 - Family psychotherapy ($800.00)
F43.12
2x T1016 - (Telehealth) Case Management ($70.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
1x 90846 - 50 minutes of family psychotherapy without the patient present ($200.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.9, F90.0
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.9,
1x F90.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.9,
1x F90.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.9,
1x F90.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.9,
1x F90.0
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.9, F90.0
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F41.1
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F90.2
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F90.2
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90834 - Psychotherapy 45 min ($180.00)
F43.10,
1x 90834F84.0, F90.2
- Psychotherapy 45 min ($180.00)
F43.10,
1x 90834F84.0, F90.2
- Psychotherapy 45 min ($180.00)
F43.10,
1x 90846F84.0, F90.2 50 minutes of family psychotherapy w/o the patient present ($200.00)
- (Telehealth)
F43.12,
1x 90837F32.1, F41.8 psychotherapy 60 minutes ($225.00)
- Telehealth
F43.12,
1x 90832F32.1, F41.8 30 min psychotherapy ($130.00)
- telehealth
F43.12,
3x T1016F32.1,
- CaseF41.8
management ($105.00)
F43.12, F32.1, F41.8
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12,
1x 90846F32.1, F41.8 50 minutes of family psychotherapy w/o the patient present ($200.00)
- (Telehealth)
F43.12, F32.1,
2x T1016 - CaseF41.8
management ($70.00)
F43.12, F32.1, F41.8
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12,
1x T1016F32.1,
- CaseF41.8
management ($35.00)
F43.12, F32.1, F41.8
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.12,
1x 90846F32.1, F41.8 50 minutes of family psychotherapy w/o the patient present ($200.00)
- (Telehealth)
F43.12,
1x 90846F32.1, F41.8 50 minutes of family psychotherapy w/o the patient present ($200.00)
- (Telehealth)
F43.12,
1x 90846F32.1, F41.8 50 minutes of family psychotherapy w/o the patient present ($200.00)
- (Telehealth)
F43.12,
1x 90791F32.1, F41.8 Diagnostic Evaluation ($250.00)
- Telehealth
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F31.76
1x 90837 - 60 minute therapy ($225.00)
F31.76
1x 90837 - 60 minute therapy ($225.00)
F31.76
1x 90791 - Diagnostic Evaluation ($250.00)
F31.76
1x 90834 - Psychotherapy 45 min ($180.00)
F43.22
1x 90847 - Family psychotherapy ($200.00)
F43.22
3x T1016 - (Telehealth) Case Management ($105.00)
F43.22
2x T1016 - (Telehealth) Case Management ($70.00)
F43.22
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90785 - Interactive Complexity ($15.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90837 - 60 minute therapy ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
F43.10
Co Pay: $35.00
F43.23
Co 90785
1x Pay: $35.00
- Interactive Complexity ($15.00)
F93.0
1x 90785 - Interactive Complexity ($15.00)
F93.0
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F33.2,
1x F43.12
90791 - Diagnostic Evaluation ($250.00)
F33.0
2x T1016 - (Telehealth) Case Management ($70.00)
F33.0
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.10
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.10
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.10
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.10
2x T1016 - Case management ($70.00)
F43.10
1x T1016 - Case management ($35.00)
F43.10
3x T1016 - (Telehealth) Case Management ($105.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F42.2, F32.A
1x 90837 - 60 minute therapy ($225.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
F43.21
Coinsurance:
1x $22.50 psychotherapy 45 min ($180.00)
90834 - Telehealth
F41.1, F41.0, F32.1, F42.9
Deductible:
1x $112.64 30 min psychotherapy ($130.00)
90832 - telehealth
F41.1,
1x F41.0,
90832 F32.1, F42.9
- telehealth 30 min psychotherapy ($130.00)
F41.1, F41.0, F32.1, F42.9
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F41.0,
90837 F32.1, F42.9
- Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F41.0,
90837 F32.1, F42.9
- Telehealth psychotherapy 60 minutes ($225.00)
F41.1, F41.0, F32.1, F42.9
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F41.0,
90834 F32.1, F42.9
- (Telehealth) Psychotherapy 45 min ($180.00)
F41.1,
1x F41.0,
90837 F32.1, F42.9
- Telehealth psychotherapy 60 minutes ($225.00)
F41.1, F41.0, F32.1, F42.9
F41.1
Co 90834
1x Pay: $10.00
- Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x T1016 - Case management ($35.00)
F43.89
1x T1016 - Case management ($35.00)
F43.89
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.89,
1x T1016F84.0
- (Telehealth) Case Management ($35.00)
F84.0,
1x F43.89
90834 - Psychotherapy 45 min ($180.00)
F41.1,
1x F33.0
90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1, F33.0
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.23
1x 90791 - Diagnostic Evaluation ($250.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F20.0,
1x F43.10
90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F20.0,
1x F43.10
90832 - (Telehealth) 30 min psychotherapy ($130.00)
F20.0,
1x F43.10
90832 - telehealth 30 min psychotherapy ($130.00)
F90.2
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.2
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.2
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.89
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F90.0,
1x F40.10
90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.0,
1x F40.10
90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.0, F40.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F32.0
90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x T1016 - Case management ($35.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90832 - 30 minute psychotherapy ($130.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.23
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F43.23
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F43.23
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.0,
1x F41.1,
90832 F43.21 30 min psychotherapy ($130.00)
- (Telehealth)
F90.0, F41.1, F43.21 Evaluation ($250.00)
1x 90791 - Diagnostic
F43.22
1x 90847 - Family psychotherapy ($200.00)
F43.22
1x 90785 - Interactive Complexity ($15.00)
F43.22
F34.1
Co Pay:F90.0
F34.1, $20.00
Co Pay: $20.00
Blue Cross of Oregon Regence (ORBLS) #CPR356A52023
Co 90791
1x Pay: $20.00
- Telehealth Diagnostic Evaluation ($250.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F33.41,
1x 90837F41.1
- 60 minute therapy ($225.00)
F33.41,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F33.41,
4x T1016F41.1
- Case management ($140.00)
F33.41,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F33.41,
3x T1016F41.1
- Case management ($105.00)
F84.0, F90.2
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F84.0,
1x F90.2
90834 - Telehealth psychotherapy 45 min ($180.00)
F84.0,
1x F90.2
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F84.0, F90.2
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F84.0,
1x F90.2
90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90834 - Psychotherapy 45 min ($180.00)
F41.1
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F42.2, F34.1
1x 90837 - 60 minute therapy ($225.00)
F43.10
4x T1016 - Case management ($140.00)
F43.10
4x T1016 - Case management ($140.00)
F43.10
4x T1016 - Case management ($140.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90834 - Psychotherapy 45 min ($180.00)
F43.10
5x T1016 - (Telehealth) Case Management ($175.00)
F43.10
1x 90834 - Psychotherapy 45 min ($180.00)
F43.10
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.22
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.22
1x 90791 - Diagnostic Evaluation ($250.00)
F93.0
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0,
1x F90.0
90834 - Psychotherapy 45 min ($180.00)
F41.1
F90.2
Coordination of Benefits Amount: $145.00 covered by previous insurer, $0.00 passed to Client
F90.2
Co Pay: $30.00
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90847 - Family psychotherapy ($200.00)
F43.89
1x 90847 - Family psychotherapy ($200.00)
F43.89
2x T1016 - (Telehealth) Case Management ($70.00)
F43.89
1x T1016 - (Telehealth) Case Management ($35.00)
F43.89
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
F43.22
Co Pay: $30.00
F43.22
Co Pay: $30.00
F43.22
Co Pay: $30.00
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F43.12
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.12
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
2x T1016 - (Telehealth) Case Management ($70.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.12
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12
1x 90832 - telehealth 30 min psychotherapy ($130.00)
F43.89,
1x 90837F33.1, F90.0 therapy ($225.00)
- 60 minute
F43.89, F33.1, F90.0 therapy ($225.00)
1x 90837 - 60 minute
F43.89,
1x 90832F33.1, F90.0 30 min psychotherapy ($130.00)
- (Telehealth)
F43.89,
1x 90837F33.1, F90.0 psychotherapy 60 minutes ($225.00)
- Telehealth
F41.8, F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.8,
1x F43.89
90834 - Telehealth psychotherapy 45 min ($180.00)
F43.89,
1x 90834F41.8
- Telehealth psychotherapy 45 min ($180.00)
F41.8,
1x F43.89
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.89,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F43.89, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F50.01,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F50.01,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F50.01, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F50.01,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F50.01,
1x 90837F41.1
- Telehealth psychotherapy 60 minutes ($225.00)
F50.01, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F41.1
90846 - 50 minutes of family psychotherapy without the patient present ($200.00)
F43.89
1x 90847 - Family psychotherapy ($200.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x T1016 - Case management ($35.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90837 - 60 minute therapy ($225.00)
F43.89,
1x 90837F40.10
- Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F41.1
1x 90837 - 60 minute therapy ($225.00)
F41.1
1x 90837 - 60 minute therapy ($225.00)
F41.1
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - 60 minute therapy ($225.00)
F33.1,
1x F41.8
90837 - 60 minute therapy ($225.00)
F41.8, F33.41
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F33.41,
1x 90837F41.8
- 60 minute therapy ($225.00)
F33.41,
1x 90837F41.1
- 60 minute therapy ($225.00)
F40.10
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F40.10,
1x 90846F33.42
- (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F40.10,
2x T1016F33.42
- Case management ($70.00)
F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.89
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F43.89
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.89
2x T1016 - Case management ($70.00)
F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.89
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.89
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.12,
1x 90834F90.2
- (Telehealth) Psychotherapy 45 min ($180.00)
F43.12, F90.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23,
1x 90832F90.2
- (Telehealth) 30 min psychotherapy ($130.00)
F43.23,
1x 90837F90.2
- Telehealth psychotherapy 60 minutes ($225.00)
F43.23, F90.2
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F41.1, F90.9
CareOregon #WT101N6D
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1, F33.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
T1016 - Case management ($35.00)
F41.1,
1x F33.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1,
1x F33.1
90785 - Interactive Complexity ($15.00)
F43.89
1x 90785 - Interactive Complexity ($15.00)
F43.89
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90834 - Telehealth psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F41.1
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x T1016 - Case management ($35.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F43.9
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F43.9
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F43.9
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1, F43.9
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F34.1,
1x F43.9
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.23
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - 60 minute therapy ($225.00)
F43.10,
1x 90837F41.8
- 60 minute therapy ($225.00)
F43.10, F40.11
1x 90837 - 60 minute therapy ($225.00)
F43.10,F43.10
F90.2, F40.11
Coordination
F90.2, F43.10of Benefits Amount: $0.00 covered by previous insurer, $0.00 passed to Client
Coordination
F90.2, F43.10of Benefits Amount: $185.00 covered by previous insurer, $0.00 passed to Client
Coordination
F90.2, F43.10of Benefits Amount: $120.60 covered by previous insurer, $0.00 passed to Client
Coordination of BenefitsCase
1x T1016 - (Telehealth) Amount: $184.40 covered
Management ($35.00)by previous insurer, $0.00 passed to Client
F90.2,
1x F43.10
T1016 - (Telehealth) Case Management ($35.00)
F90.2,
1x F43.10
90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F90.2, F43.10
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F90.2,
1x F43.10
90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F90.2,
1x F43.10
90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F90.2,
1x F43.10
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F32.9, F41.1
1x 90834 - (Telehealth) Psychotherapy 45 min ($180.00)
F32.9,
1x F41.1
90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F41.8,
1x F32.9
90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F41.8,
1x F32.9
90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F41.8,
1x F32.9
90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F41.8, F32.9
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.89
1x 90837 - 60 minute therapy ($225.00)
F43.89
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90785 - Interactive Complexity ($15.00)
F93.0
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F93.0
1x 90834 - Psychotherapy 45 min ($180.00)
F93.0
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F43.20
1x 90847 - (Telehealth) 50 minutes of family psychotherapy with the patient present ($200.00)
F95.2,
1x F34.81,
90847 F90.0 50 minutes of family psychotherapy with the patient present ($200.00)
- (Telehealth)
F95.2,
1x F34.81,
90847 F90.0 50 minutes of family psychotherapy with the patient present ($200.00)
- (Telehealth)
F95.2, F34.81, F90.0 Crisis 60 minutes ($250.00)
1x 90839 - Telehealth
F95.2,
1x F34.81,
90847 F90.0
- Family psychotherapy ($200.00)
F95.2,
1x F34.81,
90837 F90.0 psychotherapy 60 minutes ($225.00)
- Telehealth
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
3x T1016 - (Telehealth) Case Management ($105.00)
F41.1
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F41.1
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.10
1x 90834 - Psychotherapy 45 min ($180.00)
F42.2, F43.23,
1x 90834 F40.10
- Psychotherapy 45 min ($180.00)
F42.2,
1x F43.23,
90834 F40.10
- Psychotherapy 45 min ($180.00)
F42.2,
1x F43.23,
90834 F40.10
- Psychotherapy 45 min ($180.00)
F42.2,
1x F43.23,
90834 F40.10
- Psychotherapy 45 min ($180.00)
F42.2,
1x F43.23,
90837 F40.10 psychotherapy 60 minutes ($225.00)
- Telehealth
F44.81,
1x 90837F33.1
- Telehealth psychotherapy 60 minutes ($225.00)
F44.81,
1x 90837F33.1
- Telehealth psychotherapy 60 minutes ($225.00)
F44.81,
1x 90837F33.1
- Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.10
1x 90834 - Psychotherapy 45 min ($180.00)
F43.10
2x T1016 - Case management ($70.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
1x T1016 - Case management ($35.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.10
3x T1016 - Case management ($105.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
1x T1016 - Case management ($35.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.10
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F43.10
1x T1016 - Case management ($35.00)
F43.10
1x 90834 - Psychotherapy 45 min ($180.00)
F43.10
1x 90846 - (Telehealth) 50 minutes of family psychotherapy w/o the patient present ($200.00)
F43.10
1x 90837 - 60 minute therapy ($225.00)
F43.10
2x T1016 - Case management ($70.00)
F43.10
1x 90847 - Family psychotherapy ($200.00)
F43.22
F41.1
Co 90837
1x Pay: $30.00
- Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.2
1x 90785 - Psytx complex interactive (Telehealth) ($15.00)
F32.2,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.2,
1x F41.1
90785 - Psytx complex interactive (Telehealth) ($15.00)
F32.2, F41.1, F43.12
1x 90840 - crisis add on 30 minutes ($130.00)
F32.2,
Blue F41.1,
Cross of F43.12
Oregon Regence (ORBLS) #UDWW770394869
1x 90791 - Diagnostic Evaluation ($250.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - 60 minute therapy ($225.00)
F43.22
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.A, F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.A,
1x F41.1
90837 - Telehealth psychotherapy 60 minutes ($225.00)
F32.A, F41.1
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.20
3x T1016 - Case management ($105.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
3x T1016 - Case management ($105.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
4x T1016 - Case management ($140.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - 60 minute therapy ($225.00)
F43.20
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F41.1
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation ($250.00)
F43.20
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation (Telehealth) ($250.00)
F43.22
1x 90791 - Diagnostic Evaluation ($250.00)
F43.22
F80.1, F41.1
Co Pay:F41.1
F80.1, $30.00
Co Pay:F41.1
F80.1, $30.00
Co 90837
1x Pay: $30.00
- Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90834 - Psychotherapy 45 min ($180.00)
F90.2
1x 90832 - (Telehealth) 30 min psychotherapy ($130.00)
F90.2
1x 90791 - Diagnostic Evaluation ($250.00)
F90.2,
1x F93.0
90791 - Diagnostic Evaluation ($250.00)
F43.10
1x 90791 - Diagnostic Evaluation ($250.00)
F43.10
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F41.1
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90837 - Telehealth psychotherapy 60 minutes ($225.00)
F42.2
1x 90791 - Telehealth Diagnostic Evaluation ($250.00)
F43.25
Birth Date
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
9/9/2009
5/31/2007
5/31/2007
5/31/2007
1/15/2004
1/15/2004
9/28/2008
5/20/1992
5/20/1992
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
12/9/2001
 12/9/2001
12/9/2001
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
5/21/2004
9/30/1969
9/30/1969
9/30/1969
12/6/2010
10/17/1986
5/9/1990
5/9/1990
1/20/1984
1/20/1984
11/17/2011
11/17/2011
12/17/2001
1/30/2002
1/30/2002
1/13/2013
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/26/2010
7/2/2001
7/2/2001
7/2/2001
7/2/2001
10/22/1978
10/22/1978
10/22/1978
10/22/1978
 8/30/1998
6/15/2013
11/18/2017
11/18/2017
11/18/2017
7/5/2015
7/5/2015
7/5/2015
7/5/2015
4/4/1990
4/4/1990
4/4/1990
1/19/2013
1/19/2013
1/19/2013
1/19/2013
3/13/2017
3/13/2017
3/13/2017
3/13/2017
3/13/2017
3/13/2017
8/21/1981
8/21/1981
8/21/1981
1/15/1980
1/15/1980
1/15/1980
1/15/1980
1/15/1980
10/13/2013
10/13/2013
10/13/2013
10/13/2013
5/9/1995
5/9/1995
5/9/1995
5/9/1995
5/9/1995
5/9/1995
5/12/2007
7/24/2000
7/24/2000
3/27/1967
3/27/1967
3/27/1967
4/5/2011
4/5/2011
 4/5/2011
1/27/2016
1/27/2016
1/27/2016
1/27/2016
1/27/2016
11/10/1971
11/10/1971
11/10/1971
12/23/2008
12/23/2008
12/23/2008
12/23/2008
4/28/1979
5/18/2003
5/18/2003
5/18/2003
5/18/2003
5/18/2003
5/18/2003
5/18/2003
12/6/2007
12/6/2007
12/6/2007
12/6/2007
3/16/2009
3/16/2009
3/16/2009
3/16/2009
3/16/2009
3/16/2009
3/16/2009
1/7/2012
1/7/2012
1/7/2012
1/7/2012
1/7/2012
2/29/2008
2/29/2008
2/29/2008
2/29/2008
4/14/2018
4/14/2018
2/4/2015
2/4/2015
2/4/2015
10/30/1988
10/30/1988
10/30/1988
10/30/1988
10/30/1988
10/30/1988
10/30/1988
7/21/2011
7/21/2011
3/26/1969
3/26/1969
3/26/1969
3/26/1969
3/26/1969
3/17/1985
3/17/1985
3/17/1985
3/17/1985
3/17/1985
3/17/1985
3/9/2005
3/9/2005
3/9/2005
3/9/2005
3/9/2005
10/30/2009
10/30/2009
10/30/2009
11/10/1975
11/10/1975
11/10/1975
6/29/2007
6/29/2007
6/29/2007
6/29/2007
2/25/2008
10/28/1976
10/28/1976
10/28/1976
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
 7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
7/31/2009
10/11/1998
10/11/1998
10/11/1998
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
12/26/2007
6/21/1988
6/21/1988
6/21/1988
6/21/1988
6/21/1988
6/21/1988
3/27/2007
6/7/2012
6/7/2012
6/7/2012
6/7/2012
6/7/2012
6/7/2012
4/25/2010
4/25/2010
4/25/2010
12/2/2009
12/2/2009
12/2/2009
12/2/2009
12/2/2009
12/2/2009
12/2/2009
 12/2/2009
12/2/2009
12/2/2009
12/2/2009
12/2/2009
12/2/2009
6/6/2017
6/6/2017
6/6/2017
3/29/2000
3/29/2000
3/29/2000
3/29/2000
11/4/2016
11/4/2016
11/4/2016
11/4/2016
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
8/17/1992
10/3/1968
10/3/1968
5/8/2014
5/8/2014
11/21/2008
6/15/2008
6/15/2008
11/17/1978
11/17/1978
11/17/1978
11/17/1978
5/25/1994
5/25/1994
5/25/1994
5/25/1994
5/25/1994
5/25/1994
11/13/1990
10/25/2001
10/25/2001
10/25/2001
10/25/2001
10/25/2001
6/7/1976
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
6/20/2001
3/22/1987
3/22/1987
3/22/1987
3/22/1987
10/25/2013
10/25/2013
10/25/2013
10/25/2013
5/30/1992
5/30/1992
11/26/1973
11/26/1973
11/26/1973
8/15/1975
3/12/1992
3/12/1992
3/12/1992
2/26/2013
2/26/2013
2/26/2013
9/1/2011
8/20/2004
8/20/2004
8/20/2004
6/8/1994
4/25/1992
4/25/1992
4/25/1992
4/25/1992
4/25/1992
4/25/1992
4/25/1992
4/25/1992
4/25/1992
8/30/1982
 8/30/1982
8/30/1982
8/30/1982
8/30/1982
8/30/1982
4/14/2007
4/14/2007
4/14/2007
6/15/2006
6/15/2006
11/24/1968
11/24/1968
11/24/1968
8/24/1970
8/24/1970
8/24/1970
9/25/1990
8/18/1998
8/18/1998
8/18/1998
8/18/1998
8/18/1998
3/5/2002
3/5/2002
3/5/2002
3/5/2002
3/5/2002
1/10/2013
1/10/2013
1/10/2013
11/6/2006
8/19/2016
8/19/2016
8/19/2016
8/19/2016
8/19/2016
8/19/2016
8/19/2016
8/19/2016
8/19/2016
3/31/2016
3/31/2016
3/31/2016
3/31/2016
3/31/2016
5/21/2013
5/21/2013
5/21/2013
 5/21/1974
5/21/1974
5/21/1974
5/21/1974
5/27/2015
5/27/2015
5/27/2015
1/17/1978
1/17/1978
1/17/1978
8/20/2013
8/20/2013
8/20/2013
8/20/2013
8/20/2013
8/20/2013
8/20/2013
12/23/2008
12/23/2008
12/23/2008
12/23/2008
10/26/2009
10/26/2009
10/26/2009
10/26/2009
9/11/2010
9/11/2010
9/11/2010
9/11/2010
9/11/2010
9/11/2010
5/19/2003
5/19/2003
5/19/2003
5/19/2003
5/19/2003
5/19/2003
6/13/1998
6/13/1998
6/13/1998
6/13/1998
6/13/1998
6/13/1998
1/25/2015
1/25/2015
1/25/2015
1/25/2015
1/25/2015
 1/25/2015
1/25/2015
1/25/2015
1/25/2015
1/25/2015
2/23/1996
2/23/1996
2/23/1996
2/23/1996
2/23/1996
2/24/2009
2/24/2009
11/29/2012
11/29/2012
11/29/2012
9/12/2011
9/12/2011
5/21/1984
5/21/1984
5/21/1984
5/21/1984
8/2/2010
8/2/2010
8/2/2010
8/2/2010
8/2/2010
8/2/2010
8/2/2010
3/1/2015
3/1/2015
3/1/2015
3/1/2015
3/1/2015
3/1/2015
3/1/2015
3/1/2015
3/1/2015
5/7/1989
5/7/1989
1/11/1994
1/11/1994
1/11/1994
1/11/1994
1/11/1994
1/11/1994
7/6/2016
5/26/2011
8/16/2019
 9/14/1999
9/14/1999
9/14/1999
9/14/1999
9/14/1999
9/14/1999
10/21/2015
10/21/2015
11/7/1992
11/7/1992
11/7/1992
11/7/1992
11/7/1992
7/3/2015
7/3/2015
7/3/2015
7/3/2015
7/3/2015
7/3/2015
7/3/2015
7/3/2015
4/8/1982
4/8/1982
4/8/1982
6/11/1992
6/11/1992
6/11/1992
6/11/1992
6/11/1992
8/15/1983
8/15/1983
8/15/1983
8/15/1983
8/15/1983
1/30/1974
1/30/1974
1/30/1974
1/30/1974
8/13/2009
8/13/2009
8/13/2009
8/13/2009
11/19/1997
11/19/1997
11/19/1997
11/19/1997
11/19/1997
 2/21/2010
2/21/2010
2/21/2010
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
9/23/2012
3/11/2000
3/11/2000
3/11/2000
3/11/2000
1/12/1993
1/12/1993
10/4/2010
10/4/2010
10/4/2010
10/4/2010
7/28/2017
11/1/2003
11/1/2003
7/28/2017
7/28/2017
7/28/2017
7/28/2017
7/28/2017
7/28/2017
9/5/2019
9/5/2019
9/5/2019
9/5/2019
9/5/2019
9/5/2019
9/5/2019
11/16/2006
11/16/2006
11/16/2006
11/16/2006
11/16/2006
3/12/1997
3/12/1997
3/12/1997
3/12/1997
 5/15/1991
7/13/2007
7/13/2007
7/13/2007
7/13/2007
7/13/2007
9/12/2001
9/12/2001
9/12/2001
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
3/29/2011
12/24/1981
12/6/2010
1/1/2002
1/1/2002
1/1/2002
10/7/1984
10/7/1984
10/7/1984
10/7/1984
10/7/1984
10/7/1984
10/7/1984
1/4/2011
5/21/2015
5/21/2015
5/21/2015
5/21/2015
5/21/2015
5/6/1996
5/6/1996
5/6/1996
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
6/12/2018
1/8/2001
1/8/2001
1/8/2001
2/15/2018
2/15/2018
2/15/2018
2/15/2018
2/12/2013
2/12/2013
7/23/2009
7/23/2009
7/23/2009
1/5/2008
1/5/2008
1/5/2008
5/14/2014
5/14/2014
4/28/2015
4/1/2019
4/1/2019
8/6/1991
6/29/2009
6/29/2009
10/1/2017