IHC presentation data 2015.xlsx

Provider Discipline Value # of Appointment

Central Utah Clinic Cardiac Diagnost cardiology $ 2,265.00 7 7

Dr. Marv Allen cardiology $ 1,987.00 9 3

Dr. Chun Hwang cardiology $ 1,027.00 3 0

Dr. David Cragun cardiology $ 673.00 4 1

Dr. Ronald Asay cardiology $ 637.00 4 2

Dr. Aaron Weaver cardiology $ 563.00 3 2

Dr. Charles Dahl cardiology $ 491.00 3 2

NP Rachelle Frost cardiology $ 130.00 1 1

NP Nancy Radle cardiology $ 104.00 1 0

Damien Moreno dental lab $ 490.00 4 1

Angus Dental Lab dental lab $ 390.00 3 2

Dr. Kenneth Molen dentistry $ 7,867.00 50 46

Dr. Joe Winward dentistry $ 7,195.00 10 5

Dr. Donny Allred dentistry $ 6,005.00 5 4

Dr. Kyle Clark dentistry $ 5,899.00 7 5

Dr. L. Craig Rosvall dentistry $ 4,862.00 9 7

Dr. David Nance dentistry $ 4,848.00 9 5

Dr. Quinn Schiffman dentistry $ 4,739.00 10 7

Dr. Garry Brown dentistry $ 4,584.00 5 2

Dr. Renn Flinders dentistry $ 4,318.00 7 4

Dr. Randal Hadfield dentistry $ 4,058.00 4 4

Dr. Keith Dodge dentistry $ 3,936.00 13 8

DMD Robert Baird dentistry $ 3,375.00 3 0

Dr. Devin Davidson dentistry $ 3,088.00 3 2

Dr. J. Chris Crawford dentistry $ 2,592.00 3 2

Dr. Gavin Huntington dentistry $ 2,414.00 6 6

Dr. Albert Clark dentistry $ 2,412.00 7 5

Dr. Scott Stapley dentistry $ 2,384.00 10 8

Dr. Jerel Hill dentistry $ 2,153.00 5 5

Dr. Jeremy White dentistry $ 1,725.00 3 1

Dr. Corbin Matthews dentistry $ 1,590.00 2 2

DMD Ashley Heid dentistry $1,521.00 2 0

Dr. Richard Leishman dentistry $ 1,520.00 3 1

# of Patients


Dr. Gary Wiest dentistry $ 1,502.00 4 2

Dr. Nicholas Young dentistry $ 1,253.00 6 4

Dr. Reed Robinson dentistry $ 1,202.00 4 3

Dr. Glenn Payne dentistry $ 1,168.00 5 2

Dr Stephen Pratt dentistry $ 1,083.00 3 2

Tanya Westmorland dentistry $ 1,037.00 2 1

Bart Gardiner dentistry $ 1,010.00 2 1

Dr. Scott Chandler dentistry $ 635.00 1 1

Alexander Larsen dentistry $ 482.00 1 1

Dr. Ronald Smith dentistry $ 305.00 3 1

David Hansen dentistry $0 1 1

Community Health Connect dentistry - education $ 47.00 52 48

UCDH UCDH dentistry - hygiene $ 4,500.00 46 46

UVU UVU dentistry - hygiene $ 2,100.00 23 22

Dr. Daryn Moody dentistry - kids $ 9,121.00 8 4

Dr. Adam Shepherd dentistry - kids $ 4,491.00 7 5

James Bonny dentistry - kids $ 3,652.00 7 2

Dr. Don Gifford dentistry - kids $ 3,087.03 8 3

Bruce Howell dentistry - kids $ 2,705.00 5 3

Dr. Paul Nielsen dentistry - kids $ 2,318.00 6 2

Dr. Michael Lorscheider dentistry - kids $ 1,576.00 5 3

Dr. Tyler Ashman dentistry - kids $ 1,080.00 2 0

Darren Chamberlain dentistry - kids $ 687.00 2 1

Dr. S. Peterson dermatology $ 23,706.0 8 3

Dr. Mark Donaldson dermatology $ 4,421.00 15 12

Dr. Brad Huber dermatology $ 2,793.00 13 13

NP Christina Linton dermatology $ 2,107.00 13 11

NP Lisa Williams dermatology $ 1,870.00 11 11

Dr. Brian Bradshaw dermatology $ 1,324.00 8 7

NP Nicole Rawle dermatology $ 1,232.00 8 5

Dr. Kraig Jenson dermatology $ 695.00 7 7

Dr. David Myers dermatology $ 395.00 3 2

PA Byron Edwards dermatology $ 192.00 2 1

# of Patients


NP Clarene Hansen endocrinology $ 765.00 4 3

Dr. Soubhi Nizam endocrinology $ 729.00 4 3

Ryan Van Moorlehem endodontics $ 3,855.00 4 3

Dr. Paul Creer endodontics $ 3,048.00 8 6

Dr. Daniel Burr endodontics $ 2,619.00 3 1

Dr. S. Todd Hamilton ENT $ 6,718.00 6 4

Dr. David Darley ENT $ 5,059.00 9 7

Dr Seth Riddle ENT $ 2,647.00 8 6

Dr Kirt Beus ENT $ 1,847.00 7 5

Dr Kipp Robins ENT $ 1,078.00 4 2

Dr Steven Parson ENT $ 937.00 4 3

Dr Randal Gibb ENT $ 467.00 4 4

Dr Scott Shipley ENT $ 459.00 2 1

Dr Douglas Denys ENT $ 390.00 4 3

P.A. Aaron Paxman ENT $ 223.00 1 0

P.A. Scott Summers ENT $ 223.00 2 1

Dr. Kelly Ence ENT $ 120.00 2 0

Dr Heidi Heras ENT $ 95.00 1 0

PA Dawn Ngo gastroenterology $ 1,967.00 13 11

PA Dan Ibarra gastroenterology $ 1,281.00 8 3

Dr. David Fraintz gastroenterology $ 1,136.00 8 5

NP Adrianne Shaver gastroenterology $ 954.00 3 2

Dr Chad Kawa gastroenterology $ 891.00 3 3

Dr Mohammad Alsolaiman gastroenterology $ 776.00 3 3

Dr. Haslem Bryce gastroenterology $ 542.00 3 2

Dr. Tom Dickinson gastroenterology $ 410.00 3 1

Dr. David Frantz gastroenterology $ 340.00 2 2

NP Chris Biesinger gastroenterology $ 170.00 1 1

Dr. Karl Francis general surgery $ 9,205.00 8 7

Dr. Craig Cook general surgery $ 6,484.00 6 3

Dr Lee Peterson general surgery $ 6,380.00 7 5

Dr. Richard Rasmussen general surgery $ 5,410.00 8 5

Dr Brian Gill general surgery $ 4,640.00 5 1

# of Patients


Dr David Garry general surgery $ 4,150.00 4 4

Dr Jennifer Tittensor general surgery $ 3,750.00 4 2

Dr. Clark Sheffield general surgery $ 3,195.00 3 2

Dr Bruce Hill general surgery $ 3,100.00 3 2

Dr. David Watts general surgery $ 2,250.00 2 2

UVRMC UVRMC hospitals $ 77,409.0 13 13

American Fork Hosptial hospitals $ 20,682.1 4 4

Central Utah Surgical hospitals $ 14,460.0 6 5

Revere Health Care Imaging - Provo hospitals $ 12,717.0 0 0

Utah Valley Outpatient Center hospitals $ 8,802.02 3 3

Orem Community Hospital hospitals $ 3,966.12 1 0

Revere Health Imaging - American F hospitals $ 729.00 2 2

Dr. Henry Yeates immunology $ 170.00 1 0

NP Valarie Juarez internal medicine $ 691.00 3 1

Dr. Larry Nobuhara internal medicine $ 359.00 1 0

Dr. Robert Corniea internal medicine $ 244.00 1 1

Revere Health Care Laboratory medical lab $ 983.00 10 10

NP Mark Boyack nephrology $ 1,075.00 7 7

Dr. William Barager nephrology $ 690.00 4 3

Dr. Mariusz Kielar nephrology $ 534.00 1 1

Dr Terry Hammond nephrology $ 310.00 1 0

Dr. Jeff Groves neurology $ 590.00 4 2

Dr. Howard Reichman neurosurgery $ 180.00 2 1

Dr. Scott Rees OB/GYN $ 5,500.00 3 1

Dr Jennifer Booth OB/GYN $ 800.00 2 0

Dr. Christy Jorgensen OB/GYN $ 255.00 2 2

Dr. Scott Jacob OB/GYN $ 220.00 2 1

Dr Donna Bennett OB/GYN $ 160.00 1 1

NP Heidi Mcsweeney OB/GYN $ 160.00 1 1

NP Steve Larsen oncology $ 167.00 1 1

Dr. Mark Nuttall oncology $ 46.00 1 1

Dr. Duane Nelson ophthalmology $ 5,311.00 13 12

Dr. Michael Lloyd ophthalmology $ 4,091.00 19 13

# of Patients


Dr. Jeremy Valentine ophthalmology $ 1,050.00 5 2

Dr. Ryan Isom ophthalmology $ 544.00 1 0

Dr. Scott Yeates ophthalmology $ 431.00 2 2

Dr. Richard Corey ophthalmology $ 394.00 1 1

Dr. John Carver ophthalmology $ 390.00 1 0

Dr. Blaine Bird optometry $ 2,490.00 12 9

Dr. Frank Edmunds optometry $ 1,225.00 5 5

Dr. Joe Haggard optometry $ 930.00 4 2

Provo Lenscrafters optometry $ 340.00 2 2

ShopKo Spanish Fork optometry $ 170.00 1 1

Dr. Paul Olson optometry/opthalmolo $ 1,809.00 5 2

Dr. Kristine Dunn optometry/opthalmolo $ 1,530.00 8 5

Dr. David Nicholls oral surgery $ 5,572.00 7 3

Dr. William McBee oral surgery $ 3,622.00 8 2

Dr. Heath Hendrickson oral surgery $ 3,499.00 3 3

Dr. David Park oral surgery $ 383.00 1 1

Dr. Gary Crawford oral surgery $ 220.00 1 0

Dr. David Christiansen orthodontics $ 9,164.00 7 3

Dr. Kendall Barrowes orthodontics $ 5,549.00 6 6

Dr. Scott Nord orthodontics $ 4,387.00 8 1

Dr. Robert Jackson orthopedics $ 4,946.00 8 5

Dr. Jeff Wallentine orthopedics $ 4,047.00 8 8

Dr. Karl Weenig orthopedics $ 3,116.00 14 8

Dr. John Wells orthopedics $ 1,661.00 4 4

Dr. Richard Jackson orthopedics $ 1,475.00 7 5

Dr. Michael Carlson orthopedics $ 1,178.00 3 1

Dr. Mitch Larsen orthopedics $ 1,027.00 2 2

Dr. Ryan Slater orthopedics $ 462.00 2 2

Dr. William Bacon orthopedics - back $ 266.00 1 0

Dr. Robert Faux orthopedics - foot $ 6,884.00 9 8

Dr Daniel Hoopes orthopedics - foot $ 2,644.00 5 3

Dr. M. Shane Fraizer orthopedics - hand $ 5,366.00 9 3

Dr. Ryan Richards orthopedics - hand $ 3,532.00 7 5

# of Patients


Dr. Curtis Johnson orthopedics - hand $ 2,914.00 4 1

PA David Waldron orthopedics - hand $ 1,257.00 4 4

Dr. Paul Francis periodontics $ 5,343.00 5 5

Von Hill physical therapy $ 14,777.0 71 1

Coleby Clawson physical therapy $ 12,152.0 56 39

Jim Anderson physical therapy $ 9,250.00 51 19

Braden Taylor physical therapy $ 7,834.00 39 9

Brent Butler physical therapy $ 6,602.00 31 9

Doug Bagley physical therapy $ 4,698.00 20 10

Richard Nielsen physical therapy $ 434.00 2 2

Dr. Kelly Gomez podiatry $ 2,556.00 9 5

Dr. Jared Clegg podiatry $ 2,347.00 9 5

Dr. Michael Nelson podiatry $ 70.00 3 1

Dr. Tala-at Al-Shuqairat pulmonology $ 637.00 4 1

Dr. RHC Revere Health Care radiology $ - 1 1

Dr. Steven Call rheumatology $ 170.00 1 1

# of Patients

Discipline Value

hospitals $ 138,765.3

dentistry $ 92,762.00

physical therapy $ 55,747.00

general surgery $ 48,564.00

dermatology $ 38,735.00

dentistry - kids $ 28,717.03

ENT $ 20,263.00

orthodontics $ 19,100.00

orthopedics $ 17,912.00

oral surgery $ 13,296.00

orthopedics - hand $ 13,069.00

ophthalmology $ 12,211.00

orthopedics - foot $ 9,528.00

endodontics $ 9,522.00

gastroenterology $ 8,467.00

cardiology $ 7,877.00

OB/GYN $ 7,095.00

dentistry - hygiene $ 6,600.00

periodontics $ 5,343.00

optometry $ 5,155.00

podiatry $ 4,973.00

optometry/opthalmolo $ 3,339.00

nephrology $ 2,609.00

endocrinology $ 1,494.00

internal medicine $ 1,294.00

medical lab $ 983.00

dental lab $ 880.00

pulmonology $ 637.00

neurology $ 590.00

orthopedics - back $ 266.00

oncology $ 213.00

neurosurgery $ 180.00

immunology $ 170.00

Discipline Value

rheumatology $ 170.00

dentistry - education $ 47.00

radiology $ -

ApptDate Patient PatientDOB Discipline Provider CPTCode CPTDesc ICDCode ICDDesc Value

12/16/2015 Maria Vazquez 2/10/1958 cardiology Central Utah Clinic Cardiac Diagnostic 93227 - I49.1 - $179

11/20/2015 Jesus Garcia 2/19/1973 cardiology NP Nancy Radle 99213 - I49.9 - $104

10/12/2015 Eva Pinales 6/26/1944 cardiology NP Rachelle Frost 93280 - V53.31 - $130

9/25/2015 Maria Vazquez 2/10/1958 cardiology Central Utah Clinic Cardiac Diagnostic 99204 - 424.1 - $275

8/27/2015 Maria Vazquez 2/10/1958 cardiology Dr. Chun Hwang 99212 - 427.31 - $58

8/20/2015 Wen Li Dong 1/10/1934 cardiology Dr. Marv Allen 93306 - 4280 - $527

8/10/2015 Myriam Licet Salomon 9/2/1965 cardiology Central Utah Clinic Cardiac Diagnostic 99243 - 4019 - $223

6/9/2015 Nubia Pena 12/31/1961 cardiology Dr. Ronald Asay 99213 - 785.59 - $117

5/18/2015 Eva Pinales 6/26/1944 cardiology Dr. Chun Hwang 93280 - V53.31 - $911

4/23/2015 Javier Aguayo 8/6/1954 cardiology Dr. David Cragun 84443, 36415 thyroid stimulating hormone, collection of venous blood by venipuncture 4019 hypertension $49

3/26/2015 Magalis Garces 3/23/1949 cardiology Dr. Ronald Asay 99214 - 2724 - $175

3/5/2015 Ramon Fraustro 5/20/1940 cardiology Dr. Ronald Asay 99214 office visit 4019, 41400 hypertension, CAD $175

11/30/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99024/NC - 226/D34 - $0

11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 15260/58 - C44311 - $3,965

11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 14060/58 - 07810/B079 - $3,965

11/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 17110/5979 - - - $3,965

11/17/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application i83.018 Varicose veins of right lower extremity with ulcer o $100

11/12/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 99214 - M5136 - $175

11/10/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application i83.018 Varicose veins of right lower extremity with ulcer o $100

11/4/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99024/NC - 226/D34 - $0

11/3/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 una boot application I83.018 Varicose veins of right lower extremity with ulcer o $100

10/30/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 88305 - 226/D34 - $161

10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 12051 - R229 - $1,431

10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 11442/59 - 2382/D485 - $1,431

10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 11310/59 - D229 - $1,431

10/28/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 88305 - - - $1,431

10/27/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 Una boot application - - $100

10/26/2015 Rick Giovanini 4/13/1993 dermatology Dr. Brian Bradshaw 99202 - 7061/L709 - $120

10/26/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99215 - M5136 - $236

10/21/2015 Manuela Sanchez 6/17/1966 dermatology Dr. Mark Donaldson 99213 - 2382/D485 - $117

10/20/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 29580 - I83.018 Varicose veins of right lower extremity with ulcer o $100

10/14/2015 Leticia Casasola 7/21/1981 dermatology Dr. Brad Huber 99202 - 7061/L709 - $120

10/13/2015 Raymundo Madrid 8/30/1965 dermatology Dr. Kraig Jenson 99202 new patient 216.5 Benign neoplasm of skin of trunk except scrotum $110

10/13/2015 Rita Rodriguez 5/23/1955 dermatology Dr. Kraig Jenson 99201 new patient L08.9 local infection of the skin and subcutaneous tissue $85

10/8/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards 99212 established office visit - - $70

9/15/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99024/NC - V5842 - $0

9/8/2015 Dolores Hurtado 4/13/1961 dermatology NP Christina Linton 99212 - 695.3 - $70

9/1/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 99024/NC - V5832 - $0

8/25/2015 Maurice Kaouk 1/6/1946 dermatology NP Nicole Rawle RECON/NC - 2322 - $182

8/25/2015 Maurice Kaouk 1/6/1946 dermatology NP Nicole Rawle 11310 - 2382 - $182

8/18/2015 Shaira Morralla Estrada 7/18/2000 dermatology NP Christina Linton 99202 - 7061 - $120

8/18/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 99024/NC - V5832 - $0

8/17/2015 Carmen Argueta 3/31/1982 dermatology Dr. Brian Bradshaw 99212 - 757.9 - $70

8/12/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110 - 7810 - $178

8/10/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards 11900 intralesional injections of up to and including seven lesions - - $122

8/10/2015 Maribel Saavedra 11/18/1975 dermatology PA Byron Edwards J.3301 intralesional injections of up to and including seven lesions - - $122

8/10/2015 Cheryl Luker 4/11/1962 dermatology Dr. S. Peterson 14061/79 - 173.81 - $16,529










8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17000 - 702 - $505

8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17003 - 7810 - $505

8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 17110/59 - 173.31 - $505

8/7/2015 Cheryl Luker 4/11/1962 dermatology Dr. Brad Huber 99202/25 - - - $505

8/5/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99212 - 7014 - $70

8/3/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 99024/NC - V5832 - $0


7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 13151 - 17311 - $2,976



7/27/2015 Norma Farris 5/28/1963 dermatology Dr. S. Peterson 11100/59 - - - $2,976



7/22/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110 - 7810 - $178

7/17/2015 Norma Farris 5/28/1963 dermatology Dr. Brian Bradshaw 99213 - 17311 - $117

7/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99212 - 7092 - $70


7/10/2015 Norma Thayne 5/23/1959 dermatology Dr. Brad Huber 99202 - 2168 - $120

7/8/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson A9270 - 709.2 - $1,000

6/24/2015 Bianca Ferreira 6/21/2011 dermatology Dr. Mark Donaldson 99202 - 704.01 - $120

6/19/2015 Mayra Cisneros 9/14/1982 dermatology Dr. Brad Huber 17110 - 78.1 - $178

6/16/2015 Yulissa Buritica 7/24/1988 dermatology NP Nicole Rawle 99202 - 757.39 - $120

6/15/2015 Susana Nunez 1/17/1946 dermatology Dr. Brian Bradshaw 99213 - 702.19 - $117


6/8/2015 Yolanda Contreras 2/10/1950 dermatology NP Lisa Williams 17000 - 702 - $248

6/8/2015 Yolanda Contreras 2/10/1950 dermatology NP Lisa Williams 99213 - 216.8 - $248

6/8/2015 Catalina Mora 7/10/1993 dermatology NP Lisa Williams 99202 - 706.1 - $120

6/4/2015 Nohemi Medina 5/18/1996 dermatology Dr. Brian Bradshaw 99212 - 701.4 - $70

5/26/2015 Chengzhen Chen 12/4/1938 dermatology Dr. David Myers 99202 - 705.81 - $110

5/26/2015 Carlos Zegarra 9/18/1957 dermatology Dr. David Myers 99202 - 702.19 - $110

5/26/2015 Carlos Zegarra 9/18/1957 dermatology Dr. David Myers - - 709.8 - $110

5/20/2015 Alma Avila 3/26/1972 dermatology Dr. Brad Huber 99202 - 216.3 - $120

5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 11900 - 709.2 - $276

5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson J3301 - 706.1 - $276

5/13/2015 Nohemi Medina 5/18/1996 dermatology Dr. Mark Donaldson 99203 - - - $276

4/28/2015 Efrain Del Anda 9/17/1969 dermatology NP Nicole Rawle 11100, 99202 - 782.1, 692.9, 238.2 - $300

4/21/2015 Rosalina Rivera 4/6/1954 dermatology NP Christina Linton 99203 office visit 6929 other disorders of female genital organs $175

4/21/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 99213 office visit 693 dermatitis due to drugs and medicines $117

4/20/2015 Tania Martinez 4/5/1998 dermatology NP Lisa Williams 17110,11900, J3490 destruction of benign lesions other than skin tags or cutaneous vascular prol 78.1 viral warts, unspecified $275

4/16/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 88305, 88312, 99024 Level IV - Surgical pathology, gross and microscopic examination;Special stai 692.9, V58.32 dermatitis due to unspecified cause; encounter for $303

4/14/2015 Carmen Argueta 3/31/1982 dermatology Dr. Brian Bradshaw 992,028,444,336,415 office visit, Thyroid stimulating hormone, Collection of venous blood by veni 709.01 vitiligo $169

4/9/2015 Alejandra Hermoso 7/17/1982 dermatology NP Christina Linton 11100 biopsy of skin 7821, 6929 rash and other nonspecific skin eruption; dermatiti $180

3/20/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 99212 exam 692.9 dermatitis due to unspecified cause $70


3/16/2015 Melanie Wiersema 9/23/1966 dermatology Dr. Brad Huber 95044 patch or application test 692.9 dermatitis due to unspecified cause $975


3/12/2015 Madeleine Cortes 7/30/1993 dermatology Dr. Mark Donaldson 17106, 99203 destruction of cutaneous vascular proliferative lesions, office visit 448.9, 216.8 other and unspecified capillary diseases, benign ne $836

3/10/2015 Maria Moreno 9/15/1967 dermatology NP Nicole Rawle 99202 office visit 692.9 dermatitis due to unspecified cause $120

3/4/2015 Marcos Calderon 2/12/1957 dermatology NP Lisa Williams 99203 office visit 110.1 Dermatophytosis of nail $175

3/2/2015 Rafael Vizcarra 10/24/1970 dermatology Dr. Brian Bradshaw 99024 New patient office visit 696.1 Generalized pustular psoriasis $661

5/7/2015 Patricia Herrera 8/31/1974 endocrinology Dr. Soubhi Nizam 99215 - 193 - $236

4/2/2015 Patricia Herrera 8/31/1974 endocrinology Dr. Soubhi Nizam 99215 office visit 193 malign neopl thyroid $236

3/31/2015 Erika Lugo 1/10/1988 endocrinology NP Clarene Hansen 99214 office vist 701.2 Acquired acanthosis nigricans $175

3/26/2015 Elvira Orozco 2/18/1973 endocrinology NP Clarene Hansen 99213 office visit 245.9 Thyroiditis, unspecified $117

3/24/2015 Erika Lugo 1/10/1988 endocrinology NP Clarene Hansen 80053, 36415, 83036, 83525, 84439, 84443 Comprehensive metabolic panel; Collection of venous blood by venipunctur 277.7, 244.9 Dysmetabolic syndrome X; Unspecified hypothyroi $141

3/17/2015 Marisa Rodriguez 3/17/1973 endocrinology NP Clarene Hansen 99214, 80048, 36415, 84439, 84443, 82306 office visit; Basic metabolic panel (Calcium, total); Collection of venous bloo 275.41, 244.0 Disorders of calcium metabolism; hypocalcemia; P $332

3/11/2015 Kenny Lemus 4/13/1985 endocrinology Dr. Soubhi Nizam - - 701.2, 255.0, 277.7, 241.0 - $82

11/19/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 99024 4731/J321 - - $450

11/19/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 31231 4731/J321 - - $450

11/10/2015 Silverio Gonzalez 2/14/1932 ENT P.A. Aaron Paxman 76536 R221 - - $223

11/9/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4731/J321 - - - $5,584



11/6/2015 Kristi Alvey 11/20/1961 ENT Dr Randal Gibb 99203 2411/E042 - - $175

11/4/2015 Cristabel Cabrales 11/27/1978 ENT P.A. Scott Summers H9192 - - - $223

11/2/2015 Luz Ramirez 3/15/1979 ENT Dr Douglas Denys 99204 - - - $295

10/28/2015 Magalis Garces 3/23/1949 ENT Dr Kipp Robins 47830/J3800 99203/25, 31505 - - $354

10/20/2015 Laura Flores 10/19/1973 ENT Dr. S. Todd Hamilton 4719/J339 - - - $175

10/13/2015 Jesus Gutierrez 4/21/1972 ENT Dr. S. Todd Hamilton 99203 6989/L299 - - $175

10/7/2015 Rita Rodriguez 5/23/1955 ENT Dr. Kelly Ence 2411/E042 - - - $120

9/15/2015 Tila Rosado 5/28/1970 ENT Dr. David Darley 99214 - - - $370




3/11/2015 Laura Valenzuela 6/1/1960 ENT Dr. S. Todd Hamilton 99213 - 338.70, 384.21 - $117

12/30/2015 Gabriela Salas 3/24/1960 gastroenterology Dr Mohammad Alsolaiman 99243 25000/R1031 - - $223

12/29/2015 Sandra Robles 9/26/1970 gastroenterology Dr Chad Kawa 99214 - R12 - $175

12/22/2015 Saul Flores 6/2/1972 gastroenterology PA Dawn Ngo 99203 R0789 - - $175

12/10/2015 Jania Pedro 12/19/1950 gastroenterology Dr Chad Kawa 83014 R1013 (2), 56400/ R1013 - - $445



12/9/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 83014 R1011 (2), 53081/R1011 - - $291



12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 36415 07054/B182 - - $508






12/7/2015 Stanley Evans 3/22/1961 gastroenterology NP Adrianne Shaver 99204/25 07054/B182 - - $508



12/7/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman 99214 R1011 - - $175

11/19/2015 Eloisa Landin 6/1/1969 gastroenterology PA Dan Ibarra 99204 7242/R109 - - $271

11/13/2015 Sandra Robles 9/26/1970 gastroenterology Dr Chad Kawa R12 99204 - - $271

11/13/2015 Teresa Esparza 12/26/1951 gastroenterology PA Dan Ibarra 99204 5368/K30 - - $271

11/6/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 56400/K589 99213 - - $117

11/4/2015 Juan Cid 4/26/1971 gastroenterology Dr. David Fraintz 99204 53081/R760 - - $271

11/4/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman R740 3,641,580,076,830,140,000,000,000 - - $378

11/4/2015 Veronica Mosqueda 1/3/1966 gastroenterology Dr Mohammad Alsolaiman 53081/R109 3,641,580,076,830,140,000,000,000 - - $378

11/3/2015 Luz Alvarez 11/6/1955 gastroenterology Dr. Haslem Bryce 99204 R1032 - - $271

11/3/2015 Claudia Masso 8/23/1972 gastroenterology Dr. Haslem Bryce 99204 K5792 - - $271

10/6/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 56400/R110 99213 - - $117

9/23/2015 Marcela Ramos 11/21/1968 gastroenterology PA Dawn Ngo 99203 - 5781 - $117

9/3/2015 Josefina Solorio 4/17/1951 gastroenterology PA Dawn Ngo 99213 - 5715 - $117





7/9/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99213 - - - $117

7/2/2015 Emigdio Mariluz 8/4/1952 gastroenterology PA Dawn Ngo 99203 - - - $175

7/2/2015 Marcela Ramos 11/21/1968 gastroenterology PA Dawn Ngo 99203 - 5781 - $175


6/30/2015 Travis Clements 10/25/1985 gastroenterology Dr. David Fraintz 99213 7054 - - $117

5/28/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99213 - - - $117

5/5/2015 Judy Hardman 1/7/1964 gastroenterology PA Dawn Ngo 99214 - 211.3 - $175

4/29/2015 Maria Lee 4/2/1964 gastroenterology PA Dan Ibarra 99204 - 789 - $271

3/4/2015 Sarantsetseg Dulamjav 3/5/1973 gastroenterology PA Dawn Ngo 43235 Esophagogastroduodenoscopy 536.8, 789.06 Abdominal pain, epigastric $120

2/23/2015 Travis Clements 10/25/1985 gastroenterology NP Adrianne Shaver 99214 07054, V053, V053 - - $326



12/30/2015 Saribek Danilyan 1/5/1951 general surgery Dr. Karl Francis 49650 K40.20 - - - $2,200

12/28/2015 Seda Danilyan 9/9/1954 general surgery Dr. Craig Cook 49585 K42.9 - - - $950

12/15/2015 Javier Alemandi 7/11/1970 general surgery Dr Brian Gill 99203 - 553.1 - $200

12/15/2015 Saribek Danilyan 1/5/1951 general surgery Dr. Karl Francis 99204 K40.20 - - - $250

12/10/2015 Olga Catherine Pena Aguiar 1/10/1979 general surgery Dr Bruce Hill 99203 R10.84 - - - $200

11/24/2015 Rita Rosales 6/21/1958 general surgery Dr Lee Peterson 99202 F10.13 - - - $150

11/23/2015 Leonel Esqueda 7/30/1971 general surgery Dr Bruce Hill 49587 - 552.1 - $1,450

11/3/2015 David Ulbrich 9/12/1986 general surgery Dr. Richard Rasmussen 99203 - 550.9 - $200

10/29/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 49568 - 553.2 - $500

10/27/2015 Sandra Rodriguez 6/19/1983 general surgery Dr Brian Gill 47563 K81.0 - - - $1,970

10/7/2015 Yarelly Ovalle 7/19/1988 general surgery Dr David Garry 21554 - 782.2 - $2,150

9/30/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 49565 - 553.2 - $1,500

9/30/2015 Stan Johnson 11/28/1956 general surgery Dr. David Watts 49650-50 - - - $2,050

9/30/2015 Stan Johnson 11/28/1956 general surgery Dr. David Watts K40.20 - - - $2,050

9/24/2015 Mirna Mireya Flores Uite 8/23/1967 general surgery Dr. Karl Francis 99203 - 553.2 - $200

9/22/2015 Erika Nava 8/24/1984 general surgery Dr David Garry 99203 - 553.1 - $200

9/15/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 99204 - 782.2 - $250

9/4/2015 Jorge Serrano 9/24/1962 general surgery Dr. Richard Rasmussen 49585 - 552.1 - $1,450

8/31/2015 Araceli Mendoza 6/3/1975 general surgery Dr. Clark Sheffield 47563 - 574.1 - $1,970

8/28/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 47563 - 574.1 - $1,970

8/27/2015 Dolores Hurtado 4/13/1961 general surgery Dr Lee Peterson 47563 - 574.1 - $1,970

8/25/2015 Yadina Ibarra 3/29/1980 general surgery Dr Brian Gill 99204 - 574.2 - $250

8/25/2015 Jorge Serrano 9/24/1962 general surgery Dr. Richard Rasmussen 99203 - 552.1 - $200

8/21/2015 Dolores Hurtado 4/13/1961 general surgery Dr Lee Peterson 99203 - 574.1 - $200

8/21/2015 Araceli Mendoza 6/3/1975 general surgery Dr. Clark Sheffield 99203 - 574.1 - $200

8/4/2015 Luis Orozco 5/1/1953 general surgery Dr. Richard Rasmussen 49507 - 550.1 - $1,610

7/29/2015 Abdiel Gaxiola 7/2/1999 general surgery Dr Jennifer Tittensor 47563 - 574.2 - $1,970

7/20/2015 David Rocha 7/5/1973 general surgery Dr David Garry 21554 - 784.2 - $1,800

7/15/2015 Oscar Ceballos 5/27/1970 general surgery Dr Jennifer Tittensor 49585 - 553.1 - $1,150

7/14/2015 Rob Larsen 7/23/1963 general surgery Dr. Craig Cook 49585 - 553.1 - $1,150

7/14/2015 Shaun Murphy 10/20/1962 general surgery Dr Lee Peterson 49650 - 550.9 - $1,350

7/7/2015 Abdiel Gaxiola 7/2/1999 general surgery Dr Jennifer Tittensor 99204 - 574.2 - $250

6/29/2015 Shaun Murphy 10/20/1962 general surgery Dr Lee Peterson 9920 - 550.9 - $250

6/29/2015 Rob Larsen 7/23/1963 general surgery Dr. Craig Cook 99204 - 553.1 - $250

6/25/2015 Eloisa Landin 6/1/1969 general surgery Dr. Karl Francis 47563 - 574.1 - $1,970

6/16/2015 Oscar Ceballos 5/27/1970 general surgery Dr Jennifer Tittensor 99203 - 553.1 - $200

5/19/2015 Luis Orozco 5/1/1953 general surgery Dr. Richard Rasmussen 99204 - 550.1 - $250

5/15/2015 Wilford Harris 3/23/1968 general surgery Dr. Clark Sheffield 49650 - 550.9 - $1,025

5/14/2015 Lennin Santos 11/3/1982 general surgery Dr Bruce Hill 49587 - 552.1 - $1,450

4/27/2015 Sergio Leiva 1/8/1973 general surgery Dr. Craig Cook 49585 - 553.1 - $1,150


4/24/2015 Alejandro DaSilva 10/7/1961 general surgery Dr Lee Peterson 49650 - 550.92 - $2,460

4/23/2015 Julio Nolasco 6/28/1998 general surgery Dr. Karl Francis 49650 - 550.92 - $2,460

4/22/2015 Jacob Miller 5/25/1987 general surgery Dr. David Watts 99203 - 229 - $200

3/25/2015 Maria Barrionuevo 7/15/1941 general surgery Dr. Craig Cook 49566 - 552.2 - $2,300

3/24/2015 Jose Servin 9/19/1972 general surgery Dr. Richard Rasmussen 49651 - 550.91 - $1,450

2/26/2015 Jose Servin 9/19/1972 general surgery Dr. Richard Rasmussen 99204 - 550.91 - $250

11/19/2015 Eloisa Landin 6/1/1969 hospitals Revere Health Imaging - American Fork 74000 56400/K5900 - - $65

11/16/2015 Silverio Gonzalez 2/14/1932 hospitals Revere Health Care Imaging - Provo 76536 2411/E042 - - $317

11/13/2015 Kristi Alvey 11/20/1961 hospitals Revere Health Imaging - American Fork 10022 2411/E042 - - $664




10/28/2015 Maria Lee 4/2/1964 hospitals UVRMC UVRMC 5589/K529 45380, 43239 - - $2,162

10/28/2015 Maria Lee 4/2/1964 hospitals UVRMC UVRMC 53520/K2960 45380, 43239 - - $2,162

9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 72132 - 722.1 - $2,006


9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo 72295 - - - $2,006

9/30/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo Q9966 - - - $2,006

8/10/2015 Alejandra Hermoso 7/17/1982 hospitals Central Utah Surgical 65426 Pterygium surgery - - $3,624

7/27/2015 Felicitas Mendoza 3/11/1939 hospitals Central Utah Surgical 66984 cataract removal - - $3,743


7/6/2015 Maria Esquivel 1/29/1966 hospitals Revere Health Care Imaging - Provo A9579 - - - $1,936

6/15/2015 Erika Escareno 9/19/2002 hospitals Central Utah Surgical 20680 - V54.01 - $4,099

6/4/2015 Janet Talbot 5/11/1959 hospitals UVRMC UVRMC 64721 - 354 - $3,634.3

5/8/2015 Maria Lee 4/2/1964 hospitals Revere Health Care Imaging - Provo 76700 - 573.9 - $337

4/15/2015 Chengzhen Chen 12/4/1938 hospitals UVRMC UVRMC 96365 - 733 - $824.44

4/15/2015 Chengzhen Chen 12/4/1938 hospitals UVRMC UVRMC 80053 - - - $824.44

4/14/2015 Maria Rodriguez (youth) 5/25/1999 hospitals UVRMC UVRMC 27422 - 718.36 - $22

4/14/2015 Maria Rodriguez (youth) 5/25/1999 hospitals UVRMC UVRMC 29873 - - - $22

4/8/2015 Maria Garrido 1/20/1958 hospitals Revere Health Care Imaging - Provo 76770 - 5939 - $310

2/23/2015 Leticia Escareno 8/30/1975 hospitals Central Utah Surgical 65855 - 365.9 - $1,210

12/31/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 99214 - 29632/M1A9XX0 - $175

12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 99214 - 4019/E1149 - $244

12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 84443 - 2449/E039 - $244

12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 80048 - - - $244

12/10/2015 Magalis Garces 3/23/1949 internal medicine Dr. Robert Corniea 36415 - - - $244

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 80061 - 2724/E785 - $289

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 80050 - 2449/E039 - $289

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 36415 - E1149 - $289

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 86140 - M8580 - $289

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 85652 - 71590/M1990 - $289

12/3/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 84439 - - - $289





11/19/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 99397 - Z0000 - $227

11/19/2015 Magalis Garces 3/23/1949 internal medicine NP Valarie Juarez 36415 - Z5189 - $227

3/9/2015 Magalis Garces 3/23/1949 internal medicine Dr. Larry Nobuhara 99214, 80050, 36415, 82150, 84439, 83036, 81001, 82570, 8204 office visit; General health panel; Collection of venous blood by venipunctur 78900, 25060, 2449, 25060 abdominal pain, unspecified site; Diabetes with ne $359

8/14/2015 Julia Lopez 7/4/1974 medical lab Revere Health Care Laboratory 80069, 36415 renal function panel; Collection of venous blood by venipuncture 583.9 Nephritis and nephropathy, not acute or chronic $30

5/7/2015 Patricia Herrera 8/31/1974 medical lab Revere Health Care Laboratory 80069, 36415 - 193 - $30

5/4/2015 Chris Missett 12/28/1958 medical lab Revere Health Care Laboratory 36415 - 586 - $10

4/16/2015 Adriana Armenta 9/29/1974 medical lab Revere Health Care Laboratory 80069, 82570, 82043, 36415 Renal function panel; Creatinine; Albumin; urine, microalbumin, quantitativ 791 Nonspecific findings; proteinuria $53

3/24/2015 Magalis Garces 3/23/1949 medical lab Revere Health Care Laboratory 80069, 36415, 81001, 82340, 83986, 81050 renal function panel; Collection of venous blood by venipuncture; urinalysis; 275.41 Disorders of calcium metabolism; hypocalcemia $64

9/2/2015 Carlos San Juan 9/27/1991 nephrology Dr. William Barager 99214 - - - $175

5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 85025 - 586 - $214

5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 80069 - - - $214

5/20/2015 Chris Missett 12/28/1958 nephrology NP Mark Boyack 80076/59 - - - $214



5/7/2015 Chris Missett 12/28/1958 nephrology Dr Terry Hammond 76770 - 593.9 - $310

4/17/2015 Julia Lopez 7/4/1974 nephrology NP Mark Boyack 99213 office visit 401.9 Essential hypertension; unspecified $117

4/16/2015 Adriana Armenta 9/29/1974 nephrology Dr. William Barager 99214 office visit 585.1 Chronic kidney disease, Stage I $175

4/3/2015 Paul Dalley 4/2/1957 nephrology NP Mark Boyack 99213 office visit 5849 acute kidney failure $117

3/30/2015 Magalis Garces 3/23/1949 nephrology NP Mark Boyack 99213 office visit 592 Stone in kidney $117

3/3/2015 Debrah Lewis 6/14/1956 nephrology Dr. Mariusz Kielar 84443, 36415, 99214, 76770 hypertension, venipuncture, chronic kidney, ultrasound on kidney and bladd 4019, 5853 hypertension NOS, chronic kidney disease stage III $534

4/9/2015 Magalis Garces 3/23/1949 neurology Dr. Jeff Groves 99215 office visit 340 multiple sclerosis $236

3/6/2015 Julio Ruiz 9/12/1987 neurology Dr. Jeff Groves 99214 - 345.4 epilepsy and epileptic syndromes w/ complex parti $118

7/21/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 99213 - - - $5,210







4/16/2015 Ankleida Tarellari 1/10/1977 OB/GYN Dr Jennifer Booth 99213 - - - $370


4/10/2015 Mayra Cisneros 9/14/1982 OB/GYN NP Heidi Mcsweeney 99203 - - - $160




3/31/2015 Refugio Basilio 11/24/1957 OB/GYN Dr. Scott Jacob 99203 - 618.02, 553.9, 627.3 - $110

3/25/2015 Margarita Posadas 2/22/1944 OB/GYN Dr. Scott Rees 99213 - 625.6, 618.84 stress incontinence, cervical stump prolapse $145

3/24/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Scott Rees 99214 - 626.9, 625.9, 218.9 Abrnormal uterine bleeding, pelvic pain, uterine fib $145

3/5/2015 Maribel Gonzalez 7/17/1980 OB/GYN Dr. Christy Jorgensen 99214 - 611.71, 625.5 Mastodynia, pelvic congestion syndrome $145

2/3/2015 Margarita Rivas 6/10/1974 OB/GYN Dr. Christy Jorgensen 99213 - 626.9 Abnormal uterine bleeding $110

11/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - - - $205


10/12/2015 Rosibel Attentio 10/7/1944 ophthalmology Dr. Jeremy Valentine 92014 - H04123 - $225

10/12/2015 Rosibel Attentio 10/7/1944 ophthalmology Dr. Jeremy Valentine 92015 - - - $225

10/9/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92012 - - - $205

10/9/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92134 - - - $205

10/7/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd 92012 - H40.11 - $120

10/7/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd - - E11.359 - $120

9/18/2015 Narcisa Barcia 10/26/1956 ophthalmology Dr. Duane Nelson 92002 - 375.15 - $130

9/18/2015 Narcisa Barcia 10/26/1956 ophthalmology Dr. Duane Nelson - - 379.91 - $130

9/16/2015 Margarita Calderon 1/1/1945 ophthalmology Dr. Michael Lloyd 92004 - 366.16 - $295

9/16/2015 Margarita Calderon 1/1/1945 ophthalmology Dr. Michael Lloyd 92015 - - - $295

9/14/2015 Eloisa Alvarez 6/13/1949 ophthalmology Dr. Paul Olson 92004 - 366.18 - $295

9/14/2015 Eloisa Alvarez 6/13/1949 ophthalmology Dr. Paul Olson 92015 - - - $295

8/25/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92024 - - - $0

8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92014 - 366.16 - $350

8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92015 - - - $350

8/20/2015 Jesus Nuno 10/15/1952 ophthalmology Dr. Michael Lloyd 92134 - - - $350


8/14/2015 Mayra Villalpando 11/2/1998 ophthalmology Dr. Duane Nelson 92004 - V72.0 - $295

8/14/2015 Mayra Villalpando 11/2/1998 ophthalmology Dr. Duane Nelson 92015 - - - $295


8/10/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 65426 - 372.41 - $925

7/27/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 66984 - 366.16 - $1,200

7/21/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 99203 - 372.41 - $180

7/21/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd - - 375.15 - $180

7/15/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 92012 - 365.11 - $260


7/15/2015 Maria Romero 1/21/1979 ophthalmology Dr. Jeremy Valentine 92004 - 37240 - $275

7/15/2015 Maria Romero 1/21/1979 ophthalmology Dr. Jeremy Valentine 92015 - - - $275

7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92004 - 366.16 - $670

7/1/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92015 - - - $670



6/26/2015 Alejandra Hermoso 7/17/1982 ophthalmology Dr. Michael Lloyd 92014 - V72.0 - $329



6/25/2015 Maria Romero 1/21/1979 ophthalmology Dr. John Carver 99204 new office visit, posterior segment imaging (eye 1), posterior segment imagi - - $390



6/24/2015 Rosa Estrada 2/19/1966 ophthalmology Dr. Jeremy Valentine 92004 - 37515 - $275

6/24/2015 Rosa Estrada 2/19/1966 ophthalmology Dr. Jeremy Valentine 92015 - 37515 - $275

6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson 92004 - V72.0 - $295

6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson 92015 - 372.4 - $295

6/24/2015 Sonia Alvarado 6/15/1977 ophthalmology Dr. Duane Nelson - - 372.51 - $295

6/20/2015 Nancy Rios 7/21/1953 ophthalmology Dr. Paul Olson 92014 - 375.15 - $265

6/20/2015 Nancy Rios 7/21/1953 ophthalmology Dr. Paul Olson 92015 - 366.16 - $265

6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson 92014 - 351 - $265

6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson 92015 - 375.15 - $265

6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson - - 366.16 - $265

6/2/2015 Martha Borja 1/4/1955 ophthalmology Dr. Duane Nelson - - 379.24 - $265

5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 99204 - 372.4 - $394

5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92250 - - - $394

5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92225R - - - $394

5/19/2015 Rosa Villalpando 5/22/1960 ophthalmology Dr. Richard Corey 92225L - - - $394

5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson 92004 - 372.41 - $585



5/19/2015 Felicitas Mendoza 3/11/1939 ophthalmology Dr. Duane Nelson - - 250.01 - $585


5/13/2015 Rita Rosales 6/21/1958 ophthalmology Dr. Jeremy Valentine 92004 - 36616 - $275

5/13/2015 Rita Rosales 6/21/1958 ophthalmology Dr. Jeremy Valentine 92015 - 36616 - $275


5/4/2015 Maritza Leyva Garcia 12/18/2007 ophthalmology Dr. Scott Yeates 92012 - 368 - $138

5/4/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 66984 - 366.16; 366.02 - $1,200

4/13/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Ryan Isom 99204, 92250, 92225R, 92225L - 362.01; 362.07; 366.16 - $544

4/13/2015 Aurelia Polar 9/20/1934 ophthalmology Dr. Paul Olson 92014; 92015; 66821 - 379.39; 366.53; 375.15 - $865

4/7/2015 Alfredo Cabral 11/25/1957 ophthalmology Dr. Duane Nelson 92004; 92015; 92134; 92136 - 366.16; 362.01; 374.33; 366.0 - $670

4/2/2015 Ramon Villaroman 1/10/1950 ophthalmology Dr. Michael Lloyd 92012 - 365.11; 250.50 - $120

3/5/2015 Leticia Salazar 11/6/1962 ophthalmology Dr. Michael Lloyd 92012; 92083 - 365.11 - $260

3/4/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd - - 365.11 - $1


2/23/2015 Leticia Escareno 8/30/1975 ophthalmology Dr. Michael Lloyd 65855-LT - 365.11 - $600


8/21/2015 Regina King 1/17/1935 optometry Dr. Kristine Dunn 92012 - 375.15 - $120

8/21/2015 Regina King 1/17/1935 optometry Dr. Kristine Dunn - - 379.91 - $120

8/18/2015 Valeria Perez 11/30/2003 optometry Dr. Frank Edmunds 92004 - V72.0 - $295

8/18/2015 Valeria Perez 11/30/2003 optometry Dr. Frank Edmunds 92015 - - - $295

8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird 92004 - V72.0 - $295

8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird 92015 - 367.9 - $295

8/14/2015 Stella Fassa 10/8/1966 optometry Dr. Blaine Bird - - 367.4 - $295

8/12/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 92020 - 365.52 - $170

8/12/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird - - 366.16 - $170



7/10/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird - - 372.41 - $205

7/7/2015 Rosario Rabi 11/22/1971 optometry Dr. Blaine Bird 92004 - V72.0 - $295

7/7/2015 Rosario Rabi 11/22/1971 optometry Dr. Blaine Bird 92015 - - - $295



6/17/2015 Natividad Vivar 12/11/1944 optometry Dr. Blaine Bird 76514 - - - $345

6/15/2015 Daniela Olaya 7/25/1998 optometry Dr. Kristine Dunn 92014 - V72.0 - $265

6/15/2015 Daniela Olaya 7/25/1998 optometry Dr. Kristine Dunn 92015 - - - $265

6/12/2015 Alejandro Rios 1/6/1990 optometry Dr. Blaine Bird 92004 - - - $295

6/12/2015 Alejandro Rios 1/6/1990 optometry Dr. Blaine Bird 92015 - - - $295


4/4/2015 Marga Turner 12/10/1969 optometry Dr. Kristine Dunn 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati V72.0, 367.9, 372.51 Examination of eyes and vision; Unspecified disord $295

3/17/2015 Ezequiel Ruiz 11/30/1972 optometry Dr. Frank Edmunds 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati 366.16, 372.41 nuclear sclerosis, cataracta brunescens, nuclear cat $295

3/10/2015 Salvador Lopez 7/28/1966 optometry Dr. Blaine Bird 92004, 92015 Ophthalmological services: medical examination and evaluation with initiati V72.0, 367.9 Examination of eyes and vision, Unspecified disord $295

12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn 92014 - Z01.00 - $265

12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn 92015 - H16.223 - $265

12/9/2015 Rhena Davila 10/21/1961 optometry/opthalmology Dr. Kristine Dunn - - H25.13 - $265

11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson 92004 - H25.13 - $295

11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson 92015 - H11.053 - $295

11/16/2015 Margarita Posadas 2/22/1944 optometry/opthalmology Dr. Paul Olson - - H16.233 - $295

10/14/2015 Alejandra Hermoso 7/17/1982 optometry/opthalmology Dr. Kristine Dunn 92012 - - - $120

11/21/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - Z471 - $316

11/21/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 27570/78LT - S80242A - $316

10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - Z471 - $93

10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 73562/LT - - - $93

10/27/2015 Magalis Garces 3/23/1949 orthopedics Dr. Richard Jackson 99024/NC - - - $93

10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 99212 - M170 - $288

10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 73564/LT - - - $288

10/20/2015 Pedro Ramirez 6/27/1948 orthopedics Dr. Richard Jackson 73564/RT - - - $288

10/20/2015 Magalis Garces 3/23/1949 orthopedics Dr. Robert Jackson 99024/NC - Z471 - $0

10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 99212/25 - M170 - $410

10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/LT - - - $410

10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/RT - - - $410

10/16/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson J3301 - - - $410

10/8/2015 Franco Bianchetti 8/31/1999 orthopedics Dr. Ryan Slater 99213 - M222X1 - $117

10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 99203/25 - M1711 - $614

10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 20610/RT - - - $614

10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig J3301 - - - $614

10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig 73564 - - - $614

10/8/2015 Ioane Elisaia 8/26/1952 orthopedics Dr. Karl Weenig L1820/RT - - - $614

10/7/2015 Magalis Garces 3/23/1949 orthopedics Dr. Robert Jackson 27447/LT - M1712 - $4,131

9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 99203 - 715.16 - $335

9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 73560/RT - - - $335

9/24/2015 Candido Suarez 5/27/1948 orthopedics Dr. Richard Jackson 73560/LT - - - $335

9/21/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 724.2 - $213

9/21/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 72100 - - - $213

8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 99213 - 722.4 - $287


8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 72040 - 726.2 - $287

8/27/2015 Luz Aguayo 8/1/1965 orthopedics Dr. Karl Weenig 73030 - - - $287

7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater 99203/25 - 715.96 - $345

7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater 20610/LT - - - $345

7/9/2015 Candido Suarez 5/27/1948 orthopedics Dr. Ryan Slater J3301 - - - $345

7/9/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 724.2 - $117

6/17/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 99024/NC - V5489 - $0

6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson 99212/25 - 71946 - $240

6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson 20610/RT - 71946 - $240

6/9/2015 Maria Menjivar 1/7/1957 orthopedics Dr. Michael Carlson J3301 - 71946 - $240

6/8/2015 Maria Esquivel 1/29/1966 orthopedics Dr. Karl Weenig 99213 - 7242 - $213


6/4/2015 Maria Ruelas 12/10/1969 orthopedics Dr. Karl Weenig 99213 - 7242 - $117

5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 99213/25 - 71516 - $528

5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/RT - 71516 - $528

5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson J3301 - 71516 - $528

5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 20610/LT - 71516 - $528

5/22/2015 Luis Jimenez 10/3/1963 orthopedics Dr. Michael Carlson 73030/LT - 71941 - $528


5/20/2015 Cheryl Tarnuev 5/22/1966 orthopedics Dr. Jeff Wallentine 99212 - 72252 - $166

5/20/2015 Cheryl Tarnuev 5/22/1966 orthopedics Dr. Jeff Wallentine 72100 - 72252 - $166

5/6/2015 Robert Baggett 6/13/1980 orthopedics Dr. Mitch Larsen 99203 - 71946 - $175

4/29/2015 DeAnna Alexander 5/27/1955 orthopedics Dr. Jeff Wallentine 20610/RT; J3301; 73564/LT; 73564/RT - 71596 - $388

4/22/2015 Maria Abrego 10/27/1974 orthopedics Dr. John Wells 99024/NC - V5878 - $1


4/16/2015 Maria Abrego 10/27/1974 orthopedics Dr. John Wells 29873/LT - 7179 - $1,105

4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 99202/25 - 71596 - $534

4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 20610/RT - 71595 - $534

4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson J3301 - 71595 - $534

4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 72170 - 71695 - $534

4/16/2015 Eva Pinales 6/26/1944 orthopedics Dr. Robert Jackson 73565 - 71695 - $534

4/16/2015 Maritza Gonzalez 8/15/1987 orthopedics Dr. Robert Jackson 99211 - V5489 - $34

4/14/2015 Maria Lopez 3/24/1947 orthopedics Dr. Richard Jackson 72170; 73500; 99213 - 71595 - $264

4/14/2015 Maria Rodriguez (youth) 5/25/1999 orthopedics Dr. Jeff Wallentine 27427; 29876; 27427/AS - 71836 - $3,374


4/13/2015 Nubia Pena 12/31/1961 orthopedics Dr. Karl Weenig 99213 - 7265 - $117

2/18/2015 Sandra Zavala 11/10/1972 orthopedics Dr. Jeff Wallentine RECON/NC - 71945 - $0

11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - S82851D - $126

11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes A4466 - - - $126

11/23/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 73610/RT - - - $126

11/9/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - Z478.9 - $86

11/9/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 73610/RT - - - $86

10/12/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - S82852D - $377

10/12/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes L4361/RT - - - $377


10/8/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - Z478.9 - $86


9/3/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99024/NC - V548.9 - $86


8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 99212/25 - 71527 - $200

8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux J3301 - - - $200

8/31/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 20605/LT - - - $200

8/31/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99024/NC - V548.9 - $0

8/20/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 27814/RT - 824.4 - $1,784

8/20/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 77071 - - - $1,784

8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 28446/RT - 84500 - $5,738

8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 29898/RT - 73390 - $5,738

8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 28446/ASRT - 84500 - $5,738

8/19/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 29898/ASRT - 73390 - $5,738

8/17/2015 Brett Allison 10/24/1995 orthopedics - foot Dr Daniel Hoopes 99204 - 824.6 - $357


8/4/2015 Angela Estrada 9/4/1967 orthopedics - foot Dr. Robert Faux 99213 - 782.2 - $196

8/4/2015 Angela Estrada 9/4/1967 orthopedics - foot Dr. Robert Faux 73630/RT - - - $196

6/18/2015 Ruthmarie Carlisle 4/15/1971 orthopedics - foot Dr. Robert Faux 99214 - 73390 - $175

4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 99212/25 - 71597 - $200

4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux 20605/LT - 71597 - $200

4/2/2015 Sandra Uribe 11/21/1976 orthopedics - foot Dr. Robert Faux J3301 - 71597 - $200

3/19/2015 Magalis Garces 3/23/1949 orthopedics - foot Dr. Robert Faux 99213 - 7350 - $117

12/9/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 64721/RT - G5601 - $2,256

12/9/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 64721/LT - G5602 - $2,256

11/30/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99213 - S62635D - $201

11/30/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 73140/F3 - - - $201


11/5/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - Z4789 - $0

10/29/2015 Julio Valdes 5/10/1979 orthopedics - hand Dr. M. Shane Fraizer 99203 - G5602 - $175

10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron L3933?LT - M20014 - $405

10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99213 - S62635D - $405

10/21/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 73140/F3 - - - $405

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 99202/25 - M65341 - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F8 - M65322 - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F6 - - - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 20550/F1 - - - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson J3301 - - - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 73140/RT - - - $657

10/14/2015 Maria Belmont 1/28/1964 orthopedics - hand Dr. Curtis Johnson 73140/LT - - - $657

10/7/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron 99202 - S62635A - $154

10/7/2015 Janderle Reyes 1/26/2002 orthopedics - hand PA David Waldron L3927/LT - - - $154

9/22/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - V5489 - $0

8/25/2015 Jose Correa 10/7/1968 orthopedics - hand Dr. M. Shane Fraizer 99203 - 727.41 - $271

8/25/2015 Jose Correa 10/7/1968 orthopedics - hand Dr. M. Shane Fraizer 73110/LT - - - $271

8/25/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99024/NC - V5489 - $0

8/12/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 26055/F6 - 72703 - $2,454

8/12/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 26055/XSF8 - - - $2,454

8/5/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 99204/NC - V548.9 - $70

8/5/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 73090/RT - - - $70

7/28/2015 Elsa Martinez 3/23/1954 orthopedics - hand Dr. Ryan Richards 99203 - 715.94 - $246

7/28/2015 Elsa Martinez 3/23/1954 orthopedics - hand Dr. Ryan Richards 73120/RT - - - $246

7/16/2015 Sandra Zavala 11/10/1972 orthopedics - hand Dr. M. Shane Fraizer 99202 - 72703 - $120

7/7/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 20682/RT - V5401 - $1,267

6/15/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 20680/RT - V5401 - $1,267

6/4/2015 Janet Talbot 5/11/1959 orthopedics - hand Dr. Curtis Johnson 64721/RT - 3540 - $2,256

6/4/2015 Janet Talbot 5/11/1959 orthopedics - hand Dr. Curtis Johnson 64721/LT - 3540 - $2,256

6/3/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 99213 - 996.78 - $197

6/3/2015 Erika Escareno 9/19/2002 orthopedics - hand Dr. Ryan Richards 73100/RT - - - $197

4/22/2015 Janet Talbot 5/11/1959 orthopedics - hand PA David Waldron 99214/25; 20526/LT; 20526/RT; J3301 - 3540 - $497

12/17/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - Z5189 - $154

12/17/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97124 - - - $154


12/14/2015 Olga Rodriguez 12/18/1967 physical therapy Brent Butler 97110 - 72887/Z5189 - $210



12/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - 72887/M25661 - $210

12/11/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - - - $210


12/9/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - 72887/M25661 - $210






12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97110 - M25661 - $265

12/7/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97530/XU - - - $265












12/1/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97014 - 72887/Z5189 - $255











11/24/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - Z5189 - $255









11/23/2015 Magalis Garces 3/23/1949 physical therapy Jim Anderson 97140 - Z5189 - $235








11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/z5189 - $153

11/17/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97014 - - - $153

















11/10/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/Z5189 - $153











11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 99211/25 - 6960/L4050 - $226

11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 96401 - - - $226

11/5/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor J3357 - - - $226

11/3/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887/z5189 - $153





10/27/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - 72887-z5189 - $153










10/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic massage, ultrasound, electrical stim, aquatic th - - $182





10/20/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley 97110 - - - $219









10/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, aquatic therapy, therapeutic exercise,therapeutic massage, - - $252






10/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97010 - Z5189 - $128













10/12/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97140 - z5189 - $159




















10/1/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, therapeutic massage, ultrasound, elec - - $252






9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley L3908 - - - $412





9/29/2015 Sandra Zavala 11/10/1972 physical therapy Doug Bagley A9300 - - - $412

9/29/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, therapeutic massage, electrical stim, ultrasound - - $112




9/24/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, aquatic therapy, therapeutic exercise, therapeutic massage - - $252






9/22/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 - - - $112




9/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy,manual therapy - - $120

9/15/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 aquatic therapy,manual therapy - - $120

9/14/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V57.1 - $128





9/12/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy - - $50





9/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 electrical stimulation, aquatic therapy - - $66

9/8/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 electrical stimulation, aquatic therapy - - $66





9/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, ultrasound, electrical stimulation,aqu - - $252










9/1/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97110 - V57.1 - $159

9/1/2015 Evelia Ruiz 9/4/1965 physical therapy Brent Butler 97140 - - - $159


8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97110 - V57.1 - $226

8/27/2015 Alejandra Ramirez 7/18/1971 physical therapy Brent Butler 97140 - - - $226











8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97110 - V57.1 - $226

8/25/2015 Alejandra Ramirez 7/18/1971 physical therapy Jim Anderson 97140 - - - $226











8/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, aquatic therapy - - $100

8/20/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 aquatic therapy, aquatic therapy - - $100








8/17/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 97110 - V57.1 - $214






8/13/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, electrical stimulation, ultrasound, aqu - - $222











8/11/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic exercise, therapeutic massage, ultrasound,elec - - $252














8/6/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic exercise, therapeutic massage, ultrasound, elec - - $252










8/4/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 99213/25 - 6960 - $309.01

8/4/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor 96401 - - - $309.01

8/4/2015 Adriana Flores 10/20/1974 physical therapy Braden Taylor J3357 - - - $309.01

8/4/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy,ultrasound, electrical exercise, therapeutic massage, ultraso - - $182


















7/30/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, aquatic therapy - - $152

7/30/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97113 manual therapy, aquatic therapy - - $152





7/28/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, ultrasound, electrical stimulation, aquatic therapy - - $182











7/23/2015 Janet Talbot 5/11/1959 physical therapy Doug Bagley 97001 - V57.1 - $294

7/23/2015 Janet Talbot 5/11/1959 physical therapy Doug Bagley 97010 - - - $294



7/23/2015 Janet Talbot 5/11/1959 physical therapy Doug Bagley A9300 - - - $294




7/23/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic massage, therapeutic exercise, ultrasound, electrical stimulation - - $222




7/22/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97001 - v57.1 - $199






















7/14/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, electrical stimulation, ultrasound, aquatic therapy, therape - - $182













7/10/2015 Janet Talbot 5/11/1959 physical therapy Doug Bagley A9300 - - - $389










7/7/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy, therapeutic massage, ultrasound, electrical stimulation, aq - - $182





7/2/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise, manual therapy, therapeutic massage,ultrasound, elec - - $200





6/30/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 - 724.2 - $182


















6/18/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97110 - V571 - $163


6/12/2015 Maria Rodriguez (youth) 5/25/1999 physical therapy Brent Butler 97110 - V571 - $316



6/12/2015 Maria Rodriguez (youth) 5/25/1999 physical therapy Brent Butler 97016/XU - V571 - $316







6/11/2015 Ronda Smart 4/9/1954 physical therapy Braden Taylor 97110 - V571 - $133











6/9/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill - - 724.2 - $182

6/9/2015 Maria Abrego 10/27/1974 physical therapy Braden Taylor 97110 - V571 - $214



















































5/26/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110 - V571 - $159

5/26/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110 - - - $159





















5/22/2015 Maria Rodriguez (youth) 5/25/1999 physical therapy Brent Butler 97016/59 - V571 - $189


















5/20/2015 Nubia Pena 12/31/1961 physical therapy Jim Anderson 97110 - V571 - $132



5/20/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110 - 813.42 - $291




















5/14/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110; 97110; 97140; 97022 - V571 - $184




















5/12/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140; 97124; 97035; 97014 - 724.2 - $132

5/11/2015 Maria Rodriguez (youth) 5/25/1999 physical therapy Brent Butler 97110; 97140; 97016/XU; 97010 - V571 - $189

5/7/2015 Maria Abrego 10/27/1974 physical therapy Braden Taylor 97110; 97014; 97016/XU; 97010 - V571 - $218

5/7/2015 Maria Rodriguez (youth) 5/25/1999 physical therapy Brent Butler 97001; 97110; 97140; 97535; 97014; 97016/XU; 97010 - V571 - $340


5/7/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110; 97140; 97124; 97035; 97014; 97113 - 724.2 - $252




5/6/2015 Maria Esquivel 1/29/1966 physical therapy Jim Anderson 97001; 97010; 97110 - V571 - $285

5/6/2015 Rosalinda Sanchez 5/1/1953 physical therapy Braden Taylor 97001 - V571 - $289




5/5/2015 Maria Abrego 10/27/1974 physical therapy Braden Taylor 97110; 97016/XU; 97014; 97010 - V571 - $218

5/5/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140; 97124; 97035; 97014; 97113 - 724.2 - $182


4/30/2015 Maria Abrego 10/27/1974 physical therapy Braden Taylor 97001; 97110; 97535; 97014; 97016/XU; 97010 - V571 - $344

4/28/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill - - 724.2 - $182

4/21/2015 Angela Estrada 9/4/1967 physical therapy Braden Taylor 97110 - V571 - $153




4/16/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110; 97140; 97022/XU - V571 - $185

4/14/2015 Angela Estrada 9/4/1967 physical therapy Braden Taylor 97110; 97140; 97010 - V571 - $108





4/7/2015 Angela Estrada 9/4/1967 physical therapy Braden Taylor 97110; 97140 - V571 - $149


4/7/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110; 97140; 97022/XU; E1399 - V571; V571; V571; 7823 - $195








4/2/2015 Angela Estrada 9/4/1967 physical therapy Braden Taylor 97140 - - - $159

4/2/2015 Angela Estrada 9/4/1967 physical therapy Braden Taylor 97010 - - - $159

4/2/2015 Nubia Pena 12/31/1961 physical therapy Jim Anderson 97110/XU - V571 - $230

4/2/2015 Nubia Pena 12/31/1961 physical therapy Jim Anderson 97113 - - - $230






3/31/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley L3808/RT; 97110; 97010 - 81344; V571; V571 - $511

3/26/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97140 manual therapy 724.2 lumbago $275


3/19/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97530 therapeutic activities 724.2 lumbago $275

3/17/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97110 therapeutic exercise 724.2 lumbago $275

3/12/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97124 massage therapy 724.2 lumbago $275

3/10/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97014 Electrical stimulation 724.2 lumbago $275

3/5/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97010 Hot pack, cold pack 724.2 lumbago $275



3/3/2015 Kimberly Reay 11/17/1970 physical therapy Von Hill 97001, 97035 PT Evaluation, Ultrasound therapy 724.2 lumbago $275

2/26/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110, 97140 - V571 - $200

2/24/2015 Theresa Baranowski 12/24/1962 physical therapy Doug Bagley 97110, 97140, 97010 - V571 - $159

12/29/2015 Celedonio Loreto 4/26/1968 podiatry Dr. Jared Clegg 99203 new patient visit M65.87 torn tendon $149

11/13/2015 Jose Santiago 10/11/1973 podiatry Dr. Kelly Gomez - - L02.612 cutaneous abscess of left foot $900

9/18/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 28060 outpatient surgery M72.2 plantar fascitis $720

9/3/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 99213 office visit M72.2 plantar fascitis $90

7/29/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 99213 follow up visit - - $0

7/28/2015 Rosario Rabi 11/22/1971 podiatry Dr. Jared Clegg 99213 office visit M25.571 ankle pain $90

7/23/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 99213 office visit M72.2 plantar fascitis $90

7/22/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 99213 office visit 735.4 hammertoes $75

7/7/2015 Rosario Rabi 11/22/1971 podiatry Dr. Jared Clegg 99203 new patient visit, bilateral xrays, injection M25.571 ankle pain $489

7/7/2015 Rosario Rabi 11/22/1971 podiatry Dr. Jared Clegg 73630 new patient visit, bilateral xrays, injection - - $489

7/7/2015 Rosario Rabi 11/22/1971 podiatry Dr. Jared Clegg 20550 new patient visit, bilateral xrays, injection - - $489

6/24/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez - - V67.00 - $75

6/15/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 99213 outpatient visit, subsequent observation - - $75

6/15/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 99225 outpatient visit, subsequent observation - - $75

6/11/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 20550 injection M72.2 plantar fascitis $200

6/10/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez - - 735.4 - $628

6/10/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 99214 office visit, fusion of left grand toe - - $628

6/10/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez 28285 office visit, fusion of left grand toe - - $628

6/3/2015 Larry Goodenough 4/9/1953 podiatry Dr. Kelly Gomez - - 735.4 - $175

5/14/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 99203 Office visit - new, injection M72.2 plantar fascitis $349

5/14/2015 Alejandra Ramirez 7/18/1971 podiatry Dr. Jared Clegg 20550 Office visit - new, injection - - $349

8/11/2015 Eva Pinales 6/26/1944 pulmonology Dr. Tala-at Al-Shuqairat 99214 - 327.23 - $175

5/12/2015 Eva Pinales 6/26/1944 pulmonology Dr. Tala-at Al-Shuqairat 99214 - 32723 - $175

97110

97140

97010

97014

97035

99213

97124

97113

99203

99214

99024

92015

99204

D0150

D0274

Therapeutic exercises to develop strength and endurance, range of motion, and flexibility (15 minute

Manual therapy techniques (e.g., connective tissue massage, joint mobilization and manipulation, and manual traction) (15 minutes)

Hot or cold pack application

Electrical stimulation (unattended)

Ultrasound (15 minutes)

established office patient

Therapeutic procedure, one or more areas, each 15 minutes; massage, including effleurage, petrissage and/or tapotement (stroking, compression, percussion)

Aquatic therapy with therapeutic exercises (15 minutes)

New patient visit

established office patient

Postoperative follow-up visit, normally included in the surgical package, to indicate that an evaluation and management service was performed during a postoperative period for a reason(s) related to the original procedure

Refraction

New office visit

Comprehensive oral exam

4 bitewing x-rays

V57.1

724.2 Lumbago

728.87

366.16

V72.0

553.1

365.11

Z51.89

V54.89

574.1

692.9

M72.2

375.15

571.5

Care involving other physical therapy

Muscle weakness

Senile nuclear sclerosis

Examination of eyes and vision

Umbilical hernia without mention of obstruction or gangren

Primary open angle glaucoma

Encounter for other specified aftercare

Other orthopedic aftercare

Calculus of gallbladder with other cholecystis

Urinary calculus, unspecified

Plantar fascial fibromatosis

Tear film insufficiency, unspecified

Cirrhosis of liver without mention of alcohol

IHC presentation data 2015.xlsx

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Transcript of IHC presentation data 2015.xlsx