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Grant Related - BOCC (003)
GRANT COUNTY COMMISSIONERS AGENDA MEETING REQUEST FORM (Must be submitted to the Clerk of the Board by 12:00pm on Thursday) REQUESTING DEPARTMENT: BOCC REQUEST suBnnirrED BY: Karrie Stockton CONTACT PERSON ATTENDING ROUNDTABLE: Karrie Stockton CONFIDENTIAL INFORMATION: ❑YES ONO DATE. 12/15/2023 PHONE:ext. 2937 kiviat TomA . MAI : . ❑Agreement / Contract ❑AP Vouchers ❑Appointment / Reappointment ®ARPA Related ❑ Bids / RFPs / Quotes Award ❑ Bid Opening Scheduled ❑ Boards/ Committees ❑ Budget ❑ Computer Related ❑ County Code ❑ Emergency Purchase ❑ Employee Rel. ❑ Facilities Related ❑ Financial ❑ Funds ❑ Hearing ❑ Invoices / Purchase Orders ® Grants — Fed/State/County ❑ Leases ❑ MOA / MOU ❑ Minutes ❑ Ordinances ❑ Out of State Travel ❑ Petty Cash ❑ Policies ❑ Proclamations ❑ Request for Purchase ❑ Resolution El Recommendation ❑Professional Sery/Consultant ❑Support Letter ❑Surplus Req. ❑Tax Levies ❑Thank You's ❑Tax Title Property ❑WSLCB .�. ..-.. :: Mfr/..✓�, �_ i -09 i �.. .. Reimbursement Request from Renew for Uninsured Services provided in the amount of $30,364.30 as part of their American Rescue Plan Act (ARPA) funds previously approved. DATE OF ACTION: -d'"07,� APPROVE: DENIED ABSTAIN D1: zw IV D2. -- D3: DEFERRED OR CONTINUED TO: GRANT COUNTY BOARD OF COUNTY COMMISSIONERS 1Ll=il_L.'J To: Grant County BOCC From: Karrie Stockton, Grant Administrative Specialist Da10 December 15, 2023 Re: ARPA Renew Uninsured Services Renew is requesting reimbursement for uninsured service expenses for the months of 3/19/2021 — 9/11/2023 in the amount of $30,364.30. ARPA funding for Renew Uninsured Services was approved by the BOCC on 11/16/2021 in the amount of $250,000.00 over afive-year period. Their backup documentation is attached for your review. Thank you. Add1k6- nA Grant; Behavior -a] Health a Wellness PO Box 1057 Moses Lake, WA 98837 Phone (509) 765-9239 BILL TO: Grant County Attention: Janice PO Box 37 Ephrata, WA 98823 DATE: October 25, 2023 THANK YOU FOR YOUR BUSINESS! ] -9992h1k. -.0dift- A000AL w eront: Sehavloml Heaft;h a Wellness PO Box 1057 Moses Lake, WA 98837 Phone (509) 765-9239 BILL TO: Grant County A Attention,, Janice PO Box 37 Ephrata, WA 98823 DATE: October 25, 2023 THANK YOU FOR YOUR BUSINESS! Service 1D Service Hate Client ID Service Type CPT CPT Code Modifier Program Location ReclphYn t Employee lVame Status STATUS lnSuranc a Due Client Due Age Date 570476 4/18/2023 12543957 IDP 90853 SUD IOP 11,11L NonResSUDFc Client Garcia, Noemi RECONCILED 0 $ 30.00 4121/2023 571542 4/20/2023 12543957 IOP 90853 SUD IOP ML NonResSUDFc Client Garcia, Noemi RECONCILED 0 210.00 4/25/2023 572746 4/24/202.3 12543957 JOP 90553 SUD 1013 ML NonResSUDFc Client Garcia, Noemi RECONCILED 0 210.00 4/27/2023 573300 4/2512023 12543957 IDP 90853 SUD IOP ML NonResSUDFc Client Garcia, I1loemi RECONCILED 0 210.00 4125/2023 574502 4/.27/2023 12543957 IDP 90853 SUD 101? IFIL NonResSUDFc Client Garcia, Noemi RECONCILED 0 $ 210.00 5/3/2023 5 12543957 Count 581871 5/1812023 12544342 Intake H0001 SULK ML NonResSUDFc Client Lopez, maleena RECONCILED 0 $ 156.25 5131/2023 1 12544342 Count 567491 4/12/2023 12535677 Med Man 99213 MH ML Office Client Sanchez, Kyleigh RECONCILED 0 $ 30.00 5/17/2023 573955 4/21%2423 12535677 Individual 90834 MH GC Office Client Yearout, Brandy RECONCILED 0 $ 30.00 5/17/2023 575036 5/1/2023 12535677 CM H0046 MH GC Clnt Home Parent Yearout, Brandy RECONCILED 0 $ 40.00 5/9/2023 575596 5/3/2023 12535677 Med Man 99214 MH M L Office Client Sanchez, Kyleigh RECONCILED 0 $ 30.00 5/31/2023 577742 515/2023 1.2535677 Individual 90837 MH GC Office Client Yearout, Brandy RECONCILED 0 $ 30.00 5/31/2023 583519 5/19/2023 12535677 Individual 90834 MH GC Office Client Yearout, Brandy RECONCILED 0 $ 30.00 6/1.4/2023 584921 5/25/2023 12535677 Med Man 99214 MH ML Office Client Sanchez, Kyleigh RECONCILED 0 $ 30.00 7/10/2023 7 12535577 Count 498124 10/5/2022 12543051 Intake 90791 MH QU Office Client Guerrero, Conne RECONCILED 0 $ 24.28 11110/2022 499370 14/10/2022 12543050 Individual 90837 MH QU Office Client Gonzalez, Madison RECONCILED 0 $ 23.56 11121/2022 503415 10/21/2022 12543050 Individual 90832 MH QU Schaal Client Gonzalez, Madison RECONCILED 0 $ 11.81 11121/2022 505576 10/27/2022 12543050 Individual 94834 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 15.70 12/2/.2022 508063 11/3/21122 12543050 Individual 90834 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 15.70 12120/2022 512501 1.1/16/2022 12543050 Individual 90834 MH QU Office Client Gonzalez, Madison RECONCILED 0 $ 15.70 12/30/2022 529922 1/6/2023 12543050 Individual 90837 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 157.08 2/2-3/2023 532017 1/12/2023 12543050 Individual 90534 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 55.71 2/23/2023 534995 1120/2023 12543050 Individual 90832 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 11.81 2123/2023 540562 2/3/21123 12543050 Individual 90832 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 11.81 3113/2023 542653 2/9/2023 12543050 Individual 90832 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 11..81 3/13/2023 567503 4/13/2023 12543050 Individual 90834 MH QU School Client Gonzalez, Madison RECONCILED 0 $ 17.59 5/10/2023 12 12543050 Count 531414 1/11/2023 22.539134 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 31.41 2/15/2023 536669 1/25/2023 3.2539134 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 31.41 3/1/21123 547293 2/22/2023 12539134 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 31.41 3/29/2023 .552994 317/2023 12539134 Individual 90837 NIH EP Office Client Hernandez, Karen RECONCILED 0 $ 31.41 4/17/2023 4 22539134 Currant 504594 10/24/2022 12543258 Intake H0031 MH ML Office Phone Barlow, Esther RECONCILED 0 $ 250.00 12/28/2022 516069 11129/2022 12543258 Individual 90832 111TH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 120.00 12/30/2022 549396 2/28/2023 12543285 Individual 90537 MH EP Office Client Andersson, Bobbie Jo RECONCILED 0 $ .240.00 4/'10/2023 S56S48 3116/2023 12543288 Individual 90837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 196.30 5/22/2023 572500 4/25/2023 125432$$ Individual 90834 MH EP School Client Anderson, Bobble -lo RECONCILED 0 $ 89.70 612712023 578186 519/2023 12543288 Individual 90837 MH EP School Client Anderson.- Bobbie Jo RECONCILED 0 $ 1.07.11 7/20/2023 6 12543288 Count 544015 2/1.3/2023 12543755 Intake H0001 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 40.00 3%24%2023 586059 5/3012023 12543755 Intrm Ind H0025 SUD IV1L NonResSUDFc Client Alamos, aarci RECONCILED 0 $ 40.00 6%312023 589106 6/612023 1.2543755 Intrm Ind H0025 SUIS ML NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 40.00 6/712023 3 1.2543755 Count 589209 6/6/2023 12544434 Group 96164 SLIM NIL NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 7/27/2023 592399 6/13/2023 12544434 Group 96164 .SUCH ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 7127/2€123 1 Service 1D Service Date Client ID Service Type CPT CPT Code Modifier Program Location Recipien t Employee Name status STATUS lnsuranc a Due Client Due Age Date 597729 6127/2023 12544434 Grasp 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 7/27/2023 3 12544434 Count 404790 1.2/22/2021 12541.545 Intake 90791 MH QU Clnt Horne Client Guerrero, Conne RECONCILED 0 $ 250.00 12/31/20.21 406385 12130/2021 12541545 CM H2O15 MH QU office Fam+Clien- Gonzalez, Hannah RECONCILED 0 $ 1.20.00 1/4/2022 2 12541545 Count 331800 4/21/2021 12533475 individual 90834 MH MIL Office Client Crawford, Matt RECONCILED 0 $ 25.00 6/4/2021 335063 513/2021 12533475 Individual 90834 MH MIL Office Client Crawford, Matt RECONCILED 0 $ 25.00 6/15/2021 341175 5/20/2021 12533475 Individual 90834 MIH ML Office Client Crawford, Matt RECONCILED 0 $ 25.00 711/2021 345886 6/4/2021. 12533475 Individual 90834 MIH ML Office Client Crawford, Matt RECONCILED 0 $ 25.00 7/24/2021 349116 6/16/2021 12533475 Individual 90834 MH ML Office Client Crawford, Matt RECONCILED 0 $ 25.02 8/2/2021 353307 6130/2021 12533475 Individual 90834 MH ML Office Client Crawford, Matt RECONCILED 0 $ 25.00 8/4/2021 354247 716/2021 12533475 Med Man 99213 GT MH MLTelehealth Fam+Ciien- Kodish, Ian RECONCILED 0 $ 25.00 8/13/2021 357227 7%14/2021 12533475 individual 90834 MH ML Office Client Crawford, Matt RECONCILED 0 $ 25.00 8/23/2021 368183 8120/2021 1.2533475 Individual 90834 MH MI.Office Client Crawford, Matt RECONCILED 0 $ 25.00 9/29/2021 374838 9/14/2021 12533475 Med Man 99215 GT MH MLTelehealth Client Kodish, !an RECONCILED 0 $ 25.00 1.012712021 411745 1118/2022 1.2533475 Med Man 99215 GT MH MLTelehealth Fam+Cllen- Kodish, [an RECONCILED 0 $ 25.00 3111/2022- 111/2022437302 437802 4/5%2022 12.533475 Med Man 99214 MH Telehealth Horn Farr+Clierr Kodish, [an RECONCILED 0 $ 25.00 611.%2022 445572 4/27/2022 12533475 Individual 90834 MH ML Office Client Crawford, Matt RECONCILED 0 $ 25.00 7/6/2[}22 451890 5/1.6/2022 12333475 Individual 90534 MH MIL Office Client Crawford, Matt RECONCILED 0 $ 25.00 716/2022 473423 7/1.9/2022 12533475 Med Man 99214 MH Telehealth Horn Farn+Clien- Kodish, Ian RECONCILER 0 $ 25.00 8/3112022 478559 $/2/2022 12533475 Individual 90834 MH EP Office Parent Pinckard, Devin RECONCILED 0 $ 25.00 9/2912022 485311 8/.241202.2 12533475 individual 90837 MIH MIL Office Fam+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 10/4/2022 487539 8/31/2022 12533475 Individual 90837 MH ML Office Fam+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 10/4/2022 458696 9/6/2022 12533475 Individual 90537 MH ML Office Fam+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 11/10/2022 491137 9/13/2022 12533475 Individual 90537 MH ML Office Fam+Clien* Pinckard, Devin RECONCILED 0 $ 25.00 1.1/10/2022 493545 9120/2022 12533475 Individual 90837 MH MIL Clnt Hoare Fara+Cilen* Pinckard, Devin RECONCILED 0 $ 25.00 1.1/10/2022 502485 10118/2022 12533475 Individual 90837 MH ML Office Fam+Clien• Pinckard, Devin RECONCILED 0 $ 25.00 12113/2022 504888 10125/2022 12533475 Med Mian 99213 MH MLTelehealth Fam+Ciien, Kodish, lan RECONCILED 0 $ 25.00 12113/2022 531297 1/10/2023 125334.75 Med Mian 99214 MH MLTelehealth Client Dick, Michelle RECONCILED 0 $ 25.00 3/29/2023 532676 1112/2023 12533475 Individual 90837 MH ML Office Fam+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 3/29/2023 556734 3116/2023 12533475 Individual 90832 MH ML Office Fam+Cllen, Alcott, Megan RECONCILED 0 $ 25.00 5/15/2023 575171 5/1/2023 12533475 Individual 90832 MH ML Office Farn+Clien- AlCott, Megan RECONCILED 0 $ 25.00 6/20/2023 587880 5/2/2023 12533475 Med Man 99213 MH Telehealth Ham Fam+Clien- Dick, Michelle RECONCILED 0 $ 25.00 715/202.3 595471 6121./2023 1.2533475 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 25.00 8/2/2023 61.8817 8/24/2023 12533475 Individual 90832 MH ML Office Farn+Clien, Alcott, Megan RECONCILED 0 $ 25.00 10/11/2023 30 12533475 Count 579779 5/1112023 22544.310 Individual 90834 MH EVIL Office CIient Alcott, Megan RECONCILED 0 $ 30.00 6/14/2023 1 1.2544310 Count 579501. 5/11/2023 12536001 individual 90834 MIH ML Office Client Alcott, Megan RECONCILED 0 $ 21.00 6/14/2023 593163 6/1412023 12536001 Indlvidual 90834 MIH MiL Office Client Alcott, Megan RECONCILED 0 $ 35.00 7/1.9/2023 609.193 7128/2023 12536001 individual 90534 MH ML Office Client Alcott, /Megan RECONCILED 0 $ 117.32 8/2.9/2023 3 12536001 Count 559637 3/24/2023 12544420 Intake 90791. MH ML Office Client Wilkinson, Barbara (Barb) RECONCILED 0 $ 36.92 4/26%2023 565060 4/5/2023 12544420 Individual 90834 MH ML Office Client Crittendon, Lacey RECONCILED 0 $ 11.7.32 5%3012029 585563 5/26/2023 12544420 individual 90834 MIH MIL Office Client Crittendon, Lacey RECONCILED 0 $ 11.7.32 6/27/2023 500424 7/3/2023 12544420 Individual 90834 MH ML Office Client Crittenden, Lacey RECONCILED 0 $ 117.32 51912023 4 12544420 Count 2 Service ID Service gate Client ID Service Type CPT CPT Code Modifier Program Location RecJpien t Employee Name Status STATUS insuranc a Due Client fare Age Date 328228 4/12/2021 12538616 Med IVlan 9921.4 MH ML Office Client Sander, Darcy RECONCILED 0 $ 82.25 5/7/2021 37-9424 4/14/2021 12538616 Individual 90832 MH GC Office Client Garza, Irene RECONCILED 0 $ 78.76 5/24/2021 344991 6/3/2021 12538616 Individual 90834 MH GDC Office Client Garza, Irene RECONCILED 0 $ 104.72 612812021 348689 £/15/2021. 12538616 Individual 90834 MIH GC Office Client Garza, Irene RECONCILED 0 $ 104.72 7/12/2021. 352722 6/30/2021 12538616 Med Man 99213 GT MH GC Telehealth Client Sander, Darcy RECONCILED 0 $ 15.14 7/26/2021. 373106 9/7/2021. 12538616 Individual 90532 MH GC Office Phone Garza, Irene RECONCILED 0 $ 11.81 10/14/2021 6 12538616 Count 572240 4/24/2023 12543491 Group 90853 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 19.94 5130/2023 575105 5/1./2023 12543491 Group 90553 SUD EVIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 21-98 615/2023 578042 5/8/2023 12543491 Group 90853 SUD VIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 21.98 615/2023 550652 511.5J2023 12543491 Group 90853 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 21-98 7/28/2023 583266 5/22/2023 12543491 Group 90853 SLID VIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ .21..98 7/28/2023 5 1.2543491 Count 624696 9/11/2023 12544191 Group 96164 SUD NIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 35.00 9/14/2023 624697 9/11/2023 12544191 Group 96165 SLID ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 70.00 9114/2023 2 12544193. Count 536409 1/23/2023 12542396 SUD Svcs 90832 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 15.75 3/312023 542307 2/8/2023 12542396 SUD Svcs 90837 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 31.41 3/8/2023 2 17542396 Count 588918 6/6J2023 12544451. Individual 90834 MH EP Office Client Anderson, Bobble Jo RECONCILED 0 $ 30.00 7/5/2023 593331 6115/2023 12544451 Individual 94837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 30.00 7/19J2023 595144 6121/2023 12544451 LRASupervn 90837 MH EP Office Client Anderson, BobbieJo RECONCILED 0 $ 30.00 7/2612023 597322 6/27/2023 12544451 Individual 90832 MH EP Office Client Anderson, 8obbieJo RECONCILED 0 $ 30.00 7/26/2023 600660 7/6/2023 1.2544451 Individual 90837 MH EP Office Client Anderson, 8obbieJo RECONCILED 0 $ 30.00 8/2/2023 602551 7/10/2023 12544451 LRASupervn 90837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 30.00 8119/2023 . 6 125444SI Court 590753 6/9/2023 12541609 Intake H0031 MH ML Office Client Wilkinson, Barbara (Barb) RECONCILED 0 $ 250.00 611412023 597505 6/2812023 12541609 CM H2O15 Mil ML Office Client Marston, Paula RECONCILED 0 $ 160-00 7/1/2023 2 12541609 Count 603128 7/5/2023 12539757 Group 96164 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 35.00 7/15/2023 603129 7/5/2023 1.2539757 Group 961.65 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 70.00 7/1.5/2023 602.721 7/12/2023 12539757 Group 96164 SUD IVIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 35.00 7/14/2023 602722 7/12/2023 12539757 Group 96165 SUD MLNonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 70.00 7/.14/2023 605738 7/19/2023 12539757 Group 96164 SUD IVIL NonResSUDFc CIient VerLrees, Katherine (Kathy) RECONCILED .0 $ 35.00 7/22/2023 605739 7/1.9J2023 12539757 Group 96165 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 70.00 7122/2023 608350 7/26/2023 12539757 Group 96165 SUD ML NonR.esSIJDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 70.00 8/1/2023 60534.9 7/2612023 12539757 Group 96164 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 35.00 8/1/2023 6103307 7/28/2023 12539757 SUD Svcs 90832 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 80.00 8/4/2.023 9 12539757 Count 545658 2116/2023 12543163 IOP -Ind 90837 SUD IOP IVIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 1.13.16 3/23/2023 552407 3/2/2023 12543.163 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 17.50 4/5/2023 554645 319/2023 12543163 Group 90853 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 17.50 4/5/2023 555200 3/13/2023 12543163 Group 90853 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 31.68 4/26/2023 559762 3123/2023 1.2543163 Group 90553 SLID ML NonResSUDFc Ctient Weaver, Dale RECONCILED 0 $ 31.68 4/26/2023 559995 3/24/2023 12543163 IOP -Ind 90832 .SUD IOP ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 78.76 4/26/2023 563719 3/3012023 125431.63 Group 90853 SUD IVIL NonResSUDFc Client Weaver, Cale RECONCILED 0 $ 31.68 4/26/2023 565698 4/6/2023 12543163 Group 90853 SUIS IVIL NonResSUDFc Client Weaver, Gale RECONCILED Irl $ 31.21 5/10/2023 3 Service Service CPT CPT Reciplen ID Date Client ID Service Type Came Nlodffrer Program Location t Employee Name .569201 4/13/2023 12543163 Group 90853 .SUD ML NonResSUDFc Client Weaver.. Dale 568618 4/14/2023 1.2543163 SUD Svcs 90832 SUD ML NonResSUDFc Client Weaver, Dale 571540 412012023 12543163 Group 90853 SUD ML NonResSUDFc Client Weaver, Gale 574212 4/27/20.23 12543163 Group 90853 SUD Mi_ NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 12 2/22/202.3 RECONCILED 0 $ 210.00 2/23/2023 542354 2/812023 12543594 SUD Svcs 90834 SUD ML NonResSUDFc Client Weaver, Dale .544584 211412023 12543594 IOP 90553 SUD IOP ML NonResSUDFc Client Cloyd, Megan 545081 211512023 12543594 [OP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 545779 2/16/2023 12543594 10P 90853 SUD IOP ML NonResSUDFC Client Cloyd, Megan 546748 2/21/,2023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 547406 2/22/2023 12543594 IOP 90853 SLID IOP IML NonResSUDFc Client Cloyd, Megan 548068 2/23/2023 12543594 IOP 90853 SUIS IOP ML NonResSUDFc Client Cloyd, Megan 549538 2/28/2023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 550411 3/1/2023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 551054 3/2/2023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 552056 3/6/2023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 553173 3/8/2023 12543594 IOP 90853 SUD IOP ML NonRes5UDFc Client Cloyd, Megan 553839 3/9/,2023 12.543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 555505 311412023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 556167 311.5/2023 1.2543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 556656 3116/207-3 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 558369 3121/2023 12543594 IOP -Ind 90832 SUD IOP ML NonResSUDFc Client Cloyd, Megan 558202 3/2112023 12543594 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 558845 3/.22/2023 12543594 IOP 50853 SUD IOP IML NonResSUDFc Client Cloyd, Megan 55945. 3/2.312023 12543594 IOP 90853 SUD 1OP N[L NonResSUDFc Client Cloyd, Megan 561291 3/28/2023 12543594 10P 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan 565525 3/29/2023 1254.3594 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi 562492 3/.30/2023 12543554 10P 90853 SUD IOP ML NonResSUDFc Client Clwyd, [Megan 23 571338 4120/2023 12543508 IOP 90853 SUD IOP ML NonRes5UDFc Client Cloyd, Megan 573514 4/24/2023 12543508 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi 573990 4/25/2023 1.2543508 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi 574131 4/27/2023 12543518 IOP 90853 SUCH IOP ML NonResSUDFc Client Pinckard, Heidi 574869 5/1./2023 12543508 IOP H0015 SUCH JOP MLNonResSUDFc Client Pinckard, Heidi 575526 5/2/2023 12543508 ICRP H0015 SUD IOP ML NonResSUDFc Client Pinckard, Heidi 577133 5/4/21123 1.2543508 IOP H0015 SUD IOP ML NonResSUDFc Client Pinckard, Heidi 577870 51812023 12543508 IOP H0015 SUD IOP IMLNonResSUDFc Client Pinckard, Heidi 578253 5/9/2023 12543508 IOP H0015 SUD IOP MLNonResSUDFc Client Cloyd, Megan 579340 5/11/2023 12543508 JOP H0015 SUD IOP IML NonResSUDFc Client Cloyd, Megan 580477 5/15/2.023 12543508 IOP H0015 SUIS IOP NIL NornResSUDFc Client Cloyd, Megan 580912 5/16/2023 12543508 IOP H0015 SUD IOP ML NonResSUDFc Client Cloyd, Megan 581918 5/18/2023 12543508 IOP H0015 SUD IOP ML NonResSUDFc Client Cloyd, [Megan 582999 5/22/2023 12543508 IOP H0015 SUD IOP ML NonResSUDFc CI€ent Cloyd, Megan 583469 5123/2023 12543508 IOP H0015 SUD IOP ML NonResSUL)Fc Client Clwyd, Megan 584655 5/25/2023 12543508 IOP H0015 SUD IOP ML NonResSUDFc Client Clayd, Megan 16 591536 6112/2023 12543873 SUI? Svcs 90837 SUD ML NonResSUDFc Client Cloyd, Megan insuranc Status STATUS a Due Client Due Age Lute RECONCILED 0 $ 31.21 5/10/2023 RECONCILED 0 $ 80.00 5/10/2023 RECONCILED 0 $ 31.21 5124/2023 RECONCILED 0 $ 31.21 5/2412023 12543163 Count RECONCILED 0 $ 70.00 2/1012023 RECONCILED 0 $ 210.00 2/16/2023 RECONCILED 0 $ 210.00 2118/202.3 RECONCILED 0 $ 210.00 2/22/202.3 RECONCILED 0 $ 210.00 2/23/2023 RECONCILED 0 $ 210.00 2/28/2023 RECONCILED 0 $ 210.00 2/28/2023 RECONCILED 0 $ 210.00 3/3/2023 RECONCILED 0 $ 210.00 3/3/2023 RECONCILED 0 $ 210.00 3/4/2023 RECONCILED 0 $ 210-00 3/8/2.023 RECONCILED O $ 210.00 3/14/2023 RECONCILED 0 $ 210.00 3/14/2023 RECONCILED 0 $ 210.00 3/17/2023 RECONCILED 0 $ 210.00 3/17/2023 RECONCILED 0 $ 210.00 3/18/2023 RECONCILED 0 $ 80.00 3/23/2023 RECONCILED 0 $ 210.00 3/23/2023 RECONCILED 0 $ 210.00 3/24/2023 RECONCILED 0 $ 210.00 3128/2023 RECONCILED 0 $ 210.00 3130/2023 RECONCILED 0 $ 210.130 4/8/2023 RECONCILED 0 $ 21.0.00 4/1/2023 12543594 Count RECONCILED 0 $ 25.110 5124/2023 RECONCILED 0 $ 25.00 5/24/2023 RECONCILED 0 .$ 25.00 5/24/.2023 RECONCILED 0 $ 25.00 5/24/20.23 RECONCILED 0 $ 97.00 715/2023 RECONCILED 0 $ 07.00 2/5/20,23 RECONCILED 0 $ 97.00 715/2023 RECONCILED 0 $ 97.00 7/5/2023 RECONC[LED 0 $ 97.00 7/5/2023 RECONCILED 0 .$ 97.00 7/5/2023 RECONCILED 0 $ 24.25 8/1612.(}23 RECONCILED 0 $ 24.25 8116/2023 RECONCILED 0 $ 24.25 8/16/2023 RECONCILED 0 $ 97.00 7/19/2023 RECONCILED 0 $ 34.84 7/1912023 RECONCILED 0 $ 14.25 7/19/2023 1.2543508 Count RECONCILED 0 $ 160.00 6/14/2023 4 Service ID Service Date Client ID Service Type CPT CPT Code )Modifier Program Location Recipien t Employee Name Status STATUS Insuranc a Due Client Due Age Date 1 12543873 Gaunt 575195 5/1/2023 12539561 CM H2O15 MH EP [office CIient Christian, Phillip RECONCILED 0 $ 120.00 5/9/2023 550722 5/15/2023 12539561 CM H2O15 MH EP Office Client Christian, Phillip RECONCILED 0 $ 160.00 5/25/2023 585771 6IS/2023 12.539561 CM H2O15 MH EP Office Client Christian'. Phillip RECONCILED 0 $ 150.00 £/1312023 595813 6/2612023 12539561 CM H2O15 MH EP Office Client Christian, Phillip RECONCILED 0 $ 160.00 7/1/2023 4 12539561. Count 498445 10/5/2022 12530674 individual 90834 NIH ML Office Client Serrano Castrel[on, Alejandra RECONCILED 0 $ 20.94 1.21212022 500329 10/12/2022 12530674 Individual 90834 NIH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 20.94 12/20/2022 532265 1/11./2023 12530674 Individual 90834 NIH NIL Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 15.70 3/29/2023 538430 1/30/2023 12530674 Individual 90534 MH NIL Office Client Serrano Castrellon,, Alejandra RECONCILED 0 $ 15.70 3/29/2023 54299.9 2/8/21123 12530674 Individual 90534 MH NIL Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 15.70 4/1712023 551345 3/2/2023 12530674 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 1.5.70 5(3112023 562788 3/29/2023 12530674 Individual 90534 NIH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 15.70 5/31/2023 583966 5/2312023 12530674 Individual 90834 MH NIL Office client Serrano Castrellon, Alejandra RECONCILED 0 $ 17.59 7/2612023 8 12530674 Count 362506 $/3/2023. 12539668 Individual 90834 MH N!L Office Client Alcott, Megan RECONCILED 0 $ 22.60 8/2612021 37517.3 9/1.4/2021 12539668 Individual 90834 MH NIL Office Client Alcott, Megan RECONCILED 0 $ 104.72 5/2/2022 357682 10/25/2021 12539668 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 104.72 12/2812021 394713 11/17/2021 12539558 Individual 90834 NRH ML Office Client Alcott, Megan RECONCILED 0 $ 104.72 12/28/2021 395043 11/3012021 12539668 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 104.72 12/28/202.1 402045 12/13/2021 12539665 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 104.72 111012022 6 12539668 Count 363197 8/5/2021 12535537 Intrm Ind H0023 SUD IVIL NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 40.00 8/7/2021 367535 8119/2021 12535537 Intrm Ind H0025 SUD ML NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 40.00 8124/2021 371173 9/1/2021 12535537 SUD Svcs 90834 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 10/412021 372997 9/7/2021 12535537 1015 90853 SUD IOP ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 10/1412021 373468 9/8/2021 3.2535537 IOP 90853 SUD IOP ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 10/14/2.021 373823 9/912021 12535537 IOP 90553 SUD 1013 ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 25.00 10/1412021 375450 9/1412021 12535537 IOP 90853 SLID IOP NIL NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 25.00 10/1412021 375853 9/15/2021 12535537 IOP 90553 SUD 10P ML NonResSUDFc Client Godinez, Cecilia RECONCILED 0 $ 25.00 10/1412021 8 12535537 Count 602085 7/1112023 12543725 Intake H0001 SUD ML NonRes$UDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 250.00 7/1312023 1 12543725 Count 587529 6/1.12023 12541296 individual 90837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 240.00 10/13/2023 594889 6/21/202.3 12541296 Individual 90537 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 240.00 6/27/2023 2 12541296 Count 517200 1.1/30/2022 12543526 Intake 90791 MH EP Office Client Shoernake, Carol RECONCILED 0 $ 25.00 12130/2022 530359 1/9/2023 12543526 Individual 90837 MIS EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 2/15/2023 535833 1./23/2023 12543526 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILER 0 $ 25.00 2/23/2023 541359 2/6/2023 1.2543525 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 3/8/2023 544025 2/1.3/2023 12543526 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 3/23/2023 54731.0 2/2212023 12543526 Individual 90837 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 3/.23/2023 551491 3/3/2023 12543526 Individual 90837 NIH EP Office Client Hernandez, Daren RECONCILED 0 $ 25.00 4/5/2023 55644-0 3113/2023 12543526 individual 90837 111tH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 4/26/202.3 563095 3/27/2023 12543526 Individual 90834 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 4/26/2023 574581 4123,/2023 12543526 Individual 90832 MH EP Office Client Hernandez, Karen RECONCILED 0 $ 25.00 5/24/2023 10 1.2543526 Count 5 Service !D Service Daae Client 1D .Service Type CPT CPT Code Modifier Program Location Recipien t Employee Narne Status STATUS lnsuranc a Due Client Due Age Date 345131 513/2.021 12540038 individual 90837 NIH EP Office Fam+Clien• Pinckard, Devin RECONCILED 0 $ 15.00 5/28/2021 349270 5/17/2021 12540038 Individual 90837 NIH EP Office Farn+Clien, Pinckard, Devin RECONCILED 0 $ 20.00 7/8/2021 353715 711.12021 12540038 Individual 90837 MH GC Office Client Pinckard, Devin RECONCILED 0 $ 20.00 7/26/2021 359313 7/2212021 12540038 Individual 50832 MH GC Office Phone Pinckard, Devin RECONCILED 0 $ 20.00 8/23/2021 361303 7/29/2021 12540038 Individual 90832 NIH GC Office Phone Pinckard, Devin RECONCILED 0 $ 20.00 8/25/2021 369907 8/26/2021 12540038 Individual 90837 MH EP Office Fam+Clien• Pinckard, Devin RECONCILED 0 $ 20.00 9/2512021 371930 9/2/2021 12540038 Individual 90837 NIH EP Office Client Pinckard, Devin RECONCILED 0 $ 20.00 101412021 373845 9/912021 12540038 Individual 90834 MH EP Office Client Pinckard, Devin RECONCILED 0 $ 20.00 1.0/1412021 376001 9/16/20.21 12540038 Individual 90637 NIH EP Office Client Pinckard, Devic► RECONCILED 0 $ 20.00 10/1412021 405694 1.2/2212021 12540038 Individual 90837 NIH EP Office Farn+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 8/3/2022 409513 1/3.112022 12540038 Individual 90837 NIH EP Office Client Pinckard, Bevin RECONCILED 0 $ 25.00 81312022 414245 1/25/2022 12540038 Individual 90837 MH EP Office Phone Pinckard, Dev[n RECONCILED 0 $ 25.00 5/28/2022 416419 2%1/2.022 12540038 Individual 90834 NIH EP Office Client Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 418716 2/812022 12540038 Individual 90837 MH EP Office Client Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 426543 3/3/2022 1.2540038 Individual 90834 MH EP Office Client Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 431364 3/1712022 12540038 Individual 90832 NIH EP Office Phone Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 435942 3/31.12022 12540038 Individual 90534 NIH EP Office Client Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 438689 4/7/2022 12540038 Individual 90534 NIH EP Office Cit Not Pr Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 440851 411412022 12540038 Individual 90532 MH EP Office Client Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 446205 4/28/2022 12540038 individual 90834 MH EP Office phone Pinckard, Devin RECONCILED 0 $ 25.00 5/28/2022 453572 5/19/202.2 12540038 Individual 90837 MH EP Office Fam+Clien- Pinckard, Devin RECONCILED 0 $ 25.00 7/1/2022 457842 6/2/2022 12540038 Individual 90837 NIH IVIL Office Prone Pinckard, Devin RECONCILED 0 $ 25.00 7111/2022 467589 6/30/2022 12540038 Individual 90832 MH EP Office Phone Pinckard, Devin RECONCILED 0 $ 25.00 8/2/2022 477291 7/28/2022 12540035 Individual 50832 MH EP Office Phone Pinckard, Devin RECONCILED 0 $ 25.00 8/23/2022 485717 8/25/2022 12540038 Individual 90834 MH EP Office Phone Pinckard, Devin RECONCILED 0 $ 25.00 9/29/2022 494624 9123/2022 12540038 Individual 90837 MH EP Office Phone Pinckard, Devin RECONCILED 0 $ 25.00 10/26/2022 26 12540038 Count 424132 2/24/2022 12540183 Individual 90834 MH ML Office Client Crawford, Matt RECONCILED 0 $ 70.00 3/1./2022 431330 3/17/2022. 12540183 Individual 90834 MH IVIL Office Client Crawford, Matt RECONCILED 0 $ 180.00 3/23/2022 440962 4/14/2022 12540183 Individual 90834 MIS Telehealth Hom Phone CrawFord, (Matt RECONCILED 0 $ 180.00 4/21/2022 3 12540183 Count 575315 5/2/2023 12544464 Individual 90832 NIH IVIL Office Client Alcott, Megan RECONCILED 0 $ 50.00 6/13/2023 1 12544464 Court 383859 10/1212021 12531168 Intake H0031 MH ML Office Client Wilkinson, Barbara (Barb) RECONCILED 0 $ 250.00 10/21/2021 543924 2/13/2023 12531168 Intake 1-10001 SUD ML NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 125.00 2[14/2023 552253 3/7/2023 12531168 SUD Svcs 90532 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 80.00 3/912023 556142 3/15/2023 12531168 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 3/17/2023 556143 3/15/2023 12591/68 Group 96165 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 3117/2023 558.923 3/22/2.023 12531168 Group 96164 SUD NIL NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 3%24.12023 558924 3/22/2023 12531168 Group 96165 SUD ML NonResSUDFc Client heaver, Gale RECONCILED 0 $ 70.00 3/24/2023 551976 312912023 12531/68 Group 96165 SUD ML NonResSUDFc Client Weaver, Dale RECONC[LED 0 $ 70.00 3[3112023 561975 3/29/2023 12531168 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 3/31/2023 565619 4/5/2073 12532168 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 4/8/2023 565620 4/5/2023 12531168 Group 96165 SUD ML (NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70-00 4/8/2023 567668 4/12/2023 12531165 Group 96165 SUD IVIL NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 4/19/2023 567667 411.2/2023 12531168 Group 96164 SUD ML NonResSUDFc Client Weaver.. Dale RECONCILED 0 $ 35.00 4%19/2023 570731 4/19/2023 12531/68 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 4/21/2023 6 Service 113 Service Date Client ID Shhrvice Type CPT CPT Code Modifier Program Location Recrplen t Employee Name Status STATUS lnsuran c a Due Client true Age Bate 570732 4119/2023 12533168 Group 96165 SUD ML NonResSUDFc CIient Weaver, Dale RECONCILED 0 $ 70.00 4/21/2023 15 125311.68 Count 594584 6/2012023 12544814 Intake 110001 SUD ML NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 156.25 £/23/2023 1 125449/4 Count 593176 6114/2023 12544604 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 55.00 7/13/2023 1 12544604 Count 522406 12/13/2022 12542961 Individual 90834 MH NIL Office Client Skjervold, Karli RECONCILED 0 $ 180.00 12/15/2022 537162 1/24/2023 7.2542961 Individual 90834 NIH ML Office Client Skjervold, Karli RECONCILED 0 $ 70.00 2/23/2023 553593 3/812023 12542961 Individual 90834 MH ML Office Client Skjervold, Karl! RECONCILED 0 $ 70.00 4/5/2023 3 12542961. Count 572186 4/2412023 12543410 SUD Svcs 90832 SUD ML NonResSUDFc Client Clwyd, Megan RECONCILED 0 $ 62.50 4/2712023 575115 5/112023 x,2543410 Group 96165 SUD ML NonResSU[)Fc Client Cloyd, Megan RECONCILED 0 $ 70.00 5/5/2023 575115 5/1/2023 12543410 Group 96164 SUIS ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 35.00 5/5/2023 588569 6/5/202.3 12543410 Croup 96164 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 35.00 6/9/2023 588570 6/5/2023 12543410 Croup 96165 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 70.00 6/9/2023 5 12543410 Count 552986 3/8/2023 1254350:3 Intake 90791 SUD ML NonResSUD% Client Pinckard, Heidi RECONCILED 0 $ 6.25 10/11/2023 563667 4/3/2023 12543803 SUD Svcs 90837 SLID ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 55.80 6/20/2023 567085 4/11/2023 12543803 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 31.21 6/14/2023 575897 5/2/2023 22543803 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena REJECTED 0 $ 205.00 6/9/2023 578678 5/9/2023 12543803 Group 90853 SVD ML NonResSUDFc Client Lopez, Maleena REJECTED 0 $ 105.00 6/9/2023 581463 511612023 12543803 SUD Svcs 90832 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 16.00 6120/2023 584075 5/23/2023 12543303 Group 90553 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 6/20/2023 586541 5/30/2023 12543803 Group 90853 SUD ML NonResSUDFc Client Lopez., Maleena RECONCILED 0 $ 6.24 6/20/2023 589305 6/612023 12543803 Group 90853 SLID ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 7/5/2023 592243 6/13/2023 12543803 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 8/912023 594721 6/2012023 12543803 SUD Svcs 90832 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 16.00 7/3.912023 597201 6/27/2023 12543803 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 7/19/2023 602166 7/11/2023 12543803 Group 961£4 SLID MIL NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 811912023 604733 7/18/2023 12.543803 Group 96164 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 6.24 8/1912023 607423 7/25/2023 12543803 Croup 90853 SLID ML NonResSUDFc Client Lopez.. Maleena RECONCILED 0 $ 6.24 8/23/20123 15 12543803 Count 523396 12115/2022 12543358 SUD Svcs 90832 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 20.00 1/26/2023 529140 1/4/2023 12543385 Group 90853 SUD ML NonResSUDFc Client Weaver, dale RECONCILED 0 $ 17.50 2/25/2023 536757 1/25/2023 12543388 SUD Svcs 90832 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 40.00 3/3/2023 539587 2/1/2023 12543388 Group 90853 SUD ML NonResSUDFc Client Weaver, [dale RECONCILED 0 $ 17!50 3/8/2023 550433 3/1/2023 12543388 Group 90853 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED? 0 $ 17.50 4/1712023 553730 3/9/2023 12543388 SUD Svcs 90832 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 40.00 4/17/.2423 563626 419/2023 12543388 Group 90853 SUD IVIL NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 31.21 5130/2023 575119 511/2023 12543388 Group 90853 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 31.21 6115/2023 576896 5/4/2023 12543358 SUD Stns 90532 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 40.00 6115/2023 585573 6/5/2023 12543388 Group 90853 SUD ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 32.21 7/5/2023 10 12543388 Count 559937 3/1512023 22543493 Group 90853 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 27.68 4/26/2023 558785 3/22/2023 12543493 Group 90853 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 31.68 4/26/2023 562875 3129/2023 12543493 Group 90853 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 31.68 4/26/2023 563997 4.14/2023 12543493 SUD Svcs 90832 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 80.00 5/10/2023 7 Service ID Service Date Client ID Service Type CPQ' CPT Code AfTodifter Program Location Recrplen t Employee Nance Status STATUS Insunanc a Due Client clue Age mate 568648 4/5/2023 12543493 Group 90853 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 31.21 5/10/2023 572451 4112/2023 12543493 Group 90853 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 31.21 5/31/2023 572952 4/19/2023 12543493 Group 90853 SUD ML NonResSUDFc Client Pinckard, Heidi RECONCILED 0 $ 31.21 5131/2023 573183 4/26/2023 1.2543493 Group 90853 SUD ML NonResSUDFc Client P-mckard, Heidi RECONCILED 0 $ 31.21 5131/2023 8 12543433 Count 543002 2/9/2023 12543764 SUD Svcs 90837 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 128.75 2/11/2023 1 12543764 Count 591522 6/12/2023 22543953 Individual 90832 MH QU Office CIient Guerrero, Conne RECONCILED 0 $ 9.48 10/3/2023 3 12543953 Count 605669 7/2012023 1.254514.8 Intake 90791. NIH GC Office Client Miller, Judy RECONCILED 0 $ 250.00 7/25/2023 1 12545148 Count 44.9976 5/11/2022 12541487 Intake 90791 NIH NIL Clnt Horne Phone Miller, Judy COMPLETED 0 250.00 5/21/20.22 1 12541487 Count 583890 5/23/2023 12540377 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 17.59 6/27/2023 594449 6/20/2023 12540377 Individual 90834 MH ML Office Client Alcott, Megan RECONCILED 0 $ 1.7.59 7/26/2023 2 1.2540377 Count 473284 7/19/2022 12540167 Individual 90837 MH ML Office Fam lien- Pineda, Ambar RECONCILED 0 $ 7.74 9/6/2022 479829 8/8/2022, 12541.67 Individual 90837 MH ML Office Farn+Clien' Pineda, Ambar RECONCILED 0 $ 23.56 9/22/2022 484913 8/24/2022 1.2540167 Individual 90837 MH ML Office Fam+Clien- Pineda, Ambar RECONCILED 0 $ 23.56 9/29/2022 3 12540167 Count 325035 3/31/2021. 12532748 SUD Svcs 90832 SUD ML NonResSUDFc Client Alamos, Darci RECONCILED a $ 78.76 8/1012021. 327068 14/7/2021 12532748 Group 90853 SUD NIL NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 87.50 4/29%2021 2 1253274$ Count 531872 1/10/2023 1.2543521 Individual 90837 NIH ML Office Client Serrano Castrellon,Alejandra RECONCILED 0 $ 10.00 2%6/2023 536704 1/2512023 12543521 Individual 90534 MH ML Office Client Serrano CastrelIon, Alejandra RECONCILED 0 $ 30.00 2/23/2023 543579 2/9/2023 12543521 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 30.00 3/1/2023 548634 2/23/2023 12543521 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 30.00 3/23/2023 553499 3/8/2023 12543521 Individual 90834 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 30.00 4/19/2023 559999 3/23/2023 12543521. Individual 90837 MH ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 30.00 4/19/2023 564M 4/3/2023 1.2543521 Individual 90834 MIS ML Office Client Serrano Castrellon, Alejandra RECONCILED 0 $ 30.00 5/3/2023 7 1.2543522 Count 592662 6/14/20123 12544937 Intake 90791 NIH EP Office Client Miller, Judy RECONCILED 0 $ 250.00 6/23/2023 1 1.2544937 Count .557107 6/1/2023 12543692 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 210.00 6/3/2023 .588887 6/6/2023 1.2543692 IOP 90853 SUD IOP ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 210.70 6/10/2023 590106 61812023 12543692 IOP 90553 SUD IOP ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 210.00 6/1.0/2023 3 12543592 Count 590394 6/8%2023 1.2544295 IOP 90853 SUD IOP ML NonResSUDFc Client Weaver, Date RECONCILED 0 $ 155.00 6/10/2023 591.775 6/13/2023 1.2544299 IOP --Ind 90832 SUD IOP ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 80.00 6/14/2423 592345 6/13/2023 1.2544299 IOP 90853 SUD IOP NIL NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 210.00 6/15/2023 592962 6/14/2023 12544299 IOP 90853 SUD IOP NIL NonRes5UDFc Client Weaver, Dale RECONCILED 0 $ 210.00 6/16/2023 4 12544299 Count 593442 6/1.5/2023 12543692 IOP 90553 SUD IOP ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 210.00 6/22/2023 1 12543692 Count 59341.5 6/1.512023 22544299 IOP 90853 SUD IOP ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 210-00 6/1.712023 1 12544299 Count 574132 4/27/2023 1.2543463 IOP 90853 SLID IOP NIL NonReSSUDFc Client Pinckard, Heidi RECONCILED 0 $ 5.54 5/31/2023 8 Service 1D .Service state Client !D Service Type CPT CPT Cade Modifier Program Location Reciplen t Employee Name Status STATUS Insuranc a Dire Client flue Age Date 590086 6/$/2023 12543463 lop 90853 SUD ICP ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 210.00 8/1112023 2 12543463 Count 596346 6%26/2023 12544206 Individual 90834 MH QU Office Cit Not Pr Gonzalez, Madison RECONCILED 0 $ 180.00 7/1/2023 1 12544206 Count 587784 6/2/2023 12532367 Cull H2O15 MH CC School Client Heen, Michelle RECONCILED 0 $ 150.00 6/5/2023 589343 6/6/2023 12532367 CM H2O15 MEI GC School Client Heen, Michelle RECONCILED 0 $ 120.00 611.12023 2 12532367 Count 506765 11/31/2022 12543306 Intake 94791 MH NIL Office Client Wilkinson, Barbara (Barb) RECONCILED 0 $ 225.00 12/21/2022 1 12543306 Count 558899 3/17/2023 12534203 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 25.00 4/19/2023 571931 4121/2023 12534203 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 25.00 511712023 578061 5/5/2023 12534203 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 25.00 5/31/2023 582635 5/17/2023 12534203 Individual 90837 MEI GC Office Client Garza, Irene RECONCILED 0 $ 25.00 6/14/2023 588105 5/31/2023 12534203 IndiVidual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 25.00 7/10/2023 5 12534203 Count 594714 6120/2023 12543941 SUD Svcs 90832 SUD ML NonResSUDFc Client Lopez, Maleena RECONCILED 0 $ 80.00 6/2412023 596682 6/26/2423 1254394. IOP 90853 SUD IOP NIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.00 6/29/2023 598390 6/27/2023 12543941 IOP 90853 SUD IOP Ml. NonResSUDFc Client Vertrees? Katherine (Kathy) RECONCILED 0 $ 210.1}4 7/412023 598372 6/29/2023 12543941 IOP 90853 SUCH IOP NIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.00 7/4/2023 602337 7/3/2023 12543941 IOP 90853 SUD IOP ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED ' 0 $ 210.00 7/13/2023 603155 7/6/2023 22543941 IOP 90853 SUD IDP ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.0€/ 7/15/2023 601634 7/10/2023 x.2543942 IOP 90853 SUD IOP NIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.00 7/12/2023 612261 7111/2.023 12543941 IOP 90853 SUD IOP NIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.00 7/13/2023 603179 7/13/2023 1254394.1 IOP 90853 SUD IOP NIL NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 210.00 7/15/2023 9 1254394. Count 561876 3/29/2023 12542751 Group 96164 SUD NIL NonResSUDFc CIient Pinckardr Heidi RECONCILED 0 $ 33.38 4/6/2023 1 12542751 Count 588747 61512023 12541482 Individual 90537 NIH MIL Office Client 013den, Danielle RECONCILED 0 $ 25.00 7/5/2023 591801 6/1212023 12541482 Individual 90834 MH ML Office Client OBrien, Danielle RECONCILED 0 $ 25.00 7/19/2023 2 1.2541482 Count 587796 5124/2023 12543590 SUD Svcs 90532 SUD ML (NonResSUDFc Client Vertrees, Katherine (K-athy) RECONCILED 0 $ 12.00 7/3/2023 588678 6/6/2023 12543590 Discharge 90832 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 13.33 7/12/2023 2 12543590 Count 588565 61512023 12540557 Group 90853 SUD ML (NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 6.24 7/12/2023 597167 6126/2023 52540567 5UD Svcs 90834 SUD ML (NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 23.46 7/26/2023 2 1254OS67 Count 523328 12115/2022 12543678 Intake 90791 MIS ML Office Fam+Clien' Shoemake, Carol RECONCILED 0 $ 40.00 2/15/2023 529898 1/6/2023 12543675 Individual 90834 MH EP School Client Anderson, Bobble Jo RECONCILED 0 $ 25.00 2/23/2023 535062. 1/20/2023 12543678 Individual 90837 MH FP Office Client Andersen, Bobbie Jo RECONCILED 0 $ 25.00 2/23/2023 544968 2/15/2023 12543678 Individual 90837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 3129/2023 554667 3/2312023 12543678 Individual 90834 MH EP School Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 4/26/2023 557433 3/20%2023 12543678 Individual 90837 MH EP School Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 4/26/2023 564570 415/2023 12543678 Individual 90837 NIH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 5/10/2023 572624 4125/2023 12543675 Individual 90534 MH EP School Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 5/31/2023 593337 6/15/2023 12543678 Individual 90834 MH EP Clnt Home Client: Anderson, Bobbie Jo RECONCILED 4 $ 25.00 7/19/2023 9 12543678 Count 575361 512/21123 12537979 individual 90837 MH EP Office Client Andersson, Bobbie Jo RECONCILED 0 $ 25.00 617/2023 9 Service ID Service Date Client 1D Service Type CPT CPT Code Modifier Program Location Reciplen t Employee Marne Status STATUS Insuranc a Due Client tate Age Date 581786 5/17/2023 12537979 Individual 90837 MH EP Office Client Anderson, Bobbie Jo RECONCILED 0 $ 25.00 6/14/2()23 2 12537979 Court 562824 3/3112023 12544475 intake 90791. SUD IML NonResSUDFc Client Weaver, Dale REJECTED 0 $ 250.00 5/10/2023 1 1.2544475 Count 569285 4/18/2023 1.2544201 Individual 90837 MH QU Mice Client Gonzalez, Madison RECONCILED 0 $ 20-00 5/31/2023 583177 5/22/2023 12544201. Individual 90834 MH QU Office Client Gonzalez, Madison RECONCILED 0 $ 20.00 0/27/2023 593829 6116/2023 12-544201. Individual 90534 NIH QU Office Client Gonzalez, Madison RECONCILED 0 $ 20.00 7/1912023 3 12544201 Count 554287 3/212023 12543556 IOP 90853 SUD IOP IML NonResSUDFc Client Pinckard, Heidi REJECTED p $ 25.00 7/3/2023 556354 3/612023 1.2543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/312023 556420 3/7/2023 12543556 IOP 90853 SUD 101? IML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/3/2023 560143 3/2012023 12543556 IOP 90853 SUD IOP IML NonResSU.DFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/3/2023 5601.74. 3/21/2023 12543556 IOP 90853 SUD IOP NIL NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/312023 560224 3123/2023 12543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/3/2023 560618 3/27/2023 12543556 IOP 90553 SVD IOP ML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/312023 561.256 3128/2023 12543556 1013 90853 SUD IOP ML NonResSLJDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/3/2023 561268 3/28/2023 12543556 1013 -Ind 90832 SUD I013 MLNonResSUDFc Client Pinckard, Held! REJECTED 0 $ 2.5.00 7/3/2023 562752 3/30/2023 12543555 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 25.00 7/312023 571982 4111/2023 12543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi REJECTED 0 $ 21.0.00 7/18/2023 573516 4/24/2023 12543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heidi RFJECTED 0 $ 210.00 7/18/2023 573991 4/25/2023 12543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heid! REJECTED 0 $ 2:10.00 7118/2023 575628 5/2/21323 1.2543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heid! REJECTED 0 $ 210.00 7118/.20323 577134 5/4/2023 12543556 IOP 90853 SUD IOP ML NonResSUDFc Client Pinckard, Heid! REJECTED 0 $ 210.00 7115/2023 575254 5/9/2023 125435.56 IOP 90853 SUD IOP NIL NonResSUDFc Client Cloyd, Megan REJECTED 0 $ 210.00 7/18/2023 579342 5111/2023 1.2543556 IOP 90553 SUD IOP MLNonResSUDFc Client Cloyd, Megan REJECTED 0 $ - 7/18/2023 17 IZ543556 Count 573224 4/19/2023 1254461.6 Intake H0001 .SUD ML NonResSUDFC Client Pinckard, Heidi COMPLETED 0 $ 250.00 5/2/2023 583317 5122/2023 12544616 SUD Svcs 90532 SUD NIL NonResSUDFc Client Redding, Carrie RECONCILED 0 $ 801.030 5/24/2023 2 12544616 Count 579956 5/1.2/2023 12533272 SUD Svcs 90832 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 80.00 5/19/2023 582476 5/18/2023 12533272 Group 96165 SUIS IVIL NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 512.4/2023 582475 5/18/2023 1.2533272 Croup 961.64 SUD IVIL rgonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 5124/2023 585204 5/25/2023 12533272 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 5/31./2023 585205 5/25/2023 12-533272 Group 96165 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 5/31/2023 588738 6/1./2023 12533272 Group 96165 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 617/2023 588737 6/1/2023 12533272 Group 96164 SUD ML NonResSUDFc Client 1Neaver, Dale RECONCILED 0 $ 35.00 6/7/2023 593531 6115/2023 12533272 Group 961.65 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 70.00 6/1.7/2023 593530 6/15/2023 12533272 Group 961.64 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 6/17/2023 595863 6/22/2023 1.2533272 Group 9616.5 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ '70.00 6/24/2023 595862 6/22/2023 1.2533272 Group 96164 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 6/24/2023 598006 6/29/2023 12533272 SUD Svcs 90832 SUD ML NonResSUDFc Client Weaver, Bale RECONCILED 0 $ 80.00 714/2023 598578 6/29/2023 12533272 Group 961.64 SUD ML NonResSUDFc Client Weaver, Dale RECONCILED 0 $ 35.00 7/4/2023 598579 6129/2023 12533272 Group 961.65 SUD ML NonResSUDFc Client Weaver, Gale RECONCILED 0 $ 70.00 7/4./2023 14 12533272 Court 321.552 3/1.9/2021 3.2538137 Individual 90834 MH GC Office Client Garza, Irene RECONCILED 0 $ 104.72 4/19/2421. 327916 4/9/2021 12538137 Individual 90834 MH GC Office Client Garza, Irene RECONCILED 0 $ 1.04.72 5/712021 336595 517/202/ 12538137 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 157.08 5/28/2021 10 Service ID Service gate Client 16 Service Type CPT CPT Gude Modifter Program Location Recipien t Employee Name Status STATUES 117$uranc a Due Client Due Mtge tate 339303 5/1412021 12538137 Individual 90837 MH GC Office Fam+Clien- Garza, Irene RECONCILED 0 $ 157.08 6/7/2021 355770 7/9/2023. 12538137 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 44.98 8/9/2021 368275 8/2012021 12538 .37 individual 90537 MH GC Office Client Garza, Irene RECONCILED 0 $ 31.41 10/14/2021 384831 10/1312021 12538137 1 ndividual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 31.4. 1112312021 395356 11/17/2021 12538137 Individual 90834 MH GC School Client Garza, Irene RECONCILED 0 $ 20.94 1/3/2022 401081 3.2/8/2021 12538137 Individual 90837 MH GC School Client Garza, Irene RECONCILED 0 $ 31..41 1/1012022 417916 217/2022 12538137 Individual 90534 MH GCSchool Client Garza, Irene RECONCILED 0 $ 104.72 3/16/2022 424416 2/2312022 12538137 Individual 90894 MH GC School Client Garza, Irene RECONCILED 0 $ 104.72 3/30/2022 428849 3/1112022 12538137 Individual 90834 NIH GC Office Client Garza, Irene RECONCILED 0 $ 104.72 4/13/2022 436736 41112022 12538137 individual 90832 MH GC Office Client Garza, Irene RECONCILED 0 $ 78.76 5/.U/2022 441412 4/15/2022 12535137 Individual 90534 MH GC School Client Garza, Irene RECONCILED 0 $ 104.72 5/20/2022 447830 5/412022 12538137 Individual 90534 MH GC School Client Garza, Irene RECONCILED 0 $ 104.72 6/13/2022 452779 5/18.12022 12538137 Individual 90832 MH GC Office Client Garza, Irene RECONCILED 0 $ 63.55 7/3./2022 471928 7/13/2.022 12538137 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 31.41 8/1712022 482584 8/12/2022. 12538137 Individual 90837 MH GC Office Client Garza, Irene RECONCILED 0 $ 31.41 9/22/2022 486709 8/2912022 12535137 Individual 90834 MH GC Office Client Garza, Irene RECONCILED 0 $ 20.94 9/29/2022 514940 11./21/2022 12538137 Indivildual 90834 MH GC Office Client Garza, Irene RECONCILED o $ 20.94 32130/2022 20 12538137 Count .598683 6/30/2023 12538446 Intake H0001 SLID ML NonResSUDFc Client Cloyd, Megan RECONCILED 0 $ 250.00 7/4/2023 598733 6/30/2023 12538446 Out & Eng H0023 HW MH ML Office Client Wilkinson, Barbara (Barb) RECONCILED 0 $ 37.50 7/4/2023 600375 7/6/2023 12535446 Intra Ind H0025 SUCH ML NonResSUDFc Client Alamos, Darci RECONCILED 0 $ 40.00 7/$/2023 3 12538446 Cunt 598655 6/3012023 12544523 Intake H0001 SUD ML NonResSUDFc Client Vertrees, Katherine (Kathy) RECONCILED 0 $ 250.00 7/7/2023 1 12544523 Count 466822 6/29/2022 1254.2311 Individual 90834 MH CLU Clnt Lorne Client Long, Tanner RECONCILED 0 $ 52.06 11/3/2022 476176 7/27/2.022 12542311 Individual 90834 NIH QU Clnt Home Client Lang, Tanner RECONCILED 0 $ 87.94 3.1/3/202.2 2 12542311 Count 421 Grand Count 76 Clients $ 30,364.30 Karrie S. Stockton From: Reyna Gonzales Sent: Thursday, December 14, 2023 4:30 PM To: Karrie S. Stockton Subject: RE: Uninsured Client list Your very welcome. From: Karrie S. Stockton <kstockton@grantcountywa.gov> Sent: Thursday, December 14, 2023 2:46 PM To: Reyna Gonzales <rgonzales@grantcountywa.gov> Subject: RE: Uninsured Client list Yes, please. Thank you! From: Reyna Gonzales <r onzales rantcount wa. ov> Sent: Thursday, December 14, 2023 2:16 PM To: Karrie S. Stockton <kstockton@grantcountywa.gov> Subject: RE: Uninsured Client list Hello Karrie, I'm sorry, it should state 09/11/23, 1 believe I was in a hurry to send it before Janice left. My apologies. Would you like me to resubmit the invoice with the correct dates? Reyna Gonzales Finance Coordinator P h : 509 765-9239 x 5433J 11 ON &MR 840 E. Plum St I Moses Lake, WA Grant Behavioral Health & Wellness From: Karrie S. Stockton <kstockton!2grantcountywa.gov> Sent: Thursday, December 14, 2023 1:18 PM To: Reyna Gonzales <rgonzales2grantcountywa.gov> Subject: Uninsured Client list Hey Reyna, I am working on the uninsured clients billing list I am seeing service dates past the 6/6/2023 date on the invoice. Can you explain, or am I am looking at the wrong dates? Thank you! IGarr�e S. 5to6ztow 1