Duns MAINECARE LIEN EXPENDITURE REPORT

Query Dales
09/01/2010 08/07/2018

 

KYLE RODERICK 1557mm

   

 

   

Run 0515 08/07/2013

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ma-- Gander 
CI: IDIRX 0 L111: Pro dl' DDS DX DX Proc Fro: Billed Paid
31 Code Des: Cad: Dem Ami Am!

17261W1JD275A1 1 CENTER FOR 3/17/2017 F04 0 Auhst/c dlsarder T1020 False/1311:3123 semces per 5291025 on $29,025 00
COMPREHENSIVE SERVICES mam "0110/ 

17310W00338A1 1 NR AMBULANCE CENTRAL 1N0 0/17/2017 F134 0 Auk/51m msarder A0430 Ambu/ance sen/1c: fixed 591832 00 591932 00
mg 3/ mm

17310W00338A1 2 NR AMBULANCE CENTRAL 1N0 3/17/2017 FM 0 Anus": msumer A0435 Fixed an mueaga per 581757 00 501757 00

50.1.,e We

17203E14301A1 1 CENTER FOR 0/1/2017 F34 01 Au115|1c d1smder T1020 Personal care semces pev 550.050 00 5501050 DU
COMPREHENSNE SERVICES PM 0 Auhshc msmder dlem n0|1or1npa1

17313E14441 1 CENTER FOR 10/1/2017 F04 0' Aunsnc answer T1 020 Peuona/ care semces per $56,265 00 $56,265 00
COMPREHENSIVE F04 0 Auusllc disorder dvem INDET

1734669602 1 CENTER FOR 11/1/2017 F84 0 msmder T1020 Perm/131mm sen/mes per $251410 00 5251010 00
101mm.

17346E19504 1 CENTER FOR 11/15/2017 F84 0 msurder T1020 Parse/151 care sen/I025 per $251400 00 5261400 00
COMPREHENSNE SERVICES mam r101 10/ 1/105!

18011E15501A1 1 CENTER FOR 12/1/2017 F04 0 chm/def T1020 Personal care serwces per 351 150 00 5511150 00
COMPREHENSIVE SERVICES dlem n01 mpal

ISMDE17973 1 CENTER FOR 1/1/2018 F84 0 Auhshc also/0e! T1020 Persunal care semces per 351,150 DD 551.150 00
COMPREHENM 5mm m. .0, We.

mummy. 1 2/1/2018 mo A1151: 1.5m T1020 wanna mango
COMPREHENSIVE SERV1CES mam noflur InDa1

10100E17020A1 1 CENTER FOR 3/1/2010 FM 0 Aunshc msomer T1020 Parsrma/ care services per $511150 00 5511150 00
man 1101 for mpa|

1B134ED7560 1 CENTER FOR 4/1fl018 FM 0 Au1/s11c msnmer T1020 Personal care services per $471350 00 5471850 00
mam/13.11131

1E134EDTSS7 1 CENTER FOR F04 0 Au11s|1c msomev T1020 Pevsunal care seMces per 51.650 00 511650 00
mm m. W.

10162E20290 1 CENTER FOR 5/1/2010 F84 0 ALA/silo dlsorder T1020 Parse/131mm semces per $51,150 00 351,150 00
COMPREHENSIVE mam mxlor l/IDa1