CNA Clinical Visit Record
Chongson, Duvin 31 Hollis, PJ 1 King, April 97 Mendizabal, Blanca Luz 11 Omandam, Minda 85 Rovillos, Helen 13 Salvani, Marie 16 Smith, Virginia 4
Visit Packet
Visit Date Patient Certification Period Frequency Claim Status Number of Days 1. Complete Visit Packet Paid Date
10/14/2025
Marie S. 		AMUNDSON, RITA
MRN: 900010489 		08/19/25 - 10/17/25
Billable 		1Week3 (09/27/25 - 10/17/25)
Regular 		10/24/2025
Claim Sent Date
235 10/21/2025
Adele N.
10/15/2025
Marie S. 		PROWS, DONNA
MRN: 900006676 		09/30/25 - 11/28/25
Billable 		1Week4 (10/01/25 - 10/24/25)
Regular 		11/14/2025
Claim Sent Date
234 10/21/2025
Adele N.
10/15/2025
Marie S. 		WOOD, NANCY
MRN: 900008215 		08/19/25 - 10/17/25
Billable 		1Week8 (08/23/25 - 10/17/25)
Regular 		11/12/2025
Claim Sent Date
234 10/21/2025
Adele N.
10/15/2025
Marie S. 		WOOD, ROGER
MRN: 900009278 		08/28/25 - 10/26/25
Billable 		1Week9 (08/30/25 - 10/26/25)
Regular 		11/12/2025
Claim Sent Date
234 10/21/2025
Adele N.
10/15/2025
Minda O. 		DUMMY, PATIENT
MRN: 900000185 		05/01/25 - 08/28/26
Billable 		7Week52 (05/01/25 - 04/24/26)
Regular 		234
10/16/2025
Marie S. 		SANTELLAN, ROBERT
MRN: 900010433 		10/06/25 - 12/04/25
Billable 		1Week4 (10/06/25 - 10/31/25)
Regular 		11/13/2025
Claim Sent Date
233 10/21/2025
Adele N.
05/06/2026
Marie S. 		ALARCON, CHRISTINE
MRN: 900010970 		03/18/26 - 05/16/26
Billable 		1Week5 (04/18/26 - 05/16/26)
Regular 		31
05/31/2026
Minda O. 		WINNEFELD, NANCY
MRN: 900010870 		04/07/26 - 06/05/26
Billable 		6
06/01/2026
Marie S. 		GUPTA, JANAK
MRN: 900011142 		05/23/26 - 07/21/26
Billable 		1Week4 (05/23/26 - 06/19/26)
Regular 		5
06/01/2026
Marie S. 		WOOD, NANCY
MRN: 900008215 		05/10/26 - 07/08/26
Billable 		1Week9 (05/10/26 - 07/08/26)
Regular 		5
06/01/2026
Marie S. 		MANGONE, KATHERINE
MRN: 900004902 		04/16/26 - 06/14/26
Billable 		1Week9 (04/18/26 - 06/14/26)
Regular 		5
06/01/2026
Marie S. 		SHAHIN, SALWA
MRN: 900011153 		05/27/26 - 07/25/26
Billable 		1Week4 (05/27/26 - 06/19/26)
Regular 		5
06/02/2026
Blanca Luz M. 		MORENO, JOSE
MRN: 900004859 		04/21/26 - 06/19/26
Billable 		1Week5 (05/21/26 - 06/19/26)
Regular 		4
06/02/2026
Blanca Luz M. 		PARKER, JUNE
MRN: 900010964 		05/15/26 - 07/13/26
Billable 		1Week9 (05/16/26 - 07/13/26)
Regular 		4
06/02/2026
Blanca Luz M. 		PARQUETTE , SARA
MRN: 900011146 		05/24/26 - 07/22/26
Billable 		1Week4 (06/01/26 - 06/26/26)
Regular 		4
06/04/2026
Marie S. 		KACHIKIS, ERNESTINE
MRN: 900009832 		05/28/26 - 07/26/26
Billable 		1Week4 (05/30/26 - 06/26/26)
Regular 		2
06/04/2026
Marie S. 		STACEY-ROBAR, JUDITH
MRN: 900005459 		05/05/26 - 07/03/26
Billable 		2
06/05/2026
Minda O. 		PROWS, DONNA
MRN: 900006676 		04/10/26 - 06/08/26
Billable 		1Week4 (05/19/26 - 06/08/26)
Regular 		1