CNA Clinical Visit Record
Chongson, Duvin 15 Mendizabal, Blanca 23 Rovillos, Helen 14 Salvani, Marie 22 Smith, Virginia 4 Stallins, Jeanette 3
Visit Packet
Visit Date Patient Certification Period Frequency Claim Status Number of Days 1. Complete Visit Packet Paid Date
06/12/2024
Marie S. 		AZEVEDO, DENNIS
MRN: 900005737 		04/19/24 - 06/17/24
Billable 		1Week2 (06/12/24 - 06/17/24)
Regular 		08/02/2024
Claim Sent Date
389 06/17/2024
Adele N.
10/15/2024
Blanca M. 		GARDNER, EME
MRN: 900008212 		10/07/24 - 12/05/24
Billable 		1Week3 (10/12/24 - 11/01/24)
Regular 		02/03/2025
Claim Sent Date
264 11/06/2024
Daniel G.
11/26/2024
Jeanette S. 		SAWICKI, JESSICA
MRN: 900009714 		10/20/24 - 12/11/24
Billable 		1Week4 (11/16/24 - 12/13/24)
Regular 		12/24/2024
Claim Sent Date
222 12/31/2024
Adele N.
06/23/2025
Marie S. 		COPPICK, GLENDA
MRN: 900008569 		05/13/25 - 07/11/25
Billable 		1Week4 (06/14/25 - 07/11/25)
Regular 		13
07/01/2025
Blanca M. 		HORNER, PATRICIA
MRN: 900010330 		06/16/25 - 08/14/25
Billable 		1Week4 (06/16/25 - 07/11/25)
Regular 		5
07/01/2025
Blanca M. 		KURLAND, ELINOR
MRN: 900010087 		05/09/25 - 07/07/25
Billable 		1Week9 (05/10/25 - 07/07/25)
Regular 		5
07/01/2025
Blanca M. 		MAISSA, MIREILLE
MRN: 900010350 		06/21/25 - 08/19/25
Billable 		1Week4 (06/24/25 - 07/18/25)
Regular 		5
07/03/2025
Marie S. 		COPPICK, GLENDA
MRN: 900008569 		05/13/25 - 07/11/25
Billable 		1Week4 (06/14/25 - 07/11/25)
Regular 		3
07/03/2025
Marie S. 		WOOD, NANCY
MRN: 900008215 		06/20/25 - 08/18/25
Billable 		1Week9 (06/21/25 - 08/18/25)
Regular 		3
07/03/2025
Marie S. 		WOOD, ROGER
MRN: 900009278 		06/29/25 - 08/27/25
Billable 		1Week9 (07/01/25 - 08/27/25)
Regular 		3
07/03/2025
Blanca M. 		CHOI, TAE
MRN: 900005476 		06/04/25 - 08/02/25
Billable 		1Week9 (06/07/25 - 08/02/25)
Regular 		3
07/04/2025
Virginia S. 		SMITH, GREGORY
MRN: 900010249 		06/23/25 - 10/09/25
Billable 		5Week16 (06/23/25 - 10/09/25)
Regular 		2