Forms to Track / Home Health Certification and Plan of Care
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RFA:
Form Date Patient Episode OASIS Status Match Frequency Primary Physician (HHRG) Primary Physician (CPC) Upload
06/09/2025 SCRIVEN, GARY
MRN: 900010273
08/16/25 - 06/22/26
SOC (Billable)
SOC (Exported to State) CALDERON, BENITO
NPI: 1396799904
Daniel 10/14/25 02:16 PM
changed the provider name
09/19/2025 FLEETWOOD, JOHN
MRN: 900009967
09/19/25 - 09/18/26
REC (Billable)
REC (Exported to State) MARGALLO, ROY MARIE
NPI: 1538314950
Daniel 08/27/25 01:47 PM
reviewed the form
10/08/2025 PATEL, JIVIBEN
MRN: 900010622
10/08/25 - 12/06/25
SOC (Billable)
SOC (Exported to State) DAULAT, GIRISH
NPI: 1235226770
DAULAT, GIRISH
NPI: 1235226770
Lala 12/02/25 02:23 PM
reviewed the form
10/17/2025 JAMES-DONALD, SHERRIA
MRN: 900010634
10/17/25 - 12/10/25
SOC (Billable)
SOC (Exported to State) ACHIN, ROWENA
NPI: 1366467888
ACHIN, ROWENA
NPI: 1366467888
Lala 12/02/25 02:23 PM
reviewed the form
12/20/2025 WALKER, BLANCHE
MRN: 900010253
12/20/25 - 12/19/26
REC (Billable)
REC (Exported to State) TAM, STEPHEN
NPI: 1689738478
Daniel 11/06/25 04:13 PM
reviewed the form
12/21/2025 HIGA, KIYOSHI
MRN: 900010751
12/21/25 - 02/18/26
SOC (Billable)
JOU, JASMINE
NPI: 1063909877
Lala 01/20/26 02:46 PM
reviewed the form automatically marking the POC Uploaded
12/24/2025 ROBINSON, JACKIE
MRN: 12323
12/24/25 - 02/21/26
SOC (Billable)
MOJTABAVI, REZA
NPI: 1225152598
Lala 01/21/26 10:32 AM
reviewed the form automatically marking the POC Uploaded
12/26/2025 ANDERSON, DANA
MRN: 900009723
12/26/25 - 01/19/26
SOC (Billable)
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
Lala 01/22/26 10:08 AM
reviewed the form automatically marking the POC Uploaded
12/26/2025 JORDAN, JOSETTE
MRN: 900010760
12/26/25 - 02/23/26
SOC (Billable)
PELLNITZ, MATTHEW
NPI: 1033647037
Lala 01/22/26 10:58 AM
reviewed the form automatically marking the POC Uploaded
12/27/2025 LEWIS, EUGENE
MRN: 900007266
12/27/25 - 02/24/26
SOC (Billable)
VICTORIA, EDWARD
NPI: 1447463500
Lala 01/23/26 09:56 AM
reviewed the form automatically marking the POC Uploaded
12/27/2025 MORRIS, ROXANNE
MRN: 900010763
12/27/25 - 01/23/26
SOC (Billable)
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
Lala 01/23/26 10:21 AM
reviewed the form automatically marking the POC Uploaded
12/28/2025 KAZARYAN, ARSHALUYS
MRN: 900009871
12/28/25 - 02/25/26
SOC (Billable)
MISHRA, RAGHAVENDRA
NPI: 1982858742
Lala 01/23/26 11:49 AM
reviewed the form automatically marking the POC Uploaded
12/28/2025 TOMLINSON, RICHARD
MRN: 900010764
12/28/25 - 01/20/26
SOC (Billable)
NGUYEN, TRUONG
NPI: 1821663428
Lala 01/23/26 12:47 PM
reviewed the form automatically marking the POC Uploaded
12/28/2025 PICKARD, ALECIA
MRN: 900004280
12/28/25 - 02/25/26
SOC (Billable)
LEELA, GOPALAKRISHNA
NPI: 1609859305
Lala 01/27/26 10:29 AM
reviewed the form automatically marking the POC Uploaded
12/29/2025 DUMBACH, FRANCES
MRN: 900010767
12/29/25 - 02/26/26
SOC (Billable)
VICTORIA, EDWARD
NPI: 1447463500
Lala 01/23/26 01:54 PM
reviewed the form automatically marking the POC Uploaded
12/29/2025 SYKES, ERIC
MRN: 900006510
12/29/25 - 02/26/26
SOC (Billable)
MANOV, ANDRE
NPI: 1801829676
Lala 01/26/26 10:05 AM
reviewed the form automatically marking the POC Uploaded
12/30/2025 OKELBERRY, GEORGIA
MRN: 900010768
12/30/25 - 12/31/25
SOC (Billable)
HEDGER, RONALD
NPI: 1447576632
Lala 01/26/26 02:50 PM
reviewed the form automatically marking the POC Uploaded
12/30/2025 TOROK, MARIE
MRN: 900008485
12/30/25 - 02/27/26
SOC (Billable)
MENGISTU, FIKRE
NPI: 1073812640
Lala 01/26/26 03:40 PM
reviewed the form automatically marking the POC Uploaded
12/30/2025 RUNGAITIS, ROBERT
MRN: 900001025
12/30/25 - 02/27/26
SOC (Billable)
CHIA, JENNY
NPI: 1871564435
Lala 01/27/26 01:29 PM
reviewed the form automatically marking the POC Uploaded
12/31/2025 GATDULA, RICHARD
MRN: 900010773
12/31/25 - 02/28/26
SOC (Billable)
DE GUZMAN-DELALUZ, EVANGELINE
NPI: 1750150215
Lala 01/27/26 03:42 PM
reviewed the form automatically marking the POC Uploaded