Deleted

	Form Date	Patient	Episode	Assessor	Packet Status (for payroll)	Days to Submit	ICD	IQIES Due Date
	01/02/2024 Medicare	SACKS, PAUL MRN: 900008624	11/08/23- 01/06/24 Billable	Lillian W.		11 01/13/24	Not yet reported	Past Due!	Delete
	01/19/2024 Medicare	ATTRIDGE, CARMEN MRN: 900008845	01/19/24- 01/25/24 Non-Billable	Joan L.	Completed	5 01/24/24	Not yet reported	Past Due!	Delete
	01/23/2024 Pro Bono (Free)	WELLS, NICOLE MRN: 900008850	01/23/24- 01/26/24 Non-Billable	Joan L.	Completed	6 01/29/24	Not yet reported	Past Due!	Delete
	02/02/2024 Medicare	VARGAS, THELMA MRN: 900008888	02/02/24- 02/05/24 Non-Billable	Lillian W.	No Visit in the Calendar Admitted @ MOUNTAINVIEW HOSPITAL (02/05/24-02/07/24)	6 02/08/24	Not yet reported	Past Due!	Delete
	02/02/2024 Medicare	KENNARD, ROCHELLE MRN: 900007606	02/02/24- 02/02/24 Non-Billable	Joan L.	Completed	25 02/27/24	Not yet reported	Past Due!	Delete
	03/02/2024 Medicaid	TAYLOR, ANGELA MRN: 900008996	03/02/24- 03/07/24 Non-Billable	Joan L.	Completed	5 03/07/24	Not yet reported	Past Due!	Delete
	03/09/2024 Medicare	RAMIREZ, ANITA MRN: 900009027	03/09/24- 03/15/24 Non-Billable	Doris B.	Completed	2 03/11/24	Not yet reported	Past Due!	Delete
	03/10/2024 Medicare	PADILLA, ROBERT MRN: 900009023	03/10/24- 03/14/24 Non-Billable	Joan L.	Completed	8 03/18/24	Not yet reported	Past Due!	Delete
	04/18/2024 Medicare	HOFFMAN, TAMARA MRN: 900009172	04/18/24- 04/19/24 Non-Billable	Joan L.	Completed	6 04/24/24	Not yet reported	Past Due!	Delete
	05/03/2024 Private Pay	MACIAS, MELISSA MRN: 900009203	04/28/24- 05/04/24 Billable	La Tressa G.			Not yet reported	Past Due!	Delete
	05/23/2024 Medicare	VILLANUEVA, CORAZON MRN: 900008945	05/23/24- 05/26/24 Non-Billable	Judy R.	Completed	13 06/05/24	Not yet reported	Past Due!	Delete
	06/01/2024 Medicare	RIMBOW, TONY MRN: 900009309	06/01/24- 07/30/24 Non-Billable	MJ O.	Completed	2 06/03/24	Not yet reported	Past Due!	Delete
	06/10/2024 Medicare	OGLE, SHEILA MRN: 900009318	06/10/24- 06/16/24 Non-Billable	Joan L.	Pending	14 06/24/24	Not yet reported	Past Due!	Delete
	06/14/2024 Medicare	VARELA RODRIGUEZ, JESUS MRN: 900009245	06/14/24- 08/12/24 Non-Billable	Joan L.	Completed	5 06/19/24	Not yet reported	Past Due!	Delete
	07/20/2024 Medicare	ROSENFELD, MARGUERITE MRN: 900009443	07/20/24- 07/21/24 Non-Billable	Joan L.	Completed	6 07/26/24	Not yet reported	Past Due!	Delete
	07/29/2024 Private Insurance	MAANI, RAMIN MRN: 900009473	07/29/24- 08/12/24 Non-Billable	MJ O.	Completed	1 07/30/24	Not yet reported	Past Due!	Delete
	09/07/2024 Medicare	LEE, MARY MRN: 900009597	09/07/24- 11/05/24 Non-Billable	MJ O.	Completed	3 09/10/24	Not yet reported	Past Due!	Delete
	09/08/2024 Medicare	LEE, MARY MRN: 900009597	09/07/24- 11/05/24 Non-Billable	MJ O.	No Visit in the Calendar Admitted @ MOUNTAINVIEW HOSPITAL (09/09/24-09/09/24)	1 09/09/24	Not yet reported	Past Due!	Delete
	09/10/2024 Medicare	CLASS, DAVID MRN: 900009496	08/05/24- 09/16/24 Billable	JM L.	No Visit in the Calendar	0 09/10/24	Not yet reported	Past Due!	Delete
	09/25/2024 Medicare	RAUDENBUSH, MAUREEN MRN: 900009651	09/25/24- 10/02/24 Non-Billable	Joan L.	Completed	6 10/01/24	Not yet reported	Past Due!	Delete
	10/02/2024 Pro Bono (Free)	CONWAY, GWENDOLYN MRN: 900009666	10/02/24- 10/07/24 Non-Billable	Joan L.	Completed	5 10/07/24	Not yet reported	Past Due!	Delete
	11/19/2024 Medicare	BOTTRELL, JAMES MRN: 900009789	11/19/24- 11/19/24 Non-Billable	Joan L.	Completed		Not yet reported	Past Due!	Delete
	12/19/2024 Pro Bono (Free)	MADRID, NICHOLAS MRN: 900009857	12/19/24- 12/21/24 Non-Billable	Joan L.	Completed	7 12/26/24	Not yet reported	Past Due!	Delete
	01/14/2025 Medicare	BROTHERS, JOHN MRN: 900009943	01/14/25- 01/15/25 Non-Billable	Kay K.	Completed	1 01/15/25	Not yet reported	Past Due!	Delete
	02/08/2025 Medicare	RICHEY, PAULA MRN: 900007519	02/08/25- 02/10/25 Non-Billable	Angel D.	Completed		Not yet reported	Past Due!	Delete
	02/15/2025 Medicare	FASO, JAMES MRN: 900001172	02/15/25- 02/17/25 Non-Billable	Joan L.	Completed	5 02/20/25	Not yet reported	Past Due!	Delete
	03/07/2025 Pro Bono (Free)	CHATFIELD, SHINITA MRN: 900010066	03/07/25- 03/07/25 Non-Billable	Joan L.	Completed	5 03/12/25	Not yet reported	Past Due!	Delete
	03/13/2025 Private Pay	SAMPSON, GENEVIEVE MRN: 900010020	03/13/25- 04/08/25 Billable	MJ O.	Completed	1 03/14/25	12	Past Due!	Delete
	03/14/2025 Medicare	MARTINEZ, JAMES MRN: 900010100	03/14/25- 03/18/25 Non-Billable	Joan L.	Completed	6 03/20/25	Not yet reported	Past Due!	Delete
	04/03/2025 Self-Pay	BUESCH, MARK MRN: 900010149	04/03/25- 04/09/25 Non-Billable	Yani C.	Completed	0 04/03/25	Not yet reported	Past Due!	Delete
	04/10/2025 Medicare	CHRISTENSEN, DEBORAH MRN: 900010172	04/10/25- 06/08/25 Non-Billable	Joan L.	Completed	6 04/16/25	Not yet reported	Past Due!	Delete
	04/30/2025 Medicare	JACKSON, TERRANCE MRN: 900010215	04/30/25- 05/17/25 Billable	Christina S.	Completed	43 06/12/25	19	Past Due!	Delete
	04/30/2025 Medicare	JACKSON, TERRANCE MRN: 900010215	04/30/25- 05/17/25 Billable	Christina S.	Completed	41 06/10/25	19	Past Due!	Delete
	04/30/2025 Medicare	JACKSON, TERRANCE MRN: 900010215	04/30/25- 05/17/25 Billable	Christina S.	Completed	41 06/10/25	19	Past Due!	Delete
	04/30/2025 Medicare	JACKSON, TERRANCE MRN: 900010215	04/30/25- 05/17/25 Billable	Christina S.	Completed	48 06/17/25	19	Past Due!	Delete
	05/01/2025 Workers Compensation	DUMMY, PATIENT MRN: 900000185	05/01/25- 06/29/25 Billable	Nurse2 N.	Pending		11	N/A	Delete
	05/03/2025 Medicare	ERIKSON, CHARLES MRN: 900010225	05/03/25- 05/05/25 Non-Billable	Pam H.	Completed	2 05/05/25	Not yet reported	Past Due!	Delete
	05/23/2025 Workers Compensation	WALKER, BLANCHE MRN: 900010253	05/23/25- 12/19/25 Billable	Ayesha R.	Pending	25 06/17/25	1	N/A	Delete
	05/23/2025 Workers Compensation	WALKER, BLANCHE MRN: 900010253	05/23/25- 12/19/25 Billable	Ayesha R.	Pending	18 06/10/25	1	N/A	Delete
	05/23/2025 Workers Compensation	WALKER, BLANCHE MRN: 900010253	05/23/25- 12/19/25 Billable	Ayesha R.	Pending	25 06/17/25	1	N/A	Delete
	05/30/2025 Workers Compensation	DUMMY, PATIENT MRN: 900000185	05/01/25- 06/29/25 Billable	Nurse2 N.	Pending		Not yet reported	N/A	Delete
	06/02/2025 Workers Compensation	DUMMY, PATIENT MRN: 900000185	05/01/25- 06/29/25 Billable	Nurse2 N.	Pending		Not yet reported	N/A	Delete
	06/02/2025 Workers Compensation	DUMMY, PATIENT MRN: 900000185	05/01/25- 06/29/25 Billable	Cindy C.	Pending	1 06/03/25	Not yet reported	N/A	Delete
	06/08/2025 Medicare	MCDONOUGH, LINDA MRN: 15376	06/08/25- 06/09/25 Non-Billable	Jennifer N.	Completed	3 06/11/25	Not yet reported	07/07/2025 Mon	Delete
	06/13/2025 Medicare	STORY, JOYCE MRN: 900002325	05/22/25- 05/23/25 Billable	Soline L.	No Visit in the Calendar	4 06/17/25	Not yet reported	07/12/2025 Sat	Delete
	06/15/2025 Medicaid	ABRANTE, JOSE MRN: 900009505	06/15/25- 08/13/25 Billable	Josh C.	Completed	8 06/23/25	15	07/14/2025 Mon	Delete

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