ORDER IVO. 251` APF'RC1V(=1L TO F'AY INDIGENT HEALTH DARE RILLS TO VARIOUS F~RGVIDERS On this the yth day of September- 1991, o_ipon motion made by Cammissi~~ner Morgan, seconded by Commissloner Oehler, the Co~_cr•t unanimously approved by a vote of 3-0-0 to pay Indigent Health Care Bl1ls in the ama~.~nt of $14, ~6~:. ~1 to vario~_is provide=r~. T . F'.:. U A T t: C;/ 10191 l a I L Y C M E C I: ~ c 6 1 5 T E K B Y G R O U P PAGE : 14 Fr,I;;f.Y l•UGUST lo. 1991 RzC1~TcR NuMe`_h i45 - -- - -- CHECK CMECK tIU'ioEn CHECY. UATi CLAI° MC' SOC ScC ~~~) `_"'L7YEE A_ CL AI"+~ T PAY T; AM CUNT _._ . L.-_y SL ..- ---~-.. - - -~~-~---t----I _ ~ -YL. ~~ S~..Q fUNu: 1P><-OU24 o,UU°: Tyr.-uG24 R=4r•. C'1v°'TY ---- -_----- -- 1415 --- _ -- Oh/16/91 - - MA11vAL O THER VOID ` CHECK #* ' .00 00 i4i6 Ua/lo/91 LI"ii OF "k~rUAL ti TttER-- * V O I D = --Y1Ip --_--- -- -- -- . .00 --- ------ - . ----- =* V 0 I D (HECK 3# .00 1416 Gollo/S1 LIN= ' UP vGUCH*_u PAYkEr.T HILL CDU1~THY RADIOLOGY 683.04 1419 '1 Ov/lo/ _. .._ _ ._ - --- v;;UC!i=R PaYMEt1 __lraLL "D. MICHAEL_ ------ --- 187.25 ---- 14ZC Oo/15/S1 VUUCMEF PAYNEt•T P~IOUR MU. DONALD J 17.00 1411 Uc/16/91 VDUCHEk P,;Yr':ENT ANOREGS MD. CHARLES P 557.50 1412 Ocl16/91 --"" ------ -`_---- ---- VOUC1sER PAYMENT - A`tESTHESIA ASSDCIATES- --- 162.90------_--_- _ --" 1423 -DZY16/91 VGUCHEF PAYNEkT HAGEMEIER MD. KARL F 107.19 1414 uo/lo/91 VtiUCHER PAYMENT MITCHELL ND. ROBERT E 687.98 1425 Ur/16/91 --- --- ----- ---- VOUCHER- pAYMEnT -GRAHAM MU."--JAMES L-- -- 629.37--- _---- - -- ---14Z6 .ObYibJ91 VOUCHEk PAYMENT NAU MD. THOMAS 22.35 1427 D8d16/91 VOUCHER PAYMENT MOODY MD. A RANDALL 49.88 1428 Oal16/91 - -- VvUCH'P °AYNEkT - ALANC PHYSICIANS SERVICE- -- 319.06 - -- -----.- 1429 D~n6/91 vCUCHcP P:,Y",EnT FAMILY PRACTICE ASSOCIATE 285.32 1436 Ot/lo/91 UDUCHcn PaYr.EnT SID ?ETERSON MEM HOSPITAL 9.464.09 141 Ov/lol91 - - - _ ------- ---- - -- - V000HcR PAYMENT H E is PHARMACY 8089 - - - 12S.62 ------- - - 1432 -Oc/lo/vl - vIUC~EF PAYNEt;T LEWIS MD, CHARLES E 46.48 1433 Oc/10191 IUCHER V~ PAYr.ENT H06R5 MG. PAUL N 38.12 1434 Oo/lo/91 - .--- - ------- . ------UUUCMETc PAY"Eri -ALLEN 9C.-WILLIAM M!- 138.79------- ---_ -- 1435 08115/Q1 ---- Vi,UCMER PAYMENT UELANEY hDi R GORDON 23.24 1436 UG/lb/Y1 VuUCHEp PxYMEr•T SHAW K8. HILTON D 74.82 1437 CZ/lo/41 _.. ___ _ -- . - ViiUCNEF PAYhERT LU5Eii rC. RANDDLPH t - - - ------37.16 - 143rs Vi;/le/vl VUUCyEF PAYr1Er;T tIILL CO NUCLEAR I'"AGING 41.7U _ 1439 UL/16191 YOUC)IEF PAYMENT SFITH D0. STEPHEN L 492.42 144G Ua/10!91 _.. __._- ---. __.------- _-- ------ YDUC'1tR °A,YMEGT --HELLS M0. JA1iE5 D- __-___ ---- 23.24- - - - - 1441 - Oi/10/91 V'!UC~~U ?AYNE`~T nOYCE MO. T R 283.99 ------------ - 14a e 0./15!91 - - ---- ------ - ----- 14, 562.51 b0~£S9 G9"bD6 ~1d101 ~3QIA0yd bQ f89 09'b06 ~1d10! dA0d9 DO'3£ 00'$£ tGlSZlLO tGIZZlLD ZObbZh044b 864t£t 1 JJdd 8 ZO'L3 SL'btt tSISZ/L4 i6/fZ/£D ZD9bZb000b Z46ZZt I NOSJI`d~IN J <<"4b SZ'l~ t6/4l!£0 lGlZllf6 S06£1£ODOG ZILZZt 3 N01{1N 1 50 SOt 4S'Stl tG/bZlL4 tG13t!£D 900btiQD06 54i5Z[ 3 0}13;108 Q LZ'$l 6Z'bZ [6ILZIZD lGItZIZD f09b[fOD05 ' SfOZSO 3 1!31114! t! DO GL 04'GC t6/14/8D E6ItlISD bD99DbD00G 4trbG£ I l1dA 1 DG~tt 00'bt idl80/90 tb/$0!90 LlS6tZD406 19ZYd0 3 S}Jlilif {" 04`9b GO'9b t6/[£!1D tblBtlLD tOZt£60046 t6096 3 ~SINN~lON D DD'Lt 00'Lt tGlGt!£0 16/b4lZO DI.LZ4£400G ££58Z4 3 ~ SI8'J~N D 00'lt 44'Ll tb!£OILO t61at150 b!f[f£0006 bt69Zl 3 B8a13 9 ZL'Sb 09 bl tb/9Z/9D !6!97.!90 S05bL£004b B9Sblt 3 HOSaIiJi Q 00'4Z 00'4Z tG/ZOI80 l&/t£!t0 ZO£bZbDODG 94L1£t 3 ddlkftd Q f,A~OZ Ol}'OZ t5/lt/LO lki/btlS4 £ZSOZ10006 89ZOf 3 110:15I?1ti d 00'Lt 40'Lt 16lSO19D tG/S0/90 9t99££OD46 LLtSB 3 NIJ3102 f 19'9Qt SZ 49t t61ZZlLO t6lbl1t0 tObLEh000b ZCS1El 3 ~ QaN38 S QIHd 39?ldHZ O1 it083 ~ON 'ON 'd3Q ikdltIdl7 'Id1(~1 Gld3A0D 03~f1aNi ~ AIdl9 IN3Ildd A1Ni103 ~Z13H 6700-841 b5010It1d0 A81Nf105 'illti l9L££ll-bl t iJdd ~NII''ri1 213N~t10t1 lf3QI11021d t6/'3t/RO 3lHII ~9HI '.d . • '! ~. P. A., IiiC. ttA'iE OEl16/91 PRUVIDER VOtiCHfR LISTIti6 PAST 1 74-2186835 uALL MQ. IIIG}!A[L , 1PK-0424 Y,fRR GOUkfY PAiICkT CLAIA INCUfifiCD COUFfiCD TUTAL GLAI11ANt &FP, ii0. NU. FRUli TG CNRRGf PAID J JEFFCItS £ 9400219518 46/08/91 06149141 196.OQ 187.25 6Rt)iTi' TOTAL ~ 196.09 181, i5 PROVIDER TOTA1~ 196.04 187.25 ` T. r R., INC. DRtE 08/lb/91 Pfi0VI0ffi VOUCHER LIBTI?TG FR6L 1 7+V-1878810 Pf~IOUR MD, DOtIRLD J tPX-0024 KIRK COUi1TV NATIFIIT CLAIA INCURRED CtR)FRiE! TOT RE CLRIIIRItT Di~F. MO. 110. FROfi TO CHRRaE PAID M DDEE I 9000425004 11!?$1y0 06112/41 1?.Ou i7.OG GROUP TOTRI: 77.GD 17.00 PROVIDER TOTAL: T?.Ob 17.00 .~- ' ?. r'. A., INS;. DATE OtiJi6l41 PROVIDER UO!lCNER LlstItt6 FAGF 1 )4-2222533 ANDRENS fiD, L'HARLES~P ?pX-4t?24 KERR Cl7UN?Y RA?TENT CLAIA INCURfiE4 CQ6~fREJ tOtftL C1AIl1Aht CEP. NO. N0. FROM 14 GNAR6E PHID M HARRIS F 9104391 4400362710 42!04!91 03!19191 6fl5.t14 551.90 6fi0UP TOTAL: 605.i~0 557.54 PfiO11IDE~ TOTAL: b05.OD ~+57.5U ' T. .. A., INC. ilA~if 08I1b191 PROVIDER UGUCHfR LISIIN6 PAGE 1 74-201F2$$ ANESTHESIA AS.;OCTATCS TPK-4029 KFRR GOU?!TY PATIENT CLAIM INCURREfl COUEREII T-?CAL CLAIMAi~i DfP. NQ. ii0. FROM IO CHARGE PAID '~ LACKkY F 9444373711 G7l15/91 48/G1/91 40A.4D 1b2.94 6R0-!P TOTAL= 4Q4.QC 16~.4Q PRQIlIDER TQTAI: 904.4D 162.94 1. P. A. , IifG RATE 09/16/91 PROUIOER UUUCHER LISTIK6 Pfl6C i 7~-2441181 Hfl6fllflfR AD, KARL F - TPX-00~4 KERit COUNTY PATIIKI CLAM! INCURRfA COUE1?In IC~IAL CLHItlP,l1T aEP. NO. M0. FROfi TO GHRR6E PRia D FRAZIfR E 90044Qb4Q4 07/1~/R1 07/31/S1 t25.OD t01.t9 6ROUF' TOTAL: 125.00 107.1E PROUIdER TOiRI: 12S.0Q 167.19 T. ~ . A,, INC. 1_IATE 98J1bIRt PROVIDER UUltCNER LISTI~t6 PAGE 1 S1i-58-2]02 !lITCNELL Htt, RJEERT E TPR-9024 KERB COUNTY PATIENT CLAIq INCURRED COUEREA TGTAL CLAIKANi DEL'. NG, ~l0. FROl1 TU CNAR6E PAIB D DUNLAP F 10Yf2 9000424302 Q]!31/91 08/02/41 45. t;9 24.'#4 Y LA-:KIY E 10212 9000373711 07!1519! 48101/91, 1290.OQ h63.04 GROUP TOTAL: 1335.09 b87.~18 PROVIDER TOTAL: 1335.AQ bB].9S 1. P. A., IhC. ANTE 08/1b191 PROVIDER 4000NER IISiINS FADE # 79-23579Sb -~AHAtI tfD, JAfIES L TPX-UO29 KERR CDl~Rf4 PATIENI GLAIR Ii{GURREO C~7UERED ItlTAL GLAIltAlii DE#'. iiG. t!(I. FRGl1 TO GHARGE PbIi~ -.._o_»»»_nz:,_....-c_ ~:~__ _._.__ssets-»»._-xasssa.»_xssa__»ssasassssmur._..___ssrz»ssss S SEARF E 90004s7a0f 07114191 07/72/91 fUb,U3 fUU.00 D fRA1IER L 400090b904 O1/i9191 01131/9i 595.00 519.37 6ROtiP TOTAL : 795, bD bZ4.37 PRG~lIDER TATAL: 795.0Q b24.37 T. r. R., IMC. DR1'F 08/16!41 PRUUIDFI; VO11CNfR LI5TIIIG P46E 1 14-X456173 HAU flD, TNOdAS TPX-002~ XIRR GOUMTY PRIIENT CLAIn INCURRED COVERED TOTRL GLNInP,~T DEP. 110. K0. TRGit TO CHRR6E FRID h nRU6HAN F 4000320111 06/20/91 0'x/31/91 35.00 22.35 GROUP TOTRL~ 35.00 22.35 PROVIDER IOTAL~ 35.00 22.35 T.. A., Iltc. DBTf ORl16l91 PC04IDER VOUCHER LIS3IH6 PftGE 1 456-42-)3)9 If00D4 ifD, A RAHDALL 3P4~-0414 KEGfi CaUNTY PA3IElIl CLAIA IIiCURRFB COVi~ED TOTA! CIAIAkii7 DEP. MO. KO. FROi{ IO CIiARGf PAID !1 Ht~ICliKISS E 9000431201 41113191 01/3i/9! 44.69 14.34 J PA3if!N E 4)49 9440424544 01!43/91 07/18l9t 40 U9 24.94 GROUP 3U3AL: 80.04 49.83 PROVIDER 30tAt: 80.40 49.D8 T. ~•. A., 1Mt:. DA?E 4g/16/91 PRWIOER VOUCHER LISTIItG P(16F 1 74-2452367 ALAIIO PHYSICIAnS SfRVIGF TP8-4424 KEiiR ~;OUNTV P8TIF11T CIRIA IiiCURRFD COUfRFD it(THl ClRIt1RNf DfP . NO. NU. fR0!{ TO C!lRR6E PAID L QELEDM E #743x2 9064337511 46!14;91 01112!91 246.00 101.gb P BRIrCOLI E 174484 9404224523 65/14/41 47/11/91 53.60 37.43 II E~IGSGH E #74988 9400374505 06/26/91 0617514# 82.60 50.74 F G1t4M f 154901 9440226943 41123/9D 44/49190 138.OD 141.44 C fIHRSGNRLI ~. 1743x8 9000337215 05172/91 07/14/91 82.04 50.70 u !(ILLIS E 11x113 9404474902 06149/91 06/49/91 53.00 37.43 SROt(P TOTAL 654.04 374.06 PR{C. DATE Sib/1bl41 PRGVIDEIi 110UCHER I~.I.STIi1G PASE 1 7q-1911555 FAtlILY PRpG1ICE A~54C1ATE iPK-442~V !(ERR ~,'s1SJHi'<' ~ATIINI CIAIq INC URRED C4UFRFD TU1FIt CtriIHAltT DEP. N4. Mtl. FROt1 TO CtEARSE PAID U HOTGNkISS E 9444~31i41 4111$!91 41lZ1/91 29.4D P3.2C C liRRSCNAIt F 3921'x1 9444x31715 45l22l~1 41/14!91 ,7~i5.44 214.15 5 pIIi;INS4M I 2135 9444436841 41!21/9i 41/7191 Sb.Q4 51.33 6RRUP TOCAt: 38U.DD 285.32 PROVIDER TOTflL• 3$0.4D 285.11 '-- ., 1. A., INC. [!tilf 08116/91 F(~sI UIf1ER UOUL'HEFt LISIIN6 fiAGf 1 74-:5518 20 SID PETERSON nE1J NOSJ'ITAt T1'ti-g02~1 kERR COi~}!1 PA1iENT CLAIn INCURRED ~ CGVERE~D I(tTAL ~, ClAInANT L~l;P. N0. ItO. F"ROn IO CMARfiE PAID L QELEUN E b46?44 9000337511 06114191 07/11/91 -15:6.75 158.75 0 S~fitiISS F 511f'19 94002?0011 07/24/91 07!31/91 59.?5 54.75 P !;RISC©LL E 1187742 90062?0513 05/14/91 07/11/41 145.40 145.00 & EL(~"H E 638D31 9000337314 05114/41 07/03/41 17.25 17.15 B FRNNhLIN F 696444 9400391505 0)117!91 07!17191 48.00 9H.4q • C F1{tiN{{E E 511[15 900043130# 07!17191 07/1?141 ?57.50 757.50 F ~:QnEl E 697°5G 9040374409 0110b/91 47/#4141 ?95.15 295.t5 .J JETTEliS E 1.12713 9QtTg219519 46108191 0b/12l91 ?555.3b 2555.35 {.. KgLACE{t f 517:`57 ~'4ggt37101 45/?8191 0&/0419! 103.75 503.75 1. 1'4L(:~'Fi; E ?3q::i:?] 9000437102 45/1$!91 08/29/91 950.5b 950.5b Y IA~NEt' F 311S7Z 9048373711 41/15/91 08/01/91 1199.b5~ 1199.b5 n llr;{Ir{RN E SG8'1? ; 9040!20111 06/10/91 07/31/91 b4.90 64.90 C' t!f!~;CNRI! I 51gb57 90gD3371f5 05/21/91 07/14193 Y40.75 - TR0.35 Y nRl! 1 5127.E5 9404946604 05/17/91 48141/41 4'1.00 9:.40 f 11i~RNRIl.Y E 51#437 900443674# 01/15/91 47/30/41 198.00 195.00 D NOttl:NO F 511Sb7 9CGG37400b 03/18!41 07/24/91, 60.3D b4.30 t1ft:KF{t^C-N I 508532 9040124642 63/27/91 4)125191 209.00 309.44 {1 UQEf. E 511451 9000415402 07!15191 07115/91 4?.G6 49.#}0 t4 CnFI F 13916`r `~04g4T5443 0512x/91 46!43191 3361 35 1436,;;? S 1'~f;K F 509582 9CG042490c^ 07122(91 471?5/91 ?$5.40 188_nG J {-R{{dH E 5101:33 41?40414304 07/03/91 01/18/91 51.Crp TU1AL t;LRIMRhl1 DEf'. NU. N0. FROM i0 CHRRGE PAID R l~3ZAt?t; E 19258 '900040b105 Q5/23/9i 05/23!91 14.85 14.8$ f' SRf~CMEi E 1$7;17 9000219001 r3blE}~d91 96105/41 23.30 23.24 bROs1P TOiAI: 38.18 38.12 PROUIDFR TOiAI~ 3$.18 38.12 T. .. A., Itlc. D~TF G8/t6l91 PR4UIDER VOUCHER LISTING ati~f t 71-204b814 ALLEM AD, IiILIIAfl 0 i i'?~- 0024 ttECf; £UtlHTV PA(Iflil CLAIM It(CURRED C(~ttfRED T01A1 ClfllitflNT DEP. tl0. tfA. ~'ROt! Tfl CHARbE PAID C Bt'CicgDt:TN E 9G00373b69 07l2GJ9t 07/2b/9i 2].44 23.24 I CCA~(NLI~ E 9(-00436701 07/15!91 07/3x/91 166. Q1 9~.3f !. P'OGINSON E 9D00229b14 Oll1b/9t 47124/91 27.44 23.24 6ROtJP T4IAL: 221.85 138.19 !'nOUIDER TOTAL: 221.$5 138.19 1, r. A., IrlG. GtlTf 08/1b/91 FfiQUIDFR U04{GRER kIfiTING FA6E Z 7~'-1738370 DELA1iEY 11D, R 60RD41~ TrK-0024 Kfi~R f0U{4CY , FATiINT GLAIfI Ii~GURRFD GOVFRFO iOTAk r_:LAltIANT i t1J~F. NQ. H0. FRO!{ TO C!#ARfiE FATa k RC,E~?ti;tlP1 E 1riU~~)~, 9040229b14 O1/ib191 01I2~/91 34.00 23.24 6T{OUP TOTAk: 30.00 23.24 i I PROUTAf.R TOTAL: 30.00 2?.24 I i ,.-. T. P. A., IRG. t~t~lE 081#E1'it FROUIDER VOUCHER LIBTING PAEE 1 ?i-239?281 SHAD tiD, tlIlTON D TPK-442~i +iERR ~'t~81#IY PA3IEHI CiAI[f IlifJJRRE4 COUEREI] TOTAL CLfrI19f1~iT I~fP. 3~0. 1i0. FR011 70 CHARGE PAID D :RIL'SOh~ E c6 944437~54b 43/#1141 46!14/9# #45.04 74.82 SFO~lP TOTAL ~ 165.OG 74.82 PRtWIDFR TOTAL: 105.OD 74.8 T. P. A., I~tC. G~RTE 0$l1bi41 ~ PROVIDER UQIfCNER lI5TIN6 Pfl6E 1 {Jb~-b2-i$lti ZUBER i1D, RAKDOLPH C ' (f ~i°0024 KERR CGt~~ITY FAI3ENT CLAM INCID;RED COtfEREG TONAL fLl?EMRi11 P.EP. ~t~. t10. FR(!11 TO Cf4AFCE f1l~i t'RRR E 14~'.~+bl 900042440x G7/2Z141 07/25/91 53.OD 37.16 6R0!!P TDTAL~ 53.00 37.15 PROVIDER TOTAL= 53.00 37.fb i I i .. P. fl., INC. llAff 4Uflfit4l PROVIDER VOi3CNIR LISTING FAGF 1 7~k-:919155 NILI GD hUCiEAIi If1RGIN6 TE'X-OOZE KErr f33U!iTP E`tt1IkNT CLRI11. INCt1RRFD C4UERE:A i01RL CIRItIItNT DEi'. i'O. N0. FROM TO CHARGE PRIG ..x..___ _cr__-~c_.-r..-_='-==.._--._=-_-=-=°~==s_ssc..e,z^a.aeaxozeaess ~eccmz=ac__naxcvor~ r dAt.r_ _, a~~~~ 700040b604 OSi17191 08101!91 2ti4.OD al.~~ fiROUP TQJRL: ?G4.OD 41.TQ PROVIDER i01At: 264.00 41.20 I __ _. i ', t i . f'. A., INC. ' r4Cf (12116191 PR4UIIfIR U(tllGHF.R IISiIi~G BASF i ~IF'I-14-9613 St1ITH D4, STEPHEN L C'ATIENT GLAIl1 INCURRED C4VEfiE1f TOTAL i1.A1riAiT( .CIF. tiG. ti0. FRD11 TO GH8tt6E PAID D Nri~1.I!I F 9444437441 06!46191 46/13/91 3fi8.4U A9Z.47 &R4UP TQ(AL: 6B8.4~ 491.41 PROVIDER TOTAL: $BR.OD 49"c.4Y .,. ,~. ~-, Enc. Il'iTE ~3/1bl~{ FFtlilIlif{i up~1t,NER LI~jiItlS FREE i ?4.991363 ilkllS 11D, J,9C11;S D Tt'n-t1U2~ i(EtiP. CO~tHit' P~!TIEltT (~iRIPI THGUR!CED CfltlfRfD ttlTfll (;tRIltR!?T FEF. hn. NtJ. ffif)fl TO CHARGE FRID fl 9T;EICS. f 91144224413 07J2~t191 47J31J~1 25.44 2.3.YV GROUP 'f tlTAl = 25. RA 23.24 PROt1I0Efi TOTR1.: 25.4G 2-3.24 ~. ~, A., INC. fi~i!E `!3. t~,r;; f'~~~7lisEs? t!OUGHER LISIIN6 FflCE 1 '~~-iti~¢!1'i l3U9CE tiQ , T R Pf!tl?N1 rtRlll INCURRED C08EOED ts)iAL r4.~,]~fi~{T tsFp +;~. Mv. FR01f TO CHAfiCE SAID ~_. ___.... ._ i !: ;:`!+t'vt:H 'aQCt-392545 01f11191 0Il11l~1 35.OU X9.44 r. !±;r.?ICs.` ~ ~C00406404 01fi~if91 07/31/41 SO.UA l~.tiQ i Ki~1_!lf ~!' s 900D437101 051[$lyt 08/09/91 210.0D 183.41 ' GROUP TOTAL 325.00 cS3.99 PRUUIgER IOTAI~ 325.00 Y83.49 t