ORDER N0. 20800
APPROVAL TO PAY INDIGENT HEALTH CARE BILLS
TO VARIOUS PROVIDERS
On this the 24th day of February 1992, upon motion made by Commissioner
Morgan, seconded by Commissioner Lackey, the Court UNANIMOUSLY APPROVED
BY A VOTE OF 4-0-0, to pay the Indigent Health Care Bi11s in the
amount of $7,068.46.
r' ..,~~ ~,lA` '~ ~.
CNcCK CHECK
' r~UnBER GATE CLAIM NO	
GROUP NO SOC SE< N4 EMPLiiYtE	
CIAiMANT	
PAY TO	CHECK
AMOUNT	
.
~n:.~r ~;_;i;~~~~ u~4 Kt~i' CUUtlTY					
e 1674 U2/O7/42
;625 02/07/42	TPk-GG74
iPk-OG24	MANUAL GTNER
VOUCHER PAYMENT	YG1D
MEDICAL SEhY1CF Rd~ PLAN	,nU
163.72	
._.'~! {)C ~ti'i /`~~	T~'a~J U:'~	~'Q;J(HF'i; f~Y ~4~c"!	h _. ~'Y~Afie ~(v,. fit, k,,. -	~ +1,7!	
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' T. P. A., INC.
DATE 02/07/9? PROVIDER VOUCHER LISTING PACE 1
tPV003?
FOR PROVIDER: 74-1586031A MEDICAL SERVICE RdD PLAN
FOR GROUP: TF%-0024 !{ERR COUNTY
SEQUENCE NO: t
PATIENT CLAIM INCURRED COVERE9 TOTAt
CLAIMANT DEP. NO. N0. FROM t0 CHARGE PAID
=sasasssoases~asse:assasos:_xsaas-sssexseet~-ssess~xeaeseeao=ar_sescxsrxm=:cr_neaxce
N CANTO E 1224653 9000573604 10/02191 10!02/91 275.00 163.12
CRORIP TOTAL: 275.00 163.72
PROOIDER TOTAL: 275.04 163.72
' T. P. A., INC.
BATE O2/Ol/9Z PR01IDFtt I~CIIER tISTYt16 FM:F 1
tP00A3I
fOR PROtlIBER: 74-25578'10 SID PETERSON ITEM R08PITAl
iOR 4'ROIlP: TPK-0024 KERB COUNTY
SEpUENCE N0: 2
PATIENT CLAIM INCURRED COnEREH TOTi~
CLAIMANT ~A. N0. 110. FROM TO CNARCE PAIR
szazzassazsasaszsaasasazaasszxaxzaazzsa=ssszasssr_sssazasszsaszaaaszaszsaaaaasssaazas
N AIIITE f 234926 9000552906 09/30/91 10/04/91 (729.90 1186.96
6 YO11NC E 239589 9000524314 Q8/26/91 09/i7/91 14273.10 5574.01
GCD11P TtiTAt: 16003.00 6862.97
PROIII>~R TOTAL: 16003.00 6862.97
T. P. A., IRC.
DATE 02/47/92 PROVIlFR V01lCNER LISTIi1C PACE t
I1~0003)
fOR PROVIDER: 79-0537115T R E e PNARIMCY 1099
FOR CROUP: iPX-0029 IQ:RR I:OIlNT4
SEQBEIICE 110: 3
		PATIEIR	C1AIM I111~RED	COOERE!	TOTAL
p.AIdANT	AFP. N0.	N0. fROR TO	CNARCE	PAID
ssxsassssssssssrsssssssseassssssa	sssrsassssasasssasssssrsrasssasrsssssssssxssssassss
0 FARREI1TROtD	E	62119179	9000990202 04!30/91 00!30/9i	15.3E	15.36
f COIIEI	E	6221228	9000988310 Ob/16/91 06//6/91	8.26	8.2b
f PEgA	E	62199bS	9400943302 0,'1/02/91 05/02/91	15.36	13.36
R PIEPER	E	7200172	9400492906 03!11191 03/11/91	2.79	2.19
			CROUP TOTAL:	41.71	41.77
			PROOIQER TOTAL:	91.71	91.71