ORDER N0. ^c7252 VERICLAIMS, INC.-LATE RILL On this the 24th day of September 2~D01, upon motion made by Commissioner^ Griffin, seconded by Commissioner Williams, the Court unanimously approved by a vote of 4-0-0, to approve late bill in the amount of 41,6SQ~.69 to Ver•iclaims, Inc. The Co~_mty Auditor and the County Treasurer are hereby authorised to write a handcheck in the amount of X1,630.69 made payable to Vericlaims, Inc. Sheet! ~ FOR AUDITOR'S OFFICE USE ONLY LATE BILL FOR 09/24/01 WILL NEED A HANDCHECK VENDOR # INVOICE # PAID TO: VERICLAIMS, INC. AMOUNT: 57,630.69 EXPENSE CODE: 50-64186 DESCRIPTION: FEE ON CLAIMS PROCESSED:919/01 INVOICE NUMB: 010909/FEE INVOICE DATE: 09/10/01 RECVD DATE: 09/14/01 DUE DATE: 09/24!01 VeriClaims, Inc. 207 Meadowgrove Houston, Texas 77037-4303 Kerr County Auditor's Office Attention: Mindy Williams 700 Main Street Kerrville, Texas 78028 Indigent Health Care September 10, 2001 September 9, 2001 Claims3~Q8~7~ @ 4.5% _ 36,237.62 Please remit to address shown above. Thank you. Less Milton Taylor (Sid Peterson Hosp) " (T.C.E.P./Sid Pete) " (Hill Country Image) " (Eckerd Drugs) Less Julian Colunga (Urocor, Inc.) Less Thomas Nixon (Colorado Surgical) Less Nora Bishop (Echerd Drugs) -i66&9r 1,630.69 . Q ~~ ~ ~~~ $ 282.10 72.83 7.91 130.55 180.30 127.93 48.51 $ 850.13 --SSI/Medicaid --SSI --Wrong Provider --Wmng Amount S~~ 1.4 ~Q~~