patnum | trial_lname_2 | fname | middlei | trial_preferred_5 | patstatus | gender | position | trial_birthdate_9 | ssn | address | address2 | trial_city_13 | trial_state_14 | zip | hmphone | wkphone | wirelessphone | guarantor | credittype | email | salutation | estbalance | priprov | trial_secprov_25 | feesched | billingtype | imagefolder | addrnote | famfinurgnote | medurgnote | apptmodnote | studentstatus | trial_schoolname_34 | chartnumber | trial_medicaidid_36 | trial_bal_0_30_37 | trial_bal_31_60_38 | bal_61_90 | balover90 | insest | trial_baltotal_42 | trial_employernum_43 | employmentnote | trial_county_45 | trial_gradelevel_46 | urgency | datefirstvisit | clinicnum | hasins | trial_trophyfolder_51 | plannedisdone | trial_premed_53 | trial_ward_54 | preferconfirmmethod | prefercontactmethod | trial_preferrecallmethod_57 | trial_schedbeforetime_58 | schedaftertime | scheddayofweek | language | admitdate | title | payplandue | sitenum | trial_datetstamp_66 | trial_responsparty_67 | canadianeligibilitycode | trial_asktoarriveearly_69 | trial_prefercontactconfidential_70 | superfamily | txtmsgok | trial_smokingsnomed_73 | country | datetimedeceased | trial_billingcycleday_76 | secusernumentry | secdateentry | trial_hassuperbilling_79 | patnumclonefrom | discountplannum | trial_hassignedtil_82 | shortcodeoptin | trial_securityhash_84 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7 | Smith | 4 | 0 | 0 | 0001-01-01T00:00:00.000Z | 7 | 0 | 1 | 0 | 0 | 40 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||||||||||||
| 8 | * T | * TRI | 0 | 1 | 1 | 1974-02-08T00:00:00.000Z | 4528 Panama St SE | South | * | 52981 | * TRIAL * TRI | (521)258-6511 | 8 | 150 | 3 | 0 | 0 | 40 | PPOPatty8 | 0 | 0 | 0 | 0 | 72 | 150 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | |||||||||||||||||||||||
| 9 | Medicaid | * TRIA | 0 | 0 | 0 | 1964-06-08T00:00:00.000Z | * TRIAL * TRIAL | Sahara | NJ | 22815 | * TRIAL * TRI | 9 | 225 | 3 | 0 | 0 | 40 | * TRIAL * TRIAL | 225 | 0 | 0 | 0 | 225 | 225 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | * | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | * TRIAL * | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||||
| 10 | Out of Network | Nancy | 0 | 1 | 0 | 1980-05-06T00:00:00.000Z | 15 Welcome Ave #295 | Salem | NY | 15611 | (855)369-8746 | 10 | 150 | 1 | 0 | 0 | 40 | NancyNormal10 | 0 | 150 | 0 | 0 | 120 | 150 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | * TRIAL * | ||||||||||||||||||||||||
| 11 | Allowed | Allen | 0 | 0 | 1 | 1980-06-05T00:00:00.000Z | 266 Jamaica Street | Forbes | CT | * TRI | (253)687-9654 | 11 | 230 | 1 | 0 | 0 | 40 | AllowedAllen11 | 0 | 0 | 0 | 370 | 265 | 370 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | * | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||||
| 12 | Allowed | Anna | 0 | 1 | 1 | 1984-02-07T00:00:00.000Z | 266 Jamaica Street | Forbes | CT | 21598 | * TRIAL * TRI | 11 | 140 | 1 | 0 | 0 | 40 | AllowedSara12 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | * | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | * TRIAL * | ||||||||||||||||||||||||
| 13 | * TRI | Candi | 0 | 1 | 0 | 1990-03-08T00:00:00.000Z | 163 Madison Loop | Sandy | OR | * TRI | * TRIAL * TRI | 13 | 140 | 1 | 0 | 0 | 40 | * TRIAL * TR | 0 | 140 | 0 | 0 | 65 | 140 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | * | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||||
| 14 | PPO | LittleAnnie | 0 | 0 | 0 | 2002-03-27T00:00:00.000Z | 4528 Panama St SE | * TRI | CA | 52981 | * TRIAL * TRI | 8 | 0 | 3 | 0 | 0 | 40 | PPOLittleAnnie14 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | |||||||||||||||||||||||||
| 15 | * TRI | John | 0 | 0 | 1 | 1979-06-23T00:00:00.000Z | 125 Satin Heights | * TRIAL | CA | 05698 | * TRIAL * TRI | (536)265-8587 | (536)987-5621 | 15 | johns@hotmail.com | 140 | 1 | 0 | 0 | 40 | SmithJohn15 | 0 | 388 | 0 | 0 | 360 | 388 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | * TRIAL * | |||||||||||||||||||||
| 16 | * TRI | Jane | 0 | 1 | 1 | 1976-05-24T00:00:00.000Z | * TRIAL * TRIAL * | * TRIAL | * | 05698 | * TRIAL * TRI | (536)987-4822 | 15 | * TRIAL * TRIAL * | 180 | 1 | 0 | 0 | 40 | * TRIAL * T | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | * TRIAL * | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||
| 17 | * TRI | * TRIA | 0 | 0 | 2 | 2002-02-09T00:00:00.000Z | 125 Satin Heights | San Jose | CA | * TRI | * TRIAL * TRI | 15 | 68 | 1 | 0 | 0 | 40 | * TRIAL * TRI | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | * TRIAL * | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | ||||||||||||||||||||||||
| 18 | Smith | Sis | 0 | 1 | 2 | 2008-06-25T00:00:00.000Z | * TRIAL * TRIAL * | San Jose | CA | * TRI | * TRIAL * TRI | 15 | 0 | 1 | 0 | 0 | 40 | SmithSis18 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-03-30T00:00:00.000Z | 0 | I | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | * TRIAL * | ||||||||||||||||||||||||
| 19 | Smith | 4 | 0 | 0 | 0001-01-01T00:00:00.000Z | 125 Satin Heights | San Jose | CA | 05698 | (536)624-5871 | 19 | 0 | 1 | 0 | 0 | 40 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | |||||||||||||||||||||||||||
| 20 | Zarren | Amy | 0 | 1 | 1 | 1949-04-02T00:00:00.000Z | * TRIAL * TRIAL | * TRIA | TX | 25415 | (625)879-5462 | 21 | 0 | 3 | 0 | 0 | 40 | ZarrenAmy20 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | * TRIAL * | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception | |||||||||||||||||||||||||
| 21 | * TRIA | Bob | 0 | 0 | 1 | 1951-06-09T00:00:00.000Z | 3652 Memory Lane | Dallas | TX | 25415 | (625)879-5462 | 21 | 0 | 3 | 0 | 0 | 40 | ZarrenBob21 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2009-04-30T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 00:00:00 | 00:00:00 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 2023-07-11T13:51:13.000Z | 0 | 0 | 0 | 0 | 0 | 0 | 266927001 | 0001-01-01T00:00:00.000Z | 1 | 0 | 0001-01-01T00:00:00.000Z | 0 | 0 | 0 | 0 | 0 | Exception |