AUTO ELIGIBILITY VERIFICATION FOR APPOINTMENT SCH

Pat # Pat F NamePat L Name Pat Birthdate Date Appt Type ProviderName
Primary Insurance
Primary
NameIns Subscriber No
147341 DEBORAH NEELY 3/11/1970 12/13/2023 FUV GEMAYEL $0.00 $0.00
156618 AMJAD ALSANAI 1/1/1993 12/13/2023 FUV SCHUPBACH PROGRESSI23-5720575
50200 TASHA HOLLAND 02/24/1984 12/13/2023 FUV RAMPERSAU AUTO OWN30000184672018
35125 SHELLEY SILK 3/12/1974 12/13/2023 FUV RAMPERSAU USAA Casua
010720258-003
48151 MELINDA WEBB 01/24/1970 12/13/2023 FUV RAMPERSAU AMERIPRISCN-002-144148
136757 ABDULLAHALMATTAR3/5/1969 12/13/2023 FUV SCHUPBACH WESTFIELD2395769
121229 VENITA SIMS 10/18/1961 12/13/2023 FUV SCHUPBACH SEDGWICK302056360390001
134554 ERIKA CAMPBELL09/24/1984 12/13/2023 FUV RAMPERSAU ALLSTATE 692033236
142283 NIA REESE 12/10/1988 12/13/2023 PostOp SCHUPBACH STATE FAR2224G394R
155322 JAMIE BROWN 08/30/1978 12/13/2023 DEARFUV SCHUPBACH NATIONWI127076-GP
160022 DAVID PEEL 11/9/1967 12/13/2023 L1NPC PESKIN EV ESIS INC 1E01E015104693
32008 MELISSA MOLDENHA 05/22/1985 12/13/2023 INJECTION RAMPERSAU NATIONWI457264GK
159334 ALI FADEL 12/9/2007 12/13/2023 DEARFUV SCHUPBACH ($45.00) $0.00
148074 CHRISTOPHLAROCQUE11/17/1974 12/13/2023 INJECTION RAMPERSAU STATE FAR2257Z113V
98580 ANDRE MOFFETT 9/9/1967 12/13/2023 WARFUV Doyle AlyssPROGRESSI201314323
123885 HALEESHA WILLIAMS 01/22/1982 12/13/2023 WARFUV SRIPADA SIPROGRESSI22-582-6635
139823 KAYLA WELSING 01/14/1992 12/13/2023 FUV Danko Joe PROGRESSI212240059
145185 MADEEN ALJUHAIM 1/2/1978 12/13/2023 WARFUV SRIPADA SIPROGRESSI228054543
134092 FRANK STEWART 01/17/1971 12/13/2023 FUV Danko Joe AAA MICH 401558375
132968 TARA SIDOTE 04/16/1989 12/13/2023 WARFUV SRIPADA SIHANOVER M 46-23040002
131753 BASSAM SALMAN 8/10/1981 12/13/2023 WARFUV SRIPADA SIPROGRESSI21-5581913
152902 SANDRA DEH 04/19/1960 12/13/2023 ISH INJ SHENAVA CURE AUT CLM1438
94677 RODNEY KIRK 10/23/1973 12/13/2023 WARFUV Doyle AlyssSTATE FAR2226T068J
119549 HENRY MELSON 9/1/1979 12/13/2023 WARFUV SRIPADA SISTATE FAR2223Q804D
139288 SHERMONGANTT 11/18/1969 12/13/2023 WARFUV SRIPADA SISTATE FAR2243Z896G
74539 CARRIE BUZZARD 3/4/1962 12/13/2023 INJECTION SRIPADA SIPROGRESSI182864647
117652 ARYANA INGRAM 01/31/1994 12/13/2023 WARFUV SRIPADA SISTATE FAR3528S690K
150175 MARVIE GARDNER 4/1/1995 12/13/2023 WARFUV Doyle AlyssSTATE FAR2252J184W
85130 JOHN DALEY 10/21/1966 12/13/2023 ISH INJ SRIPADA SISTATE FAR22A374713
148924 ADRIAN LOVE 11/2/1966 12/13/2023 ISH INJ SRIPADA SICURE AUT CLM- 11639
135533 CYNTHIA CASTILLO- 12/11/1974 12/13/2023 FUV Widzinski JCHESTERFI23W284271C
120515 MICHELE ADAMS 4/2/1966 12/13/2023 FUV McDougallESURANCEPAMI006771801
50200 TASHA HOLLAND 02/24/1984 12/13/2023 FUV McDougallAUTO OWN30000184672018
144945 GREGORY ZELLAR 05/29/1963 12/13/2023 FUV Torcuator PENDING AUTO
153274 ANTHONY JOHNSON 08/23/1976 12/13/2023 L1NPC McDougallGALLAGHER 002227013848WC-
150028 KELLEY WHEELER 03/16/1976 12/13/2023 CHIRO-CASH Sullivant R $0.00 $0.00
38666 AVERY JACKSON 08/17/1996 12/13/2023 CHIRO-AUTOSullivant R STATE FAR226T14950
131609 CASSANDRGIBSON 06/25/1975 12/13/2023 PT FUV Thota BhavUSAA Casua 016748310-017
147341 DEBORAH NEELY 3/11/1970 12/13/2023 FUV Jondy Moh$0.00 $0.00
121916 CEDRIC SMITH 12/23/2000 12/13/2023 CHIRO-AUTOSullivant R FARMERS 7003554985-1
157785 HUNTER PEDERY 10/25/2010 12/13/2023 NP Jondy Moh$0.00 $0.00
147844 ADA MALLOY 12/20/1978 12/13/2023 PT FUV TeachwortPROGRESSI238839552
158060 MANAR AL-NASIR 06/28/2000 12/14/2023 DEARNP Belasher ZaMeemic In2048436
128828 WILLIE SMALL 04/22/1960 12/14/2023 FUV Danko Joe PROGRESSI232677345
159677 GILMER MILTON 05/29/1959 12/14/2023 L1NPC PESKIN EV PENDING AUTO
16136 ROGER LEDFORD 9/12/1984 12/14/2023 FUV Danko Joe PROGRESSI91328421
133232 TERRELL MCDONAL11/15/1982 12/14/2023 FUV SCHUPBACH $0.00 $0.00
32072 KAREN SPENCER 07/18/1973 12/14/2023 FUV SCHUPBACH ACCIDENT AFC230662168
152672 JAMES DELORENZ07/22/1967 12/14/2023 SURG ASST Piatt Alliso PROGRESSI236614229
75092 NIQUAI SHAW 8/12/1973 12/14/2023 FUV Danko Joe PROGRESSI239417381
29916 LOMA HARRIS 8/12/1958 12/14/2023 FUV Danko Joe STATE FAR227Z47051
96736 BYRON RAY 09/18/1958 12/14/2023 INJECTION RAMPERSAU ASU GROUFTO-20-0000-33-01
112055 EL-HAILE BLACKWEL12/3/1982 12/14/2023 FUV Danko Joe NATIONWI810617GM
45683 MARK HEATHER 02/28/1984 12/14/2023 INJECTION RAMPERSAU CORVEL C 30095562017
153231 MEADOW PORTILLO 7/3/2005 12/14/2023 NEW2U SCHUPBACH $0.00 $0.00
123626 DENISE NICKLEBER11/24/1962 12/14/2023 FUV Widzinski JESURANCE186359936
115191 KRISTY BURRIS 08/20/1973 12/14/2023 INJECTION SHENAVA FARMERS 7006337994-1
158659 MARTELL GRESHAM 1/8/1985 12/14/2023 DEARFUV SRIPADA SIPENDING AUTO
144638 FAIZA OGAILI 11/18/1957 12/14/2023 DEARFUV SRIPADA SIAllstate I 2302051201
145145 HUDA ADHAB 07/16/1984 12/14/2023 DEARFUV SRIPADA SIWESTFIELD2445707
152672 JAMES DELORENZ07/22/1967 12/14/2023 SURGERY Sarmast ZuPROGRESSI236614229
15502 SABRA SCHOCKE 06/28/1966 12/14/2023 FUV McDougallAUTO OWN098-0000488-2005
158060 MANAR AL-NASIR 06/28/2000 12/14/2023 DEARNP Belasher ZaMeemic In2048436
138801 JAMERE MAXWELL 10/1/1992 12/14/2023 PT RE-EVAL Bhole NeerGEICO 8.74255765E+15
139031 EMMANUEBELTRAN 3/6/1997 12/14/2023 PT FUV Thota BhavESURANCE230121883
101088 CAROLYN GRUNDY 02/19/1957 12/14/2023 CHIRO-AUTOSullivant R PROGRESSI204690347
117076 MICHAEL DAVIS 09/21/1964 12/14/2023 CHIRO-AUTOSullivant R AUTO OWN30002837342022
150175 MARVIE GARDNER 4/1/1995 12/14/2023 PT FUV Thota BhavSTATE FAR2252J184W
131089 KEVIN CHABAN 04/27/1986 12/14/2023 FUV NASIR MOHPROGRESSI223471492
94063 TOSOINA COLEMAN 01/26/1983 12/15/2023 NP Belasher ZaSTATE FAR2240H825D
27588 BRENT RENSHAW 06/20/1976 12/15/2023 NEW2U Belasher ZaGRANGE I APV1523333
145644 JENNIFER PROFFER 04/20/1967 12/15/2023 FUV Danko Joe PROGRESSI237475781
152182 CHRISTIANZEMBO 09/13/1996 12/15/2023 TPI RAMPERSAU STATE FAR2246S108C
146344 MORGAN WARNICK 4/2/1990 12/15/2023 FUV Widzinski JSEDGWICK4A2109F06280001
111286 HAROLD ASHBURN 06/16/1953 12/15/2023 FUV Widzinski JPROGRESSI217336007
45683 MARK HEATHER 02/28/1984 12/15/2023 FUV Widzinski JCORVEL C 30095562017
109778 KYLE MAPES 3/7/1983 12/15/2023 FUV Widzinski JHANOVER M 4621041098
14848 SAMUEL MONCZUNS 4/7/1956 12/15/2023 FUV Widzinski JPROGRESSI21-3303629
37975 MICHAEL LOVE 12/1/1973 12/15/2023 FUV Widzinski JPROGRESSI228122971
121922 YVONNE CROCKETT 2/12/1965 12/15/2023 WARFUV SRIPADA SIESURANCEFLA0328590
155472 BRITNEY ROSS 12/28/1999 12/15/2023 WARFUV SRIPADA SILIBERTY M301504610
159936 JOSEPH ACHTABOW 11/22/1989 12/15/2023 WARFUV SRIPADA SIPENDING AUTO
160177 STEVEN GRANT 03/22/1986 12/15/2023 WARNPV SRIPADA SIALLSTATE 733523104
156243 BRANDON TAYLOR 10/24/1985 12/15/2023 WARFUV SRIPADA SIPENDING AUTO
115800 TYLER AYERS 12/11/1971 12/15/2023 WARFUV SRIPADA SIFARM BURAC-1000797570
156037 MICHAEL MITCHELL 12/29/1991 12/15/2023 WARFUV SRIPADA SIFARMERS SLV535003C
151684 MARCUS TATE 10/8/1947 12/15/2023 WARFUV Doyle AlyssPENDING AUTO
141480 MICHAEL BOWERS 11/30/1990 12/15/2023 WARFUV Doyle AlyssTRAVELERSFXW-4531
159360 FLORIAN GJEKAJ 12/15/1967 12/15/2023 WARFUV Doyle AlyssPROGRESSI238958719
149109 KIZIA GWYN 08/17/1979 12/15/2023 WARFUV Doyle AlyssTRAVELERSFOM3802TRV
105659 JACLYN HOEFLEIN 09/13/1980 12/15/2023 FUV Yin Dali PROGRESSI19-2000941
94063 TOSOINA COLEMAN 01/26/1983 12/15/2023 NP Belasher ZaSTATE FAR2240H825D
27588 BRENT RENSHAW 06/20/1976 12/15/2023 NEW2U Belasher ZaGRANGE I APV1523333
86317 ERICA SIMS 02/13/1981 12/15/2023 FUV Torcuator STATE FAR2234B306V
156655 LESLIE PARRENT 11/3/1982 12/15/2023 FUV Torcuator PENDING AUTO
155687 SUZANNE ROMANO 02/13/1942 12/15/2023 FUV Torcuator U FARMER5025302077
65491 GARY KLICZINSKI9/10/1946 12/15/2023 FUV Torcuator PROGRESSI18-5620189
156982 KELLY HEIZER 10/17/1962 12/15/2023 FUV Sarmast ZuGALLAGHER 0106583149098WC
163561 John Karimov 1/3/1989 12/15/2023 NP Sarmast Zu($135.00) $0.00
152698 SHONDA BROWN 05/28/1978 12/15/2023 PostOp Sarmast ZuPROGRESSI222963603
131609 CASSANDRGIBSON 06/25/1975 12/15/2023 PT FUV Thota BhavUSAA Casua016748310-017
155550 JEANNE PATTERSO 2/11/1990 12/15/2023 PT FUV Thota BhavPROGRESSI233325126
117076 MICHAEL DAVIS 09/21/1964 12/15/2023 PT FUV Dasuqi AngAUTO OWN30002837342022
86343 JEREMY DIENER 08/18/1980 12/17/2023 FUV Widzinski JU AUTO O 30001261642020
83939 RONNIE FIELDS 01/19/1966 12/17/2023 FUV Widzinski JU NATION 766034-GL
81655 CHANEL TRUSS 12/25/1977 12/17/2023 FUV Widzinski JU ALLSTAT562713214
35125 SHELLEY SILK 3/12/1974 12/17/2023 FUV Widzinski JUSAA Casua
010720258-003
134466 ERIC LOVELADY 1/1/1966 12/17/2023 FUV Widzinski JU AAA LP294969
APPOINTMENT SCHEDULE DTD 12/13/2023 to 12/17/2023
Ins Type New/Follow up Comments Status Remarks Worked By Worked date
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 Assigned to
Deepika
Madhu
Arshiya
Madhu
Arshiya
Nisha
Jyothi
Deepika
Nisha
Jyothi
Puneetha
Jyothi
Deepika
Nisha
Aishwaryia
Aishwaryia
Aishwaryia
Madhu
Deepika
Puneetha
Aishwaryia
Arshiya
Nisha
Nisha
Nisha
Madhu
Nisha
Nisha
Nisha
Arshiya
Arshiya
Arshiya
Arshiya
Jyothi
Puneetha
Deepika
Nisha
Madhu
Deepika
Puneetha
Deepika
Aishwaryia
Jyothi
Aishwaryia
Jyothi
Aishwaryia
Deepika
Deepika
Madhu
Aishwaryia
Nisha
Arshiya
Jyothi
Puneetha
Deepika
Arshiya
Puneetha
Jyothi
Deepika
Nisha
Madhu
Arshiya
Jyothi
Puneetha
Arshiya
Madhu
Arshiya
Nisha
Madhu
Nisha
Puneetha
Aishwaryia
Nisha
Jyothi
Madhu
Puneetha
Puneetha
Aishwaryia
Aishwaryia
Arshiya
Jyothi
Jyothi
Deepika
Jyothi
Puneetha
Puneetha
Jyothi
Nisha
Madhu
Nisha
Madhu
Nisha
Puneetha
Nisha
Jyothi
Puneetha
Aishwaryia
Puneetha
Deepika
Madhu
Madhu
Aishwaryia
Arshiya
Arshiya
Jyothi
Deepika
Madhu
Deepika