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Data_Source|Patient_Type|Department_ID|Encounter_ID|MRN|Patient_Name_Prefix|Patient_First_Name|Patient_Middle_Name|Patient_Last_Name|Patient_Name_Suffix|Street_Address|Street_Address_2|City|State|Zip_Code|Birth_Date|Gender|Admission_Date|Discharge_Date|Discharge_Status_Code|Total_Charges|Total_Payments|Total_Adjustments|Client_FM_4|Fin_Class_Code|Fin_Class_Name|Ins_Plan_Code|Ins_Plan_Name|ICD10_Prim_Diag_Code|ICD10_Prin_Proc_Code|Prin_CPT_Code|ADM_Phys_ID|ADM_Phys_Name|ATT_Phys_ID|ATT_Phys_Name|OPR_Phys_ID|OPR_Phys_Name|REF_Phys_ID|REF_Phys_Name|PC_Phys_ID|PC_Phys_Name|MSDRG_Code|NO-SSN|Marital_Status|Spoken_Language|Race_Code|Employer_ID|Email_Address|Home_Phone_Number|Cell_Phone_Number
Epic HB|E|10101690|31112298|164781||Zuri|Sade|Barnes||2203 HOLIDAY ROAD||WICHITA FALLS|TX|76301|19861112|F|20230306|20230307|01|15501.57|-9145.93|-6355.64||12|BLUE CROSS|6000002|BLUE CROSS BLUE ADVANTAGE|L03.116||J3010|||1376861401|MEYER, EVAN|||||1063876209|MCQUERRY, MICHELLE|||S|English|B|1085|
[email protected]|9402350088|
Epic PB|C|10501301|72315048|194280||Erica|A|Cuin||602 VAN BUREN Street||WICHITA FALLS|TX|76301-0000|19900831|F|20230327|20230327||275.85|-78.55|-197.30||09|MANAGED MEDICAID|5002000|SUPERIOR STAR|||99214|||1801123872|STEEN, BONNIE|1801123872|STEEN, BONNIE|||1952954703|BUCHAN, JASON M|||M|English|H|1071|
[email protected]|9403414585|9403414585
Epic HB|C|10501174|31093297|150971||Heather||Walker||4403 NASSAU DR||WICHITA FALLS|TX|76308|19820119|F|20230302|20230302|01|4248.06|-2612.56|-1635.50||12|BLUE CROSS|6000000|BLUE CROSS PPO|N83.201||74176|||1467872127|BARNETT CT|||1467872127|RUSSELL, WILLIAM K|1467872127|RUSSELL, WILLIAM K|||M|English|U|1000|
[email protected]|9406361807|9406361807
Epic PB|C|10501123|72192495|807684||Randall|R|Vernon||111 Mary Kay Dr||TIPTON|OK|73570|19510516|M|20230224|20230224||669.41|-258.71|-410.70||12|BLUE CROSS|6000000|BLUE CROSS PPO|||99245|||1184821522|MAI, FLOWER H|1184821522|MAI, FLOWER H|||1487697033|LEVERETT, JOE|||D|English|W|1099||5804715586|5804715586
Epic PB|C|10501301|72230321|692141||Ambri||La Master||5112 Tower Dr||WICHITA FALLS|TX|76310|20130318|F|20230217|20230217||326.49|.00|.00||09|MANAGED MEDICAID|5000001|AMERIGROUP STAR|||87880|||1447809579|HILL, AMBER|1447809579|HILL, AMBER|||1023374949|HAYLEY, LAUREN|||S|English|W|1097|
[email protected]|9402247098|9402247098
Epic HB|I|10101502|31099434|739802||Essie||Bowman||400 Burnett St|Apt 309|WICHITA FALLS|TX|76301|19550515|F|20230220|20230224|06|27697.78|-5937.42|-21760.36||07|MANAGED MEDICARE|4010002|UHC WELLMED MCR ADV HMO|E11.10||99223|1447363338|PYRON, BRADDEN|1285911636|QUBTY, ROBIN|1336615343|MCBROOM, TRENTON|||1033680731|MAY, HANH|638||S|English|B|1096|
[email protected]|9409234149|9409234149
Epic HB|C|10101162|31127737|080210||Larry|D|Davis||1308 10TH ST NO 3||WICHITA FALLS|TX|76301|19610414|M|20230330|20230330|01|394.41|-13.63|-380.78||02|MEDICARE|10603|MEDICARE PART A AND B|S91.102A||G0463|||1205063435|COLEMAN, ALAN|||1093179079|JAISWAL, RADHIKA|1780035956|CLARK, HEATHER|||D|English|W|1096||9406134149|9406134149
Epic HB|C|10101155|31132722|107996||Shakalia|Lagenia|Coleman||1701 Pearlie Dr Apt 1B||WICHITA FALLS|TX|76306|19921116|F|20230411|20230411|01|803.60|-474.12|-329.48||12|BLUE CROSS|6000002|BLUE CROSS BLUE ADVANTAGE|N63.14||77066|||1093216582|BRIDWELL US 2|||1093216582|WILLIAMS, APRIL R|1093216582|WILLIAMS, APRIL R|||M|English|B|1293|
[email protected]||9402288928
Epic PB|C|10501101|71943438|128734||Judy|K|Mitchell||1400 COVINGTON||WICHITA FALLS|TX|76306|19490506|F|20230223|20230223||312.42|-125.53|-186.89||02|MEDICARE|10603|MEDICARE PART A AND B|||G0439|||1811989858|WOLFE, MITCHELL C|1811989858|WOLFE, MITCHELL C|||1811989858|WOLFE, MITCHELL C|||M|English|W|1099|
[email protected]|9407814134|9407814134
