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N CHIMBERRY AVE", "insurancepackageaddress1": "PO BOX 9201", "insuredcountrycode": "USA", "insurancepolicyholdersex": "M", "eligibilityreason": "Athena", "insuredzip": "79758", "ircname": "Boon Chapman Benefit Admin", "insuredlastname": "PRADON", "insuranceplanname": "BOON CHAPMAN BENEFIT ADMINISTRATORS", "insurancetype": "Commercial", "insuredsex": "M", "insuredcity": "GARDENDALE", "insurancephone": "(800) 252-9653", "insureddob": "01/23/1985", "insurancepackagestate": "TX", "insurancepackagecity": "AUSTIN", "id": "38576", "insuredaddress": "16081 N CHIMBERRY AVE", "insuredstate": "TX", "relationshiptoinsuredid": 2, "insuranceid": "38576", "insurancepolicyholder": "BARRETT PRADON", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholdermiddlename": "D", "insurancepolicyholderfirstname": "BARRETT", "insurancepackageid": 2448, "ircid": 960, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Boon-Chapman", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "GARDENDALE", "insurancepackagezip": "78766-9201", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "glozano5", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 25 }, "copay": 25, "appointmenttypeid": "21", "lastmodified": "10/22/2021 12:03:30", "appointmenttype": "NEW PT", "providerid": "1", "chargeentrynotrequired": false, "scheduleddatetime": "09/27/2021 12:38:01", "coordinatorenterprise": false, "templateappointmentid": "445924", "appointmentnotes": [ { "displayonschedule": false, "text": "in office", "id": 88376 } ], "patientappointmenttypename": "NEW PT" }, { "date": "10/25/2021", "appointmentid": "448092", "patient": { "guarantorcountrycode": "USA", "firstname": "Jessica", "primarydepartmentid": "1", "contactpreference": "HOMEPHONE", "contactrelationship": "SPOUSE", "lastemail": "CONSULTING921@GMAIL.COM", "state": "TX", "racename": "Patient Declined", "balances": [ { "departmentlist": "1", "balance": "92", "cleanbalance": "true" } ], "email": "Jiminezje73@gmail.com", "race": [ "declined" ], "emailexists": "true", "departmentid": "1", "confidentialitycode": "N", "homephone": "4325306635", "firstappointment": "08/27/2019 14:00", "contacthomephone": "4325564730", "language6392code": "eng", "guarantorstate": "TX", "patientid": "9714", "dob": "09/21/1973", "zip": "79763-2640", "portalaccessgiven": "true", "guarantordob": "09/21/1973", "primaryproviderid": "1", "guarantoraddresssameaspatient": "true", "address1": "1718 Hemphill Ave", "guarantorrelationshiptopatient": "1", "driverslicense": "true", "patientphoto": "true", "portaltermsonfile": "true", "status": "active", "consenttocall": "true", "lastname": "Jiminez", "guarantorfirstname": "Jessica", "guarantorphone": "4325306635", "homebound": "false", "defaultpharmacyncpdpid": "5923657", "city": "ODESSA", "driverslicenseurl": "/v1/9928/patients/9714/driverslicense", "lastappointment": "10/22/2021 16:15", "patientphotourl": 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"79763-2640", "ircname": "BCBS-TX", "insuredlastname": "JIMINEZ UTAJARA", "insuranceplanname": "BCBS-TX: BCBS OF TX (PPO)", "insurancetype": "Group Policy", "insuredsex": "F", "insuredcity": "ODESSA", "insurancephone": "(800) 451-0287", "insureddob": "09/21/1973", "insurancepackagestate": "TX", "insurancepackagecity": "DALLAS", "id": "38304", "insuredaddress": "1718 HEMPHILL AVE", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "38304", "insurancepolicyholder": "JESSICA JIMINEZ UTAJARA", "eligibilitylastchecked": "10/21/2021", "insurancepolicyholderfirstname": "JESSICA", "insurancepackageid": 11993, "ircid": 143, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "BCBS-TX (PPO)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "75266-0044", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ATHENA", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 50 }, "copay": 50, "appointmenttypeid": "4", "lastmodified": "10/24/2021 11:03:32", "appointmenttype": "LAB ORDERS-CUSTOM", "providerid": "6", "chargeentrynotrequired": false, "scheduleddatetime": "10/22/2021 18:49:39", "coordinatorenterprise": false, "templateappointmentid": "391796", "appointmentnotes": [ { "displayonschedule": false, "text": "ecg; shape ; cxr ua and culture; cbc cmp vit d vit b12 mg uric acid a1c,thyroid panel and lipid panel ; pt /ptt prolation", "id": 90358 } ], "patientappointmenttypename": "LAB ORDERS-CUSTOM" }, { "date": "10/25/2021", "appointmentid": "444879", "patient": { "primarydepartmentid": "1", "contactpreference_lab_email": "true", "donotcall": "false", "racename": "Patient Declined", "email": "tinatobar@grandecom.net", "balances": [ { "departmentlist": "1", "balance": "80.75", "cleanbalance": "true" } ], "contactpreference_announcement_sms": "false", "suffix": "Ms", "emailexists": "true", "race": [ "declined" ], "departmentid": "1", "homephone": "4323682400", "firstappointment": "03/31/2014 09:00", "guarantorstate": "TX", "language6392code": "eng", "portalaccessgiven": "true", "primaryproviderid": "1", "workphone": "4323334482", "driverslicense": "true", "patientphoto": "true", "consenttocall": "true", "homebound": "false", "contactpreference_appointment_email": "true", "defaultpharmacyncpdpid": "5923657", "contactpreference_billing_email": "true", "contactpreference_appointment_sms": "false", "patientphotourl": "/v1/9928/patients/2708/photo", "contactpreference_billing_phone": "true", "mobilephone": "4329408603", "contactpreference_announcement_email": "true", "medicationhistoryconsentverified": "true", "hasmobile": "true", "guarantorsuffix": "Ms", "ethnicitycode": "declined", "caresummarydeliverypreference": "PAPER", "notes": "BCBS HealthSelect **UPDATED 2/7/20**\r\nRef #U21088AXFQ Dr Matt Brown (BOSS) (10) 03/29/20221 - 03/22/2022 gma\r\n", "contactpreference_announcement_phone": "true", "guarantorlastname": "Tobar", "guarantorcountrycode": "USA", "firstname": "Maria", "contactpreference": "MOBILEPHONE", "state": "TX", "confidentialitycode": "N", "guarantorssn": "*****7310", "contactpreference_appointment_phone": "true", "contactpreference_lab_sms": "false", "patientid": "2708", "dob": "03/18/1966", "zip": "79761", "guarantoraddresssameaspatient": "false", "address1": "1900 E 14th St", "portaltermsonfile": "true", "contactpreference_billing_sms": "false", "status": "active", "lastname": "Tobar", "guarantoraddress2": "1900 E 14th St", "guarantorfirstname": "Maria", "guarantorphone": "4329408603", "city": "ODESSA", "ssn": "*****7310", "driverslicenseurl": "/v1/9928/patients/2708/driverslicense", "lastappointment": "10/13/2021 08:45", "guarantorcity": "ODESSA", "maritalstatus": "M", "guarantorzip": "79761", "countrycode": "USA", "sex": "F", "maritalstatusname": "MARRIED", "privacyinformationverified": "true", "consenttotext": "true", "countrycode3166": "US", "contactpreference_lab_phone": "true", "guarantorcountrycode3166": "US" }, "starttime": "09:30", "departmentid": "1", "appointmentconfirmationid": "7", "appointmentstatus": "f", "scheduledby": "ncortez10", "patientid": "2708", "appointmentconfirmationname": "Reschedule", "duration": 15, "templateappointmenttypeid": "1", "hl7providerid": 1, "insurances": [ { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 1, "insurancepolicyholderssn": "453557310", "insuredmiddleinitial": "C", "insurancepolicyholderlastname": "TOBAR", "insuredentitytypeid": 1, "insuranceidnumber": "JEA010892130", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79761", "insurancepolicyholderdob": "03/18/1966", "issuedate": "09/01/2017", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "policynumber": "238000", "insuredfirstname": "MARIA", "insurancepolicyholderaddress1": "1900 E 14TH ST", "insurancepackageaddress1": "PO BOX 660044", "insuredcountrycode": "USA", "insurancepolicyholdersex": "F", "eligibilityreason": "Athena", "insurednamesuffix": "MS", "insuredzip": "79761", "ircname": "BCBS-TX", "insuredlastname": "TOBAR", "insuranceplanname": "BCBS-TX: BCBS OF TX - HEALTHSELECT (POS)", "insurancetype": "Group Policy", "insuredsex": "F", "insuredcity": "ODESSA", "insurancephone": "(800) 451-0287", "insureddob": "03/18/1966", "insurancepackagestate": "TX", "insurancepackagecity": "DALLAS", "id": "30593", "insuredaddress": "1900 E 14TH ST", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "30593", "insurancepolicyholder": "MARIA TOBAR", "eligibilitylastchecked": "10/19/2021", "insurancepolicyholdersuffix": "MS", "insurancepolicyholdermiddlename": "C", "insurancepolicyholderfirstname": "MARIA", "insurancepackageid": 455673, "insuredssn": "453557310", "ircid": 143, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "BCBS-TX - HealthSelect (POS)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "75266-0044", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ncortez10", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 25 }, "copay": 25, "appointmenttypeid": "1", "lastmodified": "09/13/2021 11:45:49", "appointmenttype": "FOLLOW UP", "providerid": "1", "chargeentrynotrequired": false, "scheduleddatetime": "09/13/2021 11:45:49", "coordinatorenterprise": false, "templateappointmentid": "444879", "appointmentnotes": [ { "displayonschedule": false, "text": "in office", "id": 87314 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "423399", "patient": { "primarydepartmentid": "1", "contactpreference_lab_email": "true", "donotcall": "false", "racename": "Patient Declined", "email": "firefox_bay2@yahoo.com", "balances": [ { "departmentlist": "1", "balance": "9.36", "cleanbalance": "true" } ], "contactpreference_announcement_sms": "true", "suffix": "Mr", "emailexists": 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"collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "10/24/2021 13:45:21", "appointmenttype": "FOLLOW UP", "providerid": "9", "chargeentrynotrequired": false, "scheduleddatetime": "10/01/2021 12:48:46", "coordinatorenterprise": false, "templateappointmentid": "423399", "appointmentnotes": [ { "displayonschedule": false, "text": "in office", "id": 88788 } ], "frozen": true, "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445899", "patient": { "primarydepartmentid": "1", "contactpreference_lab_email": "true", "donotcall": "false", "racename": "White", "email": "nicklaff@hotmail.com", "balances": [ { "departmentlist": "1", "balance": 0, "cleanbalance": "true" } ], "contactpreference_announcement_sms": "true", "suffix": "Mr", "emailexists": "true", "race": [ "2106-3" ], "departmentid": "1", "homephone": "4322308500", "firstappointment": "10/02/2013 08:00", "guarantorstate": 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"guarantorcountrycode": "USA", "firstname": "Nicholas", "contactpreference": "HOMEPHONE", "contactrelationship": "SPOUSE", "lastemail": "NICKLAFF@HOTMAIL.COM", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4322305777", "mobilecarrierid": "24", "guarantorssn": "*****6978", "contactpreference_lab_sms": "true", "contactpreference_appointment_phone": "false", "patientid": "5079", "dob": "07/27/1980", "zip": "79706-3150", "guarantordob": "07/27/1980", "guarantoraddresssameaspatient": "true", "guarantorrelationshiptopatient": "1", "address1": "6622 Patriot Pkwy", "portaltermsonfile": "true", "status": "active", "contactpreference_billing_sms": "true", "lastname": "Laff", "guarantorfirstname": "Nicholas", "guarantorphone": "4322308500", "city": "MIDLAND", "driverslicenseurl": "/v1/9928/patients/5079/driverslicense", "ssn": "*****6978", "lastappointment": "09/27/2021 10:30", "guarantoremail": "nicklaff@hotmail.com", "guarantorcity": "MIDLAND", "middlename": "S", 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"caresummarydeliverypreference": "PORTAL", "notes": "MEDICARE / AETNA\r\n", "hierarchicalcode": "R5", "contactpreference_announcement_phone": "true", "guarantorlastname": "Riley", "guarantorcountrycode": "USA", "firstname": "Cheri", "contactpreference": "HOMEPHONE", "contactrelationship": "CHILD", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4326937590", "guarantorssn": "*****5153", "contactpreference_lab_sms": "false", "contactpreference_appointment_phone": "true", "patientid": "1825", "dob": "03/20/1949", "zip": "79762-4656", "guarantordob": "03/20/1949", "guarantoraddresssameaspatient": "true", "guarantorrelationshiptopatient": "1", "address1": "4315 Esmond Dr", "contactmobilephone": "4326937590", "portaltermsonfile": "true", "status": "active", "contactpreference_billing_sms": "false", "lastname": "Riley", "guarantoraddress2": "Apt 1101", "guarantorfirstname": "Cheri", "guarantorphone": "4322304880", "city": "ODESSA", "driverslicenseurl": 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"insuranceid": "36151", "insurancepolicyholder": "CHERI RILEY", "eligibilitylastchecked": "10/03/2021", "insuredaddress2": "4315 ESMOND DR", "insurancepolicyholdermiddlename": "L", "insurancepolicyholderfirstname": "CHERI", "insurancepackageid": 2800, "insuredssn": "449845153", "ircid": 299, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Medicare-TX (Medicare)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "MIDLAND", "insurancepackagezip": "17055-1824", "insuredcountryiso3166": "US" }, { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 2, "insurancepolicyholderssn": "449845153", "insuredmiddleinitial": "L", "insurancepolicyholderlastname": "RILEY", "insuredentitytypeid": 1, "insuranceidnumber": "AHC6375204", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79762-4656", "insurancepolicyholderdob": "03/20/1949", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "insuredfirstname": "CHERI", "insurancepolicyholderaddress1": "APT 1101", "insurancepackageaddress1": "PO BOX 981106", "insuredcountrycode": "USA", "insurancepolicyholdersex": "F", "eligibilityreason": "Athena", "insuredzip": "79762-4656", "ircname": "Aetna & Aetna/US Healthcare", "insuredlastname": "RILEY", "insuranceplanname": "AETNA (MEDICARE SUPPLEMENT)", "insurancetype": "Supplemental Policy", "insuredsex": "F", "insuredcity": "ODESSA", "insurancephone": "(800) 264-4000", "insureddob": "03/20/1949", "insurancepackagestate": "TX", "insurancepackagecity": "EL PASO", "id": "36469", "insuredaddress": "APT 1101", "insuredstate": "TX", "insurancepolicyholderaddress2": "4315 ESMOND DR", "relationshiptoinsuredid": 1, "insuranceid": "36469", "insurancepolicyholder": "CHERI RILEY", "eligibilitylastchecked": "10/22/2021", "insuredaddress2": "4315 ESMOND DR", "insurancepolicyholdermiddlename": "L", "insurancepolicyholderfirstname": "CHERI", "insurancepackageid": 23344, "insuredssn": "449845153", "ircid": 121, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Aetna (Medicare Supplement)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "79998-1106", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ATHENA", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "10/22/2021 10:55:11", "appointmenttype": "FOLLOW UP", "providerid": "1", "chargeentrynotrequired": false, "scheduleddatetime": "10/06/2021 10:38:00", "coordinatorenterprise": false, "templateappointmentid": "444904", "appointmentnotes": [ { "displayonschedule": false, "text": "per patient will probably not have sx will call back if anything changes", "id": 88992 }, { "displayonschedule": false, "text": "PRE OP CLEARANCE", "id": 88370 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "391806", "patient": { "primarydepartmentid": "1", "racename": "White", "email": "TEALM21@GMAIL.COM", "balances": [ { "departmentlist": "1", "balance": "-20", "cleanbalance": "true" } ], "contactpreference_announcement_sms": "true", "suffix": "Ms", "emailexists": "true", "race": [ "2106-3" ], "departmentid": "1", "homephone": "4326617329", "firstappointment": "12/03/2014 15:00", "guarantorstate": "TX", "language6392code": "eng", "portalaccessgiven": "true", "primaryproviderid": "1", "driverslicense": "true", "patientphoto": "true", "consenttocall": "true", "homebound": "false", "defaultpharmacyncpdpid": "4554766", "contactpreference_appointment_sms": "true", "patientphotourl": "/v1/9928/patients/1305/photo", "contactname": "RHONDA MAHAN", "contactpreference_billing_phone": "false", "mobilephone": "4326617329", "medicationhistoryconsentverified": "true", "hasmobile": "true", "ethnicitycode": "2186-5", "guarantorsuffix": "Ms", "notes": "BCBS TX **UPDATED 01/14/20**", "caresummarydeliverypreference": "PORTAL", "contactpreference_announcement_phone": "true", "hierarchicalcode": "R5", "guarantorlastname": "Largent", "guarantorcountrycode": "USA", "firstname": "Teal", "contactpreference": "HOMEPHONE", "contactrelationship": "PARENT", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4328538199", "guarantorssn": "*****4221", "contactpreference_appointment_phone": "true", "contactpreference_lab_sms": "true", "patientid": "1305", "dob": "03/05/1992", "zip": "79707-3107", "guarantordob": "03/05/1992", "guarantoraddresssameaspatient": "true", "address1": "4903 Canadian Ave", "guarantorrelationshiptopatient": "1", "portaltermsonfile": "true", "status": "active", "contactpreference_billing_sms": "false", "lastname": "Largent", "guarantorfirstname": "Teal", "guarantorphone": "4326617329", "city": "MIDLAND", "ssn": "*****4221", "driverslicenseurl": "/v1/9928/patients/1305/driverslicense", "lastappointment": "10/22/2021 15:45", "guarantoremail": "TEALM21@GMAIL.COM", "guarantorcity": "MIDLAND", "middlename": "D", "maritalstatus": "S", "guarantorzip": "79707-3107", "guarantoraddress1": "4903 Canadian Ave", "countrycode": "USA", "sex": "F", "maritalstatusname": "SINGLE", "privacyinformationverified": "true", "guarantormiddlename": "D", "consenttotext": "true", "countrycode3166": "US", "contactpreference_lab_phone": "true", "guarantorcountrycode3166": "US" }, "starttime": "13:30", "departmentid": "1", "appointmentstatus": "f", "scheduledby": "ncortez10", "patientid": "1305", "duration": 15, "templateappointmenttypeid": "6", "hl7providerid": 6, "insurances": [ { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 1, "insurancepolicyholderssn": "629304221", "insuredmiddleinitial": "D", "insurancepolicyholderlastname": "LARGENT", "insuredentitytypeid": 1, "insuranceidnumber": "ZGP826075354", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79707-3107", "insurancepolicyholderdob": "03/05/1992", "issuedate": "02/01/2021", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "policynumber": "248320", "insuredfirstname": "TEAL", "insurancepolicyholderaddress1": "4903 CANADIAN AVE", "insurancepackageaddress1": "PO BOX 660044", "insuredcountrycode": "USA", "insurancepolicyholdersex": "F", "eligibilityreason": "Athena", "insurednamesuffix": "MS", "insuredzip": "79707-3107", "ircname": "BCBS-TX", "insuredlastname": "LARGENT", "insuranceplanname": "BCBS-TX: BCBS OF TX (PPO)", "insurancetype": "Group Policy", "insuredsex": "F", "insuredcity": "MIDLAND", "insurancephone": "(800) 451-0287", "insureddob": "03/05/1992", "insurancepackagestate": "TX", "insurancepackagecity": "DALLAS", "id": "37163", "insuredaddress": "4903 CANADIAN AVE", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "37163", "insurancepolicyholder": "TEAL LARGENT", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholdersuffix": "MS", "insurancepolicyholdermiddlename": "D", "insurancepolicyholderfirstname": "TEAL", "insurancepackageid": 11993, "insuredssn": "629304221", "ircid": 143, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "BCBS-TX (PPO)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "MIDLAND", "insurancepackagezip": "75266-0044", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ncortez10", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 20 }, "copay": 20, "appointmenttypeid": "4", "lastmodified": "10/22/2021 18:34:57", "appointmenttype": "LAB ORDERS-CUSTOM", "providerid": "6", "chargeentrynotrequired": false, "scheduleddatetime": "10/22/2021 18:34:57", "coordinatorenterprise": false, "templateappointmentid": "391806", "appointmentnotes": [ { "displayonschedule": false, "text": "cbc, a1c, cmp, lipids, thyroid,vit b12, vit d, mg, uric acid", "id": 90353 } ], "patientappointmenttypename": "LAB ORDERS-CUSTOM" }, { "date": "10/25/2021", "appointmentid": "443995", "patient": { "primarydepartmentid": "1", "racename": "Patient Declined", "email": "Autobodyrepairsodessa@gmail.com", "balances": [ { "departmentlist": "1", "balance": 0, "cleanbalance": "true" } ], "occupationcode": "other", "contactpreference_announcement_sms": "true", "emailexists": "true", "race": [ "declined" ], "departmentid": "1", "homephone": "4323528545", "firstappointment": "03/08/2016 09:00", "guarantorstate": "TX", "language6392code": "eng", "portalaccessgiven": "true", "primaryproviderid": "1", "driverslicense": "true", "patientphoto": "true", "consenttocall": "true", "homebound": "false", "defaultpharmacyncpdpid": "5923657", "contactpreference_appointment_sms": "true", "patientphotourl": "/v1/9928/patients/7497/photo", "contactname": "FRANCISCO MARQUEZ III", "mobilephone": "4322023719", "medicationhistoryconsentverified": "true", "hasmobile": "true", "registrationdate": "03/07/2016", "ethnicitycode": "declined", "notes": "SELF PAY PATIENT\r\n*UPDATED INFO 1.30.20*", "caresummarydeliverypreference": "PORTAL", "guarantorlastname": "Marquez", "guarantorcountrycode": "USA", "firstname": "Francisco", "contactpreference": "HOMEPHONE", "contactrelationship": "CHILD", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4323528545", "guarantorssn": "*****2755", "contactpreference_lab_sms": "true", "patientid": "7497", "dob": "10/21/1961", "zip": "79763", "guarantordob": "10/21/1961", "guarantoraddresssameaspatient": "true", "address1": "1624 S Regal", "guarantorrelationshiptopatient": "1", "portaltermsonfile": "true", "contactpreference_billing_sms": "true", "status": "active", "lastname": "Marquez", "guarantorfirstname": "Francisco", "guarantorphone": "4323528545", "city": "ODESSA", "driverslicenseurl": "/v1/9928/patients/7497/driverslicense", "ssn": "*****2755", "lastappointment": "08/25/2021 10:30", "guarantoremail": "Autobodyrepairsodessa@gmail.com", "guarantorcity": "ODESSA", "middlename": "Jr", "maritalstatus": "D", "guarantorzip": "79763", "countrycode": "USA", "guarantoraddress1": "1624 S Regal", "sex": "M", "maritalstatusname": "DIVORCED", "privacyinformationverified": "true", "guarantormiddlename": "Jr", "consenttotext": "true", "countrycode3166": "US", "guarantorcountrycode3166": "US" }, "starttime": "13:30", "departmentid": "1", "appointmentconfirmationid": "3", "appointmentstatus": "f", "scheduledby": "gperez122", "patientid": "7497", "appointmentconfirmationname": "Contacted", "duration": 15, "templateappointmenttypeid": "1", "hl7providerid": 3, "insurances": [ { "sequencenumber": 1, "eligibilitystatus": "Unverified", "ircname": "Self-Pay (cash)", "insuranceplanname": "*SELF PAY*", "insurancetype": "Personal Payment (Cash - No Insurance)", "id": "26066", "relationshiptoinsuredid": 1, "insuranceid": "26066", "insurancepackageid": 0, "ircid": 40 } ], "lastmodifiedby": "gperez122", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "08/25/2021 12:12:53", "appointmenttype": "FOLLOW UP", "providerid": "3", "chargeentrynotrequired": false, "scheduleddatetime": "08/25/2021 12:12:52", "coordinatorenterprise": false, "templateappointmentid": "443992", "appointmentnotes": [ { "displayonschedule": false, "text": "in office w/labs and kidney us", "id": 85880 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445902", "patient": { "guarantorcountrycode": "USA", "firstname": "Amparo", "primarydepartmentid": "1", "contactrelationship": "SPOUSE", "state": "TX", "racename": "Patient Declined", "email": "LORINAVILLA@GMAIL.COM", "balances": [ { "departmentlist": "1", "balance": "-30", "cleanbalance": "true" } ], "race": [ "declined" ], "emailexists": "true", "departmentid": "1", "confidentialitycode": "N", "homephone": "4325537256", "firstappointment": "05/28/2021 09:00", "guarantorstate": "TX", "language6392code": "declined", "guarantorssn": "*****9237", "patientid": "10886", "dob": "08/01/1953", "portalaccessgiven": "true", "guarantordob": "08/01/1953", "zip": "79731-2111", "primaryproviderid": "1", "guarantoraddresssameaspatient": "true", "address1": "115 S Adams Rd", "guarantorrelationshiptopatient": "1", "driverslicense": "false", "patientphoto": "true", "portaltermsonfile": "false", "status": "active", "consenttocall": "true", "lastname": "Villa", "guarantorfirstname": "Amparo", "guarantorphone": "4325537256", "homebound": "false", "defaultpharmacyncpdpid": "5923392", "city": "CRANE", "ssn": "*****9237", "lastappointment": "09/27/2021 09:00", "patientphotourl": "/v1/9928/patients/10886/photo", "contactname": "GUILLERMO VILLA", "guarantoremail": "LORINAVILLA@GMAIL.COM", "mobilephone": "4325537256", "guarantorcity": "CRANE", "maritalstatus": "M", "medicationhistoryconsentverified": "true", "guarantorzip": "79731-2111", "guarantoraddress1": "115 S Adams Rd", "countrycode": "USA", "registrationdate": "05/13/2021", "sex": 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"insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "BCBS-TX (HMO)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "CRANE", "insurancepackagezip": "75266-0044", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ATHENA", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 10 }, "copay": 10, "appointmenttypeid": "1", "lastmodified": "10/22/2021 10:55:11", "appointmenttype": "FOLLOW UP", "providerid": "1", "chargeentrynotrequired": false, "scheduleddatetime": "09/27/2021 11:49:37", "coordinatorenterprise": false, "templateappointmentid": "445902", "appointmentnotes": [ { "displayonschedule": false, "text": "tele", "id": 88356 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445932", "patient": { "primarydepartmentid": "1", "racename": "White", "email": "karaco2@yahoo.com", "balances": [ { "departmentlist": "1", "balance": "47.87", "cleanbalance": "true" 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"WALTER C DONNER", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholdersuffix": "MR", "insurancepolicyholdermiddlename": "C", "insurancepolicyholderfirstname": "WALTER C", "insurancepackageid": 6708, "insuredssn": "492408583", "ircid": 3595, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Standard Life (Medicare Supplement)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "65808-0546", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "spamganamamula", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "10/24/2021 13:45:21", "appointmenttype": "FOLLOW UP", "providerid": "9", "chargeentrynotrequired": false, "scheduleddatetime": "08/23/2021 16:54:03", "coordinatorenterprise": false, "templateappointmentid": "423405", "appointmentnotes": [ { "displayonschedule": false, "text": "tele", "id": 85687 } ], "frozen": true, "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445935", "patient": { "primarydepartmentid": "1", "contactpreference_lab_email": "true", "donotcall": "false", "racename": "White", "email": "linksliason@gmail.com", "balances": [ { "departmentlist": "1", "balance": 0, "cleanbalance": "true" } ], "contactpreference_announcement_sms": "false", "suffix": "Ms", "emailexists": "true", "race": [ "2106-3" ], "departmentid": "1", "homephone": "4329785632", "firstappointment": "01/27/2011 09:00", "guarantorstate": "TX", "language6392code": "eng", "portalaccessgiven": "true", "primaryproviderid": "3", "driverslicense": "true", "patientphoto": "true", "consenttocall": "true", "homebound": "false", "contactpreference_appointment_email": "true", "defaultpharmacyncpdpid": "5919848", "contactpreference_billing_email": "true", "contactpreference_appointment_sms": "false", "patientphotourl": "/v1/9928/patients/2230/photo", "contactname": "ANA MARIA SANCHEZ", "contactpreference_billing_phone": "true", "contactpreference_announcement_email": "true", "medicationhistoryconsentverified": "true", "hasmobile": "false", "guarantorsuffix": "Ms", "ethnicitycode": "2135-2", "caresummarydeliverypreference": "PAPER", "notes": "MC / AETNA (MC SUPPLEMENT ) \r\nUPDATED 03/03/20\r\n", "hierarchicalcode": "R5", "contactpreference_announcement_phone": "true", "guarantorlastname": "Sanchez", "guarantorcountrycode": "USA", "firstname": "Maria", "contactpreference": "HOMEPHONE", "contactrelationship": "CHILD", "lastemail": "maruca1949@yahoo.com", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4322085996", "guarantorssn": "*****4774", "contactpreference_lab_sms": "false", "contactpreference_appointment_phone": "true", "patientid": "2230", "dob": "02/25/1949", "zip": "79761-6514", "guarantordob": "02/25/1949", "guarantoraddresssameaspatient": "true", "guarantorrelationshiptopatient": "1", "address1": "938 S Jackson Ave", "portaltermsonfile": "true", "status": "active", "contactpreference_billing_sms": "false", "lastname": "Sanchez", "guarantorfirstname": "Maria", "guarantorphone": "4329785632", "city": "ODESSA", "ssn": "*****4774", "driverslicenseurl": "/v1/9928/patients/2230/driverslicense", "lastappointment": "09/27/2021 14:15", "guarantoremail": "linksliason@gmail.com", "guarantorcity": "ODESSA", "middlename": "L", "maritalstatus": "U", "guarantorzip": "79761-6514", "guarantoraddress1": "938 S Jackson Ave", "countrycode": "USA", "sex": "F", "maritalstatusname": "UNKNOWN", "privacyinformationverified": "true", "guarantormiddlename": "L", "consenttotext": "false", "countrycode3166": "US", "contactpreference_lab_phone": "true", "guarantorcountrycode3166": "US" }, "starttime": "14:15", "departmentid": "1", "appointmentconfirmationid": "3", "appointmentstatus": "f", "scheduledby": "ncortez10", "patientid": "2230", "appointmentconfirmationname": "Contacted", "duration": 15, "templateappointmenttypeid": "1", "hl7providerid": 3, "insurances": [ { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 1, "insurancepolicyholderssn": "456784774", "insuredmiddleinitial": "L", "insurancepolicyholderlastname": "SANCHEZ", "insuredentitytypeid": 1, "insuranceidnumber": "6JN2Q92RX27", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79761-6514", "insurancepolicyholderdob": "02/25/1949", "issuedate": "07/01/2007", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "insuredfirstname": "MARIA", "insurancepolicyholderaddress1": "938 S JACKSON AVE", "insurancepackageaddress1": "PO BOX 3108", "insuredcountrycode": "USA", "insurancepolicyholdersex": "F", "eligibilityreason": "Athena", "insurednamesuffix": "MS", "insuredzip": "79761-6514", "ircname": "Medicare B-TX", "insuredlastname": "SANCHEZ", "insuranceplanname": "MEDICARE B-TX: NOVITAS SOLUTIONS", "insurancetype": "Medicare Part B", "insuredsex": "F", "insuredcity": "ODESSA", "insurancephone": "(855) 252-8782", "insureddob": "02/25/1949", "insurancepackagestate": "PA", "insurancepackagecity": "MECHANICSBURG", "id": "2038", "insuredaddress": "938 S JACKSON AVE", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "2038", "insurancepolicyholder": "MARIA SANCHEZ", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholdersuffix": "MS", "insurancepolicyholdermiddlename": "L", "insurancepolicyholderfirstname": "MARIA", "insurancepackageid": 2800, "insuredssn": "456784774", "ircid": 299, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Medicare-TX (Medicare)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "17055-1824", "insuredcountryiso3166": "US" }, { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 2, "insurancepolicyholderssn": "456784774", "insuredmiddleinitial": "L", "insurancepolicyholderlastname": "SANCHEZ", "insuredentitytypeid": 1, "insuranceidnumber": "CLI3056720", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79761-6514", "insurancepolicyholderdob": "02/25/1949", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "insuredfirstname": "MARIA", "insurancepolicyholderaddress1": "938 S JACKSON AVE", "insurancepackageaddress1": "PO BOX 981106", "insuredcountrycode": "USA", "insurancepolicyholdersex": "F", "eligibilityreason": "Athena", "insurednamesuffix": "MS", "insuredzip": "79761-6514", "ircname": "Aetna & Aetna/US Healthcare", "insuredlastname": "SANCHEZ", "insuranceplanname": "AETNA (MEDICARE SUPPLEMENT)", "insurancetype": "Supplemental Policy", "insuredsex": "F", "insuredcity": "ODESSA", "insurancephone": "(800) 264-4000", "insureddob": "02/25/1949", "insurancepackagestate": "TX", "insurancepackagecity": "EL PASO", "id": "28816", "insuredaddress": "938 S JACKSON AVE", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "28816", "insurancepolicyholder": "MARIA SANCHEZ", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholdersuffix": "MS", "insurancepolicyholdermiddlename": "L", "insurancepolicyholderfirstname": "MARIA", "insurancepackageid": 23344, "insuredssn": "456784774", "ircid": 121, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "Aetna (Medicare Supplement)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "ODESSA", "insurancepackagezip": "79998-1106", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ncortez10", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "09/27/2021 15:09:13", "appointmenttype": "FOLLOW UP", "providerid": "3", "chargeentrynotrequired": false, "scheduleddatetime": "09/27/2021 15:09:13", "coordinatorenterprise": false, "templateappointmentid": "445935", "appointmentnotes": [ { "displayonschedule": false, "text": "tele", "id": 88387 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445979", "patient": { "primarydepartmentid": "1", "racename": "Patient Declined", "email": "munguiamm@yahoo.com", "balances": [ { "departmentlist": "1", "balance": "55.32", "cleanbalance": "true" } ], "contactpreference_announcement_sms": "true", "departmentid": "1", "emailexists": "true", "race": [ "declined" ], "homephone": "4322306377", "firstappointment": "12/09/2015 15:00", "guarantorstate": "TX", "language6392code": "eng", "portalaccessgiven": "true", "primaryproviderid": "1", "driverslicense": "false", "patientphoto": "false", "consenttocall": "true", "homebound": "false", "defaultpharmacyncpdpid": "4598186", "contactpreference_appointment_sms": "true", "contactname": "KELLY MUNGUIA", "mobilephone": "4322306377", "medicationhistoryconsentverified": "true", "hasmobile": "true", "registrationdate": "11/30/2015", "ethnicitycode": "declined", "notes": "GROUP RESOURCES***UPDATED 02/18/20** /**MCT***\r\n5/20/19 call ref #latoya05202019 no auth required for Cardiolite @Naidu....jg\r\n3/15/19 REF # NancyV03152019 no auth required for MRI Pelvis w/wo contrast...jg\r\n3/5/19 Ref# Roseanne03052019 no auth req CT Abdomen/Pelvis w/wo contrast...jg", "caresummarydeliverypreference": "PORTAL", "guarantorlastname": "Munguia", "guarantorcountrycode": "USA", "firstname": "Mike", "contactpreference": "HOMEPHONE", "contactrelationship": "SPOUSE", "state": "TX", "confidentialitycode": "N", "contacthomephone": "4327705432", "mobilecarrierid": "50", "guarantorssn": "*****5959", "contactpreference_lab_sms": "true", "patientid": "7279", "dob": "10/01/1967", "zip": "79705-1912", "guarantordob": "10/01/1967", "guarantoraddresssameaspatient": "true", "address1": "1007 Almont Pl", "guarantorrelationshiptopatient": "1", "portaltermsonfile": "true", "contactpreference_billing_sms": "true", "status": "active", "lastname": "Munguia", "guarantorfirstname": "Mike", "guarantorphone": "4322306377", "city": "MIDLAND", "ssn": "*****5959", "lastappointment": "09/27/2021 10:30", "guarantoremail": "munguiamm@yahoo.com", "guarantorcity": "MIDLAND", "middlename": "M", "maritalstatus": "M", "guarantorzip": "79705-1912", "guarantoraddress1": "1007 Almont Pl", "countrycode": "USA", "sex": "M", "maritalstatusname": "MARRIED", "privacyinformationverified": "true", "guarantormiddlename": "M", "consenttotext": "true", "countrycode3166": "US", "guarantorcountrycode3166": "US" }, "starttime": "14:15", "departmentid": "1", "appointmentconfirmationid": "7", "appointmentstatus": "f", "scheduledby": "gperez122", "patientid": "7279", "appointmentconfirmationname": "Reschedule", "duration": 15, "templateappointmenttypeid": "1", "hl7providerid": 1, "insurances": [ { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 1, "insurancepolicyholderssn": "462215959", "insuredmiddleinitial": "M", "insurancepolicyholderlastname": "MUNGUIA", "insuredentitytypeid": 1, "insuranceidnumber": "4808617164745", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79705-1912", "insurancepolicyholderdob": "10/01/1967", "issuedate": "10/01/2018", "relationshiptoinsured": "Self", "eligibilitystatus": "Unverified", "policynumber": "4808031A", "insuredfirstname": "MIKE", "insurancepolicyholderaddress1": "1007 ALMONT PL", "insurancepackageaddress1": "PO BOX 21823", "insuredcountrycode": "USA", "insurancepolicyholdersex": "M", "insuredzip": "79705-1912", "ircname": "Group Resources Inc.", "insuredlastname": "MUNGUIA", "insuranceplanname": "PHCS - GROUP RESOURCES (PPO)", "insurancetype": "Commercial", "insuredsex": "M", "insuredcity": "MIDLAND", "insurancephone": "(770) 813-8474", "insureddob": "10/01/1967", "insurancepackagestate": "MN", "insurancepackagecity": "EAGAN", "id": "33241", "insuredaddress": "1007 ALMONT PL", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "33241", "insurancepolicyholder": "MIKE MUNGUIA", "insurancepolicyholdermiddlename": "M", "insurancepolicyholderfirstname": "MIKE", "insurancepackageid": 8556, "insuredssn": "462215959", "ircid": 437, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "PHCS - Group Resources (PPO)", "insurancepolicyholdercity": "MIDLAND", "insurancepackagezip": "55121-0823", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "gperez122", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 0 }, "copay": 0, "appointmenttypeid": "1", "lastmodified": "09/28/2021 09:37:42", "appointmenttype": "FOLLOW UP", "providerid": "1", "chargeentrynotrequired": false, "scheduleddatetime": "09/28/2021 09:37:42", "coordinatorenterprise": false, "templateappointmentid": "445979", "appointmentnotes": [ { "displayonschedule": false, "text": "tele", "id": 88434 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445629", "patient": { "guarantorcountrycode": "USA", "firstname": "Donald", "primarydepartmentid": "1", "contactpreference": "HOMEPHONE", "contactrelationship": "SPOUSE", "preferredname": "Don", "state": "TX", "racename": "White", "balances": [ { "departmentlist": "1", "balance": "635.04", "cleanbalance": "true" } ], "race": [ "2106-3" ], "emailexists": "false", "departmentid": "1", "confidentialitycode": "N", "homephone": "4322696900", "firstappointment": "11/27/2012 09:00", "contacthomephone": "4322696900", "language6392code": "eng", "guarantorstate": "TX", "guarantorssn": "*****6945", "patientid": "1581", "dob": "04/14/1956", "zip": "79745-3503", "portalaccessgiven": "true", "guarantordob": "04/14/1956", "primaryproviderid": "1", "guarantoraddresssameaspatient": "true", "address1": "1000 E Tascosa Ave", "guarantorrelationshiptopatient": "1", "driverslicense": "true", "patientphoto": "true", "portaltermsonfile": "false", "status": "active", "consenttocall": "true", "lastname": "Graves", "guarantorfirstname": "Donald", "guarantorphone": "4322696900", "homebound": "false", "defaultpharmacyncpdpid": "4594190", "city": "KERMIT", "driverslicenseurl": "/v1/9928/patients/1581/driverslicense", "ssn": "*****6945", "lastappointment": "09/22/2021 13:45", "patientphotourl": "/v1/9928/patients/1581/photo", "contactname": "SUE GRAVES", "mobilephone": "4322696900", "guarantorcity": "KERMIT", "maritalstatus": "M", "medicationhistoryconsentverified": "true", "guarantorzip": "79745-3503", "guarantoraddress1": "1000 E Tascosa Ave", "countrycode": "USA", "hasmobile": "true", "sex": "M", "maritalstatusname": "MARRIED", "privacyinformationverified": "true", "ethnicitycode": "declined", "consenttotext": "false", "countrycode3166": "US", "caresummarydeliverypreference": "PORTAL", "notes": "BCBS TX/ VA (authorization for all services required) \r\nRef #VA0011413048 from VA Dept 01/25/2021 - 02/25/2022 gma \r\nAUTH #0006066390 12/01/2018 - 12/01/2019 gma\r\n1/28/2020 Ref to Dr.Bajaj requesting Auth was faxed to VA DG \r\nRef #0004894480 to Dr Gupta 02/28/18 need to call VA back with appt date..EC\r\nRef #0004894385 to Dr Naidu 02/28/18 need to call VA back with appt date..EC\r\nper alisha at VA Auth #0004411502 will cover the echo 93306..02/28/18 /EC 866-606-8198.\r\nAuthorization# 0004411502 10/30/2017-10/30/2018\r\n\r\nPlease note: This is not a ChampVA nor TriWest.\r\n**UPDATED INFO 3/28/2017**** /**MCT**\r\n**DOS 5/24/16 claim for $25 is denied for credentialing issue. Transferring the balance to patient. Patient needs to file the claim directly with the insurance company , Triwest Healthcare. (adeshpande1 09/24/2017)\r\n**DOS 8/23/16 claim for $922.15 is denied for credentialing issue. Transferring the balance to patient. Patient needs to file the claim directly with the insurance company , Triwest Healthcare. (adeshpande1 09/24/2017)\r\n**DOS 9/16/17 for $25 is denied for credentialing issue. Transferring the balance to patient. Patient needs to file the claim directly with the insurance company, Triwest Healthcare (adeshpande1 09/24/2017)\r\n**DOS 10/10/16 for $25 is denied for credentialing issue. Transferring the balance to patient. Patient needs to file the claim directly with the insurance company, Triwest Healthcare (adeshpande1 09/24/2017)\r\n**DOS 11/28/16 for $25 is denied for credentialing issue. Transferring the balance to patient. Patient needs to file the claim directly with the insurance company, Triwest Healthcare (adeshpande1 09/24/2017)", "hierarchicalcode": "R5", "guarantorlastname": "Graves", "guarantorcountrycode3166": "US" }, "starttime": "14:30", "departmentid": "1", "appointmentconfirmationid": "2", "appointmentstatus": "f", "scheduledby": "ncortez10", "patientid": "1581", "appointmentconfirmationname": "Confirmed", "duration": 15, "templateappointmenttypeid": "1", "hl7providerid": 3, "insurances": [ { "insurancepolicyholdercountrycode": "USA", "sequencenumber": 1, "insurancepolicyholderssn": "449156945", "insurancepolicyholderlastname": "GRAVES", "insuredentitytypeid": 1, "insuranceidnumber": "ZGP828062360", "insurancepolicyholderstate": "TX", "insurancepolicyholderzip": "79762", "insurancepolicyholderdob": "04/14/1956", "issuedate": "12/01/2018", "relationshiptoinsured": "Self", "eligibilitystatus": "Eligible", "policynumber": "251377", "insuredfirstname": "DONALD", "insurancepolicyholderaddress1": "1000 E. TASCOSA", "insurancepackageaddress1": "PO BOX 660044", "insuredcountrycode": "USA", "insurancepolicyholdersex": "M", "eligibilityreason": "Athena", "insuredzip": "79762", "ircname": "BCBS-TX", "insuredlastname": "GRAVES", "insuranceplanname": "BCBS-TX: BCBS OF TX (PPO)", "insurancetype": "Group Policy", "insuredsex": "M", "insuredcity": "KERMIT", "insurancephone": "(800) 451-0287", "insureddob": "04/14/1956", "insurancepackagestate": "TX", "insurancepackagecity": "DALLAS", "id": "33276", "insuredaddress": "1000 E. TASCOSA", "insuredstate": "TX", "relationshiptoinsuredid": 1, "insuranceid": "33276", "insurancepolicyholder": "DONALD GRAVES", "eligibilitylastchecked": "10/22/2021", "insurancepolicyholderfirstname": "DONALD", "insurancepackageid": 11993, "insuredssn": "449156945", "ircid": 143, "insurancepolicyholdercountryiso3166": "US", "insuranceplandisplayname": "BCBS-TX (PPO)", "eligibilitymessage": "Member is eligible.", "insurancepolicyholdercity": "KERMIT", "insurancepackagezip": "75266-0044", "insuredcountryiso3166": "US" } ], "lastmodifiedby": "ATHENA", "appointmentcopay": { "collectedforother": 0, "collectedforappointment": 0, "insurancecopay": 40 }, "copay": 40, "appointmenttypeid": "1", "lastmodified": "10/22/2021 10:55:11", "appointmenttype": "FOLLOW UP", "providerid": "3", "chargeentrynotrequired": false, "scheduleddatetime": "09/22/2021 16:14:13", "coordinatorenterprise": false, "templateappointmentid": "445629", "appointmentnotes": [ { "displayonschedule": false, "text": "in office", "id": 88097 } ], "patientappointmenttypename": "FOLLOW UP" }, { "date": "10/25/2021", "appointmentid": "445829", "patient": { "guarantorcountrycode": "USA", "firstname": "Misty", "primarydepartmentid": "1", "contactrelationship": "SPOUSE", "state": "TX", "racename": "Patient Declined", "email": "mistygg4@yahoo.com", "balances": [ { "departmentlist": "1", "balance": 0, "cleanbalance": "true" } ], "suffix": "Ms", "race": [ "declined" ], "emailexists": "true", "departmentid": "1", "confidentialitycode": "N", "homephone": "4329248748", "firstappointment": "12/03/2020 13:45", "contacthomephone": "4322020182", "language6392code": "eng", "guarantorstate": "TX", "patientid": "4986", "dob": "01/04/1962", "portalaccessgiven": "true", "guarantordob": "01/04/1962", "zip": "79762-2115", "primaryproviderid": "1", "guarantoraddresssameaspatient": "true", "address1": "1509 Boise Dr", "guarantorrelationshiptopatient": "1", "driverslicense": "true", "patientphoto": "true", "portaltermsonfile": 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