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Home My WebLink About20053709.tiff RESOLUTION RE: ANCELLA 1O` •F 2005 •UTSTANDING ACCOUNTS RECEIVABLE FOR THE LD CO NTY PA- • , DIC SERVICES WHER ,the ar f C my Commissioners of Weld County, Colorado, pursuant to Colorado statute :nd t e Wel o ty Home Rule Charter, is vested with the authority of administering the a :•rs Weld C ty, Colorado, and WHEREAS, a lis of 005 Para • Services accounts has been submitted to the Accounting Department of el County, olor-•o, and WHEREAS,said accoun - ave bee deemed uncollectible in accordance with guidelines adopted by the City of Greeley an• ounty o Weld, a copy of said list being attached hereto and incorporated herein by reference, a WHEREAS,the Accounting Dep ent has recom ended the cancellation of said list of uncollectible debts due and owing the County aramedic Services in the amount of $2,119,783.42. _- NOW,THEREFORE,BE IT RESOLVE• •y t of County Commissioners of Weld County, Colorado, that the aforementioned list o 005 uncollectible accounts in the amount of $2,119,783.42 be, and hereby is, approved for can ellation. The above and foregoing Resolution was,on mo 'on duly made seconded,adopted by the following vote on the 28th da of December, A.D., 05. IELA BOARD O C COMMISSIONERS WELD COU TY, = ! 'ADO aid �• Y ATTEST: k ! ' � • � ?�� • ) ' `'� ♦ William H. ke, ' -ir Weld County Clerk to t%r s " A�� ` ilyr\ 1 ��, AYE / M. J. ile, Pro-Tem BY. ,VLdtilAjl �, t,1.6'� �� rn D puty Clark to the Boa A (AYE) David . Long \f APPRO AS I� "V� • (AYE) �% Robe asdddden ty A orney AYE Glenn aad Date of signature: ( i 2--/DG 200 \3709 AM0001 C2 / C/7-_>?C -4^4, MEMORANDUM TO: Barb Eurich, Accounting DATE:December 16, 2005 FROM: Kathy Baxley, Paramedic Services SUBJECT: Accounts Written Off in 2005 Attached are the lists of accounts written off in 2005 . Listed below are the amounts each month for a total of $2, 119,783 .42 . All journal entries have been made except for the one for December, which will be after the end of the month. Let me know if you have any questions. January $222, 507 . 19 February $181, 594 . 06 March $107, 521. 89 April $166, 028 .72 May $104, 756 .71 June $135, 246 . 90 July $73, 381. 12 August $195, 328 . 06 September $194, 535 . 68 October $267, 664 . 10 November $330, 047 .21 December $141, 171.78 Total $2, 119, 783 .42 2005-3709 Amoco Submission Batch Report WELD COUNTY PARAMEDIC SERVICES 1 Batch 6,405 Batch date: 1/4/2005 3:23:38PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance I 2004-10-26 0010-A 9,843 ARROYOS, ANTHONY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-05 0022-A 11,268 AYALA, KIM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-22 0002-A 9,720 BEBOUT, WILLIAM Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-02 0022-A 9,010 CLARK, GREGORY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-05 0029-A 9,128 CONOVER, BEATRICE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-24 0007-A • 8,742 CRANMER, RICK Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-25 0018-A 10,911 ESCOBAR, ISRAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-04 0023-A 9,082 GARZA, BRYCE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-04 0029-A 9,088 GIOIA, DANNY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-20 0008-A 8,603 GUTIERREZ, JERMAI\Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-10-17 0017-A 9,563 HENRY, DIANA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-12-18 0019-A 11,707 HUNT, TIMOTHY Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-12-13 0005-A 11,516 JOHNSON, AARON Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-10-02 0024-A 9,012 LAPLANTE, JESSE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-12 0032-A 10,431 LEE, KYUNG Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-31 0012-A 10,013 LOPEZ, DEBORAH Bill Patient Collections No Bill Sent 1,895.00 0.00 1,895.00 2004-11-08 0029-A . 10,293 MCNAMARA, WILLIAN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-14 0013-A 8,368 MUELLER, FRANK Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-11-03 0031-A 10,137 MUELLER, FRANK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-19 0009-A 9,636 PAYNE, ELIZABETH Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-09 0002-A 8,187 PEREZ, CLAUDIA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-02 0001-A 10,075 REALIVASQUEZ-SMIT Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-28 0035-A 8,898 ROMERO, MARIA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-09-13 0005-A 8,318 SALINAS, JOHN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-01 0027-A 7,974 SANCHEZ, MAIRA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-11 0025-A 10,400 SCHAFER, STEVE Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-11-01 0010-A 10,050 VIGIL, EDDIE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-09-29 0011-A 8,910 WHITE, MARYELLEN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-01 0022-A- 7,960 ZRIG, KAREN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 Trip count: 29 28,418.00 0.00 28,418.00 Trip count: 29 28,418.00 0.00 28,418.00 Total trip count: , g9 ,.., ,2,8,4 1:8,0.0. f., X0:0.0._,. 28,41.80'O'-., RescueNetTM Printed on 1/4/2005 at 3:24:23PM Page 1 11nw161rescuenet\reports321Billing\Miscellaneous\SubBatch7.rpt i Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,404 Batch date: 1/4/2005 2:59:59PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-23 0007-A 7,609 AGUILAR, SERGIO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-08-24 0008-A 7,639 ALCALA, DONNA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-08-21 0019-A 7,562 ALVIDREZ, EDUARDC Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-08-26 0017-A • 7,709 BACON, JOHN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-08-22 0005-A 7,583 BENAVIDEZ, ISIDORE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-17 0012-A 7,414 BRIGGIM, ADOLPH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-30 0025-A 7,860 CARBAJAL, VIDAL Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-08-21 0010-A 7,553 CHICO, RODRIGO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-08-29 0034-A 7,849 CISNEROS, ABEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-30 0006-A 7,834 COX, NANCY Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-08-20 0005-A 7,502 CROSS, TERRI Bill Patient Collections No Bill Sent 1,368.00 0.00 1,368.00 2004-08-17 0001-A 7,402 DEARDOORFF, DIANE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-08-31 0015-A 7,893 DEZELL, DEVOE Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-08-27 0032-A 7,762 GALLEGOS, OLIVER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-22 0018-A 7,596 GARCIA, MARIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-30 0008-A 7,836 GITTLEIN, FRANK Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-08-25 0003-A 7,668 GONZALES, MELITOE\Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-08-20 0009-A 7,510 HAIDARA, JOANNA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-19 0018-A 7,496 HAYS, SABRINA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-18 0011-A 7,443 HIOTT, PERRY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-27 0004-A 7,734 KEAHEY, CURTIS Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-31 0028-A 7,907 KLINE, SETH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-18 0013-A 7,445 LEAF, LORRAINE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-08-26 0010-A 7,702 LOPEZ, CHRISTOPHE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-17 0015-A 7,417 MARTINEZ, DALLAS Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-08-21 0034-A 7,579 MARTINEZ, JOE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-08-21 0007-A. 7,550 MONTOYA, ANGEL Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-08-23 0013-A 7,615 MORENO, RICKY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-23 0012-A 7,614 MORGAN, ASHLEY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-19 0019-A 7,497 MUSSLEWHITE, ASHI Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00. 2004-08-19 0021-A 7,505 NASH, MICHAEL Bill Patient Collections No Bill Sent 1,761.00 0.00 1,761.00 2004-08-22 0004-A 7,582 PALACIOS, REGINO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-20 0030-A 7,532 PASCARELLA, MICHA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-08-25 0026-A 7,692 PEREZ-RODRIGUEZ, Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 RescueNetTM Printed on 1/4/2005 at 3:0.1:06PM Page 1 \\nw 16\rescuen et\reports32\Billing\Miscellaneous\Sub Batch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-08-18 0004-A 7,436 RAMEY, JAMES Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-08-31 0040-A 7,919 RIOS, CHRISTINA Bill Patient Collections No Bill Sent 1,641.00 0.00 1,641.00 2004-08-17 0009-A 7,410 RODRIGUEZ, RUSSET Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-08-30 0042-A 7,878 RUBIO, FELIPE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-17 0004-A 7,405 RUSSELL, JANENE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-26 0019-A 7,711 SILVA, ALEX Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-29 0032-A 7,828 SPEER, KEVIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-30 0037-A 7,873 TALLAMY, MERRIE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-30 0035-A 7,871 WHITEHORN, PENNY Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-08-29 0018-A 7,807 WOODS, APRIL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-08-17 0025-A 7,428 ZUNIGO, PHILLIP Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 45 43,956.00 0.00 43,956.00 Trip count: 45 43,956.00 0.00 43,956.0.O—.. 1 Total trip count: ; . a w 4 ;; .Vi ii F RescueNetr" Printed on 1/4/2005 at 3.01:06PM Page 2 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,403 Batch date: 1/4/2005 2:44:39PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-13 0006-A • 7,281 ACEVIDO, RAMON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-10 0001-A 7,166 ALVAREZ, ALEC Bill Patient Collections No Bill Sent 1,473.00 0.00 1,473.00 2004-08-13 0019-A 7,294 ALVAREZ, MERCEDE:Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-08-12 0001-A 7,245 ALVIDREZ JR, IVAN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-08-16 0038-A 7,399 ATILL, ALAH Bill Patient Collections No Bill Sent 1,886.00 0.00 1,886.00 2004-08-06 0035-A 7,075 AUTOBEE, DEBRA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-08-13 0014-A 7,289 BAIRD, AMBER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-13 0021-A 7,297 BARRAZA, MIRNA Bill Patient Collections No Bill Sent 1,206.00 356.35 849.65 2004-08-15 0014-A 7,343 BAXTON, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-16 0033-A 7,394 BIRCHWELL, KALEB Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-08 0022-A 7,126 BURTON, SHANTEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-09 0019-A 7,150 CAMPBELL, DONNA Bill Patient Collections No Bill Sent 1,056.00 1,003.18 52.82 2004-08-08 0025-A 7,129 CARDENAS, VIVIAN Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-08-07 0016-A 7,093 CAREON-SOTO, OSC.Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-08-09 0024-A 7,155 CARLSON, LANCE Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-08-16 0018-A 7,379 CIELOHA, DELLA Bill Patient Collections No Bill Sent 1,206.00 1,123.72 82.28 2004-08-10 0031-A 7,197 DAVIS, BRITTANY Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-08-07 0021-A 7,099 FLORES-MARQUEZ, i Bill Patient Collections No Bill Sent 1,586.00 0.00 1,586.00 2004-08-11 0010-A 7,223 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-08-08 0007-A 7,111 GROSSHANS, DOUG Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-08-08 0004-A 7,108 HERNANDEZ, JOSEPI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-12 0023-A 7,267 LOPEZ, ANTONIO Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-16 0036-A 7,397 MARTINEZ, JANELLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-10 0021-A, 7,186 MARTINEZ, MIKE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-06 0002-A 7,036 MARTINEZ, RICHARD Bill Patient Collections No Bill Sent 1,401.00 1,314.14 86.86 2004-08-10 0022-A 7,187 MCGEE, STEFANIE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-08 0017-A 7,121 MCWILLIAMS, JOHN Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-08-14 0027-A 7,329 MOLINA, GERADO Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-08 0021-A 7,125 MONTES, ARNOLDO Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-08-06 0029-A 7,069 MONTOYA, VICKI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-08-08 0005-A 7,109 MORGAN, CHAD Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-08-07 0019-A 7,097 PEREZ, CAMELIA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-16 0004-A 7,364 QUEZADA, LAURA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-16 0005-A 7,365 QUEZADA, MARISELP Bill Patient Collections No Bill Sent 150.00 0.00 150.00 RescueNetTM Printed on 1/4/2005 at 2:45:37PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-08-08 0026-A 7,130 RAMOS, MELISSA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-09 0014-A 7,145 RIVERA, CARLOS Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-08-11 0029-A 7,242 RUBY, SHIRLEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-09 0001-A 7,132 SANTIANO, MARIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-10 0013-A 7,178 THOMSEN, AVALON Bill Patient Collections No Bill Sent 1,596.00 0.00 1,596.00 2004-08-11 0023-A 7,236 VASQUEZ, FAITH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-09 0015-A 7,146 VASQUEZ-PINEDA, M Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 Trip count: 41 41,275.00 3,797.39 37,477.61 Trip count: 41 41,275.00 3,797.39 37,477.6.1___ Total trip count: N.',+,4:141.,441 - 41 ,7 0,A,r: 2 .% 4,,,,• ,;.' 477 64".'� RescueNetTM Printed on 1/4/2005 at 2 45 37PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,402 Batch date: 1/4/2005 2:25:29PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-20 0025-A 6,497 ALVAREZ-MORALES, Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-04 0025-A 6,998 ARGUELLO,ALVIN Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-07-28 0021-A 6,755 ARREDONDO, DONA\Bill Patient Collections No Bill Sent 1,011.00 808.80 202.20 2004-07-22 0009-A 6,547 AVILA, JOSE Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-08-05 0023-A 7,023 BRETADO, RITA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-07-21 0012-A 6,512 CHICO, RODRIGO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-23 0011-A 6,579 CHRISPEN, EILEEN Bill Patient Collections No Bill Sent 1,236.00 1,158.25 77.75 2004-07-11 0013-A 6,179 CONTRERAS, COLLEI Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-08-05 0028-A 7,039 CORBET, RENE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-08-04 0010-A 6,979 CORDOVA, SEVERO Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-07-22 0018-A 6,557 DAVENPORT, ERIC Bill Patient Collections No Bill Sent 1,098.00 450.00 648.00 2004-07-31 0008-A 6,845 DENNIS, MANUEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-08-02 0006-A 6,899 DOPHEIDE, AUBURNE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-07-14 0005-A 6,262 EIKENBERG, KARL Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-07-13 0022-A 6,246 EWALD, CHRISTOPHI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-02 0022-A 6,926 EWALD, CHRISTOPHI Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-21 0035-A 6,536 FERNANDEZ, KASON Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-12 0003-A 6,196 ISAQUIRRE, VIRGINIA Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2004-08-02 0005-A 6,897 KOHN, ALTA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-07-13 0013-A 6,237 LACOSSE, THOMAS Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-07-31 0023-A 6,860 MARKLEY, JEROME Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-30 0034-A 6,833 MAYFIELD, HENRY Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-15 0010-A 6,296 MCCULLOUGH, DAVII Bill Patient Collections No Bill Sent 558.00 552.25 5.75 2004-07-31 0024-A 6,861 MCMILLEN, MICHAEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-08-05 0024-A 7,032 ORCUTT, CHRISTINA Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-07-27 0011-A 6,705 PARGAS, MARY Bill Patient Collections No Bill Sent 1,566.00 1,354.19 211.81 2004-07-27 0034-A 6,728 RAYA, SARAH Bill Patient Collections No Bill Sent 150.00 50.00 100.00 2004-07-11 0011-A 6,170 REAVIS, JACK Bill Patient Collections No Bill Sent 783.00 718.11 64.89 2004-07-13 0003-A 6,227 RIESGAARD, WHILSC Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-08-01 0008-A 6,879 RODRIGUEZ, DANIEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-02 0026-A 6,930 ROJAS, STELLA Bill Patient Collections No Bill Sent 1,526.00 0.00 1,526.00 2004-08-04 0004-A 6,973 ROSE, AMY Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-07-16 0006.-A 6,330 SALAZAR, JUAN Bill Patient Collections No Bill Sent 1,745.00 0.00 1,745.00 2004-07-30 0026-A 6,825 SANCHEZ, ADREANN.Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 RescueNetTM Printed on 1/4/2005 at 2:26:17PM Page 1 \\nw 16\rescuen et\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-07-24 0022-A 6,620 SANCHEZ, LUCY Bill Patient Collections No Bill Sent 1,116.00 1,060.75 55.25 2004-08-02 0013-A 6,917 TAPIA, CARLOS Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-07-27 0020-A 6,714 WARD, DEAN Bill Patient Collections No Bill Sent 1,206.00 1,128.32 77.68 Trip count: 37 40,774.00 7,400.67 33,373.33 Trip count: 37 40,774.00 7,400.67 33,31333.., Total trip count: tailial 161144,11 r r pia` - , 73 • RescueNet'T Printed on 1/4/2005 at 2:26:17PM Page 2 \\nw16\rescuenet\reports32\BillingAMiscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,401 Batch date: 1/4/2005 2:10:05PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-02-15 0002-A 1,285 ALBEE, CASEY Bill Patient Collections No Bill Sent 1,191.00 350.00 841.00 2004-07-08 0002-A 6,067 BEYER, JOSEPH Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-03 0040-A 5,974 BUFKIN, REGINA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-05-19 0023-A 4,349 CABALLERO, EDUARI Bill Patient Collections No Bill Sent 1,026.00 661.47 364.53 2003-02-03 0064-A . 8,520 CHAVEZ, MARY Bill Patient Collections No Bill Sent 373.00 323.00 50.00 2004-04-06 0021-A 2,868 CONTRERAS, COLLEI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-21 0023-A 5,468 COOKSEY, MILDRED Bill Patient Collections No Bill Sent 1,296.00 1,266.00 30.00 2004-07-02 0018-A 5,866 CRANE, JONI Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-06 0003-A 6,008 DAHLSTROM, RUSSE Bill Patient Collections No Bill Sent 1,056.00 664.00 392.00 2004-03-20 0022-A 2,364 DAVIES, TIMOTHY Bill Patient Collections No Bill Sent 1,670.00 1,620.00 50.00 2004-06-20 0017-A 5,424 DEERING, MARIAN Bill Patient Collections No Bill Sent 1,191.00 542.24 648.76 2004-06-06 0008-A 4,951 DEERING, MARIAN Bill Patient Collections No Bill Sent 1,191.00 542.24 648.76 2004-06-09 0007-A 5,044 EISENBARTH, AMBEF Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-01 0008-A 4,772 GARCIA, MARY Bill Patient Collections No Bill Sent 1,776.00 1,678.39 97.61 2004-06-26 0007-A 5,639 HARTER, JUSTIN Bill Patient Collections No Bill Sent 1,461.00 1,361.00 100.00 2004-07-06 0020-A 6,025 HUSS, CASEY Bill Patient Collections No Bill Sent 1,311.00 1,261.00 50.00 2003-02-01 0053-A • 8,001 LUDWIG, PAUL Bill Patient Collections No Bill Sent 1,446.26 66.25 1,380.01 2004-06-10 0001-A 5,079 MARTINEZ, ANDRES Bill Patient Collections No Bill Sent 1,281.00 976.80 304.20 2004-06-14 0007-A 5,225 MISSI, GARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-01 0012-A 5,807 MORENO, ROLAND Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-05-17 0010-A 4,277 PENA, BERENICE Bill Patient Collections No Bill Sent 1,146.00 171.00 975.00 2004-06-01 0022-A 4,786 REES, JONATHAN Bill Patient Collections No Bill Sent 150.00 25.00 125.00 2004-07-07 0023-A 6,063 SCHANEMAN, CLARK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-02 0030-A 5,878 THORNOCK, DEANNE Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 Trip count: 24 25,236.26 11,508.39 13,727.87 Trip count: 24 25,236.26 11 508.39 13,727.87 • Total trip count: . 24 j 25,236:25; I 1'<,59:6,4 J(� 1.3,727.$7 i1 • RescueNetTM Printed on 1/4/2005 at 2.10:38PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,620 Batch date: 1/19/2005 11:38:54AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-12 0017-A 8,298 BASTARDO, ARTHUR Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-05 0020-A 9,117 COOPER, SAMUEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-12 0028-A 8,309 CORDERO, ROSE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-12 0001-A 8,282 GLENN, CHRISTOPHE Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2004-09-11 0036-A 8,281 GREDRIO, SANTIAGC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-16 0006-A 9,512 GREGG, JASON Bill Patient Collections No Bill Sent 1,101.00 0.00 . 1,101.00 2004-09-12 0010-A 8,291 HERNANDEZ, CONNIIBilI Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-10-17 0023-A 9,569 INFANTE, RICHEY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-25 0019-A 9,816 JACKSON, RAMON Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-18 0031-A 10,629 JILEK, REBECCA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-24 0005-A 10,862 JILEK, REBECCA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-09-23 0015-A 8,713 KASPAR, SHERRI Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-09-12 0002-A 8,283 MAESTAS, JENNIFER Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-09-12 0007-A 8,288 MARES, ISRAEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-17 0002-A 10,565 MCPHILLIPS, MICHAE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-11 0003-A 8,248 MEDINA, JAMIE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-11 0031-A 8,276 MINNEY, PAIGE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-12 0027-A 8,308 NIELSEN, NAOMI Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-04 0025-A 9,084 NUTTER, GORDON Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-11 0020-A 8,265 ONTIVEROS, MARGAI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-11 0026-A 8,271 PACHECO, ANTHONY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-12 0032-A 8,313 PADRON, ANTONIO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-26 0001-A 10,937 PENA, JOSE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-12-03 0033-A 11,211 REALIVASQUEZ, BRI/Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-08 0043-A 9,247 RIOJAS, GILBERT Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-12-04 0030-A 11,243 ROBERTS, JOHN Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-09-11 0015-A 8,260 RUIBAL, AMANDA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-12 0003-A 8,284 SHEEHAN, WES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-12 0015-A 8,296 SMITH, PAUL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-20 0007-A 10,688 VARELA, RANDY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-03 0004-A 10,107 VILLANUEVA, ANTON Bill Patient Collections No Bill Sent 1,221.00 1,142.31 78.69 2004-09-12 0024-A 8,305 WHITE,TRACY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-12 0026-A 8,307 WILLIAMS, HELEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-23 0033-A 8,731 WRIGHT, JOAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 RescueNetTM Printed on 1/19/2005 at 11:39:45AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES Trip count: 34 31,371.00 1,142.31 30,228.69 Trip count: 34 31,371.00 1,142.31 30 Total trip count: F.`3;1'741IIXil+ vat,„ '39,22844iu RescueNetn"^ Printed on 1/19/2005 at 11139:45AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,619 . Batch date: 1/19/2005 11:18:04AM Trio Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-06 0030-A 8,116 ACKERSON, STEVEN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-09-07 0015-A 8,140 AGUILAR-BARRAZA, [Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-02 0008-A 7,951 AGUILERA-SILVA, JOI Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-09-01 0019-A 7,942 ALVAREZ, ANGELICA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-05 0003-A 8,058 ALVIDREZ, JESUS Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-05 0005-A 8,060 ALVIDREZ, JESUS Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-06 0015-A 8,100 BERNHARDT, LORETBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-09 0008-A 8,193 BOYOK, BLAKE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-09-06 0033-A 8,119 CHAGOLLA, VENESSI Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-06 0016-A 8,101 COLLINS, GLEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-07 0011-A 8,135 DELEON, JOSE Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-09-05 0014-A 8,069 DREW, MARY Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-09-06 0036-A 8,128 GIBSON, DIONNA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-07 0012-A 8,136 GONZALES, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-03 0003-A 7,989 GUAJARDO, VANESS,Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-09-05 0004-A 8,059 HERNANDEZ, MARIA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-06 0006-A 8,091 IBARRA, CLAUDIO Bill Patient Collections No Bill Sent 1,466.00 0.00 1,466.00 2004-09-06 0014-A 8,099 KOPPENHAVER, ERIN Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-09-09 0016-A 8,201 LUDWIG, PAUL Bill Patient Collections No Bill Sent 1,011.00 961.55 49.45 2004-09-09 0035-A 8,220 MEDINA, GEORGE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-05 0006-A 8,061 MENDOZA, ALONDRA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-05 0007-A 8,062 MENDOZA, PAOLA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-09 0014-A 8,199 MERAZ, MONICA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-09-09 0021-A 8,206 MINNEY, PAIGE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-10 0019-A 8,243 MINNEY, PAIGE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-04 0011-A 8,038 MINTLE,TROY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-04 0011-B 8,047 MINTLE, TROY Bill Patient Collections No Bill Sent 678.00 0.00 678.00 2004-09-02 0017-A 7,963 MIRANDA, BARBARA Bill Patient Collections No Bill Sent 1,131.00 50.00 1,081.00 2004-09-09 0039-A 8,224 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-05 0023-A 8,078 MONTANO, LUCAS Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-09-04 0006-A 8,033 MORALES, MANUEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-06 0004-A 8,088 O'CONNOR, TIM Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-09-02 0026-A 7,978 RAMIREZ, MARIA Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-09-04 0009-A 8,036 REITZ, CHRISTOPHEI Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 RescueNetTh4 Printed on 1/19/2005 at 11:19:23AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-09-03 0011-A 7,999 RINCON, LETICIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-09 0007-A 8,192 RODRIGUEZ, RICHAR Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-09 0009-A 8,194 STEPHENS, DUSTIN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-09-06 0005-A 8,089 VIERNES, DANIEL Bill Patient Collections No Bill Sent 1,481.00 0.00 1,481.00 2004-09-09 0036-A 8,221 VIGIL, GINGER Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-10 0003-A 8,227 ZAMARRIPA, ANTONI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 40 40,972.00 1,011.55 39,960.45 Trip count: 40 40,972.00 1,011.55 39,860 45 Total trip count: `-y SAII ;*44.-4.19 ' w' _ - *CiA 1 i r RescueNetTM Printed on 1/19/2005 at 11:19'23AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,618 Batch date: 1/19/2005 10:48:07AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-10 0020-A 7,185 ALVAREZ, ESTELLE Bill Patient Collections No Bill Sent 1,491.00 100.00 1,391.00 2004-08-23 0009-A 7,611 BALONGUE, BRUCE Bill Patient Collections No Bill Sent 1,206.00 1,128.31 77.69 2004-08-29 0003-A 7,792 BARNES, CHRIS Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-24 0021-A 6,619 BRIDGES, DARRELL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-08-25 0023-A 7,688 CHURCHILL, ERIN Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-08-29 0038-A 7,853 CLARK, SHAWN Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-08-22 0013-A 7,591 COLLINS, ROBBIN Bill Patient Collections No Bill Sent 1,116.00 1,046.75 69.25 2004-07-27 0012-A 6,706 DELANEY, STEVEN Bill Patient Collections No Bill Sent 1,701.00 0.00 1,701.00 2004-08-27 0028-A 7,758 EVANS, COLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-17 0011-A 6,374 FOOS, DOROTHY Bill Patient Collections No Bill Sent 1,071.00 1,056.42 14.58 2004-08-29 0033-A 7,848 GARCIA, JOSE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-08-28 0019-A 7,781 GONZALES, ROSA Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-08-19 0005-A 7,469 HAMILTON, LYLE Bill Patient Collections No Bill Sent 1,596.00 1,571.00 25.00 2004-08-29 0012-A 7,801 HERNANDEZ, CESAR Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-13 0015-A 7,290 HIDALGO, PATRICIA Bill Patient Collections No Bill Sent 1,056.00 1,000.45 55.55 2004-07-26 0016-A 6,676 JENKINS, STEPHANY Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-08-16 0011-A 7,371 JOJOLA, KAREN Bill Patient Collections No Bill Sent 1,206.00 1,128.31 77.69 2004-08-31 0016-A 7,895 KOT, VERONIKA Bill Patient Collections No Bill Sent 1,071.00 50.00 1,021.00 2004-07-25 0003-A 6,631 LARSON, TYLOR Bill Patient Collections No Bill Sent 1,431.00 1,060.80 370.20 2004-08-19 0006-A 7,474 LEE, ALLEN Bill Patient Collections No Bill Sent 1,206.00 705.00 501.00 2004-07-27 0013-A 6,707 MUSGRAVE, KATHLE Bill Patient Collections No Bill Sent 1,176.00 1,101.00 75.00 2004-08-28 0016-A 7,778 PEREZ, EDGER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0019-A 6,679 REHUREK, RICHARD Bill Patient Collections No Bill Sent 1,177.64 1,127.64 50.00 2004-08-27 0027-A 7,757 RIOJAS, RACHEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-31 0034-A 6,871 RIOS, IVAN Bill Patient Collections No Bill Sent 1,101.00 880.80 220.20 2004-08-30 0016-A 7,844 ROJAS, JOSEPH Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-08-06 0027-A 7,067 ROMERO, DREW Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-31 0029-A 6,866 SANCHEZ, VALENTIN Bill Patient Collections No Bill Sent 1,311.00 20.00 1,291.00 2004-07-27 0035-A 6,729 SCHROEDER, GORD<Bill Patient Collections No Bill Sent 1,371.00 30.00 1,341.00 2004-08-06 0026-A 7,066 SELLERS, MANDY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-06 0005-A 7,044 TRUDEAU,TOMMY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-08-29 0014-A 7,803 VALDEZ, MIGUEL Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-08-16 0022-A 7,383 VAUGHN, DENISE Bill Patient Collections No Bill Sent 1,116.00 1,041.00 75.00 2004-08-17 0014-A 7,416 WILL, MOLLY Bill Patient Collections No Bill Sent 1,386.00 1,296.30 89.70 RescueNetTM Printed on 1/19/2005 at 10:49:09AM Page 1 \1nw 16lrescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-07-25 0006-A 6,634 YBARRA, SANTOS Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 Trip count: 35 40,318.64 14,343.78 25,974.86 Trip count: 35 40,318.64 14,343.78 25;974'86 Total trip count: ' ` ` . 0` , icSitt040 t 25,974,8¢ RescueNetTM Printed on 1/19/2005 at 10:49:09AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,617 Batch date: 1/19/2005 10:30:04AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-06-26 0037-A . 5,692 CABALLERO, LUIS Bill Patient Collections No Bill Sent 1,191.00 926.22 264.78 2004-02-28 0020-A 1,751 CARDERA, PATRICK Bill Patient Collections No Bill Sent 1,326.00 926.80 399.20 2004-07-13 0007-A 6,231 DANCZAK, CHARLENI Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-07-10 0014-A 6,142 ELSBURY, LOGAN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-25 0002-A 5,564 EURICH, JASON Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2003-12-14 0022-A 10,206 FOOS, DOROTHY Bill Patient Collections No Bill Sent 1,266.00 1,232.58 33.42 2004-01-09 0012-A 247 FORD, DONNA Bill Patient Collections No Bill Sent 1,131.00 131.00 1,000.00 2004-05-01 0019-A 3,662 GUTIERREZ, RICARD Bill Patient Collections No Bill Sent 1,206.00 964.80 241.20 2004-07-08 0003-A 6,068 HIGGINS, JENNIFER Bill Patient Collections No Bill Sent 1,146.00 1,020.60 125.40 2004-03-26 0012-A 2,534 HIOTT, MIKAYLA Bill Patient Collections No Bill Sent 1,206.00 989.80 216,20 2004-02-14 0014-A 1,317 IZAGUIRRE, JOSEPH Bill Patient Collections No Bill Sent 1,086.00 180.00 906.00 2004-05-02 0024-A 3,703 JOHNSON, OTIS Bill Patient Collections No Bill Sent 1,496.00 1,481.19 14.81 2004-06-22 0022-A ' 5,516 JONES, ROBERT Bill Patient Collections No Bill Sent 1,910.00 1,872.93 37.07 2004-06-02 0030-A 4,828 JONES, WOODY Bill Patient Collections No Bill Sent 1,146.00 1,121.00 25.00 2003-09-07 0002-A 6,965 KEISS, RIKI Bill Patient Collections No Bill Sent 1,476.00 350.00 1,126.00 2004-06-24 0016-A 5,600 LANGE, MARGO Bill Patient Collections No Bill Sent 1,386.00 1,256.51 129.49 2003-10-26 0001-A 8,570 LUDWIG, PAUL Bill Patient Collections No Bill Sent 1,116.00 1,075.40 40.60 2003-10-22 0016-A 8,445 LUDWIG, PAUL Bill Patient Collections No Bill Sent 1,281.00 1,237.93 43.07 2004-02-28 0005-A 1,698 LUDWIG, PAUL Bill Patient Collections No Bill Sent 1,236.00 1,178.82 57.18 2004-05-06 0041-A 3,845 MARTINEZ, JANIS Bill Patient Collections No Bill Sent 1,191.00 429.00 762.00 2004-04-22 0018-A 3,395 MARTINEZ, PRICILIAt,Bill Patient Collections No Bill Sent 1,341.00 1,299.65 41.35 2003-02-01 0069-A 8,040 MCPHAIL, PRESLEE Bill Patient Collections No Bill Sent 900.00 300.00 600.00 2004-06-16 0011-A 5,285 MEYER, GINA Bill Patient Collections No Bill Sent 150.00 100.00 50.00 2004-05-14 0006-A. 4,142 MINNEY, PAIGE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-10-22 0027-A 8,456 MONCAYO, MARY Bill Patient Collections No Bill Sent 1,176.00 225.00 951.00 2004-05-06 0036-A 3,840 MOTZ, HAROLD Bill Patient Collections No Bill Sent 1,056.00 20.00 1,036.00 2004-02-16 0001-A 1,309 PEREZ-GARCIA, FRAI Bill Patient Collections No Bill Sent 1,011.00 700.00 311.00 2004-07-15 0024-A 6,310 SALAZAR, PAYTON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-26 0007-A 2,517 TORRES, YOLANDA Bill Patient Collections No Bill Sent 1,176.00 151.00 1,025.00 2004-06-10 0025-A 5,115 VAUGHN, DENISE Bill Patient Collections No Bill Sent 1,041.00 966.00 75.00 2004-07-03 0042-A 5,976 VAUGHN, DENISE Bill Patient Collections No Bill Sent 1,191.00 1,116.00 75. 2003-12-06 0012-A 9,940 WOLF, DEVIN Bill Patient Collections No Bill Sent 1,776.00 1,644.00 n2. Trip count: 32 38,083.00 22,896.23 15,186.77 RescueNeF" Printed on 1/19/2005 at 19:30:45AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,787 Batch date: 2/2/2005 9:07:17AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance • 2004-05-23 0014-A 4,502 ABEYTA, MATTHEW Bill Patient Collections No Bill Sent 1,326.00 1,176.00 150.00 2004-07-26 0022=A-----6;68-2--- AH Dill WaTient--- Collections No Bill Sent 996.00 648.40 347.60 2004-08-19 0023-A 7,570 ALVAREZ, MERCEDE Bill Patient Collections No Bill Sent 663.00 530.40 132.60 2004-08-21 0031-A 7,576 AUTOBEE, CORA Bill Patient Collections No Bill Sent 1,356.00 1,296.00 60.00 2004-08-20 0024-A 7,526 BEECHER, JASON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-17 0033-A 6,396 BRNAK, ASHLEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-19 0027-A 6,453 BRNAK, ASHLEY Bill Patient Collections No Bill Sent 858.00 0.00 858.00 2004-06-19 0005-A 5,381 BUTZ, LAURA Bill Patient Collections No Bill Sent 1,071.00 1,046.46 24.54 2003-05-15 0005-A 3,280 CAUDILLO, JESUS Bill Patient Collections No Bill Sent 855.00 510.00 345.00 2004-01-24 0005-A 656 GRAHAM, ALAN Bill Patient Collections No Bill Sent 996.00 500.00 496.00 2004-08-09 0022-A 7,153 HERNANDEZ, ANTON Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-02-17 0017-A 1,365 INFANTE, ALYSE Bill Patient Collections No Bill Sent 633.00 50.00 583.00 2004-06-09 0005-A 5,042 LEBSACK, LARRY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-23 0005-A 7,607 LLANAS, JULIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-18 0010-A 7,442 MATHEWS, JUNE Bill Patient Collections No Bill Sent 1,386.00 1,296.53 89.47 2004-05-14 0030-A 4,195 MCCRARY, LORNA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-05 0020-A 7,020 MIDDLETON, ROBER"Bill Patient Collections No Bill Sent 1,206.00 851.20 354.80 2004-08-28 0026-A 7,788 MIDDLETON, ROBER"Bill Patient Collections No Bill Sent 1,266.00 30.00 1,236.00 il 2004-08-13 0009-A 7,284 MIDDLETON, ROBER"Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-13 0009-B 7,295 MIDDLETON, ROBER"Bill Patient Collections No Bill Sent 528.00 0.00 528.00 2004-07-12 0019-A 6,216 MILLER, JEFF Bill Patient Collections No Bill Sent 1,311.00 268.80 1,042.20 2004-07-23 0004-A 6,572 MURPHY, RACHAEL Bill Patient Collections No Bill Sent 1,805.00 0.00 1,805.00 2004-08-18 0014-A 7,446 NAVARRETTE, JUANF Bill Patient Collections No Bill Sent 1,311.00 1,240.00 71.00 2004-08-30 0014-A 7,842 PEREZ-ESTRADA, GL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-27 0009-A 8,646 PISANO, JARED Bill Patient Collections No Bill Sent 1,026.00 225.00 801.00 2004-07-25 0015-A 6,643 RIOS, BENJAMIN Bill Patient Collections No Bill Sent 1,251.00 612.60 638.40 2004-06-25 0028-A 5,611 RUTT, BRIAN Bill Patient Collections No Bill Sent 1,131.00 877.50 253.50 2004-07-19 0033-A 6,463 SCHACHTLER, JOHN Bill Patient Collections No Bill Sent 1,956.00 0.00 1,956.00 2004-03-21 0022-A 2,452 SEMMLER, BETH Bill Patient Collections No Bill Sent 1,416.00 100.00 1,316.00 2004-07-17 0032-A 6,395 SMITH, CALEB Bill Patient Collections No Bill Sent 1,191.00 50.00 1,141.00 2004-08-20 0023-A 7,525 SMITH, CINDY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-31 0006-A 6,843 THOMPSON, JOHN Bill Patient Collections No Bill Sent 1,329.30 1,273.30 56.00 2003-10-22 0034-A 8,633 TOFT, STACIE Bill Patient Collections No Bill Sent 1,221.00 775.40 445.60 2004-08-15 0016-A 7,345 TRYON, PEGGY Bill Patient Collections No Bill Sent 150.00 90.00 60.00 RescueNet'M Printed on 2/2/2005 at .9:08:22AM Page 1 \1nw 16\rescuenet\reports321Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-04-13 0027-A 3,099 WALLACE, NICOLE Bill Patient Collections No Bill Sent 1,386.00 50.00 1,336.00 2004-08-29 0031-A 7,827 WOLERY, CHRYSTAL Bill Patient Collections No Bill Sent 1,296.00 1,086.80 209.20 Trip count: 36 36,044.30 14,584.39 21,459.91 Trip count: 36 36,044.30 14,584.39 21,459.91^ �\ Total trip count: 8¢'t ,,16;044 0 t, 14; 84ti"C: 21,459;,91 :'1 __--/ RescueNetTM Printed on 2/2/2005 at 9:08:22AM Page 2 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,788 Batch date: 2/2/2005 9:33:41AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-17 0002-A 8,473 ALLEN, LARRY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-16 0026-A 8,454 BARRON, PEDRO Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-09-18 0047-A 8,549 BIRCHWELL, KALEB Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-04 0001-A 8,028 BUTZ, LAURA Bill Patient Collections No Bill Sent 1,071.00 1,039.45 31.55 2004-09-14 0017-A 8,372 CAMPBELL, DONNA Bill Patient Collections No Bill Sent 996.00 942.88 53.12 2004-09-12 0029-A 8,310 CERVANTES, MICHAE Bill Patient Collections No Bill Sent 996.00 20.00 976.00 2004-09-13 0033-A 8,346 COLEMAN, CHRISTIN Bill Patient Collections No Bill Sent - 1,161.00 0.00 1,161.00 2004-09-17 0023-A 8,494 COPELAND, MARY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-13 0042-A 8,355 CRON, LEIGH Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-14 0027-A 8,382 DELAROSA, PATRICl/Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-04 0014-A 8,041 ESPARZA, SUE Bill Patient Collections No Bill Sent 1,266.00 1,156.68 109.32 2004-09-18 0004-A 8,506 GOODRO, GENIE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-18 0016-A 8,518 GORE, KAREN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-09-13 0014-A 8,327 GUITE, BJ Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-14 0006-A 8,361 HARDING, SAMANTH)Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-16 0020-A 8,448 HATCHER, LISA Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-09-17 0027-A 8,498 HEIL, MARY Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-09-18 0009-A 8,511 JAMES, DALENA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-09-14 0037-A 8,392 JIMINEZ, MARCO Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-09-13 0038-A 8,351 JOHNSON, THELMA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-18 0006-A --83508--'--KELS€Y #ENRY---- tient Collections No Bill Sent 1,506.00 0.00 1,506.00 2004-09-16 0025-A 8,453 KIEHN, DAMIAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-12 0018-A 8,299 LOPEZ-DOMINGO, IC Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-16 0027-A 8,455 MARTINEZ, LAURA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-09-13 0007-A 8,320 MENDEZ, JAMIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-18 0028-A 8,530 OJEDO, FACUNDO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-16 0040-A 8,469 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-18 0022-A 8,524 REYES, JESUS Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-18 0014-A 8,516 ROMERO, ROBERT Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2004-09-15 0024-A 8,423 ROYBAL, MATHEW Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-16 0033'A 8,462 RUBIO-CASTILLO, JO Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-09-15 0008-A 8,404 RUBY, SHIRLEY Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-09-15 0025-A 8,424 SAENZ, ISABELLE Bill Patient Collections No Bill Sent 1,056.00 844.80 211.20 2004-09-11 0019-A 8,264 SELLERS, JEFFREY Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 RescueNetTM Printed on 2/22005 at .9:35:40AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-09-13 0020-A 8,333 SHIPSOCK, ANGEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-03 0026-A 8,014 SORENSON, WENDY Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-09-18 0051-A 8,553 SUAREZ, RUTH Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-15 0022-A 8,421 TELLEZ, LISA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-15 0006-A 8,402 UNDERDOWN, CHAN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-09-04 0018-A 8,045 VAZQUEZ, CORA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-09-16 0023-A 8,451 WELLER, JAMES Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-16 0001-A 8,427 WILLIAMSON, JAMES Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-09-08 0011-A 8,169 WITHROW, KAREN Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-09-18 0049-A 8,551 ZAMORA, GUADALUPBill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 44 46,293.00 4,003.81 42,289.19 Trip count: 44 46,293 00 4,003.81 42,28 .,.. Total trip count: . Fitt ' ,:`.'4 1Itn`} `# 4'2,2&9:19,/ RescueNetTM Printed on 2/2/2005 at 9.35:40AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,789 Batch date: 2/2/2005 9:52:20AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-09-28 0005-A 8,864 ANDERSON, BRIAN Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-09-26 0016-A 8,817 ANDERSON, BRIAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-22 0022-A 8,689 BELO, GRACE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-28 0020-A • 8,882 BOSELEY, RICHARD Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2004-09-23 0017-A 8,715 BROWN, SHARON Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-22 0014-A 8,681 CANNON, DARRELL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-20 0001-A 8,590 CASARES, RENE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-20 0024-A 8,620 COVILLE, ADAM Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-09-28 0022-A 8,884 GARCIA, ADRIANNA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-28 0027-A 8,889 GUEL-BAEZ, SAUL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-28 0029-A 8,891 GUERRA, GERARD Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-09-23 0034-A 8,732 LARSON, TYLOR Bill Patient Collections No Bill Sent 1,431.00 1,216.14 214.86 2004-09-24 0010-A 8,745 LOPEZ, ANTONIO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-26 0003-A 8,804 MANTER, MARY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-09-21 0004-A 8,629 MATHESON, BRIANNE Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-09-22 0020-A 8,687 MCALLISTER, JAMES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-26 0008-A 8,809 MONTANEZ, FRANC':Bill Patient. Collections No Bill Sent 981.00 0.00 981.00 2004-09-30 0001-A 8,930 MOSS, JEFF Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-30 0019-A 8,948 MUNGIA, SAMMY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 ' 2004-09-22 0017-A 8,684 NAJR, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-27 0002-A 8,829 OBRZUT, KRYSTOPH Bill Patient Collections No Bill Sent 1,308.00 0.00 1,308.00 2004-09-21 0017-A 8,642 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-25 0003-A 8,769 RESENDIZ, CEFERINI Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-09-30 0016-A 8,945 RIPPY, CASSONDRA Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-09-19 0009-A 8,562 ROMAN-PEREZ, LEOt Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-19 0028-A 8,582 ROMERO, MARIA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-09-22 0001-A 8,668 SANDOVAL, KATRINABill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-09-22 0015-A 8,682 TEGTMAN, BILLY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-25 0011-A 8,779 YINGLING, BRANDIE Bill Patient Collections No Bill Sent 2,136.00 0.00 2,136.00 2004-09-24 0001-A 8,736 ZARATE-PEREZ, LIBCBill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 30 30,489.00 1,216.14 29,2 Trip count: 30 30,489.00 1,216.14 29,272.86____"/, RescueNetTM Printed on 2/2/2005 at 9:53:03AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,790 Batch date: 2/2/2005 10:42:57AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-04 0027-A 10,169 CHALI, ERICK Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-06 0008-A 10,219 CHALI, ERICK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-27 0001-A 9,865 CHARLES, CLAIRE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-24 0006-A 10,863 FERNANDEZ, TILLIE Bill Patient Collections No Bill Sent 1,131.00 1,060.75 70.25 2004-10-05 0009-A 9,106 GONZALEZ, AUGUST:Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2005-01-01 0034-A 34 HERRERA, DAVID Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2004-11-24 0028-A 10,885 HESSELDEN, DONALI Bill Patient Collections No Bill Sent 1,176.00 900.81 275.19 2004-10-10 0005-A 9,299 HOLMBERG, LARS Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-04 0007-A 11,218 HOLMBERG, LARS Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-07 0015-A 9,179 JONES, RUSSELL Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-10-14 0034-A 9,464 LESSER, CONNIE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-27 0030-A 9,895 MARTINEZ, RUBY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-05 0014-A 9,111 MINNEY, PAIGE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-07 0027-A 9,191 OAKLEY, GARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-31 0018-A 10,019 OLMEDA, MARIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-10-02 0042-A 9,030 OWENS, JASON Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2005-01-11 0013-A 359 RODGERS, SCOTT Bill Patient Collections No Bill Sent 1,364.00 0.00 1,364.00 2005-01-17 0008-A 569 RODGERS, SCOTT Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2004-10-05 0025-A 9,122 ROMERO, MARIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-15 0025-A 11,592 SOTO-ENRIGUEZ, JO Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-10-02 0035-A 9,023 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-10-02 0015-A 9,003 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2005-01-21 0007-A 705 TOCKTOO, MARICIO Bill Patient Collections No Bill Sent 1,195.00 0.00 1,195.00 2004-10-07 0017-A 9,181 VARGAS-GARCIA, JE,Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-24 0030-A. 10,887 VELASQUEZ, DILMA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count: 25 25,229.00 1,961.56 23,267.44 Trip count: 25 25,229.00 1,961.56 Total trip count: 25 , '1 ;,2.5;229 110 4n.'f 1t9fi1=:56 - .k 7 23,267 44:_;u RescueNetT" Printed on 2/2/2005 at 10:44:17AM Page 1 1\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,832 Batch date: 2/4/2005 10:33:02AM Trip Date Job Run Name Current Flavor Schedule Event Charges Credits Balance 2004-12-21 0001-A 11,785 AHREND, MELODY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-09-08 0025-A 8,183 ALANIZ, ROBERT Bill Patient Collections No Bill Sent 1,236.00 1,158.14 77.86 2004-12-22 0046-A 11,862 BARNES, MICHELLE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-10-05 0005-A 9,102 CARDONA, BRANDY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-06 0026-A 6,033 CARLSON, HOLLY Bill Patient Collections No Bill Sent 1,221.00 836.00 385.00 2004-10-29 0010-A 9,948 CHAVEZ, ANTHONY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-16 0001-A 6,324 CRAWFORD, SONYA Bill Patient Collections No Bill Sent 1,251,00 1,125.90 125.10 2004-10-06 0029-A 9,160 GILBERT, CRYSTAL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-05 0027-A 9,124 GONZALEZ, PETE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-10-07 0013-A 9,177 HERNANDEZ, KATY Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-07-16 0023-A 6,347 KEISS, ZACHARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-06 0012-A 9,143 MONTALVAN, MARIA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-05 0003-A 9,100 PRATT, MICHAEL Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-08-18 0008-A 7,440 RODRIGUEZ, KENNY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-26 0010-A 8,811 RUIZ-SALDANA, JUAN Bill Patient Collections No Bill Sent 1,206.00 25.00 1,181.00 2003-02-02 0056-A 8,250 TEMPLIN, NICOLE Bill Patient Collections No Bill Sent 338,00 313.00 25.00 2004-10-05 0034-A 9,133 WERNICK, KEVIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 17 15,911.00 3,458.04 12,452.96 Trip count: 17 15,911.00 3,458.04 12,452.96 Total trip count: 1 , "11 '' 15 5ttQffA_ ,{ '4 p4 � 12;4S2,,96`»cj RescueNetTM' Printed on 2/4/2005 at 10:33:27AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,121 Batch date: 2/24/2005 2:26:36PM Trip Date Job • Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-30 0003-A 5,768 BARBOZA, EMEL Bill Patient Collections No Bill Sent 1,221.00 1,009.00 212.00 2003-11-27 0010-A 9,654 BARKER, KELSEY Bill Patient Collections No Bill Sent 1,326.00 775.00 551.00 2004-07-30 0015-A 6,813 BLACK, LAURA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-22 0031-A 9,521 BRUNTZ, MARY Bill Patient Collections No Bill Sent 1,086.00 350.00 736.00 2004-06-01 0032-A 4,796 CARLSON, JON Bill Patient Collections No Bill Sent 1,521.00 1,216.80 304.20 2004-07-28 0013-A 6,746 DAMIN, JAMIE Bill Patient Collections No Bill Sent 150.00 25.00 125.00 2004-08-27 0017-A 7,747 DECRANE, JOSEPH Bill Patient Collections No Bill Sent 996.00 596.32 399.68 2004-07-21 0021-A 6,521 FORBES, SHELLY Bill Patient Collections No Bill Sent 1,360.16 1,088.96 271.20 2004-08-31 0024-A 7,903 HENRY, MONICA Bill Patient Collections No Bill Sent 1,446.00 1,156.80 289.20 2004-07-09 0017-A 6,119 HERNANDEZ, EDWAF Bill Patient Collections No Bill Sent 150.00 80.00 70.00 2004-08-16 0008-A 7,368 JARAMILLO, JESSICA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-07 0028-A 7,275 JIMENEZ, ELEANOR Bill Patient Collections No Bill Sent 150.00 135.00 15.00 2003-10-27 0016-A 8,668 KAY, CAROLINE Bill Patient Collections No Bill Sent 1,026.00 110.00 916.00 2003-02-02 0065-A 8,259 KLINGER, ELSIE Bill Patient Collections No Bill Sent 614.02 140.00 474.02 2004-08-29 0007-A 7,796 MAESTAS, ROBERT Bill Patient Collections No Bill Sent 1,910.00 1,850.00 60.00 2004-07-26 0028-A 6,688 MARICLE, CHRISTOP Bill Patient Collections No Bill Sent 1,161.00 1,111.00 50.00 2004-08-07 0018-A 7,096 MONTES-RIOS, SEFE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-21 0025-A 5,471 SAMPLE, NANCY Bill Patient Collections No Bill Sent 633.00 30.00 603.00 2004-08-31 0042-A 7,921 SCHULZE, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-14 0019-A 7,321 SEPEDA, EDNA Bill Patient Collections No Bill Sent 1,536.00 119.11 1,416.89 2004-08-10 0005-A 7,170 SODERBERG, JOSHU Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-20 0035-A 7,537 SWEENEY, SUSAN Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-08-31 0018-A 7,897 WHITE, MATTHEW Bill Patient Collections No Bill Sent 285.00 0,00 285.00 2004-08-15 0017-A 7,346 ZAMORA, JOHN Bill Patient Collections No Bill Sent 1,176.00 464.79 711.21 Trip count: 24 20,774.18 10,257.78 10,516.40 Trip count: 24 20,774.18 10,257.78 10,516.40 Total trip count: 2c.^s„ ' ., ,2Q7.7414*( n10r2,5 q 8 1P Mal • RescueNetTM Printed on 2/24/2005 at 2:27:19PM Page 1 \\nw 161rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,122 Batch date: 2/24/2005 2:48:28PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-23 0011-A 8,709 AARON, GRETCHEL Bill Patient Collections No Bill Sent 1,236.00 764.40 471.60 2004-09-06 0038-A 8,133 ALVAREZ, JOHN Bill Patient Collections No Bill Sent 150.00 20.00 130.00 2004-09-06 0037-A 8,131 ALVAREZ, VINCENT Bill Patient Collections No Bill Sent 150.00 20.00 130.00 2004-09-22 0025-A 8,692 BERNAL, CASIMIRO Bill Patient Collections No Bill Sent 1,566.00 75.00 1,491.00 2004-09-11 0029-A 8,274 BROOKS, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-25 0012-A 8,780 CADENA, MARGARIT(Bill Patient Collections No Bill Sent 1,071.00 1,019.12 51.88 2004-09-30 0014-A 8,943 CASTILLO, JANET Bill Patient Collections No Bill Sent 1,251.00 1,114.31 136.69 2004-09-23 0001-A 8,699 CHAPMAN, JEFFERS(Bill Patient Collections No Bill Sent 1,116.00 779.40 336.60 2004-09-22 0031-A 8,698 CHRISTIANSEN, AMB Bill Patient Collections No Bill Sent 1,026.00 820.80 205.20 2004-09-14 0031-A 8,386 GAONA, JACKIE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-09-22 0024-A 8,691 HEESCHEN, REBECC Bill Patient Collections No Bill Sent 1,461.00 1,370.03 90.97 2004-09-26 0028-A 8,851 HERNANDEZ, EMILIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-27 0010-A 8,837 HUNT, EMERY Bill Patient Collections No Bill Sent 1,191.00 1,118.42 72.58 2004-09-08 0008-A 8,166 MALDONADO, ROSE,Bill Patient Collections No Bill Sent 1,221.00 411.75 809.25 2004-09-22 0002-A 8,669 MEDINA, ROBERT Bill Patient Collections No Bill Sent 1,191.00 1,110.11 80.89 2004-09-21 0019-A 8,645 MOLINA, ESPERANZA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-17 0001-A 8,472 PETTI, JENNIFER Bill Patient Collections No Bill Sent 1,191.00 952.80 238.20 2004-09-23 0025-A 8,723 QUICK, DOROTHY Bill Patient Collections No Bill Sent 1,281.00 1,186.53 94.47 2004-09-16 0002-A 8,429 SEPEDA, JOHN Bill Patient Collections No Bill Sent 1,251.00 1,174.31 76.69 2004-09-09 0011-A 8,196 SPECHT, KEEGAN Bill Patient Collections No Bill Sent 150.00 20.00 130.00 2004-09-13 0018-A 8,331 SWEDBERG, JANICE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-03 0032-A 8,020 YANEZ, JENNET Bill Patient Collections No Bill Sent 1,386.00 708.80 677.20 Trip count: 22 20,691.00 12,665.78 8,025.22 Trip count: 22 20,691.00 12,665.78 8,025.22 Total trip count: , .Fz 22,,,m .1 _ ,20`,69 QfU ,1 .'C 9 .: -: .:,9 . 2 ;_J`' RescueNetTM Printed on 2/24/2005 at 2.49.31PM Page 1 \\nw16\rescuenet\reports32\Billing AMiscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY.PARAMEDIC SERVICES Batch 7,124 Batch date: 2/24/2005 3:02:06PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-10-08 0007-A 9,211 AGUILAR, JOHN Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-10-01 0019-A 8,973 AKERS, COLE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-10-01 0016-A 8,970 AKERS, DONALD Bill Patient . Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-10-01 0014-A 8,968 AKERS, NICOLE Bill Patient Collections No Bill Sent 966.00 0.00 966.00 2004-10-01 0015-A 8,969 AKERS, WENDY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-02 0040-A 9,028 ANDRADE, VICTOR Bill Patient Collections No Bill Sent 1,916.00 0.00 1,916.00 2004-10-05 0019-A 9,116 BELLFI, AMYLYNNE Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-10-09 0024-A 9,279 BREWER, JOHN Bill Patient Collections No Bill Sent 1,581.00 0.00 1,581.00 2004-10-04 0013-A 9,072 CHILCOTT, JULIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-10-01 0011-A 8,965 CLARK, GREGORY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-11 0025-A 9,356 DAVIS, DEETTA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-10-04 0014-A 9,073 DELDUCA, BRIAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-09 0020-A 9,275 DUENEZ, JESUS Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-10 0033-A 9,327 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-08 0014-A 9,218 EWALD, CHRISTOPHI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-06 0035-A 9,198 FISHER, RICK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-04 0010-A 9,069 GARCIA, OMAR Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-03 0010-A 9,041 GULLEY, DAVID Bill Patient Collections No Bill Sent 1,296.00 25.00 1,271,00 2004-10-12 0011-A 9,383 HAFLETT, JAMES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-02 0033-A 9,021 HOVANIC, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-05 0026-A 9,123 HUNT, EMERY Bill Patient Collections No Bill Sent 558.00 508.12 49.88 2004-10-10 0023-A 9,317 LEON, VICTOR Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-07 0034-A 9,202 LUNA, RACHAEL Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-10-10 0019-A 9,313 MACHADO, MARLON Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-10-09 0007-A 9,262 MARTINEZ, FRANK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-01 0009-A 8,963 MUSSLEWHITE, ASHI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-08 0002-A 9,206 NAJREA, BLAS Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-10-10 0037-A 9,331 OLTMAN, JUSTIN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-10-08 0012-A 9,216 PADEN, BRENDA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-06 0037-A 9,200 PEREZ, CARLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-01 0001-A 8,949 QUICK, BARBARA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-01 0002-A 8,950 RIPPY, CASSONDRA Bill Patient Collections No Bill Sent 858.00 0.00 858.00 2004-10-01 0033-A 8,987 SAENZ, JAVIAR Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-08 0026-A 9,230 URBAN, KYLIE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 RescueNer Printed on 2/24/2005 at ,3:02:49PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-10-01 0032-A 8,986 WOFFORD, TAYLOR Bill Patient Collections No Bill Sent 1,941.00 0.00 1,941.00 Trip count: 35 36,323.00 533.12 35,789.88 Trip count: 35 36,323.00 533.12 35,789.88 Total trip count: :,..i.4:,,-;.4011t:,.(1 ', al,A, 3,110 -t ht. 3g , it 35;789c$$ ;) RescueNetTM Printed on 2/24/2005 at 3:02:49PM Page 2 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,125 Batch date: 2/24/2005 3:18:29PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-10-18 0022-A 9,603 BROWN, JOHN Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-11 0009-A 10,367 CADY, MIRANDA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-30 0001-A 11,078 CHAVEZ, MARY Bill Patient Collections No Bill Sent 1,955.00 1,854.65 100.35 2004-10-18 0003-A 9,584 CHRISTIANSEN, AMB Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-13 0012-A 9,412 CORRAL, YOMAIRA Bill Patient Collections No Bill Sent 1,746.00 0.00 1,746.00 2004-10-16 0026-A 9,534 CRESS, BRIAN Bill Patient Collections No Bill Sent 1,116.00 892.80 223.20 2004-10-18 0014-A 9,595 FERGUSON, CRAIG Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-10-13 0022-A 9,422 GARCIA, DANIEL Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-11-26 0023-A 10,966 GARCIA-ANDRADE, E Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-10 0023-A 10,352 GODDARD, CATHERII Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-12-25 0006-A 11,941 GONZALES, JOSE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-18 0013-A 9,594 GULLEY, PAUL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-30 0008-A 11,085 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,128.31 77.69 2004-10-16 0002-A 9,508 HERNANDEZ, ALEJAt'Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-10-17 0031-A 9,577 HERNANDEZ, GERARBill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-11-06 0009-A 10,220 HERNANDEZ, MARTIt Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-10-14 0013-A 9,442 HOFF, SHIELA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-26 0020-A 10,963 JILEK, REBECCA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-10-17 0016-A 9,562 KROL, TED Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-25 0038-A 10,934 LEBRUN, STEVEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-30 0006-A 12,119 LOCKHART, TYLER Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-10-19 0002-A 9,629 LUCERO, DANIELLE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2005-01-01 0031-A 31 LUNDQUIST, RODNE`Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2004-10-18 0023-A 9,604 MACIAS, ANTONIO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-10-17 0004-A 9,550 MARSDEN, MEGAN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-12-02 0012-A 11,139 MEDINA-PARRA, JOR Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-10-16 0020-A 9,528 MILLER, MICHAEL Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-11-19 0035-A 10,676 MORADO, JOSEPH Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-16 0038-A 9,546 MORALES, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-26 0003-A 854 MORGAN, ALITIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-02 0005-A 10,079 ORTEGA, ANTHONY Bill Patient Collections No Bill Sent 2,165.00 0.00 2,165.00 2004-10-15 0026-A 9,501 PASCARELLA, MICHA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-12-30 0024-A 12,137 PEREZ, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-03 0016-A 1,129 RODGERS, SCOTT Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 RescueNetTM Printed on 2/24/2005 at .3:19:23PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-02-05 0004-A 1,198 RODGERS, SCOTT Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-10-14 0001-A 9,430 ROJAS, IRMA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-10-15 0002-A 9,466 ROMERO, ISREAL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-10-19 0025-A 9,652 SALAZAR, BERTHA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-14 0010-A 9,439 SANCHEZ, DAVID Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2005-01-08 0021-A 285 SANCHEZ, TERRY Bill Patient Collections No Bill Sent 1,347.00 0.00 1,347.00 2004-10-14 0031-A 9,460 SANDERS, RHONDA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-10-14 0024-A 9,453 STULTS, ANNA Bill Patient Collections No Bill Sent 1,071.00 1,033.30 37.70 2004-10-17 0030-A 9,576 VERDECK, CHRIS Bill Patient ' Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-17 0021-A 9,567 WILLIAMSON, JAMES Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-10-16 0036-A 9,544 ZAMORA, ANTONIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 45 49,449.00 4,909.06 44,539.94 Trip count: 45 49,449.00 4,909.06 44,539:94 Total trip count: t 4S{„ .=a449ff 4x9O "� 4;5t$9 911: i y RescueNetw Printed on 2/24/2005 at 3:19:23PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,289 Batch date: 3/8/2005 2:31:18PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-10-29 0013-A 9,951 BAGGETT, JACK Bill Patient Collections No Bill Sent 150.00 20.00 130.00 2004-11-26 0007-A 10,948 BROWN, BEATRICE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-11-02 0020-A 10,094 CHAVEZ, ANTHONY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-12-05 0019-A 11,264 COTA, MARY Bill Patient Collections No Bill Sent 1,206.00 1,126.53 79.47 2004-12-19 0008-A 11,708 COTA, MARY Bill Patient Collections No Bill Sent 1,566.00 1,438.34 127.66 2004-12-27 0015-A 12,020 COTA, MARY Bill Patient Collections No Bill Sent 1,431.00 1,355.99 75.01 2004-11-10 0024-A 10,354 GUTIERREZ, APRIL Bill Patient Collections No Bill Sent 1,596.00 0.00 1,596.00 2004-10-30 0021-A 9,988 MARTINEZ, KATHY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-31 0006-A 10,007 ORTAGA, STEVEN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-31 0033-A 10,035 PETERSON, THOMAS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-29 0008-A 9,946 PINKSTAFF, ERIC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-31 0028-A 10,030 RODRIGUEZ, RICHARBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-01 0001-A 10,041 RODRIGUEZ, RICHARBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count: 13 13,911.00 3,940.86 9,970.14 Trip count: 13 13,911.00 3,940.86 9,9_704.4 Total trip count: '4 ' 1, 1 ran .AMY 1 "irh '9 ©"1. • RescueNetTM Printed on 3/8/2005 at 2:31:41 PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt 1 Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,288 Batch date: 3/8/2005 2:20:36PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-10-27 0029-A 9,894 ALANIZ, JOHANNA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-10-25 0026-A 9,823 AYALA, MARISOL Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-10-25 0034-A 9,831 BARNETT, TERRY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-20 0004-A 9,657 BRAUNER, TIMOTHY Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-10-28 0022-A 9,921 BRENNAN, SAMANTHBill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-26 0019-A 9,852 BRICENO, SAMMY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-26 0031-A 9,864 CARMONA, EUSTIDR,Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-20 0014-A 9,667 CHAVEZ, ANTHONY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-26 0004-A . 9,837 CHAVEZ, ROBERT Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-22 0014-A 9,732 CONSONERO, DEBOF Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-10-21 0025-A 9,707 ENRIQUEZ, OSCAR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-27 0011-A 9,875 ENRIQUEZ, PAULA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-21 0024-A 9,706 GALLEGOS, ALYSSA Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2004-10-27 0023-A 9,888 GARDNER, CHRISTA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-28 0012-A 9,910 HUYETT, LINDA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-10-25 0002-A 9,797 KING, PATRICIA Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-10-24 0004-A 9,777 MARTINEZ, ERNIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-24 0003-A 9,776 MARTINEZ, IRENE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-28 0003-A 9,901 MARTINEZ, MANUEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-10-20 0008-A 9,661 MEDINA, JASON Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-27 0032-A ' 9,897 MEDINA, ROY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-20 0007-A 9,660 MILLER, ZEB Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-10-22 0015-A 9,733 NAVARRO, LUZ Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-10-22 0025-A 9,745 RIOS, MANUEL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-10-25 0009-A 9,805 ROBBINS, RICK Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-10-21 0022-A 9,704 RODRIGUEZ, ROBER'Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-10-22 0020-A 9,738 SENSENBACH, EMILY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-19 0011-A 9,638 SEPEDA, JOHN Bill Patient Collections No Bill Sent 996.00 942.88 53.12 2004-10-27 0009-A 9,873 SOTO, LYDIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-25 0035-A 9,832 TEPPERT, ANTHONY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-10-27 0033-A 9,898 TIPTON, PAM Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-10-23 0014-A. 9,762 TORRES, STEPHANIE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-26 0026-A 9,859 TURNER, TAMARA Bill Patient Collections No Bill Sent 1,536.00 0.00 1,536.00 2004-10-23 0024-A 9,772 VALLEJOS, RUBEN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 RescueNetTM Printed on 3/8/2005 at 2:21:28PM Page 1 \\nw 16\rescu enet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-10-28 0004-A 9,902 VERGARA-GOMEZ, G Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-10-27 0019-A 9,884 VIGIL, STEPHANIE Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-10-23 0005-A 9,753 WAMBOLT, ETHEL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-10-20 0020-A 9,673 ZAVALA, CRISTINA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 Trip count: 38 39,507.00 942.88 38,564.12 Trip count: 38 39,507.00 942.88 38,5.64:12 Total trip count: m,. 38 .Al ,_r 9r ,O,�Y y,j� 1,,94Z .'i. M4.12 RescueNetTM Printed on 3/8/2005 at 2.21:28PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,287 Batch date: 3/8/2005 1:59:36PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-04 0005-A 6,974 ADOLPH, WILLIAM Bill Patient Collections No Bill Sent 1,236.00 788.00 448.00 2004-07-26 0022-A 6,682 ALEXANDER, ISAYAH Bill Patient Collections No Bill Sent 996.00 673.40 322.60 2004-08-19 0014-A 7,492 BARCKLOW, ANGELI(Bill Patient Collections No Bill Sent 1,131.00 75.00 1,056.00 2004-05-21 0030-A 4,438 BROWN, DEVON Bill Patient Collections No Bill Sent 150.00 100.00 50.00 2004-09-17 0005-A 8,476 BUTTS, JASON Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-10-14 0027-A 9,456 CAMARILLO, BEATRI;Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-10-16 0013-A 9,521 CAMPBELL, DONNA Bill Patient Collections No Bill Sent 1,056.00 984.12 71.88 2004-07-30 0027-A 6,826 CERVANTES, LYDIA Bill Patient Collections No Bill Sent 1,026.00 973.40 52.60 2004-10-17 0008-A 9,554 COTA, MARY Bill Patient Collections No Bill Sent 1,626.00 1,550.91 75.09 2003-04-01 0003-A 1,905 DILLARD, DIANE Bill Patient Collections No Bill Sent 1,145.00 157.50 987.50 2003-04-03 0020-A 1,973 DILLARD, DIANE Bill Patient Collections No Bill Sent 1,100.00 157.50 942.50 2004-10-16 0017-A 9,525 GARCIA, FAVIAN Bill Patient Collections No Bill Sent 1,176.00 1,103.12 72.88 2003-08-08 0006-A 6,001 GONZALES, EUGENE Bill Patient Collections No Bill Sent 1,311.00 700.00 611.00 2004-09-24 0012-A 8,748 GUYETTE, MINDY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-06-29 0020-A 5,748 GUZMAN-LOPEZ, ROE Bill Patient Collections No Bill Sent 1,131.00 50.00 1,081.00 2004-10-12 0015-A 9,387 LAKEY, RICHARD Bill Patient Collections No Bill Sent 1,221.00 550.61 670.39 2003-12-21 0007-A . 10,387 MAESTAS, VELMA Bill Patient Collections No Bill Sent 1,311.00 570.00 741.00 2004-09-17 0004-A 8,475 OVERBEY, JASON Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-10-11 0006-A 9,337 RAPELJE, DANIEL Bill Patient Collections No Bill Sent 1,521.00 1,425.94 95.06 2004-09-16 0029-A 8,458 SCHIRMER, JESSICA Bill Patient Collections No Bill Sent 1,326.00 1,259.70 66.30 2004-10-18 0039-A 9,620 SEPEDA, JOHN Bill Patient Collections No Bill Sent 1,056.00 998.51 57.49 2004-10-18 0045-A 9,624 SEPEDA, JOHN Bill Patient Collections No Bill Sent 513.00 464.55 48.45 2004-09-18 0007-A 8,509 SPADI, CODY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-24 0020-A 8,756 TRUJILLO, JAMIE Bill Patient Collections No Bill Sent 1,041.00 65.00 976.00 2004-09-15 0016-A 8,412 ZAGAL-BORJA, MARI/Bill Patient Collections No Bill Sent 1,281.00 168.60 1,112.40 Trip count: 25 27,058.00 12,815.86 14,242.14 Trip count: 25 27,058.00 12,815.86 14,242.14- - Total trip count: 25 ,w.,J ,,,,,,27-,05,3,9g4-_12,8,15.§§ 1..\ 14,24244„,i RescueNetTM Printed on 3/8/2005 at 2:00:21 PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission. Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,524 Batch date: 3/24/2005 10:34:49AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-15 0001-A 10,502 BASKIN, ROBERT Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-11-12 0019-A 10,417 BIRHANEMASKEL, Mil Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-11 0005-A 10,363 BONNER, ROBIN Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-11-15 0005-A 10,506 CASARES, RENE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-25 0007-A 11,942 CASARES, RENE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-11-11 0007-A 10,365 CASTRO, MARTIN Bill Patient Collections No Bill Sent 1,970.00 0.00 1,970.00 2004-11-10 0021-A 10,350 COOLEY, RUSSELL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-09 0003-A 10,302 DAVIS, ROGER Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-12-14 0012-A 11,555 ELKINS, MICHAEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-15 0016-A 10,517 ELLIOTT, CHARLES Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-11 0008-A 10,366 ESPINOSA, DION Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-09 0019-A 10,319 GUADALUPE, JOSE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-02 0021-A 11,150 GUSTAFSON, DEBRA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-11-09 0027-A 10,329 HENDERSON, MARK Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-13 0023-A 10,469 JOHNSON, DELBERT Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-13 0022-A 10,468 MACIAS, SARAI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-10 0028-A 10,358 MARKLEY, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-09 0002-A 10,301 MARTINEZ, SALLY Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2005-02-05 0029-A 1,228 MCKINNEY, RICHARD Bill Patient Collections No Bill Sent 1,144.00 1,003.87 140.13 2004-11-15 0022-A 10,523 MINNEY, PAIGE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-12 0038-A 10,437 MINTLE, TROY Bill Patient Collections. No Bill Sent 1,191.00 0.00 • 1,191.00 2004-11-09 0001-A 10,300 MOBERLY, DAVID Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-11-15 0017-A 10,518 MOCTEZUMA, IDALIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-09 0006-A 10,305 REYES, SAMUEL Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-11-13 0002-A 10,444 RHODES, CHARLES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-01 0019-A 19 RODRIGUEZ-CENICEI Bill Patient Collections No Bill Sent 1,630.00 0.00 1,630.00 2004-11-14 0001-A 10,479 RUPE, KYLE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-11-14 0013-A 10,492 SANTOS, FABIAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-12 0040-A 10,439 SEPEDA, ALFRED Bill Patient Collections . No Bill Sent 1,191.00 0.00 1,191.00 2004-11-12 0033-A 10,432 SILVA, ARMANDO Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-11-09 0012-A 10,312 STROM, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-10 0031-A 10,388 TRUJILLO, ROBBIE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-11 0020-A 10,378 WARNER, CALLIE Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-11-09 0011-A 10,310 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 RescueNetTM Printed on 3/24/2005 at 10:35:38AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-11-11 0003-A 10,361 WILBURN, CHERYL Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-11-15 0019-A 10,520 WILKINSON, HARLEY Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-12-08 0021-A 11,368 WILSON, RODNEY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-15 0032-A 10,533 ZIMMERMAN, HANNA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 Trip count: 38 38,041.00 1,003.87 37,037.13 Trip count: 38 38,041.00 1,003.87 37,Q37.13-„, Total trip count: ;1;44;z a5 �; a Ei;• $` RescueNetn" Printed on 3/24/2005 at 10:35:38AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,523 Batch date: 3/24/2005 10:19:05AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-01 0014-A 10,054 BAUMGARDNER, RA)Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-11-05 0021-A 10,196 BERNAL, DEVANIE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-08 0019-A 10,282 BULLINGTON, JASON Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-02 0002-A 10,076 CERNERES, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-03 0006-A 10,109 CONRADSON, KERR)Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-11-08 0004-A 10,267 CORDOVA, SEVERO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-06 0002-A 10,213 DELACRUZ, GERLAD(Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-11-06 0001-A 10,212 DELCRUZ, ROMANDC Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-05 0034-A 10,209 ELKINS, MICHAEL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-04 0016-A 10,157 HART, TERRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-08 0027-A 10,291 HUNTER, CHAD Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-03 0025-A ' 10,131 KUTCHER, DIANA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-05 0019-A 10,194 LIND, ROBERT Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-11-01 0004-A 10,044 LLAMAS, BENJAMIN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-08 0034-A 10,298 MARTINEZ, CHRIS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-06 0024-A 10,235 MILLIKEN, HEATHER Bill Patient Collections No Bill Sent 1,611.00 0.00 1,611.00 2004-11-06 0021-A 10,232 PEREZ, ADOLFO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-08 0031-A 10,295 PUGA, ANSELMO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-05 0028-A 10,203 PUGH-MCELWAIN, KI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-02 0031-A 10,172 RASNER, ROBERT Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-03 0030-A 10,136 SHAFFER, BRYON Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-11-03 0002-A 10,105 VIZARRAGA, CRYSTP Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-11-07 0019-A. 10,258 WAMBOLT, ETHEL Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-02 0003-A 10,077 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,323.00 0.00 1,323.00 Trip count: 24 21,789.00 0.00 21,789.00 Trip count: 24 21,789 00 0.00 21.789-80, Total trip count: = 24 -':fl .21,789 00' U`. X0:00 I21,789.0,;,A RescueNetTM Printed on 3/24/2005 at 10:20:11AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,517 Batch date: 3/24/2005 9:27:20AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-02 0023-A 6,927 ARCHULETA, JOSEPE Bill Patient Collections No Bill Sent 1,281.00 1,211.00 70.00 2004-10-01 0006-A 8,957 BROWN, JEANNE Bill Patient Collections No Bill Sent 1,236.00 1,191.00 45.00 2004-10-31 0023-A 10,025 CLARK, DENNIS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-25 0018-A 8,787 GALLEGOS, JOSE Bill Patient Collections No Bill Sent 1,236.00 1,158.28 77.72 2004-08-27 0015-A 7,745 GANN, CAROLYN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-04 0017-A 9,076 JIMENEZ, ADRIANA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-26 0030-A 7,726 LUCIO, JULIE Bill Patient Collections No Bill Sent 1,281.00 1,081.00 200.00 2004-10-24 0002-A 9,775 MARTINEZ, FRANK Bill Patient Collections No Bill Sent 1,041.00 895.55 145.45 2004-09-03 0035-A 8,023 MERTENS, JOSEPH Bill Patient Collections No Bill Sent 1,266.00 1,012.80 253.20 2004-10-22 0027-A 9,747 MORALES, SALVADOIBill Patient Collections No Bill Sent 1,281.00 1,198.31 82.69 2004-10-07 0012-A 9,176 SHAFFER JR, STANL Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-10-12 0026-A 9,398 SMITH, ERIC Bill Patient Collections No Bill Sent 1,116.00 892.80 223.20 2004-10-10 0027-A 9,321 SOTO, DELFINA Bill Patient Collections No Bill Sent 1,131.00 1,056.00 75.00 2004-10-30 0024-A 9,991 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-09-26 0023-A 8,824 YATES, GABRIELLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-28 0001-A 8,860 YATES, GABRIELLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 16 15,978.00 9,696.74 6,281.26 Trip count: 16 15,978.00 9,696.74 6,281. Total trip count: . ,r, tril * 718, . s }rAn r 101.• "As..., • RescueNetrm Printed on 3/24/2005 at 927.46AM Page 1 \\nwl Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,745 Batch date: 4/12/2005 1:45:44PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-06 0040-A 8,143 • ADDLEMAN, NICHOL/Bill Patient Collections No Bill Sent 873.00 436.50 436.50 2004-08-03 0022-A 6,965 • ALLOWAY, BREANNA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-28 0018-A 7,780 - AMEZQUITA-MORALE Bill Patient Collections No Bill Sent 1,266.00 1,012.80 253.20 2004-07-20 0015-A 6,483 --ASHTON, VALERIE Bill Patient Collections No Bill Sent 1,506.00 1,406.00 100.00 2004-08-14 0014-A 7,316 BOYD, JAMES Bill Patient Collections No Bill Sent 1,116.00 50.00 1,066.00 2003-11-12 0010-A 9,210 CRISWELL, AUSTIN Bill Patient Collections No Bill Sent 1,161.00 175.00 986.00 2004-09-14 0025-A 8,380 - DROVDAL, LEONA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-24 0013-A . 8,749 `GREGORY, BROOKLtiBillPatient Collections No Bill Sent 1,206.00 50.00 1,156.00 2004-09-16 0020-A 8,448 HATCHER, LISA Bill Patient Collections No Bill Sent 1,446.00 1,446.00 0.00 2004-07-15 0004-A 6,290 - INGLEBY, SUSAN Bill Patient Collections No Bill Sent 1,206.00 1,085.40 120.60 2004-09-07 0028-A 8,156 ' KINDSFATHER, HOW,Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-14 0029-A 8,384 KINDSFATHER, HOW,Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-09-07 0022-A 8,149 -- MORALES, ARIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-20 0005-A 8,596 ' PATTISON, JONATHA Bill Patient Collections No Bill Sent 1,251.00 1,000.80 250.20 2004-04-11 0033-A 3,024 PIER, JAY Bill Patient Collections No Bill Sent 1,536.00 1,100.00 436.00 2004-09-07 0004-A 8,125 PRINTZ, LISA Bill Patient Collections No Bill Sent 1,131.00 1,081.00 50.00 2004-10-01 0012-A 8,966 • RAMIREZ, ELENA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-12 0031-A 8,312 - ROBINSON, HUGH Bill Patient Collections No Bill Sent 1,491.00 1,257.80 233.20 2004-04-30 0001-A 3,605 - SUTTON, ILLENE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-07-24 0004-A • 5,504 . TROSTEL, HOWARD Bill Patient Collections No Bill Sent 1,311.00 650.00 661.00 2004-08-29 0036-A 7,851 _ TRUJILLO, DOMINIQL Bill Patient Collections No Bill Sent 150.00 100.00 50.00 2004-09-12 0004-A 8,285 .- WATSON, JUSTIN Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 Trip count: 22 22,770.00 10,851.30 11,918.70 Trip count: 22 22,770.00 10,851.30 11;118:70 I , Total trip count: -:27 . l'll22,777,0u004 10,851.30 I( 11,9 ' RescueNetTM Printed on 4/12/2005 at 1:46.13PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,746 Batch date: 4/12/2005 2:46:05PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-11-17 0016-A 10,579 AAB, BETTY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-01 0030-A 10,070 BENTON, AMY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-06 0025-A 10,236 BISCHOF, TIM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-11 0041-A 9,425 BLACKSTON, KOLT Bill Patient Collections No Bill Sent 1,701.00 586.74 1,114.26 2004-10-20 0018-A 9,671 BURNS, MALISSA Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-10-04 0006-A 9,065 DIEHL, DEBORAH Bill Patient Collections No Bill Sent 1,191.00 1,141.00 50.00 2004-11-18 0036-A ' 10,634 FISHER, RICK Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-10-15 0022-A 9,496 GALE, SARA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-11-18 0005-A 10,603 GUILLEN, EUFEMIA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-10-16 0008-A 9,514 HARNED, ZELPHIA Bill Patient Collections No Bill Sent 1,281.00 1,221.00 60.00 2004-11-17 0032-A 10,596 HIGGINBOTHAN, XAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-20 0016-A 9,669 INGLEBY, SUSAN Bill Patient Collections No Bill Sent 1,011.00 819.90 191.10 2004-11-18 0035-A 10,633 INGRAHAM, TERESA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-02 0026-A 10,101 JONES, WOODY Bill Patient Collections No Bill Sent 1,191.00 1,141.00 50.00 2004-11-18 0024-A 10,622 KNIGHT, MATTHEW Bill Patient Collections No Bill Sent . 1,236.00 0.00 1,236.00 2004-11-06 0006-A 10,217 LOPEZ, ISRAEL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-18 0010-A 10,608 LOZANO, RITA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-18 0026-A. 10,624 MARQUEZ, JESUSITA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-11-18 0038-A 10,636 MCDONALD, RANDAL Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-10-20 0010-A 9,663 MEDINA, THOMAS Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-11-07 0009-A 10,248 MOORE, INA Bill Patient Collections No Bill Sent 1,236.00 988.80 247.20 2004-10-10 0036-A 9,330 NEWCOMB, WILLIAM Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-10-30 0005-A 9,971 PATTERSON, DUSTIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-31 0014-A 10,015 RAMOS, TEODORO Bill Patient Collections No Bill Sent 996.00 100.00 896.00 2004-11-16 0024-A 10,563 ROGERS, DONALD Bill Patient Collections No Bill Sent 1,056.00 1,044.00 12.00 2004-11-18 0001-A 10,599 TITTLE, MYRTLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-16 0010-A 10,549 VILLANUEVA, GREGC Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-06 0007-A 10,218 WEBER, TODD Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-11-17 0031-A 10,595 WEIMER, CRYSTAL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-10-09 0021-A' 9,276 WRIGHT, FRANCES Bill Patient Collections No Bill Sent 1,071.00 1,046.00 25.00 2004-11-16 0003-A 10,542 YATES, GABRIELLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 31 29,391.00 8,088.44 , 302=T,33 �6 //Trip count: 31 29,391.00 8,088.44 t 21,302.56/ RescueNetTM Printed on 4/12/2005 at 246:42PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,747 Batch date: 4/12/2005 3:00:56PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-20 0011-A 10,692 ALCANTER, AURELIO Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-11-24 0023-A 10,880 BAKER, DANIELLE Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-11-20 0005-A 10,686 BALDERAS, JORGE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-19 0013-A 10,654 CORRAL, NANCY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-11-23 0018-A . 10,839 CORTEZ-DIAZ,SARA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-11-22 0014-A 10,795 COVILLE, ADAM Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-11-21 0005-A 10,752 FLOREZ, DANILO Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-11-24 0027-A 10,884 GIRON, KATHY Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-11-20 0026-A 10,707 GRIEGO, JERRY Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-11-20 0052-A 10,733 GUTIERREZ, KELLEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-19 0010-A 10,651 JOHNSTON, KENNETIBill Patient Collections No Bill Sent 2,135.00 0.00 2,135.00 2004-11-20 0029-A 10,710 KINDVALL, JENNIFER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-25 0005-A 10,897 LEEK, ANITA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-20 0004-A 10,685 LUCERO, EVA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-11-22 0005-A 10,782 MAESTAS, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-24 0008-A 10,865 MALINE, THERESA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-11-24 0016-A' 10,873 MELENDEZ, LORENA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-21 0009-A 10,756 MENDOZA, BETHANY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-20 0055-A 10,736 MONTES, MARIA Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-11-22 0021-A 10,802 MONTOYA, BRANDOI'Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-23 0007-A 10,828 MONTOYA, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-23 0001-A 10,822 MORALES, ISAIAS Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-11-20 0039-A 10,720 PENA-IBARRA, ELISE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-20 0038-A 10,719 QUEZADA-ZAPATA, NBill Patient Collections No Bill Sent 1,496.00 0.00 1,496.00 2004-11-25 0037-A 10,933 REINSTEIN, CONNIE Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-11-23 0022-A 10,843 REYES, CHRISTIAN Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-11-25 0007-A 10,900 RODRIGUEZ, MIGUELBill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-11-19 0040-A. 10,681 STEWART, JAMES Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-22 0037-A 10,818 TALAMANTES, DAVID Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-11-25 0011-A 10,904 TAYLOR, MICHAEL Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-11-22 0008-A 10,789 YATES, CHRISTINE Bill Patient Collections No Bill Sent 150.00 0.00 15.0.00-_ 2004-11-22 0028-A 10,809 YODER, CHRISTOPHE Bill Patient Collections No Bill Sent. .1,221.00 0.00 1,22.1-.00 Trip count: 32 32,785.00 0.00 (",785.00 RescueNettM Printed on 4/12/2005 at 3:17:34PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt i • Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,748 Batch date: 4/12/2005 3:27:39PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-12-02 0011-A 11,138 AGUIRRE, SERGIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-29 0014-A 11,065 BARRIENTOS, RICAR Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-12-04 0010-A , 11,221 CHALI, ERICK Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-11-26 0006-A 10,943 CONSONERO, DEBOF Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2004-11-27 0020-A 10,983 DLUG, LEE Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-11-30 0006-A 11,083 DWAIN, ALLEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-27 0006-A 10,969 EWALD, CHRISTOPHI Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-07 0006-A 11,313 GREEN, HOWARD Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-12-02 0033-A 11,162 GUTIERREZ, OSCAR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-06 0024-A 11,305 HUBBARD, ERIN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-04 0028-A 11,239 JEFFRIES, PATRICK Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-11-29 0012-A 11,063 JENSEN, DAVID Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-12-01 0007-A 11,110 JOHNSTON, JASON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-26 0019-A 10,962 JUAREZ-LEYDA, ERAI Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-12-05 0001-A . 11,246 LOPEZ, JAVIER Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-26 0018-A 10,961 LOPEZ-SILVA, ROMAF Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-11-28 0007-A 11,012 MALDONADO, CHARL Bill Patient Collections No Bill Sent 1,681.00 0.00 1,681.00 2004-12-11 0040-A 11,518 MARTINEZ, ANDRES Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-12-10 0026-A 11,444 MCNIERNEY, MICHAE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-12-14 0022-A 11,565 MCNIERNEY, MICHAE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-11-28 0038-A 11,043 MILLER, MICHAEL Bill Patient Collections No Bill Sent 1,701.00 0.00 1,701.00 2004-11-29 0025-A 11,076 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-11-30 0026-A 11,103 MONCADA, MELISSA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-12-07 0034-A 11,342 MORADO, SAMMY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-02 0043-A 11,180 RAMOS, MELISSA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-12-01 0008-A 11,111 RIVAS, SYLVIA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-12-03 0006-A 11,184 ROGERS, DONALD Bill Patient Collections No Bill Sent 1,131.00 1,069.00 62.00 2004-11-30 0018-A 11,095 SCHIEL, JEFFREY Bill Patient Collections No Bill Sent 1,236.00 1,000.00 236.00 2004-12-02 0038-A 11,175 TIEMEYER, DANIEL Bill Patient Collections No Bill Sent 1,236.00 1,149.00 87.00 2004-12-02 0025-A 11,154 WALKER, MICHAEL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 Trip count: 30 32,926.00 3,218.00 29,701:'6Q Trip count: 30 32,926.00 3,218.00 l 29,708.00 ji RescueNetTM Printed on 4/12/2005 at 3:28:39PM Page 1 t\nw16\rescuenet\reports32\B illing\Miscellaneous\Sub Batch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,749 Batch date: 4/12/2005 3:42:10PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-12-23 0035-A 11,928 ARCHULETTA, JOE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-18 0022-A • 11,718 ARMENDARIZ, JESUS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-22 0007-A 11,823 BELO, GRACE Bill Patient Collections No Bill Sent 1,161.00 1,123.85 37.15 2005-03-08 0008-A 2,357 CHAVEZ, VERONICA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-01-03 0032-A 106 CRANMER, RICK Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-01-03 0015-A 89 ESPINOZA, DANIEL Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2004-12-20 0006-A 11,743 HALL, JAMES Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-23 0038-A 12,075 JUAREZ, YUSUKE Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2005-03-02 0027-A 2,135 MENDOZA, GLORIA Bill Patient Collections No Bill Sent 2,080.00 0.00 2,080.00 2004-12-28 0026-A 12,041 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-18 0005-A 11,685 REBETERANO, FELIX Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2005-01-21 0017-A 715 RUBENSTEIN, MARVI Bill Patient Collections No Bill Sent 1,144.00 1,098.20 45.80 2005-03-28 0032-A. 3,032 TOVAR, BENITO Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 2004-12-30 0019-A 12,132 TROYER, DUSTIN Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2005-01-05 0030-A 204 VASQUEZ, ELIAS Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 Trip count: 15 17,765.00 2,222.05 15,542.95 Trip count: 15 17,765.00 2,222.05 15,542.95 Total trip count: 15 ' .j 17,765.00 „j 2,222:05 15,542.95."I• RescueNetTM • RPrinted on 4/12/2005 at 3'42:41PM Page 1 \\nw16\rescuenet\reports32\BillinglMisceilaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,917 Batch date: 4/27/2005 3:19:10PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-01-29 0010-A 984 ARRYO SR, OSCAR Bill Patient Collections No Bill Sent 1,362.00 0.00 1,362.00 2004-12-22 0011-A 11,827 BURROLA, VICENTE Bill Patient Collections No Bill Sent 2,001.00 0.00 2,001.00 2004-12-18 0003-A 11,683 CHACON, EDGAR Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-12-19 0007-A 11,706 DENNIS, JAY Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-12-22 0002-A 11,818 DIXON, ANDREW Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-16 0030-A 11,643 ESCOBAR, MINERVA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-12-15 0002-A 11,568 GALVEZ, ROGELLO Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-12-20 0032-A 11,771 GONZALEZ, JOSE Bill Patient Collections No Bill Sent 1,790.00 0.00 1,790.00 2004-12-18 0004-A 11,684 GUAJARDO, JOSHUA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-12-15 0004-A 11,570 HERNANDEZ, ALEJADBill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2005-03-30 0006-A 3,068 HOKE, CHRIS Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-04-01 0040-A 3,170 HOKE, CHRIS Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-12-19 0026-A 11,739 KLUCK, DAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-28 0029-A 12,046 MARTINEZ, ANDRES Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2005-01-25 0014-A 845 MARTINEZ, ANDRES Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-12-13 0008-A 11,520 MILO, STEVEN Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2004-12-14 0021-A 11,564 MINTLE, TROY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-22 0004-A 11,820 PALMER, RANDY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-12-22 0044-A 11,860 PECK, STEVE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-19 0024-A 11,735 PERALES, TERRY Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-12-19 0023-A 11,733 PEREZ, RODOLFO Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-12-18 0009-A 11,689 RAWLINGS, ELI Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-01-24 0017-A 810 RIVAS, JESUS Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-01-24 0016-A 809 RIVAS,THERESA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-02-06 0003-A 1,231 ROGERS, DONALD Bill Patient Collections No Bill Sent 1,404.00 1,008.00 396.00 2004-12-13 0029-A 11,541 RUSSELL, GREG Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-17 0018-A 11,660 SHELMERDINE, ERIC Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-12-19 0015-A 11,719 TORRES, VINCE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-15 0026-A 11,593 VALLEGOS, TIMOTHY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-12-17 0014-A 11,656 VARGAS, ADRIANA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-12-19 0025-A 11,737 WEST, ROSALINDA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2005-02-06 0014-A 1,244 WRIGHT, GARY Bill Patient Collections No Bill Seht 1,423.00 0.00 1✓423 00 yn 2004-12-20 0035-A 11,774 YATES, RYAN Bill Patient Collections No Bill Sent 1,431.00 0.00 31"'t7N, Trip count: 33 37,456.00 1,008.00 /36,448.00 ) RescueNetTM Printed on 4/27/2005 at.3:20:00PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 7,916 Batch date: 4/27/2005 3:04:15PM Trip Date Job ' Run Name Current Payor Schedule Event Charges Credits Balance 2004-11-19 0002-A 10,643 DURAN-FLORES, SAN Bill Patient Collections No Bill Sent 1,116.00 811.00 305.00 2004-12-06 0015-A 11,296 EAVES, CAREY Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-05 0032-A 11,279 EPSTEIN, LEANNE Bill Patient Collections No Bill Sent 1,146.00 946.00 200.00 2004-12-12 0007-A 11,499 GALLEGOS, ANTHON Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-12-06 0014-A 11,295 GUNTER, BONNIE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-12-08 0026-A 11,373 HARRIS, JAYKOB Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-12-12 0019-A 11,511 HERNANDEZ, ALAN Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-11-21 0017-A 10,764 HERNANDEZ, JOE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-11-28 0046-A 11,051 HERNANDEZ, JOE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-11-29 0021-A 11,072 HERNANDEZ, JOE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-02 0032-A 11,161 HERNANDEZ, JOE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-12-08 0032-A 11,379 HOLGUIN, NORMA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-18 0003-A 10,601 HUGUET, ALEXA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-12-09 0028-A 11,408 KAWAMOTO, LEOMAI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-25 0023-A 10,919 KING, LORIN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-12-08 0033-A 11,624 LAY, GLEN Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2004-12-09 0017-A 11,397 LIRA, JESSICA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-09 0031-A 11,411 MANZANAREZ, YADIF Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-11-26 0025-A 10,968 MEYER, BETTY Bill Patient Collections No Bill Sent 1,071.00 50.00 1,021.00 2004-12-11 0002-A 11,451 MONTOYA, CHRISTOIBill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-10 0033-A 11,625 NUNEZ, ANGELA Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-12-10 0015-A 11,433 PALMA, MARTINA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-06 0010-A 11,291 PENA, TAMMY Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-11-24 0001-A 10,858 PEREZ, MARTIN Bill Patient Collections No Bill Sent 1,371.00 1,291.49 79.51 2004-12-03 0014-A 11,192 POOLER, LILLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-12 0001-A 11,493 RIVERA, TERESA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-11-16 0005-A 10,544 RUIZ, CATHY Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-12-11 0034-A 11,487 RUSSELL, WILLIAM Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-12-12 0016-A 11,508 SALAZAR, BONNIE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-04 0014-A 11,225 SCOTT, BRANDON Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-11-30 0021-A 11,098 SMITH, CATHERINE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-18 0021-A 10,619 TITTLE, MYRTLE Bill Patient Collections No Bill Sent 1,476.00 1,384.04 Trip count: 32 33,939.00 4,482.53 29,456.47 RescueNeV Printed on 4/27/2005 at 3:05:16PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES • Batch 7,915 Batch date: 4/27/2005 2:44:15PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-14 0015-A 10,494 ARCHULETA, JUDY Bill Patient Collections No Bill Sent 1,266.00 1,128.31 137.69 2004-11-05 0016-A 10,191 BARRANDEY, CRUZ Bill Patient Collections No Bill Sent 1,146.00 25.00 1,121.00 2004-11-06 0016-A 10,227 BRISTOL, JOAN Bill Patient Collections No Bill Sent 1,206.00 1,100.31 105.69 2004-10-09 0034-A 9,289 CLINK, RYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-05 0002-A 10,177 FRITZ, MARY K Bill Patient Collections No Bill Sent 1,401.00 1,326.00 75.00 2004-10-09 0022-A 9,277 GANN, TYLER Bill Patient Collections No Bill Sent 1,086.00 1,011.00 75.00 2004-10-28 0006-A 9,904 HEALING, MICHAEL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-11-04 0018-A 10,159 HEALING, MICHAEL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-11-11 0014-A 10,372 JARAMILLO, TERRI Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-11-10 0008-A 10,337 MARQUEZ, EVA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-12 0013-A 9,385 NUANEZ, MARGARIT/Bill Patient Collections No Bill Sent 498.00 458.20 39.80 2004-11-01 0031-A 10,071 RENFREW, DANIELLE Bill Patient Collections No Bill Sent 1,296.00 1,250.00 46.00 2004-11-05 0008-A 10,183 ROGERS, CINDY Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-10-09 0017-A 9,272 ROMERO, GILBERT Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-09-19 0012-A 8,565 SCHULT, DUSTIN Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-07-26 0011-A 6,671 TREJO-COREAS, DA\Bill Patient Collections No Bill Sent 1,146.00 400.00 746.00 2004-11-08 0033-A 10,297 WATKINS, MEFFORD Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-03-04 0008-A 1,876 WITBECK, MARVIN Bill Patient Collections No Bill Sent 1,161.00 175.00 986.00 2004-11-08 0012-A 10,275 ZUNIGA, CHARLOTTE Bill Patient Collections No Bill Sent 1,116.00 1,039.75 76.25 • Trip count: 19 21,285.00 7,913.57 13,371.43 Trip count: 19 21,285.00 7,913.57 3--\ Total trip count: :::-WC, e',.",''' 1``".. ' < " , p :3 " ' • RescueNetTM Printed on 4/27/2005 at 2:44:59PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,135 Batch date: 5/18/2005 7:38:01AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-10-15 0013-A 9,484 BACKMAN, MICHAEL Bill Patient Collections No Bill Sent 1,365.69 1,353.69 12.00 2004-10-31 0025-A 10,027 BACKMAN, MICHAEL Bill Patient Collections No Bill Sent 1,259.95 1,247.95 12.00 2004-10-17 0033-A 9,579 BROWN, JILLIAN Bill Patient Collections No Bill Sent 1,161.00 1,086.00 75.00 2004-10-17 0034-A 9,580 BROWN, KYA Bill Patient Collections No Bill Sent 1,101.00 1,026.00 75.00 2004-11-03 0036-A 10,173 COLLINS, GLEN Bill Patient Collections No Bill Sent 1,056.00 844.80 211.20 2004-10-21 0009-A . 9,691 DUVALL, JUSTIN Bill Patient Collections No Bill Sent 1,386.00 508.80 877.20 2004-10-09 0016-A 9,271 FARINACCI, MICHAEL Bill Patient Collections No Bill Sent 1,131.00 823.80 307.20 2004-09-14 0026-A 8,381 GARCIA, MARIA Bill Patient Collections No Bill Sent 1,041.00 75.00 966.00 2004-07-02 0008-A 5,856 GENTLEMAN, MATTH Bill Patient Collections No Bill Sent 1,221.00 1,051.80 169.20 2004-10-09 0018-A 9,273 HALFERTY, ADAM Bill Patient Collections No Bill Sent 996.00 672.00 324.00 2004-08-21 0008-A 7,551 HEWITT, BRANDON Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-10-21 0029-A 9,711 RICHIE, BRIAN Bill Patient Collections No Bill Sent 1,026.00 660.12 365.88 2004-10-14 0002-A 9,431 SMITH, JUSTIN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-10-21 0007-A 9,689 SMITH, PATRICK Bill Patient Collections No Bill Sent 1,101.00 880.80 220.20 2004-06-06 0004-A 4,947 STEWART, KALI Bill Patient Collections No Bill Sent 1,311.00 110.00 1,201.00 2004-11-10 0026-A 10,356 VASQUEZ, MARIA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-11-08 0020-A 10,283 VELAZCO, JESSICA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-10-07 0029-A 9,193 ZUNIGA, CHARLOTTE Bill Patient Collections No Bill Sent 1,191.00 1,114.31 76.69 Trip count: 18 21,006.64 11,455.07 9,551.57 Trip count: 18 21,006.64 11,455.07 9,551.57 Total trip count: 18 ' ,, I - 21;00§.64„,1 11,455.07 4 ";9,551.57 . iI • RescueNetT", Printed on 5/18/2005 at 739.27AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,136 Batch date: 5/18/2005 8:09:13AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-12-14 0008-A 11,551 --ALLEN, KENNEDY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-02 0031-A 11,160 ASMUSSEN, TIMOTH`Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-12-05 0010-A 11,255— BACKMAN, MICHAEL Bill Patient Collections No Bill Sent 1,281.74 1,263.74 18.00 2004-12-12 0014-A 11,506 --BENZOR, BRIAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-24 0020-A 10,877 >CANTRELL, JESSE Bill Patient Collections No Bill Sent 1,656.00 1,581.00 75.00 2004-11-14 0004-A 10,482 ---CHARNLEY, KENNETI Bill Patient Collections No Bill Sent 1,466.00 0.00 1,466.00 2004-11-27 0029-A 10,992 -DOUGHERTY, AUSTIPBill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-11-27 0028-A 10,991 -DOUGHERTY, ELIJAH Bill Patient Collections No Bill Sent 1,236.00 1,186.00 50.00 2004-11-28 0001-A 11,006 -DOUGHERTY, ELIJAH Bill Patient Collections No Bill Sent 933.00 883.00 50.00 2004-12-09 0025-A 11,405 —ENCINA, AURORA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-12-05 0021-A 11,267 -JONES, JENNIFER Bill Patient Collections No Bill Sent 1,296.00 1,221.00 75.00 2004-11-22 0027-A 10,808 -JOYNER, ROBIN Bill Patient Collections No Bill Sent 1,221.00 1,146.00 75.00 2004-12-08 0006-A 11,353 ,.KEEBAUGH, ALICIA Bill Patient Collections No Bill Sent 1,206.00 954.55 251.45 2004-12-02 0018-A 11,147 — MARTINEZ, CIRIA Bill Patient Collections No Bill Sent 1,236.00 1,149.41 86.59 2004-11-23 0026-A 10,848 —MIRANDA, BARBARA Bill Patient Collections No Bill Sent 1,131.00 104.80 1,026.20 2004-11-13 0032-A 10,478 -- OLIVER, DIANA Bill Patient Collections No Bill Sent 1,176.00 25.00 1,151.00 2004-11-27 0030-A 10,993 PENNINGTON, KELLEBill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-11-21 0028-A 10,775 —RALSTON, BRANDON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-30 0003-A 11,080 -ROBB, RONNIE Bill Patient Collections No Bill Sent 1,221.00 1,139.24 81.76 2004-11-15 0003-A 10,504 -ROSS, DELANO Bill Patient Collections No Bill Sent 2,330.00 0.00 2,330.00 2004-11-14 0021-A 10,500 -SMITH, PATRICK Bill Patient Collections No Bill Sent 1,221.00 1,171.00 50.00 2004-11-15 0013-A 10,514 -�VELAZCO, JESSICA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-27 0022-A 10,985 WILSON, VERN Bill Patient Collections No Bill Sent 1,146.00 1,067.75 78.25 2004-12-07 0020-A 11,327— WILSON, VERN Bill Patient Collections No Bill Sent 1,146.00 1,084.08 61.92 2004-12-07 0040-A 11,338 -WILSON, VERN Bill Patient Collections No Bill Sent 543.00 492.55 50.45 2004-12-04 0017-A 11,228 ZUNIGA, CHARLOTTE Bill Patient Collections No Bill Sent 1,056.00 1,005.12 50.88 2004-12-04 0023-A 11,234 ZUNIGA, CHARLOTTE Bill Patient Collections No Bill Sent 513.00 464.55 48.45 Trip count: 27 31,081.74 15,938.79 15,142.95 Trip count: 27 31,081.74 15,938.79 15,1 95 Total trip count: ,27.;.:, ,1e; 31,081.74, 'y ; 15,938.79 1 (15,142.95 :. RescueNetrm Printed on 5/18/2005 at 8:09:49AM Page 1 \\nw16\rescuenet\reports32\BillingAMiscellaneous\SubBatch7.rpt i • Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,137 Batch date: 5/18/2005 8:40:05AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-12-29 0029-A 12,110 ALLMER, LAURA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-12-28 0022-A 12,033 ALVARADO, OSCAR Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-21 0003-A 11,787 ARCHULETA, FILBER Bill Patient Collections No Bill Sent 1,131.00 1,053.75 77.25 2004-12-23 0039-A 12,076 ARELLANO, ROGELIC Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-12-21 0030-A 11,815 ARGUELLO, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-25 0008-A 11,943 BARRERA, HECTOR Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-12-21 0016-A 11,801 BRITZ, KEVIN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-17 0002-A 11,644 BURKHART, JULIA Bill Patient Collections No Bill Sent 1,536.00 1,356.30 179.70 2004-12-28 0004-A 12,004 CORDERO, DAVID Bill Patient Collections No Bill Sent 1,925.00 0.00 1,925.00 2004-12-25 0020-A 11,959 DEVORA, ANTHONY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-16 0021-A 11,622 DOBBINS, CLARA Bill Patient Collections No Bill Sent 1,116.00 1,056.08 59.92 2004-12-25 0003-A 11,938 ESPINDOLA, YRMA Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-12-23 0003-A 11,865 FLORES, HERMENEG Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-12-29 0012-A . 12,091 GELATT, KENNY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-12-30 0022-A 12,135 GONZALES, ROBERT Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-30 0037-A 12,151 GOSLIN, JAMES Bill Patient Collections No Bill Sent 1,436.00 0.00 1,436.00 2004-12-20 0017-A 11,754 HOLLAND, RONALD Bill Patient Collections No Bill Sent 1,236.00 1,156.31 79.69 2004-12-30 0033-A 12,146 JOHNSON, GARY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-12-24 0011-A 11,908 KENDALL, SAMANTH/Bill Patient Collections No Bill Sent 150.00 0.00 150.00 i 2004-12-30 0040-A 12,154 KIMBALL, TIFFANY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-22 0041-A 11,857 KLINE, TOBY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-12-27 0035-A 12,086 LATHAM, DAVID Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-12-22 0042-A 11,858 LAUER, SCOTT Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-12-26 0006-A 11,962 LAUGHLIN, SHANNON Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-31 0003-A 12,161 MARTINEZ, JACOB Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-12-21 0026-A 11,811 MARTINEZ, KORI Bill Patient Collections No Bill Sent 150.00 75.00 75.00 2004-12-24 0030-A 11,930 MORRISON, CHELSEJ Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-12-31 0010-A 12,168 NEAL, KEVIN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-21 0009-A 11,793 NEHRING, LINDA Bill Patient Collections No Bill Sent 1,176.00 1,112.45 63.55 2004-12-31 0013-A 12,171 OCHOA, LUCIO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-27 0003-A 11,986 ORANTES-MARTINEZ Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-12-27 0034-A 12,084 O'ROURKE, STACEY Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-12-22 0003-A 11,819 PARKER, BRIAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-25 0024-A 11,966 REED, JOSHUA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 RescueNetTM Printed on 5/18/2005 at 8:41:23AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-12-22 0015-A 11,831 RIDDER, DORINDA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-12-17 0008-A 11,650 RIGGINS, NORMAN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-12-21 0005-A 11,789 SEPEDA, JOHN Bill Patient Collections No Bill Sent 1,116.00 1,039.75 76.25 2004-12-20 0039-A 11,778 SMITH, CHARLIE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-12-31 0016-A 12,174 TITMUS, DONALD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-27 0011-A 12,005 VALADEZ, LEO Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-12-29 0001-A . 12,060 VRYNIOS, SARAH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-29 0026-A 12,107 WHITE-FORDYCE, TA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 Trip count: 42 44,740.00 6,849.64 37,890.36 Trip count: 42 44,740.00 6,849.64 37,890,36__ Total trip count: 42 1'' 44,740.00 I 6;849:64 C 37,890.36 ' ,\' RescueNetT" Printed on 5/18/2005 at 8.41:23AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,138 Batch date: 5/18/2005 9:01:02AM Trig Date Job . Run Name Current Pavor Schedule Event Charges Credits Balance 2005-01-01 0014-A 14 ARAIS, CESAR Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-01-01 0016-A 16 ASMASTER, RICHIE Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-06 0026-A 233 BOJORQUEZ, RENE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-01 0042-A 42 BROWNELL, GREGOF Bill Patient Collections No Bill Sent 1,543.00 0.00 1,543.00 2005-01-01 0003-A 3 CASTANEDA, DONALIBill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-08 0001-A 264 CAUDILLO, MOISES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-10 0001-A 314 GALAVIZ, CARLOS Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-01-10 0020-A 334 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,397.00 0.00 1,397.00 2005-01-08 0013-A 276 GENDREAU, JENNA Bill Patient Collections No Bill Sent 1,515.00 0.00 1,515.00 2005-01-01 0025-A 25 GONZALES,VICTOR Bill Patient Collections No Bill Sent 1,404.00 0.00 1,404.00 2005-01-08 0020-A ' 284 GRASHOT, JAMES Bill Patient Collections No Bill Sent 1,573.00 0.00 1,573.00 2005-01-01 0046-A 46 GREISS, TINA Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-04 0020-A 130 GUTIERREZ, HUGO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-09 0008-A 297 HUFFERT, TIMOTHY Bill Patient Collections No Bill Sent 1,255.00 0.00 1,255.00 2005-01-02 0013-A 62 JACKSON, ALICE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-02 0006-A 54 KASPER, BROOKE Bill Patient Collections No Bill Sent 1,218.00 0.00 1,218.00 2005-01-04 0059-A 171 KEIL, RITA Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-06 0018-A 225 KINDVALL, BRANDON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-02 0021-A 71 LANCKRIET, GREGOF Bill Patient Collections No Bill Sent 1,363.00 0.00 1,363.00 2005-01-05 0023-A 197 LUCERO, BETTY Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-01-01 0023-A 23 MAIN, ASHLEY Bill Patient Collections No Bill Sent 1,438.00 0.00 1,438.00 2005-01-03 0026-A . 100 MARTINEZ, GERALDC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-10 0014-A 328 MCQUAIN, JOE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-02 0003-A 51 MENDOZA, JOE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-01-02 0027-A 56 MENDOZA, JOE Bill Patient Collections No Bill Sent 1,490,00 0.00 1,490.00 2005-01-10 0026-A 340 MEYER, BOYD Bill Patient Collections No Bill Sent 1,345.00 0.00 1,345.00 2005-01-07 0015-A 252 MILLER, DAVID Bill Patient Collections No Bill Sent 1,427.00 0.00 1,427.00 2005-01-04 0041-A 152 ONTIVEROS, MANUEI Bill Patient Collections No Bill Sent 1,321.00 0.00 1,321.00 2005-01-02 0024-A 74 PEREZ, FELICIA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-01-07 0023-A 260 PINO, ANITA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-01-04 0042-A 153 PORTILLO, LORENZOBill Patient Collections No Bill Sent 1,246.00 0.00 1,246.00 2005-01-04 0039-A 150 QUINONEZ, LAZARO Bill Patient Collections No Bill Sent 1,457.00 0.00 1,457.00 2005-01-04 0040-A 151 QUINONEZ, NAOMI Bill Patient Collections No Bill Sent 1,532.00 0.00 1,532.00 2005-01-01 0010-A' 10 RICO, CHRISTOPHER Bill Patient Collections No Bill Sent 1,457,00 0.00 1,457.00 RescueNet"' Printed on 5/18/2005 at 9:02:36AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-01-04 0016-A 126 RIVERA, PRISCELLA Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-01-07 0001-A 238 ROJAS, JESUS Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 2005-01-01 0022-A 22 ROWE, KEISHA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-05 0028-A 202 SAMBERSON, JESSE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-04 0007-A 117 SCHNELLER, RICHAR Bill Patient Collections No Bill Sent 1,362.00 0.00 1,362.00 2005-01-01 0024-A 24 SPARKS, ARLENE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-06 0015-A 222 TOPPING, SCOTT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-01 0035-A 35 WILLIAMS, KAMI Bill Patient Collections No Bill Sent 1,427.00 0.00 1,427.00 2005-01-06 0017-A 224 ZRIG-MINTLE, KARIN Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 Trip count: 43 44,226.00 0.00 44,226.00 Trip count: 43 44,226.00 0.00 44,226-QO Total trip count 43 '.1 44,226.00 .j 0.00, i y4,226.00 ) RescueNetT" Printed on 5/18/2005 at 9.02.36AM Page 2 \\nw 1@\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,139 Batch date: 5/18/2005 9:14:12AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-01-31 0023-A 1,055 ALANIZ, ROBERT Bill Patient Collections No Bill Sent 1,386.00 1,306.87 79.13 2005-01-29 0009-A 983 ARRYO JR, OSCAR Bill Patient Collections No Bill Sent 1,362.00 0.00 1,362.00 2005-01-22 0024-A 759 BALES, DONALD Bill Patient Collections No Bill Sent 1,437.00 1,354.55 82.45 2005-01-13 0016-A 450 BERTOCH, BO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-31 0020-A 1,052 FERRELL, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-04-19 0006-A 3,773 GUERRA, GILBERT Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-12 0023-A 401 HUBBARD, ERIN Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-12 0042-A 423 KEEL, SCOTT Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-01-13 0007-A 441 KEEL, SCOTT Bill Patient Collections No Bill Sent 963.00 0.00 963.00 2005-01-13 0014-A 448 MADSEN, MATT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-12 0052-A 438 MEISTER, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-13 0022-A 456 NUNEZ, GENARA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-04-10 0021-A 3,498 ONDRAK, DILLON Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 2005-01-13 0020-A 454 PENA, BLANCA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 14 10,842.00 2,661.42 8,1.80.58 Trip count: 14 10,842.00 2,661.42 ;8;150 Total trip count: .,, 14_ 1,0,42 10- 1r-466142 ii 8.,180.58: _I RescueNetTM Printed on 5/18/2005 at 9'14:30AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,522 Batch date: 6/15/2005 2:25:25PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-09-22 0016-A 8,683 AGUILAR, FERNANDCBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-11-09 0025-A 10,325 ALTER, WILLIAM Bill Patient Collections No Bill Sent 1,251.00 1,090.24 160.76 2004-11-08 0008-A 10,271 ANTUNA, VALERIE Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-10-28 0015-A 9,913 CHAVEZ, ADELITA Bill Patient Collections No Bill Sent 150.00 25.00 125.00 2004-09-24 0013-A . 8,749 GREGORY, BROOKL\Bill Patient Collections No Bill Sent 1,206.00 500.00 706.00 2004-10-10 0011-A 9,305 HAGER, NHI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-18 0052-A 8,573 JORDAN, DIANE Bill Patient Collections No Bill Sent 1,940.00 1,552.00 388.00 2003-02-04 0030-A 8,708 KATO, NANCY Bill Patient Collections No Bill Sent 365.91 170.00 195.91 2004-04-02 0024-A 2,763 KATO, NANCY Bill Patient Collections No Bill Sent 1,146.00 1,123.44 22.56 2003-02-04 0045-A 8,725 KNIGHT, DOUGLAS Bill Patient Collections No Bill Sent 840.00 750.00 90.00 2004-09-30 0003-A 8,932 KNOLL, TRACI Bill Patient Collections No Bill Sent 981.00 784.80 196.20 2004-10-04 0004-A 9,063 LINDER, MARK Bill Patient Collections No Bill Sent 1,925.00 1,540.00 385.00 2004-06-08 0016-A 5,081 LINDSAY, Y C Bill Patient Collections No Bill Sent 1,551.00 1,432.40 118.60 2004-08-12 0028-A 7,272 LINDSAY, Y C Bill Patient Collections No Bill Sent 1,506.00 1,415.98 90.02 2004-11-12 0007-A 10,405 MITTS, JERRY Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-10-31 0009-A 10,010 OCHOA, ROLAND Bill Patient Collections No Bill Sent 1,131.00 100.00 1,031.00 2004-11-10 0007-A • 10,336 RIVERA, GLORIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-31 0002-A 10,003 SEALES, MICHELLE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-25 0040-A 9,932 VAN ABEL, EMILY Bill Patient Collections No Bill Sent 270.00 120.00 150.00 2004-09-18 0017-A 8,519 WAYNE, PATRICE Bill Patient Collections No Bill Sent 498.00 208.40 289.60 Trip count: 20 21,966.91 10,812.26 11,154.65 Trip count: 20 21,966.91 10,812.26 11454765-, Total trip count: .:4, 20• ° ." ,_21,956'94-44: '1,0;817:26" I/ 1:1,154..q.5- �' V RescueNetT" Printed on 6/15/2005 at 2:26:03PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,523 Batch date: 6/15/2005 2:40:26PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-12-13 0026-A 11,538 ARENAS, DOMINIC Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2004-12-21 0021-A 11,806 CASWELL, GREG Bill Patient Collections No Bill Sent 1,176.00 1,058.40 117.60 2004-11-28 0002-A . 11,007 DOUGHERTY, AUSTIPBill Patient Collections No Bill Sent 873.00 524.49 348.51 2004-12-13 0007-A 11,519 GARBISO, PORFELIO Bill Patient Collections No Bill Sent 1,311.75 419.21 892.54 2004-12-24 0024-A 11,922 GARCIA, JORGE Bill Patient Collections No Bill Sent 1,131.00 75.00 1,056.00 2004-11-18 0022-A 10,620 HILZER, RODGER Bill Patient Collections No Bill Sent 843.00 0.00 843.00 2004-12-22 0016-A 11,832 JARAMILLO, DESHAVA Bill Patient Collections No Bill Sent 981.00 784.80 196.20 2004-11-19 0021-A 10,662 JOYNER, WOODARD Bill Patient Collections No Bill Sent 1,221.00 1,146.00 75.00 2004-11-29 0027-A 11,137 JOYNER, WOODARD Bill Patient Collections No Bill Sent 1,581.00 1,506.00 75.00 2004-11-19 0006-A 10,647 KRUSE, CASI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-23 0011-A 11,873 MARES, RAMON Bill Patient Collections No Bill Sent 1,266.00 1,146.05 119.95 2004-12-11 0026-A 11,476 MATHEWS, JUNE Bill Patient Collections No Bill Sent 1,431.00 1,340.10 90.90 2004-12-04 0011-A 11,222 MEINEKE, DOROTHY Bill Patient Collections No Bill Sent 1,341.00 1,274.21 66.79 2004-12-17 0022-A 11,666 MUNOZ, RAUL Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-11-22 0029-A ' 10,810 OJEDA, TRINIDAD Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-12-03 0016-A 11,194 PADILLA, TONY Bill Patient Collections No Bill Sent 150.00 135.00 15.00 2004-12-06 0011-A 11,292 PADILLA, TONY Bill Patient Collections No Bill Sent 843.00 758.70 84.30 2004-12-26 0022-A 12,032 PIERSON, RICHARD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-18 0034-A 10,632 RANKINE, RENEE Bill Patient Collections No Bill Sent 996.00 511.88 484.12 2004-12-30 0014-A 12,127 ROBB, RONNIE Bill Patient Collections No Bill Sent 1,191.00 1,115.54 75.46 2004-12-30 0045-A 12,149 ROBB, RONNIE Bill Patient Collections No Bill Sent 708.00 646.54 61.46 2004-12-02 0042-A 11,179 SAIS, DEANNA Bill Patient Collections No Bill Sent 1,266.00 1,012.80 253.20 2004-12-18 0021-A 11,711 SALAZAR, LEONARD Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-12-01 0015-A 11,118 SPINK, KRISTEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-21 0027-A 10,774 THORN, MICHAEL Bill Patient Collections No Bill Sent 1,221.00 681.30 539.70 2004-12-25 0030-A , 11,977 WALTER, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-20 0021-A 10,702 WINKLEPLECK, KEEC Bill Patient Collections No Bill Sent 1,293.00 0.00 1,293.00 2004-11-23 0027-A 10,849 YAMADA, CAROL Bill Patient Collections No Bill Sent 150.00 100.00 50.00 Trip count: 28 25,041.75 14,356.02 10,685.73 Trip count: 28 25,041.75 14,356.02 10,685.73 Total trip count: i 28 j i, 25,041,75 (1, 14,356.02 I( 10,685.73 t RescueNetTM Printed on 6/15/2005 at 2:40:58PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,524 Batch date: 6/15/2005 2:50:03PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-01-18 0001-A 588 ARAGON, NICHOLE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-01-02 0010-A ' 59 BACKMAN, MICHAEL Bill Patient Collections No Bill Sent 1,404.00 1,332.00 72.00 2005-01-06 0023-A 230 BARRON, PEDRO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-01-20 0025-A 680 BOLLEN, RAYMOND Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-01-19 0010-A 631 CASADY, JASON Bill Patient Collections No Bill Sent 1,220.00 0.00 1,220.00 2005-01-20 0042-A 697 CRUM, LESLIE Bill Patient Collections No Bill Sent 1,583.00 0.00 1,583.00 2005-01-11 0021-A 368 DIEHL, DEBORAH Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-01-11 0026-A 373 DUNCAN, KIMBERLY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-19 0032-A 653 FERGUSON, DAISY Bill Patient Collections No Bill Sent 1,611.00 0.00 1,611.00 2005-01-17 0018-A 579 GONZALES, FRANKIEBill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 ' 2005-01-18 0027-A 614 HAND, RACHEL Bill Patient Collections No Bill Sent 1,330.00 0.00 1,330.00 2005-01-07 0022-A 259 HENDRICKS, KERRY Bill Patient Collections No Bill Sent 1,891.00 1,512.80 378.20 2005-01-05 0009-A 183 HERNANDEZ, MANUEBill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-01-20 0002-A 657 HOLGUIN, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-09 0021-A 310 HUNT, EMERY Bill Patient Collections No Bill Sent 1,219.00 1,143.47 75.53 2005-01-18 0017-A 604 HUNT, EMERY Bill Patient Collections No Bill Sent 1,369.00 1,290.98 78.02 2005-01-14 0005-A 466 LAVERGNE, JENNIFE Bill Patient Collections No Bill Sent 1,321.00 0.00 1,321.00 2005-01-18 0012-A 599 LUJAN, DAVID Bill Patient Collections No Bill Sent 1,270.00 0.00 1,270.00 2005-01-14 0026-A 487 LUNSFORD, VIRGINIA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-01-14 0029-A 490 MELERO, ANTONIA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-01-19 0029-A 650 MILLER, ERIN Bill Patient Collections No Bill Sent 1,607.00 0.00 1,607.00 2005-01-20 0006-A 661 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-01-06 0009-A 215 PADILLA, GARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-19 0017-A 638 PETERSEN, GARRET Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-02 0025-A. 108 ROECKER, GRACIE Bill Patient Collections No Bill Sent 150.00 135.00 15.00 2005-01-11 0010-A 355 ROECKER, GRACIE Bill Patient Collections No Bill Sent 1,515.00 1,363.50 151.50 2005-01-20 0005-A 660 SCHIFERL, ZACHARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-02 0007-A 55 SEPEDA, JOHN Bill Patient Collections No Bill Sent 1,144.00 1,069.72 74.28 2005-01-02 0026-A 66 SEPEDA, JOHN Bill Patient Collections No Bill Sent 589.00 543.20 45.80 2005-01-19 0034-A 655 SILVA, ABIGAIL Bill Patient Collections No Bill Sent 1,237.00 0.00 1,237.00 2005-01-15 0029-A 526 SMITHEY, FLOYD Bill Patient Collections No Bill Sent 1,404.00 0.00 1,404.00 2005-01-19 0023-A 644 SNYDER, ANDREW Bill Patient Collections No Bill Sent 1,288.00 0.00 1,288.00 2005-01-20 0020-A 675 TENORIO, ANNA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-14 0014-A 475 TRACKWELL, NANCY Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 RescueNetTM Printed on 6/15/2005 at 2'51:18PM Page 1 \\nwt 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-01-14 0033-A 494 URBINA, MARIO Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-01-16 0024-A 554 WADMAN, STEPHEN Bill Patient Collections No Bill Sent 1,260.00 0.00 1,260.00 2005-01-13 0001-A 433 WILLIAMS, JAMES Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-01-12 0039-A 420 ZUNIGA, PHILLIP Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 Trip count: 38 42,351.00 8,390.67 33,960.33 Trip count: 38 42,351.00 8,390.67 33,960.33 c Total trip count a„4," 53orgioat.0 _i'4y„3+ s' 4 it1/4..33s96Q"3 A'1 RescueNetTM Printed on 6/15/2005 at 2 51:18PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt 1 Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,525 Batch date: 6/15/2005 3:03:01PM • Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-01-22 0009-A 744 ADAMS, HANNAH Bill Patient Collections No Bill Sent 1,312.00 0.00 1,312.00 2005-01-27 0027-A 913 ALFARO, ROMAULDO Bill Patient Collections No Bill Sent 1,352.00 0.00 1,352.00 2005-01-27 0041-A 929 BEAN, LARRY Bill Patient Collections No Bill Sent 1,612.00 0.00 1,612.00 2005-01-24 0032-A 826 CARRANZA, TRICIA Bill Patient Collections No Bill Sent 1,481.00 0.00 1,481.00 2005-01-24 0031-A 824 DAUGHTREY, DONAL Bill Patient Collections No Bill Sent 1,253.00 0.00 1,253.00 2005-01-27 0010-A 893 DESHAZO, PAUL Bill Patient Collections No Bill Sent 1,617.00 0.00 1,617.00 2005-01-23 0001-A 764 FLORES-SANCHEZ, A Bill Patient Collections No Bill Sent 1,439.00 0.00 1,439.00 2005-01-28 0038-A 969 GARCIA, GILBERT Bill Patient Collections No Bill Sent 1,260.00 0.00 1,260.00 2005-01-27 0008-A 891 HERNANDEZ, MANUEBill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-01-31 0033-A 1,138 JACKSON, BRENDA Bill Patient Collections No Bill Sent 1,603.00 0.00 1,603.00 2005-01-29 0017-A 991 JORDAN, DELVIN Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 2005-01-27 0006-A 889 KASPAR, SHERRI Bill Patient Collections No Bill Sent 1,355.00 0.00 1,355.00 2005-01-21 0029-A 727 LIMAS, LAURIE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-01-22 0028-A 763 LOPEZ, REFUGIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-22 0023-A 758 MALDONADO, CHARL Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-01-23 0027-A 790 MARES, DAVID Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-02-01 0024-A 1,088 MEDRANO, PIETRO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-28 0023-A 954 MENDOZA, RODNEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-24 0010-A 803 MERRITT, KENT Bill Patient Collections No Bill Sent 1,541.00 0.00 1,541.00 2005-01-29 0002-A 975 MIRAMONTES, JUAN Bill Patient Collections No Bill Sent 1,413.00 0.00 1,413.00 2005-01-27 0032-A . 918 MOREHOUSE, TAMM'Bill Patient Collections No Bill Sent 1,387.00 0.00 1,387.00 2005-01-30 0007-A 1,016 OBRIEN, DAN Bill Patient Collections No Bill Sent 1,481.00 0.00 1,481.00 2005-01-28 0037-A 968 OCON, PABLO Bill Patient Collections No Bill Sent 1,845.00 0.00 1,845.00 2005-01-30 0005-A 1,014 OJEDA, EMISAEL Bill Patient Collections No Bill Sent 1,879.00 0.00 1,879.00 2005-01-30 0022-A 1,031 OLIVA-ALBA, JUAN Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-02-01 0002-A 1,066 PALMER, PATRICIA Bill Patient Collections No Bill Sent 1,591.00 0.00 1,591.00 2005-01-31 0018-A 1,050 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-01-27 0004-A 887 RAMOS, JESUS Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-29 0035-A 1,009 REYES, JESUS Bill Patient Collections No Bill Sent 1,379.00 0.00 1,379.00 2005-01-21 0028-A 726 RIGGINS, GARI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-30 0012-A 1,021 RODRIGUEZ, CRUZ Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-25 0018-A 849 ROTEN, ALEXIS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-29 0019-A 993 RUSSELL, WILLIAM Bill Patient Collections No Bill Sent 589.00 0.00 589.00 2005-01-31 0030-A 1,064 SALAZAR, RUDY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 RescueNetTM Printed on 6/15/2005 at 3:04:27PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-01-23 0008-A 771 SEPEDA, JOHN Bill Patient Collections No Bill Sent 1,219.00 1,165.62 53.38 2005-01-30 0011-A 1,020 SEWELL, HUBERT Bill Patient Collections No Bill Sent 1,698.00 0.00 1,698.00 2005-01-29 0026-A 1,000 SMITHEY, ANDREW Bill Patient Collections No Bill Sent 1,591.00 0.00 1,591.00 2005-01-28 0017-A 948 STRACKE, COURTNE Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-31 0025-A 1,058 WEAVER, FRANKLIN Bill Patient Collections No Bill Sent 1,355.00 0.00 1,355.00 Trip count: 39 46,410.00 1,165.62 45,244.38 Trip count: 39 46,410.00 1,165.62 45,244.38 Total trip count: -139 „„„. „ 1118;1 ?Dt t ; 1 a. .,' SAS 244:38x` RescueNetrm Printed on 6/15/2005 at 3:04:27PM Page 2 \\nw16\rescuenet\reports32\BillingAMiscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,526 Batch date: 6/15/2005 3:21:56PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-02-04 0035-A 1,180 ALLEE, TORI Bill Patient Collections No Bill Sent 1,676.00 600.00 1,076.00 2005-02-08 0005-A 1,284 ARCHULETA, DESIRE Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-02-04 0040-A 1,188 BROCK, ANN Bill Patient Collections No Bill Sent 1,421.00 0.00 1,421.00 2005-02-04 0038-A 1,183 BUSTAMANTE, MARA Bill Patient Collections No Bill Sent 1,539.00 0.00 1,539.00 2005-02-04 0037-A 1,182 CONTRERAS, MARIE Bill Patient Collections No Bill Sent 1,464.00 0.00 1,464.00 2005-02-06 0004-A . 1,232 COX, TYLER Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-02-04 0003-A 1,148 DONGIERT, CONNIE Bill Patient Collections No Bill Sent 1,795.00 0.00 1,795.00 2005-02-06 0023-A 1,253 FOXALL, NICOLE Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-02-06 0006-A 1,234 GILBERT, SABINA Bill Patient Collections No BID Sent 150.00 0.00 150.00 2005-02-06 0005-A 1,233 HERRMANN, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-05-11 0028-A 4,579 HOLMBERG, LARS Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-02-02 0015-A 1,106 LOPEZ, CHRISTOPHE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-02-02 0023-A 1,139 PALMER, PATRICIA Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2005-02-02 0002-A 1,093 PEREZ, CLAUDIA Bill Patient Collections No Bill Sent 1,270.00 0.00 1,270.00 2005-02-09 0026-A 1,361 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-02-03 0003-A 1,116 QUIROZ, GONZALO Bill Patient Collections No Bill Sent 1,403.00 0.00 1,403.00 2005-05-23 0024-A 4,975 SHANNON, RICKEY Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-02-09 0030-A • 1,365 STELLA, JENNIFER Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-02-03 0012-A 1,125 SWANSON, EDWIN Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-02-02 0014-A 1,105 YBARRA, BRENDA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 Trip count: 20 25,144.00 600.00 24,544.00 Trip count: 20 25,144.00 600.00 24,544.0,0\. Total trip count = 20 ol p;'2,5;144:10 #.t ;. 600:00, I ( 24,544.00 7 RescueNetTM Printed on 6/15/2005 at 3:22 36PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report JVELD COUNTY PARAMEDIC SERVICES Batch 8,665 Batch date: 6/28/2005 9:48:36AM trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-02-12 0032-A 1,460 ALLEGRIA, EMILIO Bill Patient Collections No Bill Sent 1,202.00 0.00 1,202.00 2005-01-24 0002-A 795 AMEN, AMANDA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-18 0002-A 1,676 BRAUSER, THERESA Bill Patient Collections No Bill Sent 1,539.00 0.00 1,539.00 2005-02-17 0016-A . 1,653 CHAIREZ, ANA Bill Patient Collections No Bill Sent 1,439.00 0.00 1,439.00 2005-02-14 0001-A 1,503 CHAVEZ, CHRISTIAN Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 2005-06-11 0034-A 5,655 CHAVEZ, JAKE Bill Patient Collections No Bill Sent 1,381.00 0.00 1,381.00 2005-02-15 0047-A 1,594 CORDOVA, MARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-13 0032-A 1,497 CRANMER, DAVID Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-01-27 0037-A 923 DROVDAL, LEONA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-20 0032-A 687 GAVELL, EDWARD Bill Patient Collections No Bill Sent 1,219.00 1,165.62 53.38 2005-01-31 0007-A 1,039 GOMEZ, GUSTAVO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-13 0021-A 1,485 GREEN, HOWARD Bill Patient Collections No Bill Sent 1,529.00 0.00 1,529.00 2005-01-31 0008-A 1,040 HERNANDEZ, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-17 0008-A 1,645 LOPEZ, ELIZABETH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-20 0013-A 668 MERACLE, JIMMY Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-01-21 0031-A 729 OSTLEE, JOHN Bill Patient Collections No Bill Sent 1,144.00 1,010.20 133.80 2005-02-03 0022-A 1,137 SANTOS, RAYMUNDC Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-03-28 0006-A 3,006 SESSION, CARLA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-01-28 0027-A 958 SHAFFER JR, STANL Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-06-16 0011-A 5,782 TOVAR, BENITO Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-02-15 0011-A 1,556 WALLACE, NICK Bill Patient Collections No Bill Sent 1,614.00 0.00 1,614.00 2005-02-18 0013-A 1,688 ZRIG-MINTLE, KARIN Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-02-28 0013-A 2,044 ZRIG-MINTLE, KARIN Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 Trip count: 23 23,098.00 2,175.82 20,922.18 Trip count: 23 23,098 00 2,175.82 20,922:1 Total trip count: , F' ak2 .., 11 g3;09;8 00.)it..,,2__5 82.; ,, , _20;922: 9 RescueNetTM Printed on 6/28/2005 at 9.49.27AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,663 Batch date: 6/28/2005 9:11:23AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-11-21 0022-A 10,769 BALL, SHARON Bill Patient Collections No Bill Sent 1,581.00 65.00 1,516.00 2005-01-15 0024-A 521 BRINKLEY, SARAH Bill Patient Collections No Bill Sent 1,386.00 1,306.87 79.13 2004-12-02 0041-A 11,178 CHAMPNEY, DANIEL Bill Patient Collections No Bill Sent 1,416.00 1,324.30 91.70 2004-05-13 0022-A 4,133 CHAVEZ, LUCAS Bill Patient Collections No Bill Sent 1,131.00 180.00 951.00 2004-11-27 0002-A 10,944 FLOREZ, RIGOBERTC Bill Patient Collections No Bill Sent 1,206.00 724.80 481.20 2005-01-12 0013-A 391 GAVELL, EDWARD Bill Patient Collections No Bill Sent 1,144.00 1,010.20 133.80 2004-12-04 0004-A 11,215 GONZALES, ROSALIE Bill Patient Collections No Bill Sent 2,345.00 2,270.00 75.00 2004-11-02 0024-A 10,099 HARRIS, DAVID Bill Patient Collections No Bill Sent 1,146.00 598.88 547.12 2004-12-08 0011-A 11,358 HUGHES, NATHAN Bill Patient Collections No Bill Sent 1,131.00 632.90 498.10 2005-01-07 0007-A 244 KING JR, DONALD Bill Patient Collections No Bill Sent 1,295.00 0.00 1,295.00 2004-10-21 0011-A 9,693 KING, PRESTON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-04 0001-A 111 MARES, RAYMOND Bill Patient Collections No Bill Sent 1,438.00 1,357.67 80.33 2005-01-11 0027-A 374 MILLER, ROGER Bill Patient Collections No Bill Sent 1,437.00 1,354.55 82.45 2004-12-23 0033-A 11,895 MYERS, LUCILE Bill Patient Collections No Bill Sent 1,026.00 820.80 205.20 2005-01-15 0011-A 508 PRINTZ, LISA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-11-24 0002-A 10,859 RANDALL, KERRI Bill Patient Collections No Bill Sent 1,311.00 45.00 1,266.00 2003-02-25 0026-A 779 RYDBOM, KIMBERLY Bill Patient Collections No Bill Sent 1,310.00 423.86 886.14 2005-01-09 0004-A 292 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,403.00 1,383.00 20.00 2004-11-03 0017-A 10,122 ZIEMER, KEVIN Bill Patient Collections No Bill Sent 981.00 659.00 322.00 Trip count: 19 24,148.00 14,156.83 9,991.17 Trip count: 19 24,148.00 14,156.83 9,991.17 Total trip count: 1I., 1 Z,'. , , 8 30.4,, 4,„L 5Cfla„, ,9;991,}17 RescueNetTM Printed on 6/28/2005 at 9.11.59AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,864 Batch date: 7/19/2005 2:41:11 PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-02-22 0007-A 1,813 ARCHULETA, JAMES Bill Patient Collections No Bill Sent 1,413.00 0.00 1,413.00 2005-02-27 0013-A 2,018 BUTZ, LAURA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-03-16 0017-A 2,629 CRANMER, RICK Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-03-12 0015-A 2,506 DAGEL, MICHAEL Bill Patient Collections No Bill Sent 1,430.00 0.00 1,430.00 2005-03-10 0007-A 2,420 FRENCH, KENT Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-06-26 0027-A 6,137 GARZA, FRANK Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-02-24 0040-A 1,913 HOLLAND, RONALD Bill Patient Collections No Bill Sent 1,403.00 1,322.76 80.24 2005-03-12 0024-A 2,515 HOWARD, PETENA Bill Patient Collections No Bill Sent 1,490.00 0.00 1,490.00 2005-02-22 0031-A 1,843 HUGHES, SHAWN Bill Patient Collections No Bill Sent 1,851.00 0.00 1,851.00 2005-02-28 0016-A 2,047 MEDINA, NATHANIEL Bill Patient Collections No Bill Sent 1,346.00 0,00 1,346.00 2005-03-09 0024-A 2,406 MONTOYA, GENE Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-02-24 0023-A 1,890 RETTELE, SUE ANN Bill Patient Collections No Bill Sent 1,328.00 1,062.40 265.60 2005-03-01 0006-A 2,084 SALAZAR, DOMINGO Bill Patient Collections No Bill Sent 1,497.00 0.00 1,497.00 2005-04-20 0009-A 3,806 SPRADLING, MICHAE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-02-25 0040-A 1,959 VENEGAS-ALVAREZ, Bill Patient Collections No Bill Sent 1,624.00 0.00 1,624.00 2005-03-11 0024-A 2,478 WILBURN, CHERYL Bill Patient Collections No Bill Sent 1,556.00 0.00 1,556.00 Trip count: 16 23,053.00 2,385.16 20,667.84 Trip count: 16 23,053.00 2,385.16 20,667.84 Total trip count , r°16 1 f.:,4;45:31161;14;300:46' i` 20;667.84.4 RescueNetTM Printed on 7/19/2005 at 2:41:54PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,863 Batch date: 7/19/2005 2:30:47PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-02-02 0001-A 1,092 ANTUNA, ANTHONY Bill Patient Collections No Bill Sent 2,144.00 0.00 2,144.00 2005-02-15 0004-A 1,549 ANTUNA, ANTHONY Bill Patient Collections No Bill Sent 1,456.00 0.00 1,456.00 2005-01-16 0012-A 542 ARNOLD, CLAUDE Bill Patient Collections No Bill Sent 1,920.00 0.00 1,920.00 2005-01-24 0021-A ' 814 BARNUM, ANTHONY Bill Patient Collections No Bill Sent 1,488.00 1,463.00 25.00 2005-01-16 0001-A 531 BOOTH, FORREST Bill Patient Collections No Bill Sent 1,422.00 1,387.00 35.00 2005-02-03 0008-A 1,121 BUFKIN, REGINA Bill Patient Collections No Bill Sent 1,219.00 1,105.81 113.19 2005-01-28 0032-A 963 CARLSON, MICHAEL Bill Patient Collections No Bill Sent 1,270.00 0.00 1,270.00 2005-01-28 0040-A 971 CONANT, LISA Bill Patient Collections No Bill Sent 150.09 120.09 30.00 2005-01-07 0020-A 257 FITHIAN, ROBERT Bill Patient Collections No Bill Sent 1,421.00 1,341.75 79.25 2005-01-17 0003-A 564 GAMBOA, RICHARD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-03 0019-A 1,132 GARCIA-RIVAS, MAGI Bill Patient Collections No Bill Sent 1,556.00 0.00 1,556.00 2005-01-20 0043-A 698 GOBER, ALLEN Bill Patient Collections No Bill Sent 2,032.00 1,625.60 406.40 2005-01-21 0022-A 720 GRIMALDO, REUBEN Bill Patient Collections No Bill Sent 1,550.00 _ 1,240.00 310.00 2005-02-16 0028-A 1,628 GURNEY, CASEY Bill Patient Collections No Bill Sent 1,507.00 897.40 609.60 2005-02-18 0029-A 1,704 HAINES, JAKE Bill Patient Collections No Bill Sent 1,814.00 0.00 1,814.00 2005-02-12 0033-A 1,461 HARTLEY, CATHY Bill Patient Collections No Bill Sent 1,712.00 0.00 1,712.00 2005-02-04 0029-A 1,174 HEINZE, RUTH Bill Patient Collections No Bill Sent 1,403.00 1,330.50 72.50 2005-01-10 0024-A 338 JUAREZ, ANGELINA Bill Patient Collections No Bill Sent 1,526.00 1,406.48 119.52 2005-02-15 0033-A 1,578 LAMONTINE, ELSIE Bill Patient Collections No Bill Sent 1,659.00 1,526.35 132.65 2005-01-02 0023-A 73 LENGEL, JASON Bill Patient Collections No Bill Sent 589.00 235.89 353.11 2005-02-03 0002-A 1,115 LENGEL, JASON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-01-14 0017-A 478 MCDERMID, MICHELL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-02-15 0012-A 1,557 NAVA-LEDEZMA, ARL Bill Patient Collections No Bill Sent 647.00 416.11 230.89 2005-01-04 0011-A 121 ONTIVEROS, JULIO Bill Patient Collections No Bill Sent 1,253.00 1,050.00 203.00 2005-01-27 0035-A 921 OSBORNE, BRIAN Bill Patient Collections No Bill Sent 1,618.00 0.00 1,618.00 2005-01-28 0031-A 962 PIERSON, RICHARD Bill Patient Collections No Bill Sent 1,671.00 1,591.44 79.56 2005-02-02 0003-A 1,094 RETTELE, SUE ANN Bill Patient Collections No Bill Sent 1,456.00 1,130.52 325.48 2005-02-16 0010-A 1,610 RICHARDSON, ANN Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-01-06 0005-A 211 ROBB, KAREN Bill Patient Collections No Bill Sent 1,311.00 1,264.25 46.75 2005-01-17 0009-A 570 ROBB, KAREN Bill Patient Collections No Bill Sent 1,456.00 1,386.86 69,14 2005-02-07 0008-A 1,263 SALAZAR, FRED Bill Patient Collections No Bill Sent 1,515.00 1,356.97 158.03 2005-01-15 0010-A 507 SANDOVAL, EUSEBIC Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 2005-01-18 0016-A 603 SOLIS, BETTY Bill Patient Collections No Bill Sent 1,491.00 792.80 698.20 2005-02-08 0054-A 1,335 SPERRY, CRAIG Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 RescueNetTM Printed on 7/19/2005 at 2'.32:16PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch 7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-02-09 0014-A 1,349 SPERRY, CRAIG Bill Patient Collections No Bill Sent 1,422.00 0.00 1,422.00 2005-02-02 0010-A 1,101 TAYLOR, GARY Bill Patient Collections No Bill Sent 2,373.00 1,898.40 474.60 2005-01-01 0013-A 13 TORRES, JOSEFA Bill Patient Collections No Bill Sent 1,386.00 1,048.80 337,20 2005-01-22 0011-A 746 TREVINO, JESSE Bill Patient Collections No Bill Sent 1,456.00 759.50 696.50 2005-01-26 0001-A 852 VALADEZ, SANTOS Bill Patient Collections No Bill Sent 1,676.00 1,545.27 130.73 2005-02-20 0029-A 1,770 ZLOMKE, HALEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 40 54,038.09 27,920.79 26,117.30 Trip count: 40 54,038 09 27,920.79 26,117.30 (_, Total trip count: ,,,m'.„ 40 e ,§„4,403899,1, 27,920.79 1 26;117.30 i RescueNetw Printed on 7/19/2005 at 2:32:16PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 8,862 Batch date: 7/19/2005 2:07:32PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-27 0018-A 7,748 AGUILAR, CRYSTAL Bill Patient Collections No Bill Sent 1,011.00 811.00 200.00 2004-11-26 0009-A 10,950 ALANIZ, HEATHER Bill Patient Collections No Bill Sent 1,154.73 974.73 180.00 2004-12-03 0019-A 11,197 CONANT, LISA Bill Patient Collections No Bill Sent 1,056.00 844.80 211.20 2004-12-24 0035-A 11,935 CONANT, LISA Bill Patient Collections No Bill Sent 1,371.79 1,097.59 274.20 2004-12-27 0008-A 11,994 DELGADO-RAMIREZ, Bill Patient Collections No Bill Sent 1,461.00 600.00 861.00 2004-11-02 0019-A 10,093 DUDLEY, GENETTA Bill Patient Collections No Bill Sent 1,131.00 1,075.01 55.99 -_i 1-12-26 0019-A 12,008 FLORES, FRANCES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-12-26 0020-A 12,027 FLORES, GENEVA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-07 0021-A 10,260 GOBER, ALLEN Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2004-11-03 0019-A 10,125 HESS, BEVERLY Bill Patient Collections No Bill Sent 1,161.00 1,030.68 130.32 2004-03-17 0027-A . 2,279 HICKS, ANNA Bill Patient Collections No Bill Sent 1,146.00 252.00 894.00 2004-10-25 0021-A 9,818 HOFFNER, GLEN Bill Patient Collections No Bill Sent 1,251.00 1,114.31 136.69 2004-08-04 0007-A 6,976 KRUSE, CASI Bill Patient Collections No Bill Sent 1,146.00 125.00 1,021.00 2004-12-31 0014-A 12,172 LENGEL, JASON Bill Patient Collections No Bill Sent 1,191.00 889.00 302.00 2004-04-15 0001-A 3,131 MESTAS, OWEN Bill Patient Collections No Bill Sent 1,116.00 300.00 816.00 2004-12-27 0036-A 12,090 MUSTERMAN, STEVE Bill Patient Collections No Bill Sent 1,431.00 1,144.80 286.20 2004-12-22 0019-A 11,835 PENA, BERTHA Bill Patient Collections No Bill Sent 573.00 225.00 348.00 2004-02-20 0019-A 1,476 RAEHAL, SARA Bill Patient Collections No Bill Sent 1,056.00 600.00 456.00 2004-07-16 0004-A 6,328 ROBB, JOHN Bill Patient Collections No Bill Sent 1,476.00 150.00 1,326.00 2004-12-17 0030-A 11,682 ROCHA, SABAS Bill Patient Collections No Bill Sent 1,566.00 1,464.30 101.70 20)04-11-1-i 0013-A 10,371 RODMAN, CHARLOT1 Bill Patient Collections No Bill Sent 1,251.00 25.00 1,226.00 :00-1-01-11 0010 ^- 290 SILVA, VICENTE o"" Patient Collections No Bill Sent 1,101.00 200.00 901.00 KlN: ' _ ',N C.': Patient Collections Bill Sent 1,326.00 647.57 678.43 2004-11-10 u013-A 10,341 WEEKS, MARIE Bill Patient Collections No Bill Sent 1,131.00 50.00 1,081.00 Trip count: 24 25,557.52 13,740.79 11,816.73 Trip count: 24 25,557.52 13,740.79 11,816.73 Total trip count &s42,4, „ , ,x55 n6 �� 13,740941;81_73 ; RescueNettM Printed on 7/19/2005 at 2:08.04PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,113 Batch date: 8/9/2005 8:03:36AM Trip Date Job • Run Name Current Pavor Schedule Event Charges Credits Balance 2005-07-04 0027-A 6,531 CARROLL, CHRISTO Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-07-07 0044-A 6,622 CARROLL, CHRISTO Bill Patient Collections No Bill Sent 1,438.00 0.00 1,438.00 2005-07-12 0020-A 6,785 CARROLL, CHRISTO Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 2005-07-22 0024-A 7,137 HARRIS, ANDREW Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-07-23 0023-A 7,169 LAPORTE, TIMOTHY Bill Patient Collections No Bill Sent 1,403.00 0.00 1,403.00 2005-07-26 0009-A 7,285 LAPORTE, TIMOTHY Bill Patient Collections No Bill Sent 1,471.00 0.00 1,471.00 2005-07-02 0006-A 6,328 LIVINGSTONE, DANEI Bill Patient Collections No Bill Sent 1,403.00 0.00 1,403.00 2005-06-02 0016-A 5,325 MORAN, ADAN Bill Patient Collections No Bill Sent 1,312.00 0.00 1,312.00 2005-07-09 0014-A 6,683 RODRIGUEZ, AUGUS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 9 10,684.00 0.00 10,684.00 Trip count: 9 10,684.00 0.00 10;684:06N\\ Total trip count: 1,,a,,,“ a}, SSII9r.,91 ;. ;90' ,r'• • RescueNetTM Printed on 8/9/2005 at 8:03:57AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,112 Batch date: 8/9/2005 7:54:40AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-04-06 0011-A 3,293 ACUNA, TANYA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-03-21 0008-A 2,760 AMENDOLA, JERRY Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-04-03 0022-A 3,215 ASHMORE,ANDREA Bill Patient Collections No Bill Sent 1,294.00 1,238.36 55.64 2005-04-01 0030-A 3,160 BASARA, JOSHUA Bill Patient Collections No Bill Sent 2,060.00 1,683.00 377.00 2005-02-25 0007-A 1,921 CAIN, VANESSA Bill Patient Collections No Bill Sent 1,628.00 1,302.40 325.60 2005-03-08 0019-A 2,368 CHRISPEN, EILEEN Bill Patient Collections No Bill Sent 1,328.00 1,250.02 77.98 2005-03-28 0011-A 3,011 CROSS, MARY Bill Patient Collections No Bill Sent 1,430.00 0.00 1,430.00 2005-03-08 0010-A 2,359 DAVIS, DORISANN Bill Patient Collections No Bill Sent 1,403.00 1,344.91 58.09 2005-03-08 0033-A 2,382 DAVIS, DORISANN Bill Patient Collections No Bill Sent 1,253.00 1,203.73 49.27 2005-03-19 0014-A 2,705 DEPORTER, DAVID Bill Patient Collections No Bill Sent 2,226.00 0.00 2,226.00 2005-02-21 0012-A 1,790 DUNNING, DORIS Bill Patient Collections No Bill Sent 1,457.00 0.00 1,457.00 2005-02-24 0034-A 1,907 ESPINOZA, MARIA Bill Patient Collections No Bill Sent 1,677.00 1,476.00 201.00 2005-02-25 0004-A 1,918 ESPINOZA, MARIA Bill Patient Collections No Bill Sent 800.00 755.00 45.00 2005-03-22 0028-A 2,822 ESTES, DEE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-03-26 0003-A 2,947 FERNANDEZ, HOLLY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-25 0028-A 1,943 GARZA, RELLES Bill Patient Collections No Bill Sent 1,202.00 1,137.06 64.94 2005-02-25 0030-A 1,946 GIVEN, WILLARD Bill Patient Collections No Bill Sent 1,294.00 1,182.68 111.32 2005-02-25 0024-A 1,938 GRIEGO, BEATRICE Bill Patient Collections No Bill Sent 1,578.00 793.06 784.94 2005-03-06 0033-A 2,310 GULBRANDSON, MI Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-03-15 0023-A 2,654 GUNZINGER, KURT Bill Patient Collections No Bill Sent 1,544.00 0.00 1,544.00 2005-03-14 0032-A 2,612 HERNANDEZ, LUZ Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-26 0025-A 1,988 HERR, VINCENT Bill Patient Collections No Bill Sent 1,236.00 1,181.51 54.49 2005-02-20 0026-A 1,767 JAMES, DOUGLAS Bill Patient Collections No Bill Sent 1,590.00 1,515.00 75.00 2005-02-26 0029-A 1,992 JESKE, KRISTAN Bill Patient Collections No Bill Sent 1,472.00 0.00 1,472.00 2005-04-03 0004-A 3,197 JONES, CORRIE Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-04-03 0026-A 3,220 LOPEZ, ISRAEL Bill Patient Collections No Bill Sent 185.00 0.00 185.00 2005-04-06 0002-A 3,284 MARKS, DANIEL Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-04-01 0035-A 3,165 MARTIN, SHIRLEY Bill Patient Collections No Bill Sent 1,386.00 1,346.00 40.00 2005-03-12 0040-A 2,531 MILLSAP, RAYMOND Bill Patient Collections No Bill Sent 252.00 0.00 252.00 2005-02-23 0012-A 1,851 MOLINA, AMY Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-03-19 0016-A 2,707 MOSCO, LISA Bill Patient Collections No Bill Sent 1,682.00 0.00 1,682.00 2005-04-01 0003-A 3,132 PUENTE, DILIA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-03-11 0002-A 2,456 RIVERA, RICHARD Bill Patient Collections No Bill Sent 1,369.00 1,252.19 116.81 2005-03-04 0015-A 2,208 SCHUMAN, GILBERT Bill Patient Collections No Bill Sent 1,403.00 1,322.76 80.24 RescueNetTm Printed on 8/9/2005 at 7:55:26AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-02-25 0037-A 1,955 SHETLER, CRYSTAL Bill Patient Collections No Bill Sent 1,144.00 981.72 162.28 2005-04-02 0003-A 3,173 SHOEMAKER, DOUG Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-03-14 0026-A 2,599 WALKER, EDWIN Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-03-31 0029-A 3,126 WESTOVER, SONDR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-24 0037-A 1,910 WITBECK, ELEANOR Bill Patient Collections No Bill Sent 1,869.00 1,778.82 90.18 2005-03-08 0006-A 2,355 YOUNG, RONNIE Bill Patient Collections No Bill Sent 1,365.00 1,248.10 116.90 Trip count: 40 48,824.00 23,992.32 24,831.68 Trip count: 40 48,824.00 23,992.32 24 Total trip count: a k t ;,�' z'c . i ,24;83148y1,- RescueNetTM Printed on 8/9/2005 at 7:55:26AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,111 Batch date: 8/9/2005 7:26:41AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-02-07 0011-A 1,266 ARREDONDO, ISME Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-02-01 0025-A 1,089 BARNUM, ANTHONY Bill Patient Collections No Bill Sent 1,246.00 1,221.00 25.00 2005-01-25 0005-A 834 BECHERT, LEROY Bill Patient Collections No Bill Sent 1,346.00 1,267.10 78.90 2004-05-10 0069-A 4,071 BLANCO, ISABEL Bill Patient Collections No Bill Sent 1,431.00 670.00 761.00 2005-01-25 0017-A 848 BRUNTZ, CAROL Bill Patient Collections No Bill Sent 1,420.00 1,381.31 38.69 2005-02-11 0019-A 1,427 BRUNTZ, MICHAEL Bill Patient Collections No Bill Sent 1,490.00 890.40 599.60 2004-12-27 0027-A 12,067 CARMENDY, CAITLIN Bill Patient Collections No Bill Sent 1,191.00 25.00 1,166.00 2005-02-03 0021-A 1,136 DAUM, JOSEPH Bill Patient Collections No Bill Sent 2,028.00 1,780.00 248.00 2004-10-27 0013-A 9,878 FLOT, BRENT Bill Patient Collections No Bill Sent 1,371.00 1,361.00 10.00 2005-02-13 0007-A 1,471 FREI, MARTIN Bill Patient Collections No Bill Sent 1,363.00 1,281.98 81.02 2004-10-22 0022-A 9,740 ISLES, JORGE Bill Patient Collections No Bill Sent 1,191.00 150.00 1,041.00 2003-03-11 0003-A 1,260 JOVE, LUIS Bill Patient Collections No Bill Sent 965.00 525.00 440.00 2004-07-05 0007-A 5,971 KEILITZ, SADIE Bill Patient Collections No Bill Sent 1,371.00 195.00 1,176.00 2003-03-07 0026-A 1,154 MERCADO, HOPE Bill Patient Collections No Bill Sent 1,145.00 610.00 535.00 2005-01-25 0015-A 846 MINNEY, SHAWNALO Bill Patient Collections No Bill Sent 1,196.00 0.00 1,196.00 2005-01-11 0006-A 351 MONCIVAIS, BEATRI Bill Patient Collections No Bill Sent 1,202.00 200.00 1,002.00 2005-01-25 0019-A 850 RIVERA, BLANCA Bill Patient Collections No Bill Sent 1,403.00 550.00 853.00 2003-11-07 0023-A 9,071 RODRIGUEZ, ANTON Bill Patient Collections No Bill Sent 1,461.00 600.00 861.00 2005-01-14 0035-A 496 SEALY-BROWN, SHE Bill Patient Collections No Bill Sent 1,516.00 0.00 1,516.00 2004-08-13 0020-A 7,296 VANCE, DEBRA Bill Patient Collections No Bill Sent 1,416.00 200.00 1,216.00 2005-02-13 0010-A 1,474 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,253.00 1,233.00 20.00 2004-12-30 0010-A 12,123 WILLIAMS, ERIN Bill Patient Collections No Bill Sent 1,506.00 1,204.80 301.20 2005-01-18 0031-A 621 ZIMBELMAN, FLORA Bill Patient Collections No Bill Sent 2,209.00 2,104.00 105.00 Trip count: 23 32,089.00 17,449.59 14,639.41 Trip count: 23 32,089.00 17,449.596' 14,639.41 Total trip count: r:4 0.2146A1541 I bat_, «° ≥a"1. .`� c�c .;4' e !� RescueNettM Printed on 8/9/2005 at 7:28:01AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,325 Batch date: 8/26/2005 7:47:10AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-02-14 0031-A 1,536 ALVARADO, REYNA Bill Patient Collections No Bill Sent 1,311.00 50.00 1,261.00 2004-11-12 0025-A 10,424 BENNHOFF, TIMOT Bill Patient Collections No Bill Sent 1,256.62 1,145.02 111.60 2005-01-26 0006-A 857 BURKHART, JULIA Bill Patient Collections No Bill Sent 1,730.00 1,647.57 82.43 2004-11-29 0007-A 11,058 CAMPOZ, PAUL Bill Patient Collections No Bill Sent 1,311.00 1,232.31 78.69 2005-01-22 0019-A 754 CHILDERS, ADAM Bill Patient Collections No Bill Sent 1,144.00 803.20 340.80 2005-02-20 0012-A 1,753 DAVIS, ROBERT Bill Patient Collections No Bill Sent 1,576.00 0.00 1,576.00 2005-01-22 0004-A 739 DEAN, JONATHAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-02-20 0017-A 1,758 DIAZ-AYALA, DANIEL Bill Patient Collections No Bill Sent 1,438.00 0.00 1,438.00 2004-10-18 0028-A 9,609 HAYNES, SEAN Bill Patient Collections No Bill Sent 1,101.00 451.00 650.00 2005-02-18 0015-A 1,690 HENRY, DONNA Bill Patient Collections No Bill Sent 1,328.00 70.00 1,258.00 2005-01-21 0001-A 699 LONGSWORTH, CAT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-21 0030-A 5,476 MACKENZIE, EDIE Bill Patient Collections No Bill Sent 1,161.00 180.00 981.00 2005-02-27 0001-A 2,006 MCKINLEY, JUSTIN Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-01-03 0011-A 85 MORENO, MELBA Bill Patient Collections No Bill Sent 1,294.00 892.80 401.20 2005-02-26 0037-A 2,000 NICHOLS, MATTHEW Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-02-11 0021-A 1,429 RENFREW, DANIEL Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2005-01-22 0022-A 757 SANCHEZ, GENERO Bill Patient Collections No Bill Sent 150.00 50.00 100.00 2005-02-28 0009-A 2,040 SHEARIN, KIRK Bill Patient Collections No Bill Sent 1,914.00' 1,111.43 802.57 2004-12-31 0004-A 12,162 STOLL, LISA Bill Patient Collections No Bill Sent 150.00 10.00 140.00 2005-02-08 0020-A 1,299 WOODRUFF, MICH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 20 20,749.62 7,643.33 13,106.29 Trip count: 20 20,749.62 7,643.33 13,106.2a. Total trip count: ;.:441': , SA ins'{ ° soujoilo p , `"grhm =,. • RescueNerm Printed on 8/26/2005 at 7:47:44AM Page 1 \\nw 16\rescuenet\reports 32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,326 Batch date: 8/26/2005 8:04:25AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-03-17 0019-A 2,650 AGUILERA, ROSALIE Bill Patient Collections No Bill Sent 1,507.00 1,424.49 82.51 2005-03-20 0010-A 2,720 ARMENDARIZ, BREN Bill Patient (-NAL`,, Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-04-19 0021-A 3,789 AYERS, ERIKA Bill Patient Collections No Bill Sent 1,454.00 0.00 1,454.00 2005-04-19 0022-A 3,790 BEACH, LINDA Bill Patient Collections No Bill Sent 1,405.00 0.00 1,405.00 2005-04-19 0004-A 3,771 BOWLES, MATTHEW Bill Patient Collections No Bill Sent 1,127.00 0.00 1,127.00 2005-04-15 0013-A 3,661 COLLINS, KAMI Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2005-03-24 0021-A 2,893 CORTEZ, LUSINDA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-04-02 0004-A 3,174 DABERKOW, DON Bill Patient Collections No Bill Sent 1,311.00 1,144.10 166.90 2005-04-19 0018-A 3,786 DELORENZO, PAUL Bill Patient Collections No Bill Sent 1,492.00 0.00 1,492.00 2005-08-04 0001-A 7,596 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-04-13 0015-A 3,609 GARZA, DAWN Bill Patient Collections No Bill Sent 1,569.00 0.00 1,569.00 2005-03-12 0008-A 2,499 GEORGESON, JERE Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 2005-03-21 0024-A 2,783 GOODE, JAMES Bill Patient Collections No Bill Sent 1,363.00 0.00 1,363.00 2005-04-14 0005-A 3,618 HAGER, JAMES Bill Patient Collections No Bill Sent 1,709.00 0.00 1,709.00 2005-03-18 0010-A 2,693 HERRERA, MARTHA Bill Patient Collections No Bill Sent 1,220.00 0.00 1,220.00 2005-04-20 0015-A 3,813 JACKSON, DONNY Bill Patient Collections No Bill Sent 1,507.00 0.00 1,507.00 2005-08-08 0034-A 7,910 JOHNSON, SHERMA Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-03-10 0006-A 2,419 MENDOZA, MONICA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-03-22 0033-A 2,827 MERACLE, JIMMY Bill Patient 5V .v• 1..% Collections No Bill Sent 2,144.00 0.00 2,144.00 2005-03-30 0026-A 3,089 PAYNE, ELIZABETH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-03-28 0020-A 3,020 PITTS, EARL Bill Patient Collections No Bill Sent 1,294.00 1,236.07 57.93 2005-03-19 0011-A 2,702 TRIMBLE, SUSAN Bill Patient `>,, I LH Collections No Bill Sent 1,219.00 0.00 1,219.00 2005-03-19 0001-A 2,680 WEIMER, KAREN Bill Patient"1''K c., T:, Collections No Bill Sent 1,363.00 0.00 1,363.00 2005-04-12 0005-A 3,573 ZAMARRIPA, ANTON Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 Trip count: 24 30,966.00 3,804.66 27,161.34 Trip count: 24 30,966 00 3,804.66 27,1S�� Total trip count: .- `° ` .�4 06, m'"O'r 04,r t,'1 .r"ua.27,101+,"34e41 /' RescueNetTM Printed on 8/26/2005 at 8:05:04AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,604 Batch date: 9/22/2005 8:34:44AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-05-11 0031-A 4,582 ALPS, MATTHEW Bill Patient Collections No Bill Sent 1,481.00 0.00 1,481.00 2005-05-07 0037-A 4,445 ARROYO, DOMINICK Bill Patient Collections No Bill Sent 2,273.00 0.00 2,273.00 2005-05-20 0030-A 4,874 AUSTIN, GENORA Bill Patient Collections No Bill Sent 1,800.00 1,707.51 92.49 2005-05-08 0034-A 4,480 CHILDERS, ADAM Bill Patient Collections No Bill Sent 1,144.00 915.20 228.80 2005-05-10 0017-A 4,530 DECKER, KELSEY Bill Patient Collections No Bill Sent 1,505.00 0.00 1,505.00 2005-05-04 0028-A 4,316 DYKSTRA, LINDSAY Bill Patient Collections No Bill Sent 1,761.00 1,408.80 352.20 2005-05-02 0029-A 4,231 GANDARA, ELISAB Bill Patient Collections No Bill Sent 2,096.00 0.00 2,096.00 2005-05-05 0034-A 4,366 GREEN, DOROTHY Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-08-29 0010-A 8,581 GUTIERREZ, HECTO Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-05-31 0016-A 5,268 HERZOG, ETHAN Bill Patient Collections No Bill Sent 1,507.00 0.00 1,507.00 2005-09-02 0036-A 8,764 JARAMILLO, JULIO Bill Patient Collections No Bill Sent 1,886.00 0.00 1,886.00 2005-08-18 0008-A 8,144 JOHNSON, SHERMA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-05-12 0010-A 4,594 KAROWSKY, DAVID Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-05-05 0001-A 4,332 KRAMER, KYLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-08-14 0023-A 8,022 ROMERO, BARBARA Bill Patient Collections No Bill Sent 1,195.00 1,145.88 49.12 2005-06-27 0002-A 6,139 TATMAN, JAMES Bill Patient Collections No Bill Sent 1,252.00 0.00 1,252.00 2005-06-13 0019-A 5,704 TAVENNER, ROSELE Bill Patient Collections No Bill Sent 1,127.00 1,063.31 63.69 2005-09-02 0035-A 8,763 TORREZ, ISMAEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-07-08 0027-A 6,661 WIES, DOUGLAS Bill Patient Collections No Bill Sent 1,709.00 0.00 1,709.00 Trip count: 19 27,366.00 6,240.70 21,125.30 Trip count: 19 27,366.00 6,240.70 21,1.572 Total trip count: ;' r ` 4.2 ioio -:. IS; . ?; ;n?3 °t'- ~r. • RescueNetm Printed on 9/22/2005 at 8:35:15AM Page 1 \nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt i Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,603 • Batch date: 9/22/2005 8:21:36AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2005-04-08 0030-A 3,382 BARNUM, ANTHONY Bill Patient Collections No Bill Sent 1,396.00 1,371.00 25.00 2005-04-10 0025-A 3,502 BARNUM, ANTHONY Bill Patient Collections No Bill Sent 1,338.00 1,313.00 25.00 2005-04-25 0003-A 3,953 BETANCOURT, LION Bill Patient Collections No Bill Sent 1,600.00 0.00 1,600.00 2005-04-15 0023-A 3,671 BROWN, TONI Bill Patient Collections No Bill Sent 1,464.00 0.00 1,464.00 2005-04-21 0019-A 3,856 BROWN, TONI Bill Patient Collections No Bill Sent 1,505.00 0.00 1,505.00 2005-04-06 0025-A 3,307 • CHILDERS, ADAM Bill Patient Collections No Bill Sent 1,447.00 1,405.60 41.40 2005-04-09 0009-A 3,408 COLLINS, GLEN Bill Patient Collections No Bill Sent 1,220.00 976.00 244.00 2005-04-11 0009-A 3,535 CONTRERAS, SERG Bill Patient Collections No Bill Sent 1,711.00 1,636.00 75.00 2005-04-08 0023-A 3,375 DEVORA, ANTHONY Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-04-23 0023-A 3,917 FERNANDEZ, PEDRO Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-04-07 0014-A 3,331 GARCIA, ADRIANNA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-03-25 0033-A 2,942 GARZA, ALICIA Bill Patient Collections No Bill Sent 1,591.00 0.00 1,591.00 2005-04-06 0032-A 3,314 GAVELL, EDWARD Bill Patient Collections No Bill Sent 1,329.00 1,250.50 78.50 2005-04-02 0008-A 3,178 GOODWIND, MANU Bill Patient Collections No Bill Sent 1,607.00 1,535.63 71.37 2005-03-30 0021-A 3,084 HEFTY, NEAL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-04-09 0017-A 3,418 HEINRICH, DAVID Bill Patient Collections No Bill Sent 1,546.00 0.00 1,546.00 2005-04-18 0005-A 3,745 HERNANDEZ, RICH Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2005-03-31 0002-A 3,099 HUGHLEY,TRAVIS Bill Patient Collections No Bill Sent 1,253.00 602.40 650.60 2005-04-14 0016-A 3,629 LESTER, WILLIAM Bill Patient Collections No Bill Sent 2,611.00 0.00 2,611.00 2005-03-30 0023-A 3,086 LOSSE, MARY Bill Patient Collections No Bill Sent 1,372.00 1,019.00 353.00 2005-04-09 0036-A 3,450 MAES, ABEL Bill Patient Collections No Bill Sent 1,219.00 1,142.46 76.54 2005-04-18 0015-A 3,755 MELONS, LAURANIA Bill Patient Collections No Bill Sent 1,294.00 1,219.00 75.00 2005-04-01 0037-A 3,167 MOODY, TARA Bill Patient Collections No Bill Sent 1,505.00 0.00 1,505.00 2005-04-25 0026-A 3,985 OCANAS, JOEL Bill Patient Collections No Bill Sent 1,523.00 0.00 1,523.00 2005-04-15 0010-A 3,658 O'CONNOR, DANIEL Bill Patient Collections No Bill Sent 1,437.00 669.60 767.40 2005-04-17 0016-A 3,713 PACHECO, KRISTI Bill Patient Collections No Bill Sent 1,481.00 1,292.90 188.10 2005-03-30 0035-A 3,129 PADILLA, TONY Bill Patient Collections No Bill Sent 1,386.00 1,179.90 206.10 2005-03-25 0029-A 2,937 RIGGERT, ORVILLE Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-04-01 0012-A 3,141 RODRIGUEZ, GERTR Bill Patient Collections No Bill Sent 1,403.00 1,320.81 82.19 2005-04-14 0004-A 3,617 ROGERS, DONALD Bill Patient Collections No Bill Sent 1,387.00 1,193.00 194.00 2005-04-16 0002-A 3,684 SALAZAR, SECUNDO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-04-11 0027-A 3,557 SANDOVAL, KIM Bill Patient Collections No Bill Sent 1,294.00 1,216.21 77.79 2005-03-28 0038-A 3,040 SIDEBOTTOM, BERNI Bill Patient Collections No Bill Sent 1,695.00 1,660.00 35.00 2005-04-22 0006-A 3,873 SOTO, ALFREDO Bill Patient Collections No Bill Sent 1,352.00 0.00 1,352.00 1I RescueNet'"" . Printed on 9/22/2005 at 8:22:37AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-04-16 0025-A 3,708 TURCIOS-VELASQUE Bill Patient Collections No Bill Sent 1,253.00 0.00 1,253.00 2005-04-25 0005-A 3,955 WAITS, WILLIAM Bill Patient Collections No Bill Sent 1,439.00 1,360.42 78.58 2005-04-25 0001-A 3,951 WEEDMAN, DOLOR Bill Patient Collections No Bill Sent 1,346.00 20.00 1,326.00 2005-04-25 0009-A 3,959 WILLEY, SCOTT Bill Patient Collections No Bill Sent 1,422.00 1,137.60 284.40 2005-04-23 0003-A 3,897 WILSON, VERN Bill Patient Collections No Bill Sent 1,403.00 1,344.91 58.09 Trip count: 39 54,899.00 25,865.94 29,0 r.� Trip count: 39 54,899.00 25,865.94 29,033.06 i Total trip count: '' •7 ' �..}t �" '•?°;° `i 1`3,.' p .- .,...1 z-1 �.:.4 • RescueNetT" Printed on 9/22/2005 at 8.22.37AM Page 2 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,601 Batch date: 9/22/2005 7:48:50AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-01-26 0007-A 858 ASKELAND, TANNER Bill Patient Collections No Bill Sent 1,491.00 1,212.30 278.70 2005-03-07 0022-A 2,335 BISEL, RANDALL Bill Patient Collections No Bill Sent 1,471.00 0.00 1,471.00 2005-03-08 0022-A 2,371 BISEL, RANDALL Bill Patient Collections No Bill Sent 1,371.00 647.50 723.50 2005-03-17 0004-A 2,635 CLARKE, RANDALL VA- FORT HARRISOhCollections No Bill Sent 1,295.00 0.00 1,295.00 2005-02-23 0017-A 1,862 FRITZLER JR, FRED Bill Patient Collections No Bill Sent 1,421.00 1,364.02 56.98 2005-03-14 0008-A 2,562 GUTIERREZ, GERAL Bill Patient Collections No Bill Sent 1,464.00 0.00 1,464.00 2005-01-23 0009-A 772 LIMING, JAMES Bill Patient Collections No Bill Sent 1,386.00 958.80 427.20 2005-03-05 0022-A 2,259 MACRAE, LISA Bill Patient Collections No Bill Sent 1,481.00 0.00 1,481.00 2003-02-07 0012-A 226 'MCMILLEN, TARA Bill Patient Collections No Bill Sent 995.00 425.12 569.88 2005-03-17 0029-A 2,664 ORBECK, LINDA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-03-18 0002-A 2,681 ORBECK, LINDA Bill Patient Collections No Bill Sent 664.00 0.00 664.00 2005-01-24 0011-A 804 PADILLA, TONY Bill Patient Collections No Bill Sent 1,144.00 1,029.60 114.40 2005-01-24 0036-A 825 PADILLA, TONY Bill Patient Collections No Bill Sent 1,014.00 912.60 101.40 2004-05-15 0012-A 4,217 SNIDOW, RANDY Bill Patient Collections No Bill Sent 1,206.00 100.00 1,106.00 2004-11-07 0003-A 10,242 SNIDOW, RANDY Bill Patient Collections No Bill Sent 1,835.00 60.00 1,775.00 2004-11-26 0016-A 10,959 TEERAVESSASES, S Bill Patient Collections No Bill Sent 1,281.00 1,081.00 200.00 2005-02-09 0003-A 1,338 WILSON, CATLIN Bill Patient Collections No Bill Sent 1,294.00 998.77 295.23 2005-03-17 0010-A 2,641 WISROTH, CAROLE Bill Patient Collections No Bill Sent 1,648.00 1,556.69 91.31 Trip count: 18 23,755.00 10,346.40 13,408.60 Trip count: 18 23,755.00 10,346.40 13 40 Total trip count: v` lt ' ±t °R. . r �xi . a �at::-421 RescueNetTM Printed on 9/22/2005 at 7:50:54AM Page 1 \\nw l6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 9,845 Batch date: 10/12/2005 9:48:05AM Trip Date Job Run Name Current Payer Schedule Event Charges Credits Balance 2005-05-06 0034-A 4,406 ANDERSON, DOROT Bill Patient Collections No Bill Sent 1,352.00 1,275.08 76.92 2005-08-21 0019-A 8,283 APODACA, ANTHON Bill Patient Collections No Bill Sent 1,346.00 1,266.92 79.08 2005-04-09 0001-A 3,391 ARGUELLO, JOSEPH Bill Patient Collections No Bill Sent 1,161.00 811.00 350.00 2005-04-27 0007-A 4,029 ARIS, OLGA Bill Patient Collections No Bill Sent 1,531.00 1,461.00 70.00 2005-04-06 0004-A 3,286 BLAKE, JUDY Bill Patient Collections " No Bill Sent 1,420.00 578.69 841.31 2005-09-27 0014-A 9,716 CADENA, MAX Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-04-18 0016-A 3,756 CAVALIERE, FRANCI Bill Patient Collections No Bill Sent 1,515.00 1,441.16 73.84 2005-04-25 0035-A 4,149 CAVALIERE, FRANCI Bill Patient Collections No Bill Sent 1,365.00 1,286.94 78.06 2005-05-03 0013-A 4,247 CAVALIERE, FRANCI Bill Patient Collections No Bill Sent 1,515.00 1,419.01 95.99 2005-05-21 0029-A 4,904 CHARTIER, FRANK Bill Patient Collections No Bill Sent 1,410.00 0.00 1,410.00 2005-04-28 0012-A 4,065 CONNELLY, ALENA Bill Patient Collections No Bill Sent 1,508.00 1,433.00 75.00 2005-04-13 0008-A 3,602 DONEHOO, FRANCE Bill Patient Collections No Bill Sent 1,473.00 1,403.00 70.00 2005-09-11 0002-A 9,070 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-09-13 0002-A 9,143 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 1,403.00 0.00 1,403.00 2005-05-14 0013-A 4,655 GONZALES, LARRY Bill Patient Collections No Bill Sent 1,277.00 0.00 1,277.00 2005-05-14 0025-A 4,668 GONZALES, LARRY Bill Patient Collections No Bill Sent 1,600.00 0.00 1,600.00 2005-04-07 0018-A 3,335 HERRERA, NINA Bill Patient Collections No Bill Sent 1,569.00 0.00 1,569.00 2005-05-30 0020-A 5,244 LUCIO, JULIA Bill Patient Collections No Bill Sent 1,658.00 0.00 1,658.00 2005-05-02 0023-A 4,225 MARTIN, JOSHUA Bill Patient Collections No Bill Sent 1,328.00 1,247.99 80.01 2005-09-08 0010-A 8,987 MARTINEZ, ALBERT Bill Patient Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-06-05 0006-A 5,417 MIJARES, DAVANA Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-04-15 0034-A 3,682 NEVAREZ, CESAR Bill Patient Collections No Bill Sent 1,195.00 956.00 239.00 2005-04-08 0032-A 3,384 ORTON, RUTH Bill Patient Collections No Bill Sent 1,540.00 1,481.49 58.51 2005-05-28 0006-A 5,154 PECKINPAUGH, DON Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-06-04 0013-A 5,398 PEREZ, ANTONIO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-05-19 0003-A 4,815 PETERSON, MARK Bill Patient Collections No Bill Sent 1,607.00 0.00 1,607.00 2005-05-01 0013-A 4,189 PINKSTAFF, CLAREN Bill Patient Collections No Bill Sent 1,473.00 1,392.72 80.28 2005-09-15 0014-A 9,260 ROBERTS, JUSTIN Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-04-15 0020-A 3,668 ROWTON, CASSAND Bill Patient Collections No Bill Sent 1,423.00 1,224.00 199.00 2005-05-25 0018-A 5,034 SEPEDA, VICTOR Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-04-03 0005-A 3,198 SIMMONS, JAMES Bill Patient Collections No Bill Sent 1,591.00 1,272.80 318.20 2005-04-26 0024-A 4,021 STANLEY, SHARON Bill Patient Collections No Bill Sent 1,386.00 1,275.61 110.39 2005-05-03 0004-A 4,237 STEEL, JAMES Bill Patient Collections No Bill Sent 1,386.00 1,306.87 79.13 2005-09-15 0035-A 9,281 SWALLOW, LEO Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 RescueNetT"' Printed on 10/12/2005 at 9:49:05AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-09-16 0039-A 9,327 SWALLOW, LEO Bill Patient Collections No Bill Sent 1,178.00 0.00 1,178.00 2005-09-17 0024-A 9,351 SWALLOW, LEO Bill Patient Collections No Bill Sent 1,438.00 0.00 1,438.00 2005-09-18 0025-A 9,398 SWALLOW, LEO Bill Patient Collections No Bill Sent 1,288.00 0.00 1,288.00 2005-04-22 0008-A 3,875 TAPIA, ANADINE Bill Patient Collections No Bill Sent 1,314.00 0.00 1,314.00 2005-05-10 0019-A 4,532 TROSTEL, HOWARD Bill Patient Collections No Bill Sent 1,556.00 1,481.00 75.00 2005-09-12 0004-A 9,108 VISCAINO, REFUGIO Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 Trip count: 40 55,207.00 24,014.28 31,192.72 • Trip count: 40 55,207.00 24,014.28 31,192.72 Total trip count: -, .t " t ,�,. ,a.. $'tea 4'.t • RescueNetTM • Printed on 10/12/2005 at 9:49:05AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES • Batch 9,844 Batch date: 10/12/2005 9:23:40AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance • 2005-03-11 0032-A 2,486 ANSBACH, MONIQUE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2005-03-07 0033-A 2,347 ARCHAMBULT-STEV Bill Patient Collections No Bill Sent 1,420.00 1,278.00 142.00 2003-02-03 0050-A 8,504 FLOT, BRENT Bill Patient Collections No Bill Sent 965.00 335.00 630.00 2003-08-20 0029-A 6,414 FLOT, BRENT Bill Patient Collections No Bill Sent 1,371.00 315.00 1,056.00 2005-03-29 0019-A 3,058 GROEGER, PAUL Bill Patient Collections No Bill Sent 1,387.00 1,348.54 38.46 2005-04-01 0032-A 3,162 HERNANDEZ, LUCAS Bill Patient Collections No Bill Sent 1,379.00 1,304.00 75.00 2005-03-21 0007-A 2,759 HYNEY, ERIC Bill Patient Collections No Bill Sent 1,607.00 0.00 1,607.00 2005-02-04 0025-A 1,170 LEAR, HEIDI Bill Patient Collections No Bill Sent 1,547.00 821.50 725.50 2005-03-05 0013-A 2,248 LEON, TAMMY Bill Patient Collections No Bill Sent 1,277.00 777.00 500.00 2005-02-18 0026-A 1,701 MARTINEZ, CIRIA Bill Patient Collections No Bill Sent 1,516.00 1,454.38 61.62 2005-01-30 0008-A 1,017 NICHOLS, JESSIE Bill Patient Collections No Bill Sent 1,396.00 748.80 647.20 2005-03-14 0002-A 2,556 NORRIS, WILLIAM Bill Patient Collections No Bill Sent 2,414.00 2,305.71 108.29 2005-01-28 0025-A 956 PINON, MARK Bill Patient Collections No Bill Sent 2,311.00 150.00 2,161.00 2004-07-07 0007-A 6,047 PINON, OLIVIA Bill Patient Collections No Bill Sent 1,251.00 801.00 450.00 2005-03-09 0029-A 2,411 RING, BRADY Bill Patient Collections No Bill Sent 1,311.00 1,048.80 262.20 2004-03-19 0013-A 2,341 SCHERMANN, GILB Bill Patient Collections No Bill Sent 1,131.00 691.00 440.00 2004-11-19 0004-A 10,645 SMITH, CHRIS Bill Patient Collections No Bill Sent 1,281.00 850.00 431.00 2005-01-22 0015-A 750 TAYLOR, GARY Bill Patient Collections No Bill Sent 1,508.00 1,136.00 372.00 2005-02-04 0013-A 1,158 TAYLOR, PAMELA Bill Patient Collections No Bill Sent 1,369.00 784.80 584.20 2003-10-14 0008-A 8,216 WEIR, CAROLYN Bill Patient Collections No Bill Sent 1,206.00 56.00 1,150.00 2003-11-09 0020-A 9,143 WEIR, CAROLYN Bill Patient Collections No Bill Sent 1,071.00 39.00 1,032.00 2004-01-17 0004-A 458 WEIR, CAROLYN Bill Patient Collections No Bill Sent 1,176.00 50.02 1,125.98 2005-03-07 0032-A 2,346 WESTWOOD, COUR Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-03-23 0013-A 2,843 WOLFE, GORDON Bill Patient Collections No Bill Sent 2,310.00 1,884.00 426.00 Trip count: 24 34,659.00 18,178.55 16,480.45 Trip count: 24 34,659.00 18,178.55 16,480.45 Total trip count: t„4 iit .:' „r 4 ,U i1w .:4,„ n __ RescueNetTM Printed on 10/12/2005 at 9:25:35AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 10,068 Batch date: 10/26/2005 1:46:29PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-05-27 0005-A 5,122 ANDERSON, CHARL Bill Patient Collections No Bill Sent 1,352.00 1,275.08 76.92 2003-03-24 0012-A 1,741 AVERSANO, VICTOR Bill Patient Collections No Bill Sent 1,130.00 365.00 765.00 2005-03-19 0012-A 2,703 BEACH, GARY Bill Patient Collections No Bill Sent 1,549.00 1,239.20 309.80 2005-06-09 0025-A 5,565 CASTILLO, JANET Bill Patient Collections No Bill Sent 1,397.00 1,281.81 115.19 2005-06-12 0024-A 5,684 CHILDERS, ADAM Bill Patient Collections No Bill Sent 1,219.00 975.20 243.80 2005-03-10 0024-A 2,438 COLLIER, LIAH Bill Patient Collections No Bill Sent 1,345.00 190.42 1,154.58 2005-03-10 0039-A 2,453 COLLIER, LIAR Bill Patient Collections No Bill Sent 1,294.00 50.00 1,244.00 2005-06-06 0011-A 5,457 CONTRERAS, SERG Bill Patient Collections No Bill Sent 1,566.00 1,491.00 75.00 2005-04-09 0035-A 3,448 DUNCAN, DELMA Bill Patient Collections No Bill Sent 1,345.76 378.71 967.05 2005-03-31 0026-A 3,123 GURNSEY, YVETTE Bill Patient Collections No Bill Sent 1,144.00 915.20 228.80 2005-05-23 0012-A 4,963 HOJIO, LARRY Bill Patient Collections No Bill Sent 1,794.00 1,665.62 128.38 2005-06-11 0038-A 5,659 JOHNSON, BRUCE Bill Patient Collections No Bill Sent 1,439.00 0.00 1,439.00 2005-06-17 0038-A 5,837 KEAHEY, LAURA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-05-29 0037-A 5,223 LOZOYA, ARACELY Bill Patient Collections No Bill Sent 1,369.00 1,163.00 206.00 2005-06-11 0020-A 5,641 LUEVANO-LABRA, MP Bill Patient Collections No Bill Sent 1,396.00 1,333.72 62.28 2005-06-07 0008-A 5,484 MAEL, FRANCIS Bill Patient Collections No Bill Sent 970.00 0.00 970.00 2005-06-14 0004-A 5,718 MALM, SHANE Bill Patient Collections No Bill Sent 1,451.00 0.00 1,451.00 2005-06-12 0003-A 5,663 MENDEZ, LUIS Bill Patient Collections No Bill Sent 1,624.00 0.00 1,624.00 2005-05-23 0018-A 4,969 ORBECK, LINDA Bill Patient Collections No Bill Sent 1,254.00 632.75 621.25 2005-10-06 0022-A 10,087 ORDAZ, MARTIN Bill Patient: {—.1 Collections No Bill Sent 1,369.00 0.00 1,369.00 2005-05-20 0013-A . 4,857 PEREGOY, BEVERLY Bill Patient Collections No Bill Sent 1,421.00 1,363.14 57.86 2004-01-14 0001-A 383 RODRIGUEZ, WAYN Bill Patient Collections No Bill Sent 981.00 931.67 • 49.33 2005-05-16 0025-A 4,722 ROYBAL,TOMAS Bill Patient Collections No Bill Sent 1,404.00 1,259.68 144.32 2005-05-28 0028-A 5,177 SALAZAR, GILBERT Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-05-21 0036-A 4,911 STADE, DAVID Bill Patient Collections No Bill Sent 1,420.00 1,338.89 81.11 2005-04-09 0028-A 3,431 STARK, LAURA Bill Patient Collections No Bill Sent 1,474.00 10.00 1,464.00 2005-06-08 0006-A 5,508 TAFT, LORI Bill Patient Collections No Bill Sent 1,575.00 0.00 1,575.00 2005-06-18 0021-A 5,858 TREVINO, JESSICA Bill Patient Collections No Bill Sent 1,202.00 0.00 1,202.00 2005-05-26 0038-A 5,113 WARD, DEAN Bill Patient Collections No Bill Sent 1,641.00 1,545.27 95.73 2005-06-11 0015-A 5,636 WARD, DEAN Bill Patient Collections No Bill Sent 1,539.00 1,449.91 89.09 2005-04-24 0007-A 3,936 WEIMER, KAREN Bill Patient Collections No Bill Sent 1,338.00 0.00 1,338.OQ` 2005-06-09 0002-A 5,542 WHITLOCK, THOMAS Bill Patient Collections No Bill Sent 1,760.00 0.00 — 1,760.00 .' Trip count: 32 44,367.76 20,855.27 / 23,512.49 RescueNetTM Printed on 10/26/2005 at 1:47:44PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 10,268 Batch date: 11/15/2005 10:19:04AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-07 0008-A 6,048 CANO, LEO Bill Patient Collections No Bill Sent 1,176.00 826.00 350.00 2005-06-30 0011-A 6,263 CHIPPS, ROGER Bill Patient ' Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-06-06 0019-A 5,465 CIELOHA, ROBERT Bill Patient Collections No Bill Sent 1,346.00 1,291.09 54.91 2005-06-12 0008-A 5,668 CIELOHA, ROBERT Bill Patient Collections No Bill Sent 1,386.00 1,218.87 167.13 2005-07-11 0021-A 6,761 CLARKE, RANDALL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-06-15 0030-A 5,770 COLLINS, GLEN Bill Patient Collections No Bill Sent 1,220.00 976.00 244.00 2005-06-17 0020-A 5,817 DOWNING, LEE Bill Patient Collections No Bill Sent 1,263.00 840.00 423.00 2005-06-16 0026-A 5,797 FRITZLER, ELSIE Bill Patient Collections No Bill Sent 1,451.00 1,372.02 78.98 2005-07-09 0003-A 6,671 FRYSINGER, HAROL Bill Patient Collections No Bill Sent 1,721.00 1,639.90 81.10 2005-07-02 0007-A 6,329 GALLEGOS, GILBER Bill Patient Collections No Bill Sent 1,403.00 0.00 1,403.00 2005-10-16 0027-A 10,462 GANDARA, BONNIE Bill Patient t-- Collections No Bill Sent 1,484.00 0.00 1,484.00 2005-05-29 0030-A 5,216 HEBERLING, ROBER Bill Patient Collections No Bill Sent 1,509.00 1,290.98 218.02 2005-10-18 0009-A 10,510 HOLMBERG, LARS Bill Patient O. Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-01-04 0032-A 143 IZQUIERDO, RUBEN Bill Patient Collections No Bill Sent 1,287.00 350.00 937.00 2005-05-27 0009-A 5,126 KING, KYLAN Bill Patient Collections No Bill Sent 1,515.00 0.00 1,515.00 2005-05-12 0011-A 4,595 LOPEZ, CONSUELO Bill Patient Collections No Bill Sent 1,471.00 0.00 1,471.00 2005-01-04 0060-A 172 LOVIN, BENJAMIN Bill Patient Collections No Bill Sent 2,028.00 600.00 1,428.00 2005-05-28 0037-A 5,186 LUNSFORD, LESLIE Bill Patient Collections No Bill Sent 1,328.00 781.70 546.30 2005-05-29 0007-A 5,193 LUNSFORD, LESLIE Bill Patient Collections No Bill Sent 1,218.00 1,026.00 192.00 2005-07-07 0032-A 6,604 MCCLURE, WILLIAM Bill Patient Collections No Bill Sent 1,413.00 0.00 1,413.00 2005-05-18 0025-A 4,788 MCCUE, GEORGE Bill Patient Collections No Bill Sent 1,474.00 1,369.00 105.00 2005-05-31 0009-A 5,261 MEDINA, MARIA Bill Patient Collections No Bill Sent 1,277.00 1,202.00 75.00 2005-06-02 0009-A 5,318 MERACLE, JIMMY Bill Patient Collections No Bill Sent 1,590.00 0.00 1,590.00 2005-06-02 0003-A 5,312 MEZA, ELIBERTO Bill Patient Collections No Bill Sent 1,561.00 1,446.79 114.21 2005-02-16 0015-A 1,615 NICKS, HAROLD Bill Patient Collections No Bill Sent 1,455.00 1,373.66 81.34 2005-06-10 0012-A 5,595 NICKS, HAROLD Bill Patient Collections No Bill Sent 1,455.00 1,372.65 82.35 2004-12-15 0019-A 11,586 PEREZ, ANGELA Bill Patient Collections No Bill Sent 1,101.00 400.00 701.00 2005-05-23 0025-A 4,976 PETERSON, RICKE Bill Patient Collections No Bill Sent 1,755.00 1,730.75 24.25 2005-01-05 0027-A 201 RASMUSSEN, AMAN Bill Patient Collections No Bill Sent 1,540.00 265.00 1,275.00 2005-06-08 0009-A 5,511 RODRIQUEZ, LUCY Bill Patient Collections No Bill Sent 1,311.00 1,241.59 69.41 2005-06-15 0004,A 5,743 ROECKER, KAREN Bill Patient Collections No Bill Sent 1,566.00 1,270.00 296.00 2005-01-15 0015-A 512 ROLDON-BLANCO, J Bill Patient Collections No Bill Sent 1,422.00 1,212.60 209.40 2005-09-19 0029-A 9,439 SANDOVAL, EUSEBI Bill Patient Collections No Bill Sent 1,144.00 0.00 1,144.00 2005-04-24 0003-A 3,932 SANDOVAL,VICTOR Bill Patient Collections No Bill Sent 1,386.00 1,218.87 167.13 RescueNetm Printed on 11/15/2005 at 10:20:54AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2005-06-08 0027-A 5,531 SCHAFER, STEVE Bill Patient Collections No Bill Sent 1,439.00 1,360.98 78.02 2005-05-30 0011-A 5,235 SCHELLER, MARIET Bill PatienttttU" Collections No Bill Sent 1,585.00 1,445.00 140.00 2005-05-21 0017-A 4,891 SECREST, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-06-09 0033-A 5,573 SIGG, KATHLEEN Bill Patient Collections No Bill Sent 1,406.00 0.00 1,406.00 2005-06-12 0011-A 5,671 SLAWSKI, MARK Bill Patient Collections No Bill Sent 1,607.00 1,282.00 325.00 2005-06-02 0011-A 5,320 STARKS, RANDY Bill Patient 0, Collections No Bill Sent 1,569.00 880.20 688.80 2004-01-02 0003-A 33 THARP, JEFFREY "-.) Bill Patient c)-l* Collections No Bill Sent 1,161.00 375.00 786.00 2004-07-11 0019-A 6,185 THARP, JEFFREY Bill Patient Collections No Bill Sent 1,221.00 225.00 996.00 2005-03-02 0033-A 2,141 THARP, JEFFREY` Bill Patient Collections No Bill Sent 963.00 100.00 863.00 2005-07-30 0012-A 7,438 WAITS, WILLIAM Bill Patient Collections No Bill Sent 1,369.00 1,290.98 78.02 2005-06-03 0014-A 5,361 WISROTH, CAROLE Bill Patient Collections No Bill Sent 1,869.00 1,774.25 94.75 Trip count: 45 61,033.00 35,048.88 25,984.12 • Trip count: 45 61,033.00 35,048.88 25,98442-7: • Total trip count: is e. aw k . 'gaap.,pa't.. s35,f, '.,: 5,9 RescueNetm Printed on 11/15/2005 at 10:20:54AM Page 2 \\nw16\rescuenet\reports32\BillingA Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 10,412 Batch date: 11/29/2005 11:21:36AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2005-06-13 0021-A 5,706 ANDERSON, DOROT Bill Patient Collections No Bill Sent 2,299.00 2,190.42 108.58 2005-06-20 0009-A 5,920 ATTWOOLL, DEBRA Bill Patient Collections No Bill Sent 1,456.00 715.20 740.80 2005-07-19 0013-A 7,013 BERNAL, LARRY Bill Patient Collections No Bill Sent 1,294.00 0.00 1,294.00 2005-07-27 0016-A • 7,332 BOARDMAN, BENJA Bill Patient Collections No Bill Sent 1,515.00 0.00 1,515.00 2005-04-15 0008-A 3,656 BRAMBLETT, WAYN Bill Patient Collections No Bill Sent 1,185.00 1,041.00 144,00 2004-11-03 0037-A 10,464 CERVANTES, MICHA Bill Patient Collections No Bill Sent 1,191.00 190.00 1,001.00 2005-03-12 0021-A 2,512 CHISM, ELMER Bill Patient Collections No Bill Sent 1,509.00 1,439.00 70.00 2005-11-02 0012-A 11,034 COATNEY, FRED Bill Patienttrf:. Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-05-06 0016-A 4,388 GRIDDLE, NICOLE Bill Patient Collections No Bill Sent 1,311.00 1,048.80 262.20 2005-06-28 0022-A 6,231 CROMWELL, CHAR Bill Patient Collections No Bill Sent 1,601.00 1,449.93 151.07 2005-04-14 0020-A 3,633 DALLOW, BARBARA Bill Patient Collections No Bill Sent 1,743.00 867.50 875.50 2005-05-20 0007-A 4,851 DANIELS, CONNIE Bill Patient Collections No Bill Sent 1,488.00 1,429.48 58.52 2005-05-21 0014-A 4,888 EMANUEL, KRISTIN Bill Patient Collections No Bill Sent 1,195.00 0.00 1,195.00 2005-04-03 0020-A 3,213 GOHIER, JEANNE Bill Patient Collections No Bill Sent 1,474.00 1,425.98 48.02 2005-05-25 0031-A 5,047 HAAS, LARRY Bill Patient Collections No Bill Sent 1,881.00 1,806.00 ' 75.00 2005-05-23 0028-A 4,979 HAYES, SABRINA Bill Patient Collections No Bill Sent 1,415.00 0.00 1,415.00 2005-03-22 0034-A 2,828 HEBERLING, RICHA Bill Patient Collections No Bill Sent 1,404.00 1,365.98 38.02 2005-06-19 0003-A 5,886 HORNER, SUE Bill Patient Collections No Bill Sent 1,444.00 0.00 1,444.00 2005-02-24 0009-A 1,863 JANDA, BARBARA Bill Patient Collections No Bill Sent 1,474.00 1,290.98 183.02 2005-06-29 0015-A 6,215 KING JR;DONALD Bill Patient Collections No Bill Sent 1,254.00 0.00 1,254.00 2005-07-19 0028-A 7,033 KOCH, PAUL Bill Patient Collections No Bill Sent 1,447.00 0.00 1,447.00 2005-06-21 0003-A 5,919 LOGAN, JENNIFFER Bill Patient Collections No Bill Sent 1,346.00 1,121.80 224.20 2004-09-18 0046-A 8,548 LOZANO, SALVADOR Bill Patient Collections No Bill Sent 1,191.00 300.00 891.00 2005-05-11 0002-A 4,539 LUJAN, DAVID Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2005-06-14 0004-A 5,718 MALM, SHANE Bill Patient Collections No Bill Sent 1,451.00 0.00 1,451.00 2005-07-16 0034-A 6,929 MANNING, ARON Bill Patient Collections No Bill Sent 1,539.00 0.00 1,539.00 2005-11-04 0003-A• 11,109 MCCORKLE, DENNIS Bill Patient 6Au(a.) Collections No Bill Sent 1,510.00 0.00 1,510.00 2005-07-15 0011-A 6,884 ORTEGA, PHILLIP Bill Patient Collections No Bill Sent 1,512.00 0.00 1,512.00 2005-06-27 0041-A 6,181 PETERON, ROBERT Bill Patient Collections No Bill Sent 1,624.00 1,463.52 160.48 2005-07-09 0010-A 6,678 PRESTON, SHAWN Bill Patient Collections No Bill Sent 1,328.00 0.00 1,328.00 2005-06-12 0022-A 5,682 ROBERTSON, TRACI Bill Patient Collections No Bill Sent 1,219.00 0.00 1,219.00 2005-11-07 0007-A 11,209 ROSS, JARED Bill Patient peR. Collections No Bill Sent 1,271.00 0.00 1,271.00 2004-12-07 0037-A 11,345 SAINZ, JOEL Bill Patient Collections No Bill Sent 1,026.00 450.00 576.00 2005-07-07 0035-A 6,609 SAMORA, MARY Bill Patient Collections No Bill Sent 1,489.00 0.00 1,489.00 RescueNet^^ Printed on 11/29/2005 at 11:23:59AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt • WELD COUNTY PARAMEDIC SERVICES 2005-06-23 0013-A 6,023 SANDOVAL, LAURA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2005-03-18 0034-A 2,775 SCHLAGER, WILLIAM Bill Patient Collections No Bill Sent 1,750.00 1,374.39 375.61 2005-07-18 0001-A 6,959 SHADDEN, COURTN Bill Patient Collections No Bill Sent 1,556.00 0.00 1,556.00 2005-04-28 0031-A 4,107 SHARP, RUDOLPH Bill Patient '"LL. Collections No Bill Sent 1,180.00 1,140.06 39.94 2005-07-15 0006-A 6,879 SIDEBOTTOM, BERNI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2005-07-23 0049-A 7,237 SITTINGDOWN, DORI Bill Patient Collections No Bill Sent 1,556.00 0.00 1,556.00 2005-11-09 0036-A 11,327 SWALLOW, LEO Bill Patientlni Collections No Bill Sent 1,236.00 0.00 1,236.00 2005-05-05 0009-A 4,340 TAYLOR, SARAH Bill Patient Collections No Bill Sent 150.00 20.00 130.00 2005-06-29 0001-A i 6,188 WARD, DEAN Bill Patient Collections No Bill Sent 1,798.00 1,664.07 133.93 2005-03-14 0019-A 2,579 ZAMORA, JEREMY Bill Patient Collections No Bill Sent 1,311.00 1,048.80 262.20 2005-03-14 0036-A 2,603 ZAMORA, JEREMY Bill Patient Collections No Bill Sent 1,456.00 0.00 1,456.00 Trip count: 45 62,312.00 24,842.91 . 37,469.09 Trip count: 45 62,312.00 24,842.91 3j,,46970Thk r Total trip count: ;,v,`.xsossi ala +' a `+ a ¢1' is1 o/37,4f4,Q9 RescueNettM Printed on 11/29/2005 at 11:23:59AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Hello