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Home My WebLink About20043606.tiff RESOLUTION RE: CANCELLATION OF 2004 OUTSTANDING ACCOUNTS RECEIVABLE FOR THE WELD COUNTY PARAMEDIC SERVICES WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, a list of 2004 Paramedic Services accounts has been submitted to the Accounting Department of Weld County, Colorado, and WHEREAS, said accounts have been deemed uncollectible in accordance with guidelines adopted by the City of Greeley and County of Weld, a copy of said list being attached hereto and incorporated herein by reference, and WHEREAS, the Accounting Department has recommended the cancellation of said list of uncollectible debts due and owing the Weld County Paramedic Services in the amount of $2,054,678.39. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the aforementioned list of 2004 uncollectible accounts in the amount of$2,054,678.39 be, and hereby is, approved for cancellation. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 29th day of December, A.D., 2004. BOARD OF COUNTY COMMISSIONERS Iisah% W D COUNTY, COLORADO (, t'. Robert D. Masden, Chairman 1861 �;• ' : agal erk to the Board IijI . EXCUSED ♦ l ' / William H. ke, Pro-Tem stninirei,i2,07 ,de( Deputy Cler o the Board M. J. �J D AS TO David . Long ounty Atto y lenn Vaa Date of signature: O-C 2004-3606 AM0001 �� ;4714,7/ 4-c o f 1 Os- MEMORANDUM TO: Barb Eurich, Accounting DATE:December 10, 2004 FROM: Kathy Baxley, Paramedic Services SUBJECT: Accounts Written Off in 2004 Attached are the lists of accounts written off in 2004 . Listed below are the amounts each month for a total of $2, 054, 678 .39 . 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 $270, 820 .29 February $184, 369 .26 March $139, 171. 17 April $120, 739 .71 May $192, 327 . 16 June $141, 463 .77 July $210, 682 .30 August $189, 508 .73 September $154, 958 .16 October $217, 639 .26 November $85, 039 . 05 December $147, 959 . 53 Total $2, 054, 678 .39 During the year there were accounts that were sent to collection that amounted to $14, 976 .62 that were accounts for the old accounts receivable system. This amount is reflected in the amount $2, 054 . 678 .39 . 2004-3606 Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,726 Batch date: 1/6/2004 4:00:03PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-02-23 0021-A 691 CRISWELL, SHANNOI Bill Patient Collections No Bill Sent 1,145.00 0.00 1,145.00 2003-02-14 0008-A 417 MILLER, ERIN Bill Patient Collections No Bill Sent 1,280.00 22.00 1,258.00 2003-02-19 0024-A 582 MILLER, ERIN Bill Patient Collections No Bill Sent 1,055.00 27.00 1,028.00 2003-02-19 0030-A 598 POINTER, DONNA Bill Patient Collections No Bill Sent 1,220.00 1,125.98 94.02 2003-02-21 0014-A 632 RHEES, JOSEPH Bill Patient Collections No Bill Sent 1,340.00 1,078.87 261.13 2003-02-16 0019-A 492 SANCHEZ, MARK Bill Patient Collections No Bill Sent 1,055.00 0.00 1,055.00 2003-02-23 0023-A 693 SHERIN, JERAMY Bill Patient Collections No Bill Sent 1,235.00 1,185.00 50.00 Trip count: 7 8,330.00 3,438.85 4,891.15 Trip count: 7 8,330.00 3,438.85 4 .15,u_ Total trip count: 7 I 8,330.00 I 3,438.85 I 4,891.15 ' RescueNetTM Printed on 1/6/2004 at 4:00:21PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,731 Batch date: 1/7/2004 3:10:02PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-04-03 0009-A 1,958 ARMENDARIZ, BRENE Bill Patient Collections No Bill Sent 1,100.00 0.00 1,100.00 2003-03-14 0014-A 1,366 DAWSON, JOSEPH Bill Patient Collections No Bill Sent 1,055.00 1,030.00 25.00 2003-02-03 0068-A 8,524 EDWARDS, MATTHEV Bill Patient p id-I'lt) Collections No Bill Sent 825.00 0.00 825.00 2003-03-19 0001-A 1,514 GALINDO, LEE Bill Patient Collections No Bill Sent 1,130.00 1,049.09 80.91 2003-04-22 0018-A 2,542 GONZALEZ, ANITA Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-02-01 0062-A 8,033 MARTINEZ, SELIA Bill Patient ta'l'l&uI°Z Collections No Bill Sent 930.00 0.00 930.00 2003-03-11 0002-A 1,259 MERINO-DOMINGUE2Bill Patient %\`P Collections No Bill Sent 995.00 75.00 920.00 2003-02-01 0055-A 8,003 MORRIS, MARYNA Bill vt, - ff Collections No Bill Sent 218.56 0.00 218.56 2003-02-01 0054-A 8,002 PIPER, DONNA Bill Patienti)r5 "late- Collections No Bill Sent 450.00 0.00 450.00 2003-03-10 0010-A 1,239 RAMIREZ, CRISTAL Bill Patient Collections No Bill Sent 1,205.00 1,092.00 113.00 2003-03-10 0006-A 1,212 SAULIS, GREGORY Bill Patient Collections No Bill Sent 1,055.00 0.00 1,055.00 W 2003-02-02 0089-A 8,283 SLAVENSKI, ELSIE Bill Patient ' '�a"HO&Collections No Bill Sent 33.63 0.00 33.63 2003-02-02 0063-A 8,257 STEKETEE, JERRY Bill Patient 005 ,i1Ia1od,Collections No Bill Sent 850.00 0.00 850.00 2003-04-30 0021-A 2,829 SUBLETTE, TERESA Bill Patient Collections No Bill Sent 1,370.00 584.80 785.20 2003-04-23 0034-A 2,607 TATE, MICHELLE Bill Patient Collections No Bill Sent 1,220.00 0.00 1,220.00 2003-04-20 0001-A 2,508 TIEDGEN, WANDA Bill Patient Collections No Bill Sent 150.00 50.00 100.00 Trip count: 16 13,567.19 3,880.89 9,686.30 Trip count: 16 13,567.19 3,880.89 9,686.30 Total trip count: 16 I 13,567.19 I 3,880.89 I 9,686.30 I RescueNetTM Printed on 1/7/2004 at 3:10:31PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,733 Batch date: 1/7/2004 3:28:13PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-06-14 0017-A 4,213 BOLANOS, RUBEN Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-06-09 0031-A 4,067 CHAIREZ, ANA Bill Patient Collections No Bill Sent 1,145.00 0.00 1,145.00 2003-06-12 0001-A 4,080 CONANT, LISA Bill Patient Collections No Bill Sent 900.00 0.00 900.00 2003-06-06 0004-A 3,949 FERNANDEZ, KASON Bill Patient Collections No Bill Sent 1,100.00 0.00 1,100.00 2003-06-06 0019-A 3,969 GIBSON, CINDY Bill Patient Collections No Bill Sent 1,115.00 0.00 1,115.00 2003-06-07 0025-A 3,999 GROSS, ALVIN Bill Patient Collections No Bill Sent 1,055.00 0.00 1,055.00 2003-05-27 0030-A 3,700 HARCUS, SARAH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-05-04 0008-A 2,901 KASPAR, SHERRI Bill Patient Collections No Bill Sent 450.00 0.00 450.00 2003-05-02 0004-A 2,844 KASPAR, SHERRI Bill Patient Collections No Bill Sent 920.00 0.00 920.00 2003-05-27 0009-A 3,671 KASPAR, SHERRI Bill Patient Collections No Bill Sent 870.00 0.00 870.00 2003-06-06 0020-A 3,970 LOBATO, ALONZO Bill Patient Collections No Bill Sent 545.00 495.00 50.00 2003-05-13 0006-A 3,200 ORTEGA, MARIA Bill Patient Collections No Bill Sent 1,475.00 290.00 1,185.00 2003-06-14 0027-A 4,223 ROMERO, JUAN Bill Patient Collections No Bill Sent 965.00 0.00 965.00 2003-06-14 0031-A 4,227 ROMERO, LUIS Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-05-15 0008-A 3,283 SHAFER, MAXINE Bill Patient Collections No Bill Sent 510.00 456.88 53.12 2003-05-01 0023-A 2,887 SUBLETTE, TERESA Bill Patient Collections No Bill Sent 1,275.00 883.20 391.80 2003-05-13 0022-A 3,228 TERRIERE, JOSH Bill Patient Collections No Bill Sent 960.00 0.00 960.00 Trip count: 17 15,395.00 2,125.08 13,269.92 Trip count: 17 15,395.00 2,125.08 13,269.92 Total trip count: 17 ' 15,395.00 ' 2,125.08 ( 13,269.92 il RescueNetT"" Printed on 1/7/2004 at 3:28:42PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,734 Batch date: 1/7/2004 3:43:07PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-06-27 0003-A 4,617 BECK, LILIA Bill Patient Collections No Bill Sent 1,070.00 0.00 1,070.00 2003-07-14 0017-A 5,228 ELLIOTT, CHARLES Bill Patient Collections No Bill Sent 1,236.00 70.00 1,166.00 2003-06-20 0025-A 4,412 EWING, WALLACE Bill Patient Collections No Bill Sent 1,010.00 935.00 75.00 2003-07-03 0021-A 4,846 FLYNN, GEORGE Bill Patient Collections No Bill Sent 633.00 0.00 633.00 2003-07-12 0005-A 5,142 GOETZ, CAROL Bill Patient Collections No Bill Sent 1,341.00 289.00 1,052.00 2003-06-28 0030-A 4,708 GUZMAN, LORENE Bill Patient Collections No Bill Sent 1,325.00 1,060.00 265.00 2003-07-06 0025-A 4,966 HACKETT, STEPHANI Bill Patient Collections No Bill Sent 1,071.00 25.00 1,046.00 2003-06-29 0006-A 4,667 HANDT, DEBRA Bill Patient Collections No Bill Sent 935.00 0.00 935.00 2003-06-26 0012-A 4,607 HAPPEL, LESLIE Bill Patient Collections No Bill Sent 1,160.00 0.00 1,160.00 2003-07-12 0009-A 5,151 HARRIS, BRIAN Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-07-10 0022-A 5,117 JENNEY, HOWARD Bill Patient Collections No Bill Sent 1,446.00 1,367.69 78.31 2003-06-29 0019-A 4,703 LEACH, RACHEL Bill Patient Collections No Bill Sent 1,160.00 864.00 296.00 2003-06-30 0042-A 4,778 MCNEECE, MICHELLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-06-24 0028-A 4,568 MEDINA, GENEVA Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-07-03 0037-A 4,867 MEDINA, GENEVA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-07-05 0003-A 4,872 MONTES, ERIKA Bill Patient Collections No Bill Sent 1,221.00 1,071.00 150.00 2003-07-07 0025-A 5,026 MORGAN, BRIDGETT Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-07-08 0002-A 4,982 MYERS, MYRA Bill Patient Collections No Bill Sent 1,191.00 1,118.49 72.51 2003-06-30 0028-A 4,752 PADILLA, PLACIDA Bill Patient Collections No Bill Sent 1,010.00 943.01 66.99 2003-06-28 0003-A 4,658 PADILLA, PLACIDA Bill Patient Collections No Bill Sent 1,055.00 992.09 62.91 2003-06-25 0014-A 4,592 REINI, MARTHA Bill Patient Collections No Bill Sent 855.00 0.00 855.00 2003-07-03 0019-A 4,843 RIOS, ERNESTO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-06-26 0020-A 4,615 SCHAEFFER, DOROT Bill Patient Collections No Bill Sent 1,025.00 953.24 71.76 2003-06-25 0001-A 4,579 SIMMONS, MARTIN Bill Patient Collections No Bill Sent 1,055.00 75.00 980.00 2003-06-24 0005-A 4,532 SMITH, PAUL Bill Patient Collections No Bill Sent 1,265.00 1,239.66 25.34 Trip count: 25 27,303.00 11,003.18 16,299.82 Trip count: 25 27,303.00 11,003.18 16,299.82 Total trip count: 25 I 27,303.00 I 11,003.18 16,299.82 RescueNetTM Printed on 1/7/2004 at 3:43:52PM Page 1 \\nw16\rescuenet1reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,735 Batch date: 1/7/2004 4:01:39PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-07-25 0041-A 5,588 ALARCON, JERAMY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-07-25 0002-A 5,537 BECERRA, ELLIOT Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-07-25 0003-A 5,538 CERIDON, MONIKA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-07-23 0022-A 5,506 CHRISTIANSEN, SARI Bill Patient Collections No Bill Sent 693.00 0.00 693.00 2003-07-26 0017-A 5,603 ESPINOZA, ROGELIO Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-07-25 0043-A 5,590 FARNSWORTH, ERIK Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-07-23 0001-A 5,479 GARZA, ROY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-07-26 0019-A 5,607 GONZOLES, JAYDA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-25 0017-A 5,553 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,132.58 73.42 2003-07-24 0024-A 5,525 HOYT, SCOTT Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-07-17 0014-A 5,338 JASSO, JOE Bill Patient Collections No Bill Sent 1,191.00 1,118.49 72.51 2003-07-21 0006-A 5,433 JUAREZ, CESER Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-07-20 0030-A 5,436 KING, JOSEPH Bill Patient Collections No Bill Sent 1,491.00 1,396.51 94.49 2003-07-25 0032-A 5,568 KOWATSCH, FRED Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-21 0002-A 5,421 MORRISON, DEBORA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-07-25 0001-A 5,536 PRADO, JESUS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-07-23 0017-A 5,496 ROBLEDO, LILY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-26 0035-A 5,624 RODRIQUEZ, FLOREt Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-07-26 0003-A 5,572 SEPEDA, BELGRABE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-07-26 0015-A 5,600 SMALL, CINDY Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-07-25 0034-A 5,574 SOTO, SERGIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-22 0016-A 5,473 WASWICK, CARA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 Trip count: 22 21,090.00 3,647.58 17,442.42 Trip count: 22 21,090.00 3,647.58 17,442. Total trip count: 22 I 21,090.00 I 3,647.58 I 17, 42.42 RescueNetTM Printed on 1/7/2004 at 4:02:19PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report I WELD COUNTY PARAMEDIC SERVICES Batch 2,772 Batch date: 1/14/2004 8:03:46AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-05-30 0019-A 3,767 ARIZMENDI, DESIREE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-05 0030-A 4,912 BENAVIDEZ, BENNY Bill Patient Collections No Bill Sent 1,191.00 1,130.84 60.16 2003-05-25 0001-A 3,590 GARZA, DAWN Bill Patient Collections No Bill Sent 1,355.00 1,330.00 25.00 2003-07-27 0012-A 5,626 GILL, VICTOR Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-02-02 0006-A 17 GOMEZ, RAMON Bill Patient Collections No Bill Sent 1,340.00 250.00 1,090.00 2003-07-02 0024-A 4,819 HIGGINS, SHANNON Bill Patient Collections No Bill Sent 1,401.00 40.00 1,361.00 2003-07-10 0020-A 5,114 HILL, DIXIE Bill Patient Collections No Bill Sent 1,221.00 1,146.68 74.32 2003-07-27 0006-A 5,599 LEON, ALMA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-07-27 0004-A 5,596 LEON, ANDRES Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-04-25 0007-A 2,622 LEWIS, CLAUDE M Bill Patient,?- .•.- Collections No Bill Sent 995.00 120.00 875.00 2003-02-01 0056-A 8,027 LEWIS, CLAUDE 0r'f Bill Patient</..._,>-:, Collections No Bill Sent 445.00 20.00 425.00 2003-05-04 0007-A 2,900 MENDOZA, MONICA Bill Patient Collections No Bill Sent 995.00 0.00 995.00 2003-07-27 0003-A 5,594 REFFEL, JUSTON Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-04-14 0006-A 2,330 RODRIGUEZ, JOE Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-07-27 0005-A 5,597 SANCHEZ, ADRIAN •Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-06-05 0019-A 3,933 STEIN, JAMIE Bill Patient Collections No Bill Sent 980.00 25.00 955.00 2003-06-25 0005-A 4,583 UHRICH, JENNIFER Bill Patient Collections No Bill Sent 1,115.00 0.00 1,115.00 2003-06-24 0009-A 4,540 UHRICH, JENNIFER Bill Patient Collections No Bill Sent 1,160.00 0.00 1,160.00 2003-07-14 0024-A 5,237 VALLADARES, HERLIIBill Patient Collections No Bill Sent 1,131.00 30.00 1,101.00 2003-07-07 0016-A 5,017 WILLIAMS, SHIRLEY Bill Patient Collections No Bill Sent 1,236.00 1,186.00 50.00 Trip count: 20 21,395.00 5,278.52 16,116.48 Trip count: 20 21,395.00 5,278.52 16,116.48 Total trip count: 20 I 21,395.00 ' 5,278.52 I 6,116.48 ' / _/ RescueNetTM Printed on 1/14/2004 at 8:04:56AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,774 Batch date: 1/14/2004 8:27:22AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-07-31 0039-A 5,821 ARELLANO-GONZALE Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-08-03 0014-A 5,865 CASTILLO, JUSTINO Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-08-04 0003-A 5,869 CERDA, FREDDIE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-08-05 0006-A 5,904 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,326.00 1,301.00 25.00 2003-07-29 0012-A 5,686 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,356.00 1,331.00 25.00 2003-07-28 0022-A 5,671 COVARRUVIAS, ADRI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-07-28 0017-A 5,666 DELANEY, LURA Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2003-08-02 0002-A 5,815 DESTIGLER, THANE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-31 0011-A 5,750 EITEL, JOEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-31 0040-A 5,822 GARCIA, GUSTAVO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-08-04 0012-A 5,879 GUEVARA, RUBEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-04 0013-A 5,880 HOFFMAN, LORI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-05 0004-A 5,902 LOYA, BERNARDA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-30 0030-A 5,820 LUERSEN, STEPHEN Bill Patient Collections No Bill Sent 1,221.00 1,196.00 25.00 2003-08-04 0025-A 5,893 LUJAN, ERNANI Bill Patient Collections No Bill Sent 150.00 50.00 100.00 2003-08-01 0031-A 5,813 MILLER, JESSICA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-08-02 0021-A 5,839 MORALES, ROBERT Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-05 0022-A 5,937 PHAE, MORGAN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-07-30 0018-A 5,728 POOLE, DEBORAH Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-08-01 0005-A 5,783 ROBAR, KEVIN Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-08-01 0023-A 5,805 ROJAS, JOSEPH Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-07-31 0020-A 5,759 SELDERS, SCOTT Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-08-04 •0019-A 5,886 ZONZO,VITO Bill Patient Collections No Bill Sent 1,206.00 924.80 281.20 Trip count: 23 21,717.00 4,802.80 16,914.20 Trip count: 23 21,717.00 4,802.80 16,914.20 Total trip count: 23 1 21,717.00 I 4,802.80 016'914.2" RescueNetTM Printed on 1/14/2004 at 8:28:11AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,775 Batch date: 1/14/2004 8:53:53AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-08-11 0023-A 6,126 BRICENO, ANDREA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-08-11 0012-A 6,099 DE HOYOS, ROSLYNI Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-08-10 0009-A 6,069 DIAZ,ANGEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-06 0018-A 5,938 GALVIN, ANAISE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-08-06 0012-A 5,927 GONZALEZ, DANNY Bill Patient f\vC-- Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-06 0010-A 5,920 HERNANDEZ, RAYML Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-08-08 0011-A 6,006 HYNES, JOE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-08-12 0024-A 6,145 KAMAKELE, DAVID Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-08-08 0020-A 6,015 KINDSFATHER, JOSH Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-08-11 0015-A 6,106 KOPCIK, JULIE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-08-06 0029-A 5,953 MARIN, RAYMOND Bill Patient Collections No Bill Sent 1,626.00 1,549.05 76.95 2003-08-09 0022-A 6,044 MARTINEZ, JESSE F Bill Patient Collections No Bill Sent 1,191.00 0.00 1.191.00 2003-08-13 0029-A 6,184 MARTINEZ, JESSE c Bill Patient h' - Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-07 0001-A 5,956 MARTINEZ, NATHAN Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-08-09 0032-A 6,054 MAY, REGINA Bill Patient Collections No Bill Sent 1,521.00 0.00 1,521.00 2003-08-08 0007-A 6,002 MONTOYA, ELOY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-06 0017-A 5,935 MUNOZ, FRANCISCO Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-08-06 0015-A 5,932 MUNOZ-SOTO, MANUBill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-08-09 0008-A 6,030 PACKWOOD, DANA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-08-06 0016-A 5,934 PEREIDA, IVAN Bill Patient rp,,,A, Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-08-10 0031-A 6,107 RAMOS, MELISSA Bill Patient h`•f;._ Collections No Bill Sent 150.00 0.00 150.00 2003-08-10 0008-A 6,068 RANGEL, BEATRIZ Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-08-11 ..0011-A 6,098 ROMERO, DEBRA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-12 0033-A 6,154 SOLIS, DANIEL Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-08-07 0021-A 5,976 VIGIL, MAGGIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 25 28,158.00 1,549.05 26,608.95 Trip count: 25 28,158.00 1,549.05 26, Total trip count: 25 I 28,158.00 I 1,549.05 26,608.95 RescueNetTm Printed on 1/14/2004 at 8:54:37AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,776 Batch date: 1/14/2004 9:27:13AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-08-16 0016-A 6,275 BRAND, AMANDA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-15 0020-A 6,247 BREMKAMP, ALLY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-14 0020-A 6,209 BURT, BRIAN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-08-19 0003-A 6,332 CASE, CHAD Bill Patient j Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-08-16 0022-A 6,285 COLLINS, JOHN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-08-17 0007-A 6,300 DELGADILLO, SUSAN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-08-20 0018-A 6,403 DILKA, LANNY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-21 0013-A 6,430 ENCINIA, PAULINE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-08-21 0036-A 6,453 EWING,WAYNE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-08-20 0014-A 6,399 FRITZLER, CHANDRA Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2003-08-21 0043-A 6,460 GENTRY, GARY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-08-21 0014-A 6,431 GUTIERREZ,ASHELY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-16 0018-A 6,281 HERNANDEZ, VICTOF Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-08-14 0002-A 6,191 HERRERA, ENRIQUE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-08-21 0012-A 6,429 HUERTA, MANUELA Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-08-16 0001-A 6,260 KNIGHT, BRUCE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-21 0001-A 6,418 MINER, ROBYN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-16 0030-A 6,293 MORGAN, CAROL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-21 0017-A 6,434 MUNOZ-SOTO, MANU Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-16 0019-A 6,282 PADILLA, CLAUDIA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-08-14 0035-A 6,224 PEREZ,ASHLEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-14 0036-A 6,225 RODRIGUEZ, AMY Bill Patient ,-( Collections No Bill Sent 1,706.00 0.00 1,706.00 2003-08-19 0005-A 6,336 SMALL, CINDY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-19 0025-A 6,383 SWINDLE, KATIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-18 0001-A 6,302 WALKER, DOROTHY Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-08-21 0029-A 6,446 YANES, AMADO Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-08-21 0028-A 6,445 YANES, TONY Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 Trip count: 27 28,148.00 0.00 28,148.00 Trip count: 27 28,148.00 0.00 28,148.00 "mss, Total trip count: 27 I 28,148.00 I, 0.00 1(28,148.O RescueNetTM Printed on 1/14/2004 at 9:28:56AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt j Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,777 Batch date: 1/14/2004 9:46:34AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-02 0012-A 6,827 BOCOCK, LUCRETIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-16 0022-A 7,295 kk- CLARK, JEREMY Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-08-22 0033-A 6,495 COMBS, WILLIAM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-23 0020-A 6,545 rt ,LCRUZ, CANDELARIA Bill Patientltt Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-08-24 0005-A 6,508 DEINES, ROGER Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-08-29 0027-A 6,717 GALLEGOS, MARIA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-09-02 0023-A 6,838 GALLEGOS, MARIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-09-08 0021-A 7,026 GALLEGOS, MARIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-08-22 0007-A 6,467 GLICKEN, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-26 0014-A 6,607 MILLER, RYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-11 0028-A 7,158YO, PEREZ, FELIX Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-19 0013-A 7,380-- RHODES, KATHY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-08 0009-A 7,014 b`r".RIVERA, ARNULFO Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-25 0027-A 6,584 RODRIGUEZ, JUAN Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-08-24 0008-A 6,513 RYEL, LYAN Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2003-08-23 0012-A 6,517 SANCHEZ, RACHEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-28 0022-A 6,668 SEE, RYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-23 0024-A 6,549 STINNETT, MICHELLE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-07 0022-A 6,991 TRUJILLO, MICHAEL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-12 0029-A 7,213 TRUJILLO, TONY Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-09-08 0008-A 7,013 rlLWALKER, COURTNEY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-24 0014-A 6,524 WERNER, MARLYS Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 Trip count: 22 20,922.00 0.00 20,922.00 Trip count: 22 20,922.00 0.00 Total trip count: 22 ' 20,922.00 I 0.00 I 20,922.00 RescueNetTM Printed on 1/14/2004 at 9:47:28AM Page 1 Wiwi 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,778 Batch date: 1/14/2004 10:06:24AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-26 0020-A 7,616 AGONOY, VANDER fr'411 Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-03 0011-A 7,826 BUCKNER, JOHN n+0- Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2003-10-08 0011-A 8,008 CASTILLO, APRIL h'+1 Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-10-04 0009-A 7,839 CROSBY, WAYNE Bill Patient riot`... > Collections No Bill Sent 1,056.00 1,023.30 32.70 2003-09-24 0014-A 7,570 DE HOYOS, ROSLYN?Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-10-19 0009-A 8,410 GOMEZ, GILBERT Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-10-20 0014-A 8,460 JACKSON, DANIEL Bill Patient tit—U"' Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-10-17 0031-A 9,234 JACKSON, DANIEL Bill Patient( Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-09-22 0032-A 7,509 KASPAR, SHERRI Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-09-23 0008-A 7,502 KASPAR, SHERRI Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2003-10-10 0020-A 8,111 LACEY, RACHELLEW.Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-05 0002-A 7,842 MORALES, MARTINP Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-10-22 0028-A 8,584 REED, RICHARD o+n- Bill Patient Collections No Bill Sent 1,656.00 0.00 1,656.00 2003-10-04 0018-A 7,852 ROMAN, ANNA rn,w Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-09-25 0003-A 7,543 SMITH, ROBERT \1^$$ Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-10-17 0016-A 8,364 STROMSTA, PAUL *4-Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-10-28 0018-A 8,702 TREVINO, CYNTHIAMitill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-22 0026-A 7,503 WOOLEY, KIM 'i4- Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 Trip count: 18 19,719.00 1,023.30 18,695.70 Trip count: 18 19,719.00 1,023.30 18,695.70 Total trip count: 18 i 19,719.00 1 1,023.30 i C8,695.70 RescueNetTM Printed on 1/14/2004 at 10:06:53AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,780 Batch date: 1/14/2004 10:30:41AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-12-08 0021-A 9,995 CADENA, MAX i'v a Bill Patient :1-iitAl Collections No Bill Sent 996.00 0.00 996.00 2003-11-17 0010-A 9,348 DIAZ, ODALLYS n,C Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-17 0011-A 9,349 DIAZ-ROJAS, ELVIii',1-.Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-12-14 0020-A 10,204 FINN, THOMAS k j._ Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-14 0017-A 9,280 GARCIA, ALDOLFOp"Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-11 0001-A 9,175 GONZALEZ, MANUEL Bill Patienthr'ia- Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-11-10 0022-A 9,174 GUTIERREZ, JUANA Bill Patient ir1_ Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-12-17 0011-A 10,264 HERNANDEZ, LEON Bill Patient ivL(- Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-08 0013-A 9,089 LEWIS, CLAUDE rw+l- Bill Patient6,A:e...-“, Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-26 0006-A 9,630 LOPEZ, MARIA UL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-12-06 0005-A 9,883 LOPEZ, MARIA ti k-- Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-12-24 0013-A 10,494 LOPEZ, MARIA tt C-- Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-22 0036-A 9,526 MALHOTRA, VINOD Bill Patient "'A Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-10 0018-A 10,075 MATA, JOSE rn,;ti. Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-24 0035-A 9,604 MCNAMARA, WILLIAh Bill Patient t Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-12-06 0028-A 9,961 ROMERO, BARBARA Bill Patient ii L Collections No Bill Sent 996.00 946.50 49.50 2003-12-13 0004-A 10,155 ROMERO, BARBARA Bill Patient y._ Collections No Bill Sent 1,131.00 1,064.92 66.08 2003-12-12 0018-A 10,137 ROMERO, BARBARA Bill Patient ,AL,--- Collections No Bill Sent 1,131.00 1,058.24 72.76 2003-11-26 0021-A 9,677 WHITESHIRT, GUY Bill Patient ti'.-- Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-25 0003-A 9,576 WHITESHIRT, GUY Bill Patient ttL-- Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-11-15 0008-A 9,291 WOOD, SAMMY iim.L Bill Patient Collections No Bill Sent 1,715.00 0.00 1,715.00 Trip count: 21 23,885.00 3,069.66 20,815.34 Trip count: 21 23,885.00 3,069.66 20,815.34 Total trip count: 21 I 23,885.00 I 3,069.66 20,815.34 J/ RescueNet'"" Printed on 1/14/2004 at 10:31:34AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,900 Batch date: 1/23/2004 2:22:36PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-04-20 0020-A 2,587 BAKER, RONNIE Bill Patient Collections No Bill Sent 1,310.00 0.00 1,310.00 2003-03-13 0028-A 1,397 CHOCKLEY, DELBER Bill Patient Collections No Bill Sent 1,940.00 1,144.60 795.40 ' 2003-03-07 0015-A 1,136 CONWAY, MARVIN Bill Patient Collections No Bill Sent 980.00 0.00 980.00 2003-04-06 0014-A 2,065 GOFF, JACQUELYNN Bill Patient Collections No Bill Sent 870.00 0.00 870.00 2003-03-06 0024-A 1,108 GRIEGO, FREDERICK Bill Patient Collections No Bill Sent 1,085.00 976.50 108.50 2003-04-02 0013-A 1,946 HARVEY-YBARRA, DE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-05-20 0005-A 3,444 JAVERI, SAVITRI Bill Patient Collections No Bill Sent 870.00 0.00 870.00 2003-02-21 0004-A 605 MURCH, NICHOLAS Bill Patient Collections No Bill Sent 1,070.00 30.00 1,040.00 2003-05-17 0002-A 3,343 THOMPSON, JON Bill Patient Collections No Bill Sent 960.00 0.00 960.00 2003-05-17 0024-A 3,365 THOMPSON, JON Bill Patient Collections No Bill Sent 1,010.00 0.00 1,010.00 ' 2003-05-27 0028-A 3,698 WOOD, BROOKE Bill Patient Collections No Bill Sent 1,160.00 0.00 1,160.00 Trip count: 11 11,405.00 2,151.10 9,253.90 Trip count: 11 11,405.00 2,151.10 9, Total trip count: 11 I 11,405.00 ' 2,151.10 ' 9,253.90 RescueNetT"' Printed on 1/23/2004 at 2:23:02PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,901 Batch date: 1/23/2004 2:49:04PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-06-18 0002-A 4,319 BARNETT, CASEY Bill Patient Collections No Bill Sent 1,005.00 0.00 1,005.00 2003-06-27 0008-A 4,627 BOHN, DOUGLAS Bill Patient Collections No Bill Sent 1,025.00 0.00 1,025.00 2003-06-29 0011-A 4,682 BOHN, DOUGLAS Bill Patient Collections No Bill Sent 1,745.00 0.00 1,745.00 2003-08-08 0004-A 5,994 CAMPOZ, PAUL Bill Patient Collections No Bill Sent 1,296.00 1,221.78 74.22 2003-06-11 0036-A 4,280 COLEMAN, DANA Bill Patient Collections No Bill Sent 1,205.00 0.00 1,205.00 2003-07-26 0022-A 5,611 FAUSTO, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-06-27 0007-A 4,625 FELIX, MICHAEL Bill Patient Collections No Bill Sent 1,050.00 100.00 950.00 2003-06-20 0030-A 4,418 GONZALEZ, ALEJANC Bill Patient Collections No Bill Sent 1,145.00 916.00 229.00 2003-08-22 0029-A 6,491 GRIEGO, FREDERICK Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-07-08 0020-A 5,014 HENDERSON, SARAI-Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-08-06 0006-A 5,913 HILLS, SHERRI Bill Patient Collections No Bill Sent 1,461.00 1,267.80 193.20 2003-06-05 0032-A 3,991 HUMPHREY, ELIZABE Bill Patient Collections No Bill Sent 1,340.00 868.00 472.00 2003-08-17 0022-A 6,348 KLINGER, RONALD Bill Patient Collections No Bill Sent 1,191.00 1,122.61 68.39 2003-06-05 0010-A 3,924 PEREZ, JAIME Bill Patient Collections No Bill Sent 1,490.00 150.00 1,340.00 2003-06-22 0019-A 4,500 REINSTEIN, DAVID Bill Patient Collections No Bill Sent 1,275.00 0.00 1,275.00 2003-06-17 0016-A 4,304 RENFREW, DANIELLE Bill Patient Collections No Bill Sent 1,100.00 0.00 1,100.00 2003-07-09 0017-A 5,089 SANCHEZ-WENTZ, AF Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-06-13 0034-A 4,185 SEGURA, ANDREA Bill Patient Collections No Bill Sent 1,070.00 902.00 168.00 2003-07-31 0012-A 5,751 TAPIA, CRYSTAL Bill Patient Collections No Bill Sent 1,596.00 0.00 1,596.00 2003-08-16 0008-A 6,267 WILSON, BRADLEY Bill Patient Collections No Bill Sent 1,221.00 1,121.00 100.00 Trip count: 20 23,983.00 7,669.19 16,313.81 Trip count: 20 23,983.00 7,669.19 16,3 Total trip count: 20 I 23,983.00 ' 7,669.19 ' 16,313.81 RescueNetT' Printed on 1/23/2004 at 2:49:33PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,902 Batch date: 1/23/2004 3:07:36PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-08-31 0028-A 6,786 ALBANI, ERIC Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2003-08-31 0029-A 6,787 ALVAREZ, SALVADOF Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-09-02 0021-A 6,836 BARRON, MIGUEL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-09-02 0004-A 6,819 BECK, TAMERA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-03 0018-A 6,867 COSTA, ROANNA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-08-29 0003-A 6,682 CRUZ, BENITO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-03 0016-A 6,865 DELACRUZ, MANUEL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-08-30 0017-A 6,747 DOMINGUEZ, PEDRO Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-08-29 0016-A 6,703 FISHER, MARGARITA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-01 0021-A 6,812 FORTNER, JESSICA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-08-30 0022-A 6,753 GONSALES LERMA, C Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-02 0016-A 6,831 JONES, CHARLES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-31 0027-A 6,785 KENNEDY, JAY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-08-30 0006-A 6,711 LAWLER, KELBY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-03 0005-A 6,854 LEORA, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-03 0015-A 6,864 LOMA, ISRAEL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-08-31 0004-A 6,726 MILLER, SHEREE Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 2003-08-30 0021-A 6,752 MORALES, JOSE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-09-03 0007-A 6,856 MORIMITSU, DANIELI Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-08-30 0026-A 6,770 NAVARRO, ANDRES Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-28 0028-A 6,674 NICKS, PEARB Bill Patient Collections No Bill Sent 1,146.00 515.70 630.30 2003-09-03 0008-A 6,857 PEREZ, FILEMON Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-09-03 0006-A 6,855 ROYBAL, GENEVIEVE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-08-30 0013-A 6,737 SANCHEZ, CYNTHIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-01 0013-A 6,804 SLICKMEYER, JOHN Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 Trip count: 25 24,945.00 515.70 24,429.30 Trip count: 25 24,945.00 515.70 Total trip count: 25 ' 24,945.00 1 515.70 24,429.30 RescueNetTM Printed on 1/23/2004 at 3:08:23PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 2,904 Batch date: 1/23/2004 3:23:31PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-07 0028-A 7,000 CARLSON, LAURA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-08 0018-A 7,023 CHASE, DOUGLAS Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-08 0005-A 7,010 FRANCO, MIGUEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-08 0028-A 7,051 GARCIA, ANTHONY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-09-08 0006-A 7,011 HARRIS, MATTHEW Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-06 0035-A 7,029 JENKINS, JENNIFER Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-11-23 0004-A 9,548 LEWIS, CLAUDE Bill Patient Collections No Bill Sent 1,361.00 0.00 1,361.00 2003-09-08 0003-A 7,004 MACIAS, JAIME Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-12-27 0030-A 10,578 MARCELENO, PAUL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-09-07 0012-A 6,975 RUBENSTEIN, MARVI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-05 0028-A 6,929 SAMPLE, KATHERINE Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-09-07 0018-A 6,983 SANCHEZ-LOPEZ, JA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-11-20 0004-A 9,426 SCHULTZ, KEVIN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-04 0005-A 6,883 SERNA, BENITO Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-09-04 0004-A 6,882 SERNA, FELIX Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-09-04 0006-A 6,884 SERNA, ORLANDO Bill Patient Collections No Bill Sent 165.00 0.00 165.00 2003-09-06 0026-A 6,956 WILLARD,TIFFANY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 17 13,901.00 0.00 13,901.00 Trip count 17 13,901.00 0.00 1 dU 1.0 Total trip count: 17 1 13,901.00 I 0.00 j 13,901.00 RescueNetTM Printed on 1/23/2004 at 3:23:58PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,053 Batch date: 2/10/2004 8:31:20AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-06-03 0014-A 3,874 ARROYO, DANIEL Bill Patient Collections No Bill Sent 1,055.00 792.00 263.00 2003-06-14 0020-A 4,216 BOWDEN, GEORGE Bill Patient Collections No Bill Sent 150.00 75.00 75.00 2003-07-06 0012-A 4,950 BROWN, KAYLEE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 • 2003-02-03 0069-A 8,525 CAREY, BRETT Bill Patient Collections No Bill Sent 490.00 20.00 470.00 2003-07-13 0019-A 5,195 CHRISTOHPERSON, IBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-02-03 0056-A 8,511 DAVENPORT, ERIC Bill Patient Collections No Bill Sent 710.00 25.00 685.00 2003-05-23 0031-A 3,582 DOUGLAS, MARY Bill Patient Collections No Bill Sent 1,085.00 1,023.03 61.97 2003-05-22 0030-A 3,550 DOUGLAS, MARY Bill Patient Collections No Bill Sent 980.00 910.96 69.04 2003-06-02 0015-A 3,837 GUZMAN, LORENE Bill Patient Collections No Bill Sent 1,265.00 1,012.00 253.00 2003-07-11 0018-A 5,147 LUCERO, LEROY Bill Patient Collections No Bill Sent 1,011.00 637.70 373.30 2003-07-04 0006-A 4,887 MARTIN, SAM Bill Patient Collections No Bill Sent 1,221.00 991.80 229.20 2003-04-06 0035-A 2,106 MILLER, ERIN Bill Patient Collections No Bill Sent 1,205.00 23.00 1,182.00 2003-05-04 0002-A 2,895 MILLER, ERIN Bill Patient Collections No Bill Sent 1,070.00 13.00 1,057.00 2003-02-01 0041-A 7,980 MILLER, ERIN Bill Patient Collections No Bill Sent 3,077.00 8.00 3,069.00 2003-03-24 0028-A 1,803 MILLER, ERIN Bill Patient Collections No Bill Sent 1,265.00 24.00 1,241.00 2003-06-20 0013-A 4,388 NEHRING, LINDA Bill Patient Collections No Bill Sent 870.00 830.50 39.50 2003-07-05 0023-A 4,903 NEHRING, LINDA Bill Patient Collections No Bill Sent 1,116.00 1,054.15 61.85 2003-06-10 0003-A 4,072 NEHRING, LINDA Bill Patient Collections No Bill Sent 900.00 858.69 41.31 2003-03-24 0025-A 1,800 SALAZAR, DANIEL Bill Patient Collections No Bill Sent 995.00 928.92 66.08 2003-02-02 0077-A 8,271 SENA, LORI Bill Patient Collections No Bill Sent 292.17 55.74 236.43 2003-02-02 0084-A 8,278 TONER, TONYA Bill Patient Collections No Bill Sent 520.00 0.00 520.00 2003-06-30 0009-A 4,732 YARBROUGH, ROGEI Bill Patient Collections No Bill Sent 1,175.00 681.00 494.00 Trip count: 22 22,654.17 9,964.49 12,689.68 Trip count: 22 22,654.17 9,964.49 , Total trip count: 22 I 22,654.17 ' 9,964.4 12,689.68 RescueNet1" Printed on 2/10/2004 at 8:31:54AM Page 1 \\nw 16\rescuenet\reports32\Billing\Misce llaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,054 Batch date: 2/10/2004 9:02:18AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-08-27 0021-A 6,645 BURGSTAHLER, BRA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-08-22 0028-A 6,490 CASTILLO, JANET Bill Patient Collections No Bill Sent 1,041.00 988.83 52.17 2003-08-01 0018-A 5,799 CLARK, CARLA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-26 0018-A 6,611 DICKSON, PENELOPE Bill Patient Collections No Bill Sent 1,191.00 1,166.00 25.00 2003-08-23 0013-A 6,518 FUENTES, AMERICA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-07-23 0013-A 5,491 GARCIA, BRITTANI Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-07-22 0014-A 5,471 HERNANDEZ, MARIA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-08-23 0027-A 6,552 KEIL, RITA Bill Patient Collections No Bill Sent 1,338.00 1,110.04 227.96 2003-07-29 0007-A 5,680 KVEINIS, KATHLEEN Bill Patient Collections No Bill Sent 1,446.00 1,156.80 289.20 2003-08-11 0020-A 6,116 LALIBERTE, ELLA Bill Patient Collections No Bill Sent 1,251.00 1,182.12 68.88 2003-08-20 0003-A 6,369 LARSON, ALLEN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-11 0009-A 6,091 LOVELAND, TOM Bill Patient Collections No Bill Sent 1,131.00 10.00 1,121.00 2003-08-01 0010-A 5,788 MITCHELL, ROBERT Bill Patient Collections No Bill Sent 1,401.00 1,351.00 50.00 2003-09-08 0022-A 7,027 MOORHEAD, SALLY Bill Patient Collections No Bill Sent 1,401.00 1,376.00 25.00 2003-09-06 0034-A 7,028 PREECE, MARCEL Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-07-28 0014-A 5,663 REDMAN, JOYCE Bill Patient Collections No Bill Sent 981.00 340.50 640.50 2003-08-10 0003-A 6,063 RIVAS, OLGA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-08-18 0009-A 6,310 SCHNEIDER, ERIC Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-07-31 0017-A 5,756 SEIBERT, SIMON Bill Patient Collections No Bill Sent 1,056.00 1,031.00 25.00 2003-08-07 0005-A 5,960 VASQUEZ, GERARDC Bill Patient Collections No Bill Sent 1,416.00 425.00 991.00 2003-08-29 0023-A 6,712 WESTMAN, DANNY Bill Patient Collections No Bill Sent 1,401.00 1,319.43 81.57 2003-09-07 0006-A 6,969 WHITLEY, DEWAYNE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-09-07 0017-A 6,981 YARBROUGH, ROGEI Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-08-27 0018-A 6,642 YATES, BRANDY Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-08-02 0003-A 5,816 YATES, BRANDY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 Trip count: 25 30,702.00 11,456.72 19,245.28 Trip count: 25 30,702.00 11,456.72 19 . Total trip count: 25 I 30,702.00 ' 11,456.72 I 19,245.28 RescueNetTM Printed on 2/10/2004 at 9:04:11 AM Page 1 \\n w16 16\res c u e n et\reports3 2\Billing\Miscellaneous\S u b B atc h 7.r p t Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,055 Batch date: 2/10/2004 9:20:02AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-09 0038-A 7,093 BICKLER, NANCY Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-09-12 0012-A 7,196 CAMPBELL, SHARA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-09 0022-A 7,077 CHACON, SARAH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-10 0001-A 7,098 GARZA, DAVID Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-09-14 0003-A 7,223 GUTIERREZ, MARIA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-09-14 0025-A 7,247 JOHNSON, TONY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-09 0021-A 7,076 KENDALL, SAMANTHJ Bill Patient Collections No Bill Sent 1,296.00 30.00 1,266.00 2003-09-09 0026-A 7,081 LITTLEFIELD, LARRY Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-09-13 0012-A 7,182 MAGUIRE, BRANDON Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-09-13 0005-A 7,173 MARCELENO, TASHA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-11 0021-A 7,151 MATA, TRACI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-12 0013-A 7,197 MCCLOY, DENISE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-09-10 0024-A 7,122 MOORE, ANDREW Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-09-10 0031-A 7,129 PHAE, MORGAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-11 0001-A 7,131 SALAZAR, LOUIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-09 0035-A 7,090 SOPER, DEBRA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-09-13 0015-A 7,188 SPEIER, DANIEL Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-09-11 0029-A 7,159 TRUJILLO, AARON Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-13 0001-A 7,168 VELASQUEZ, PASQUi Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-09-15 0018-A 7,269 VICENTE, ARTURO Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-09-12 0036-A 7,220 WARR, JAMIE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-10 0029-A 7,127 WYATT, NICOLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count 22 18,900.00 30.00 18,870.00 Trip count: 22 18,900.00 30.00 18,87 00 Total trip count: 22 1 18,900.00 ' 30.00 ' 18,870.00 RescueNetTM Printed on 2/10/2004 at 9:20:54AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,056 Batch date: 2/10/2004 9:48:09AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-16 0004-A 7,277 BARRIENTOS, RICAR Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-22 0024-A 7,500 CASADY, JASON Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-18 0005-A 7,337 CASARES, RENE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-09-22 0002-A 7,469 CHAVEZ, LUCAS Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-09-23 0024-A 7,525 CORDOVA, SEVERO Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-09-20 0001-A 7,404 CRON, AMANDA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-09-18 0028-A 7,365 ERIKSON, TIFFANY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-25 0016-A 7,556 GARZA, JOANNA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-09-23 0037-A 7,540 GONZALES, ANDREA Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2003-09-22 0005-A 7,472 GUTIERREZ, BRYAN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-09-16 0005-A 7,278 GUTIERREZ, BRYAN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-09-21 0027-A 7,465 GUTIERREZ, JUAN Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-09-25 0008-A 7,548 HAYNER, DAVID LIFE LINE AIR AMBULCollections No Bill Sent 573.00 0.00 573.00 2003-09-26 0011-A 7,605 KINDSFATHER, JOSH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-20 0020-A 7,424 LERMA, ANTHONY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-20 0013-A 7,417 MEYER, JIM Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-09-18 0029-A 7,366 MILLER, ERIN Bill Patient Collections No Bill Sent 1,341.00 8.00 1,333.00 2003-09-25 0020-A 7,585 MINNEY, ZANE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-09-17 0019-A 7,328 MORENO-GUTIERRE;Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-25 0005-A 7,545 POPE,THOMAS Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-09-16 0021-A 7,294 RIVERO, ESPERANZC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 _ 2003-09-16 0028-A 7,301 ROBINSON, DENNIS Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-20 0016-A 7,420 SALINAS, RAMONA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-24 0024-A 7,581 SCHUTT, JERRI Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-09-19 0021-A 7,388 VIGIL, ANTONIO Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-09-24 0005-A 7,559 WILLIAMS, CHARLES Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-09-26 0021-A 7,617 YBARRA, CRYSTAL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 27 28,080.00 8.00 28,072.00 Trip count: 27 28,080.00 8.00 28,072.00 Total trip count: 27 ' 28,080.00 ' 8.00 28,072.00 RescueNetTM Printed on 2/10/2004 at 9:49:23AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,057 Batch date: 2/10/2004 10:22:03AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-28 0027-A 7,681 BENAVIDES,THOMAF Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-28 0011-A 790 COOPER, SAMUEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-12-10 0022-A 10,079 CRANMER, RICK Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-09 0018-A 8,070 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-09-27 0007-A 7,629 DOMINGUEZ, EDGAR Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-02 0014-A 7,788 GARZA, JOANNA Bill Patient Collections No Bill Sent 1,206:00 0.00 1,206.00 2003-09-28 0003-A 7,636 HELZER, JAMES Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-12-18 0023-A 10,318 HERNANDEZ, VICTOF Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-22 0003-A 587 LEZAMA, DAVID Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-13 0011-A 362 LOPEZ, MARIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-24 0017-A 668 MATTES, PETE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-01-16 0023-A. 494 MCCLURE, CURTIS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-27 0017-A 7,647 OSTERLOH, LARRY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-12-24 0007-A 10,488 PANTALION, MELISSI Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2003-10-26 0017-A 8,588 PFLEIGER, JEFF Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-01-18 0007-A 498 RAMIREZ, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-26 0005-A 9,629 RANGEL, JOSEPH Bill Patient Collections No Bill Sent 1,146.00 1,091.36 54.64 2003-10-18 0010-A 8,380 RANNIGER, SONDRA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-01-03 0014-A 76 REHAK, BLAIR Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-06 0051-A 8,109 REYES, FLORENCE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-28 0009-A 7,649 RODARTE, JUAN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-12-23 0026-A 10,481 RODRIGUEZ, JOSE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-01-06 0016-A 175 ROE, STEPHANIE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-10-02 0029-A 7,807 ROMERO, ILYANA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-18 0002-A 10,297 SORGATZ-HINESLEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-03 0038-A 110 VISCAINO, REFUGIO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-12-13 0013-A 10,164 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-16 0023-A 10,450 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 28 28,815.00 1,091.36 27,723.64 Trip count: 28 28,815.00 1,091.36 27,728:641/ Total trip count: 28 I 28,815.00 I 1,091.36 27,723.64 u.„/ RescueNetTM Printed on 2/10/2004 at 10:22:44AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,233 Batch date: 2/27/2004 12:16:23PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-02-12 0017-A 370 ARMSTRONG,ANDRE Bill Patient Collections No Bill Sent 1,055.00 305.00 750.00 2003-06-08 0015-A 4,024 BOND, TYLER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-23 0012-A 5,490 CANTRELL, LAURA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-07-10 0007-A 5,070 GRANADOS, LUIS Bill Patient Collections No Bill Sent 1,086.00 623.00 463.00 2003-07-07 0010-A 5,007 HAMILTON, JULIE Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2003-02-04 0050-A 8,731 HUME, GWENDOLYN Bill Patient Collections No Bill Sent 705.00 50.00 655.00 2003-08-14 0016-A 6,205 JACKSON, KIM Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-07-17 0008-A 5,322 JONES, COLT Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-02-07 0031-A 9,424 KASPAR, SHERRI Bill Patient Collections No Bill Sent 930.00 0.00 930.00 2003-08-10 0018-A 6,084 MACGREGOR, JESSU Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-10 0017-A 6,081 MARQUEZ, IRMA Bill Patient Collections No Bill Sent 1,221.00 508.00 713.00 2003-08-06 0028-A 5,952 MARTINEZ, GRISELD,Bill Patient Collections No Bill Sent 1.161.00 708.27 452.73 2003-06-28 0040-A 4,726 MAYLE, JOHN Bill Patient Collections No Bill Sent 9.95.00 0.00 995.00 2003-08-01 0027-A 5,809 MORAN, FRANCISCO Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-02 0015-A 5,833 PFLEIDERER, SANDR Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-06-16 0009-A 4,317 RAMOS, LINDA Bill Patient Collections No Bill Sent 1,025.00 0.00 1,025.00 2003-07-26 0010-A 5,585 SALDOVAR, ZABRINP Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-06-06 0012-A 3,962 SCOGGINS, MARGAR Bill Patient Collections No Bill Sent 1,085.00 1,010.68 74.32 2003-08-06 0025-A 5,949 SHULTZ, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-02-02 0060-A 8,254 WHITE-MARTINEZ, la Bill Patient Collections No Bill Sent 485.00 5.00 480.00 Trip count: 20 19,135.00 3,209.95 15,925.05 Trip count: 20 19,135.00 3,209.95 15,925.05 Total trip count: 20 I 19,135.00 I 3,209.95 I 15,925.05 C RescueNetT"" Printed on 2/27/2004 at 12:16:49PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,234 Batch date: 2/27/2004 12:34:14PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-09-08 0016-A 7,021 AGUILAR, SERGIO Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-31 0009-A 6,754 —BREWER, CALEB Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-09-30 0017-A 7,730 CARDONA, RENE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-09-03 0020-A 6,869 CROSBY, WAYNE Bill Patient r'ti \ea" Collections No Bill Sent 1,131.00 1,097.97 33.03 2003-09-10 0012-A 7,109 ELLIOTT, CHARLES Bill Patient Collections No Bill Sent 150.00 5.00 145.00 2003-09-11 0012-A 7,142 ELWELL, DEREK Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-08-27 0005-A 6,629 -"EMMERT, LISA Bill Patient Collections No Bill Sent 1,296.00 1,271.00 25.00 2003-09-24 0004-A 7,558 GARCIA, NOVAR Bill Patient Collections No Bill Sent 1,266.00 1,012.80 253.20 2003-09-26 0026-A 7,625 GONZALES,ARACELI Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-09-11 0023-A 7,153 KITCH, JUSTIN Bill Patient Collections No Bill Sent 1,191.00 265.57 925.43 2003-09-09 0010-A 7,049 LARSEN, KENNETH Bill Patient Collections No Bill Sent 1,221.00 1,056.90 164.10 2003-09-25 0017-A 7,582 LEGG, ABBY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-09-25 0017-B 7,588 LEGG, ABBY Bill Patient Collections No Bill Sent 1,323.00 0.00 1,323.00 2003-08-27 0012-A 6,636 -LINDSEY, KEN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-08-22 0027-A 6,489 -LOPEZ, MANUEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-08 0001-A 7,002 LUJAN, DAVID Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-09-08 0001-B 7,008 LUJAN, DAVID Bill Patient Collections No Bill Sent 1,383.00 0.00 1,383.00 2003-09-29 0017-A 7,706 OLIVA-ALBA, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-22 0035-A 7,772 POMPA, RAUL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-07 0009-A 6,972 RIGGINS, GARI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-29 0015-A 6,702 -RODRIGUEZ, JOSH Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-08-20 0004-A 6,373 -SANCHEZ, MARTHA Bill Patient Collections No Bill Sent 1,236.00 936.14 299.86 2003-08-25 0006-A 6,562 -SMITH, BARBARA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-09-17 0002-A 7,311 TODD, HENRY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-09-30 0001-A 7,713 VANDARWARKA,ALN Bill Patient ro'os Collections No Bill Sent 618.00 482.21 135.79 2003-09-06 0024-A 6,954 WINTER, RONALD Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2003-09-04 0016-A 6,894 ZAVALA, BRANDON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 27 26,943.00 6,127.59 20,815.41 Trip count: 27 26,943.00 6,127.59 20,815.41 Total trip count: 27 I 26,943.00 ' 6,127.59 I 20,815.41 RescueNetTM Printed on 2/27/2004 at 12:34:56PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,235 Batch date:,2/27/2004 12:56:39PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-10-03 0003-A 7,811 BLACK, MAJORIE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-10-02 0005-A 7,779 DELGARITO, SHAWN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-06 0022-A 7,915 DOZAL, AGUSTIN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-04 0029-A 7,874 FISHER, NATALEEN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-02 0004-A 7,778 FLORES, HERMENEC Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-10-09 0035-A 8,088 GALVAN, FEDERICO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-04 0016-A 7,850 GAYTON, AILEEN Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-10-04 0017-A 7,851 GAYTON, JACINTO Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-10-12 0012-A 8,194 GONZALEZ, ANTONIC Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-10-17 0023-A 8,392 GRIEGO, EDWARD Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2003-10-08 0036-A 8,060 GUERRA, GERARD Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2003-10-04 0031-A 7,962 HERRERA, DANIEL Bill Patient Collections No Bill Sent 1,146.00 916.80 22920 2003-10-11 0004-A 8,125 HOPKINS, MICHAEL Bill Patient Collections No Bill Sent 1,811.00 0.00 1,811.00 2003-10-09 0030-A 8,083 KAMAKELE, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-04 0030-A 7,875 LANGHOFF, BRIAN Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-08-31 0024-A 6,782 LEHFELDT, BRIAN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-10-08 0029-A 8,050 LOPEZ, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-10 0019-A 8,110 LOPEZ-RAMIREZ, HEM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-27 0018-A 8,670 MARTIN, JOSHUA Bill Patient Collections No Bill Sent 1,146.00 1,088.61 57.39 2003-10-05 0008-A 7,867 MARTINEZ, LEO Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-10-05 0014-A 7,877 MARTINEZ, LEO Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2003-10-06 0032-A 7,928 MEFFORD, RAY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-10-14 0028-A 8,236 MUNOZ, ELIZABETH Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-06 0034-A 7,931 NAVARRO, ANDRES Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-10-30 0019-A 8,797 PASTOR, RICHARD Bill Patientd' Collections No Bill Sent 2,180.00 2,064.23 115.77 2003-10-14 0002-A 8,210 PEREZ, CAMELIA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-10-10 0026-A 8,117 PIMENTEL, LESLIE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-10 0009-A 8,098 PINTO, SANDRA Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2003-10-01 0019-A 7,769 PDXSON, GAVIN Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-10-27 0025-A 8,687 RIVERA-MARROQUIN Bill Patient Collections No Bill Sent 180.00 0.00 180.00 2003-10-02 0007-A 7,781 RUIBAL, ARCHIE Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-10-11 0030-A 8,153 SPARLING, EILEEN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-04 0020-A 7,856 YANES, AMADO Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-06 0035-A 7,934 YBARRA, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 RescueNetTM Printed on 2/27/2004 at 1:00:29PM Page 1 Mw 16 rpt WELD COUNTY PARAMEDIC SERVICES Trip count: 34 34,594.00 4,069.64 30,524.36 Trip count: 34 34,594.00 4,069.64 3 . Total trip count: 34 ' 34,594.00 I 4,069.64 30,524.36 RescueNetTM Printed on 2/27/2004 at 1:00:29PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,236 Batch date: 2/27/2004 1:32:57PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-11-14 0015-A 9,278 GEISLER, ELMER Bill Patient4't Collections No Bill Sent 1,566.00 1,471.16 94.84 2003-11-19 0021-A 9,423 GISH, DANIEL Bill Patient mL Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-08 0017-A 9,093 HUBBARD, SHERRY Bill Patient MIL Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-08 0018-A 9,094 HUBBARD, WYATT Bill Patient hit- Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-24 0002-A 10,445 LUCERO, BETTY Bill Patient Ke- Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-23 0024-A 641 MCNAMARA,WILLIAM Bill Patient Wt Collections No Bill Sent 150.00 0.00 150.00 2004-01-15 0010-A 420 NEWMAN, TERESA Bill Patient me- Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-27 0005-A 729 RASPAR, PASQUEL Bill Patient 14L- Collections No Bill Sent 1,806.00 0.00 1,806.00 2004-02-01 0007-A 906 SALEDO, MARIOS Bill Patient NL Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-02 0017-A 8,974 SANCHEZ, JOE Bill Patient Kt- Collections No Bill Sent 150.00 0.00 150.00 2003-11-03 0009-A 8,855 STRONG, KIP Bill Patient int Collections No Bill Sent 1,116.00 0.00 1,116.00 9,599 YEL!NGTON TAM! Rill Patient p& Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-24 0030-A Trip count: 12 12,810.00 1,471.16 11,338.84 Trip count: 12 12,810.00 1,471.16 11,33 At Total trip count: 12 ( 12,810.00 1 1,471.16 11,338.84 ' RescueNetTM Printed on 2/27/2004 at 1:33:19PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,413 Batch date: 3/18/2004 3:33:53PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-08-04 0015-A 5,882-- AGUERO, CAROL Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-09-11 0006-A 7,136— BARTHOLOMEW, AAF Bill Patient Collections No Bill Sent 1,326.00 1,245.34 80.66 2003-09-16 0029-A 7,302- DELACRUZ, ROSA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-09-08 0010-A 7,015- DELGADO, DEBRA Bill Patient Collections No Bill Sent 1,356.00 1,306.00 50.00 2003-09-11 0008-A 7,138— DUNN, FLORENCE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-08-14 0011-A 6,200- EISENBARTH, REBEC Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2003-08-15 0006-A 6,233^ FRALEY, BARBARA Bill Patient Collections No Bill Sent 1,461.00 1,436.00 25.00 2003-07-18 0020-A 5,336— HERNANDEZ, ADRIAP Bill Patient Collections No Bill Sent 150.00 65.00 85.00 2003-06-28 0018-A 4,688- JOJOLA, SAMUEL Bill Patient Collections No Bill Sent 870.00 0.00 870.00 2003-07-31 0034-A 5,773— MILLER, JERAD Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-02-01 0039-A 7,978— PARKER, GEORGE Bill Patient Collections No Bill Sent 252.00 30.00 222.00 2003-09-21 0002-A 7,440-- VALTIERRA, ISAIAS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 12 12,120.00 4,082.34 8,037.66 Trip count: 12 12,120.00 4,082.34 8,037..6 i Total trip count: 12 I 12,120.00 I 4,082.34 ' ,037.66 RescueNetTM Printed on 3/18/2004 at 3:34:25PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,417 Batch date: 3/19/2004 1:40:49PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-10-07 0021-A 7,953 BESECKER, JARED Bill Patient Collections No Bill Sent 1,131.00 50.00 1,081.00 2003-10-13 0005-A 8,165 BOWLES, BRITTANY Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2003-10-10 0002-A 8,091 DAY, MARY Bill Patient Collections No Bill Sent 1,206.00 1,181.00 25.00 2003-10-13 0012-A 8,174 EGGER, GABRIELLE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-09-10 0005-A 7,102 FURMAN, MYRON Bill Patient Collections No Bill Sent 1,071.00 1,006.25 64.75 2003-09-08 0041-A 7,064 FURMAN, MYRON Bill Patient Collections No Bill Sent 1,311.00 1,238.49 72.51 2003-09-29 0007-A 7,696 FURMAN, MYRON Bill Patient Collections No Bill Sent 1,116.00 1,050.82 65.18 2003-09-28 0014-A 7,666 FURMAN, MYRON Bill Patient Collections No Bill Sent 1,116.00 1,050.82 65.18 2003-09-23 0009-A 7,510 FURMAN, MYRON Bill Patient Collections No Bill Sent 1,206.00 1,134.16 71.84 2003-10-14 0022-A 8,230 HALBERG, SARAH Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-09-30 0020-A 7,734 LEAL, VALENTIN Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-10-07 0022-A 7,957 MCNEECE, MICHELLE Bill Patient Collections ^No Bill Sent 150.00 0.00 150.00 2003-10-07 0015-A 7,944 MONDRAGON, STEVE Bill Patient Collections No Bill Sent 1,221.00 1,158.09 62.91 2003-10-06 0016-A 7,908 MONDRAGON, STEVE Bill Patient Collections No Bill Sent 996.00 946.50 49.50 2003-10-13 0011-A 8,173 NELSON, MARY Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-02-02 0088-A 8,282 TRUJILLO, LUCILLE Bill Patient Collections No Bill Sent 68.00 20.00 48.00 2003-10-15 0015-A 8,295 WALLGREN, MARLIZ/Bill Patient Collections No Bill Sent 1,056.00 934.00 122.00 2003-08-18 0003-A 6,304 ZIEGRA, LYNN Bill Patient Collections No Bill Sent 1,191.00 952.80 238.20 2003-08-07 0038-A 5,999 ZIEGRA, LYNN Bill Patient Collections No Bill Sent 1,116.00 892.80 223.20 2003-10-01 0008-A 7,758 ZIEGRA, LYNN Bill Patient Collections No Bill Sent 1,191.00. 952.80 238.20 2003-09-19 0006-A 7,373 ZIEGRA, LYNN Bill Patient Collections No Bill Sent 1,221.00 976.80 244.20 Trip count: 21 22,457.00 13,545.33 8,911.67 Trip count: 21 22,457.00 13,545.33 8,911.67 Total trip count: 21 U 22,457.00 I 13,545.33 8,911.67 RescueNetTM Printed on 3/19/2004 at 1:42:14PM Page 1 \\nw 161rescuenet\reports32\Billing\Miscel laneous'S ubBatch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,418 Batch date: 3/19/2004 2:37:21PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-10-30 0035-A 8,816 ALBERT, ROBIN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-24 0005-A 8,606 ALVAREZ, DANIEL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 ' 2003-10-21 0027-A 8,560 CARMONA, FLORA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-10-19 0021-A 8,427 CORBIT, DUSTI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-26 0006-A 8,575 EASTIN, MITCH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-16 0001-A 8,290 FREEMAN, CARL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-24 0009-A 8,610 GANDARA, JULIO Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-10-23 0012-A 8,497 GEURIN, KELLY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-30 0032-A 8,811 GODDARD, CATHERII Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-10-23 0021-A 8,546 HOWARD, JOSHUA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-21 0033-A 8,567 JENKINS, MICHAEL Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 0012-A 8,539 MACIAS, HOWARD Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-10-21 , 2003-10-17 0030-A 8,400 MELENDEZ-ORTIZ, JEBill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-10-27 0031-A 8,744 MENDOZA, DEREK Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-10-26 0022-A 8,691 MENDOZA, JOEL Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-17 0017-A 8,365 MENDOZA, MIGUEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-16 0020-A 8,333 MEYER, MIKE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-19 0019-A 8,425 MONTOYA, BEVERLY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-10-20 0024-A 8,474 MOSCO,LYSSA Bill Patient Collections No Bill Sent 1,248.00 508.80 739.20 2003-10-16 0017-A 8,330 ORDONEZ, MARTHA Bill Patient— Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-10-17 0007-A 8,355 PARKER, KIMBERLY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-29 0007-A 8,761 PHILLIPS, ANN MARIE Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-10-29 0019-A 8,773 RODRIGUEZ, LYDIA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-28 0034-A 8,751 SHERMAN, RICHARD Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-10-21 0007-A 8,529 SUTTON,ANISSA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-20 0016-A 8,462 YELVINGTON, MICHE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-22 0024-A 8,453 ZAMORA, RICARDO Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 Trip count: 27 27,840.00 508.80 2T,33T:28� Trip count: 27 27,840.00 508.80 , Total trip count: 27 I 27,840.00 1 508.8 I 27,331.20 RescueNetTm Printed on 3/19/2004 at 2:37:54PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,419 Batch date: 3/19/2004 3:13:54PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-05 0019-A 9,038 BECERRA, BLANCA Bill Patient Collections No Bill Sent 1,596.00 0.00 1,596.00 2003-11-05 0002-A 9,005 BERIG, LEVI Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-10-31 0009-A 8,835 BRAVO, JOHNY Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-11-04 0013-A 8,984 COFFMAN, SHARON Bill Patient Collections No Bill Sent 1,940.00 0.00 1,940.00 2003-11-05 0008-A 9,011 FLORES, ADEL Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-11-03 0005-A 8,851 FLORES, JAMES Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-10-31 0058-A 8,937 GALLEGOS,ANTONIC Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-10-31 0011-A 8,837 GARDEA, PERLA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-11-06 0005-A 9,018 GONZALEZ, NOVIA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-10-31 0015-A 8,843 HARKLESS,ADAM Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-11-05 0022-A 9,041 HFRNANDF7 JOE Rill Patient Collections No Bill Sent 150.00 0.00 150.00 , 2003-11-08 0019-A 9,095 JORDAN, ALLNA Bill Patient Collections A No Bill Sent 1,521.00 0.00 1,521.00 2003-11-01 0013-A 8,936 KARR, LORI Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-11-06 0010-A 9,024 MARTINEZ, ELMER Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-06 0018-A 9,134 MARTINEZ, LEO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-11-09 0008-A 9,127 MARTINEZ-HERNANCBill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-08 0022-A 9,098 MCCAIG, JERRY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-03 0019-A 8,867 MCGUFFIN, SHAWN Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2003-11-09 0014-A 9,133 MURRAY, LONNIE Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-11-01 0006-A 8,925 SANCHEZ-JIMENEZ, !Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-11-04 0022-A 8,994 SHEDD, BRENDA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-08 0010-A 9,086 SHUMATE,TANYA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-09 0011-A 9,130 SMITH, GLENDA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-11-01 0002-A 8,841 SMITH, OLIVER Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-11-05 0025-A 9,044 SOTELO, JORGE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-11-07 0001-A 9,048 VALENCIA, MICHELLE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 Trip count: 26 31,799.00 0.00 31,799.00 Trip count: 26 31,799.00 0.00 31,761:06--,. Total trip count: 26 1 31,799.00 ' 0.00 I 31,799.00 RescueNetT"' Printed on 3/19/2004 at 3:14:49PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,430 Batch date: 3/19/2004 3:34:43PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-16 0007-A 9,322 BECERRA, BLANCA Bill Patient Collections No Bill Sent 2,120.00 0.00 2,120.00 2003-11-21 0009-A 9,463 BERIG, LEVI Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-11-10 0019-A 9,168 CANTU, BRIAN Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-01-18 0001-A 484 CASTILLO, JOSE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-01-19 0028-A 544 COX, CODY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-02-09 0002-A 1,143 COX, CODY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-23 0020-A 10,475 DAVIS, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-23 0014-A 9,567 GALLEGOS, HERMAN Bill Patient Collections No Bill Sent 1,326.00 1,257.69 68.31 2004-01-23 0015-A 632 GARCIA, GILBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-10 0015-A 10,067 GERMAN, GABRIELL/Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-11-11 0002-A 9,177 GOMEZ, ANTONIO Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 , 2003-11-10 0002-A 9,112 GRANTHAM, WILLIAM Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-11-10 0033-A 9,193 HERMAN, PAM Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-01-22 0007-A 596 MEYERS, LALANIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-11-20 0030-A 9,453 MONDRAGON, STEVE Bill Patient Collections No Bill Sent 1,176.00 1,113.99 62.01 2003-12-19 0023-A 10,365 MORA, MANUEL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-23 0016-A 633 PARKER, GLENN Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-02-05 0022-A 1,097 PARKER, GLENN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-11 0010-A 9,200 REDMAN, JASON Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-11-10 0024-A 9,179 RODRIGUEZ, LYDIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-10 0027-A 9,182 ROGERS, DONALD Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-12-13 0002-A 10,153 THOMPSON, HUBERI Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-12-20 0007-A 10,341 THOMPSON, HUBERI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-13 0008-A 9,235 VILLALOBOS-LOPEZ, Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-11-10 0036-A 9,258 VILLEGAS, ANNETTE Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-12-12 0006-A 10,122 WALTER, BOB Bill Patient Collections No Bill Sent 180.00 0.00 180.00 2003-12-02 0024-A 9,811 WEDDLE, DEAN Bill Patient Collections No Bill Sent 1,311.00 1,231.24 79.76 Trip count: 27 28,652.00 3,602.92 25,049.08 Trip count: 27 28,652.00 3,602.92 25,049 i Total trip count: 27 I 28,652.00 I 3,602.92 I 25,b49.08 w RescueNetTM Printed on 3/19/2004 at 3:35:15PM Page 1 Wiwi 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,517 Batch date: 3/31/2004 10:59:27AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-06-17 0022-A 4,310 ASHLEY, CRYSTAL Bill Patient Collections No Bill Sent 1,130.00 345.60 784.40 2003-10-29 0022-A 8,780 BENAVIDEZ, BENNY Bill Patient Collections No Bill Sent 1,116.00 1,044.15 71.85 2003-02-10 0023-A 329 CASTANEDA, ALEXAt Bill Patient Collections No Bill Sent 900.00 0.00 900.00 2003-10-19 0005-A 8,406 GEISICK, CHRISTY Bill Patient Collections No Bill Sent 1,146.00 716.80 429.20 2003-03-23 0017-A 1,683 GELATT, JEAN Bill Patient Collections No Bill Sent 1,235.00 1,135.00 100.00 2003-10-26 0005-A 8,574 HARTSHORN, ROSE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-05-22 0023-A 3,535 HERNANDEZ, KELLY Bill Patient Collections No Bill Sent 980.00 120.00 860.00 2003-10-17 0028-A 8,398 KNICKERBOCKER, JC Bill Patient M Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-10-19 0018-A 8,424 LAUER, KURT Bill Patient Collections No Bill Sent 1,131.00 380.06 750.94 2003-09-06 0008-A 6,938 MATHEWS, TIMOTHY Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-10-24 0021-A 8,660 MORENO, SEVERO Bill Patient Collections No Bill Sent 1,221.00 1,156.28 64.72 I .., 2003-10-19 0025-A 9,353 MORRISON, NATASH.Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-30 0042-A 8,827 MOYER, HEATHER Bill Patient Collections No Bill Sent 1,491.00 1,224.85 266.15 2003-02-01 0070-A 8,041 PINEDA, MARK Bill Patient Collections No Bill Sent 650.00 70.00 580.00 2003-06-24 0022-A 4,562 ROGERS, LANA Bill Patient Collections No Bill Sent 1,095.00 500.00 595.00 2003-09-06 0031-A 6,961 RUIZ,ANDREA Bill Patient Collections No Bill Sent 1,041.00 476.70 564.30 2003-05-14 0019-A 3,238 SANCHEZ, JOSE Bill Patient p- L Collections No Bill Sent 1,115.00 465.00 650.00 2003-02-06 0019-A 201 SARCHET, DENNY Bill Patient Collections No Bill Sent 1,415.00 400.00 1,015.00 Trip count: 18 20,550.00 8,034.44 12,515.56 Trip count: 18 20,550.00 8,034.44 1 .56 Total trip count: 18 I 20,550.00 ' 8,034.44 12,515.56 RescueNetTM Printed on 3/31/2004 at 11:00:16AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES ' Batch 3,518 Batch date: 3/31/2004 11:23:39AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-05 0023-A 9,042 AGUILAR, FLORENTI(Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-24 0016-A 1,593 COOPER, SAMUEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-11-12 0019-A 9,219 COSTILLA, MARIA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-24 0019-A 1,596 COX, CODY Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-12-16 0028-A 10,455 EVERSON, RAYMON[Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-11-13 0025-A 9,252 FULTON, DEBRA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-11-14 0013-A 9,276 GIFFORD, PRESTON Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-13 0013-A 9,240 GREEN, DANIEL Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-11-13 0019-A 9,246 HARTSHORN, ROSE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-11-08 0004-A 9,075 HENRY, SHAWN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-13 0012-A 9,239 HERNANDEZ, ROSARBill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-02-22 0017-A 1,527 JIMENEZ, JUAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-13 0011-A 9,238 LOSOYA, MICHAEL Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-11-13 0015-A 9,242 MARTINEZ, FRANCIStBill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-01-05 0007-A 143 MASSEY, DEBRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-13 0017-A 9,244 MIRELES, JOE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-11-13 0018-A 9,245 MONTOYA, BEVERLY Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-11-12 0007-A 9,207 MONTOYA, BEVERLY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-02 0002-A 1,817 NAVARRO-SAMBRAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-03-02 0007-A 1,822 PARKER, GLENN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-04 0001-A 1,869 PARKER, GLENN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-03-11 0006-A 2,080 PARKER, GLENN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-05 0036-A 1,925 PETERSON, KIM Bill Patient Collections No Bill Sent 981.00 0.00 981,00 2004-02-29 0027-A 1,753 RODRIGUEZ, SONYA Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2003-11-14 0021-A 9,318 RODRIGUEZ, STELLA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-02-21 0018-A 1,490 VANHEKLE, JOE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-02-01 0014-A 923 WHARTON, PAUL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-02-01 0014-B 926 WHARTON, PAUL Bill Patient Collections No Bill Sent 75.00 0.00 75.00 2003-11-14 0002-A 9,265 ZUNIGA, WANDA Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 Trip count 29 26,823.00 0.00 26,823.00 Trip count: 29 26,823.00 0.00 26,823.00 Total trip count: 29 I 26,823.00 ' 0.00 Q6,823.00) RescueNetTM Printed on 3/31/2004 at 11:24:37AM Page 1 \\nw 16\rescu a net\repo rts32\Billing\Miscellaneous\S u b Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,738 Batch date: 4/15/2004 10:57:01AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-02-03 0059-A 8,514 ADAMS, DENA Bill Patient Collections NQ Bill Sent 750.00 20.00 730.00 2003-08-30 0020-A 6,750 BENCOMO VARGAS, Bill Patient Collections No Bill Sent 1,041.00 449.20 591.80 2003-08-23 0005-A 6,500 CROWE, BLAKE Bill Patient Collections No Bill Sent 1,131.00 861.00 270.00 2003-09-27 0029-A 7,664 ERICKSON, PAULA Bill Patient Collections No Bill Sent 996.00 20.00 976.00 2003-09-15 0015-A 7,266 FELL, MARCIA Bill Patient Collections No Bill Sent 1,131.00 1,073.35 57.65 2003-07-27 0025-A 5,639 GUTIERREZ, SANDRJ Bill Patient Collections No Bill Sent 1,191.68 1,141.68 50.00 2003-07-25 0021-A 5,557 HOFFMAN, NANCY Bill Patient Collections No Bill Sent 1,311.00 496.97 814.03 2003-09-18 0027-A 7,364 JOHNSON, CLAUDIA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-09-26 0013-A 7,607 KENNEDY, JAY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-02-01 0046-A 7,989 LOPEZ, MARIA Bill Patient Collections No Bill Sent 765.00 50.00 715.00 2003-03-28 0001-A 1,788 MILLS. ED Bill Patient Collections No Bill Sent 930.00 588.17 341.83 2003-09-03 0029-A 6,878 NORGREN, SHANNOI Bill Patient Collections No Bill Sent 1,551.00 1,483.14 67.86 2003-09-13 0019-A 7,194 NORGREN, SHANNOt Bill Patient Collections No Bill Sent 1,566.00 1,454.50 111.50 2003-09-30 0030-A 7,747 NORGREN, SHANNOI Bill Patient Collections No Bill Sent 1,551.00 1,483.14 67.86 2003-09-10 0025-A 7,123 RAEHAL, BRAD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-27 0020-A 7,652 SANCHEZ, ANTONIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-26 0002-A 7,595 SWEDBERG, JANICE Bill Patient Collections No Bill Sent 1,206.00 964.80 241.20 2003-09-02 0030-A 6,845 SWEIGARD, RICHARC Bill Patient Collections No Bill Sent 1,431.00 1,231.00 200.00 Trip count: 18 19,353.68 11,316.95 8,036.73 . Trip count: 18 19,353.68 11,316.95 8,036:732-�_ ,, Total trip count 18 ' 19,353.68 ' 11,316.95 ( /8,036.73 1/ J/ RescueNetTM Printed on 4/15/2004 at 10:57:33AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,839 Batch date: 4/26/2004 10:33:45AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-06 0031-A 1,961 ANALCO-TLATENCO, Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-01-17 0003-A 457 ANDERSON, BENJAM Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-08 0011-A 222 BERKHOLDER, JOHN Bill Patient Collections No Bill Sent 996.00 949.88 46.12 2003-12-29 0023-A 10,627 CANDELARIA, RICHAI Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-02-23 0024-A 1,569 CRANMER, RICK Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-01-05 0018-A 158 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-21 0001-A 567 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-26 0038-A 1,708 GALLEGOS, HERMAN Bill Patient Collections No Bill Sent 1,326.00 1,244.79 81.21 2004-01-20 0011-A 553 GARCIA, JUAN Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-03-26 0046-A 2,587 GUEVARA, ISRAEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-12-14 0004-A T0,184 HALL, SHARMALEE Bill Patient Collections No Bill Sent 1,466.00 0.00 1,466.00 2004-03-17 0033-A 2,288 LANSING, REBECCA Bill Patient Collections No Bill Sent 1,206 O0 0.00 1,206.00 2003-12-14 0016-A 10,199 LEBLANC, RICHARD Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-08 0015-A 226 LOPEZ, EVA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-04 0022-A 133 MASTERS, RITCHIE Bill Patient Collections No Bill Sent 1,116.00 892.80 223.20 2003-12-14 0010-A 10,193 MATHEWS, ELBERT Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-12-13 0029-A 10,182 MCKENNEY, JOANNA Bill Patient Collections No Bill Sent 1,866.00 0.00 1,866.00 2004-01-21 0006-A 576 MONTES, LIBERTY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-26 0031-A 2,571 MOOTE, LARRY Bill Patient Collections No Bill Sent 2,285.00 0.00 2,285.00 2003-12-13 0019-A 10,170 NEHRING, LINDA Bill Patient Collections No Bill Sent 996.00 946.50 49.50 2004-01-19 0003-A 514 ORTIZ, ELIGIO Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-12-16 0018-A 10,261 REYNA, MARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-23 0003-A 10,458 RODRIGUEZ, JOHNN'Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-02-29 0016-A 1,734 SALAZAR, JULIANN Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-03-17 0002-A 2,254 TRUJILLO, GABRIEL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-01-19 0005-A 516 VILLAMOTO, JOSE Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-03-25 0010-A 2,477 WHITE, ROBIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-15 0017-A 10,226 WIEST, JEREMY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 28 32,515.00 4,033.97 28,481.03 Trip count: 28 32,515.00 4,033.97 28,481.03 Total trip count: 28 1 32,515.00 1 4,033.97 I 28,481.03 RescueNetTM Printed on 4/26/2004 at 10:34:41 AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,745 Batch date: 4/15/2004 11:13:03AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-16 0004-A 9,316 ALLEE, ALBERT Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2003-11-17 0003-A 9,334 ANDREWS, DAN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-05 0009-A 7,868 ARMENDARIZ, BRENI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-15 0016-A 9,300 BEHRING, EDWARD Bill Patient Collections No Bill Sent 996.00 946.50 49.50 2003-10-10 0021-A 8,112 CORRAL-GONZALES,Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-10 0018-A 8,108 DELAFUENTE-CAZARBill Patient Collections No Bill Sent 1,101.00 540.60 560.40 2003-11-16 0019-A 9,338 HARRIS, ROBERT Bill Patient Collections No Bill Sent 150.00 15.00 135.00 2003-09-08 0012-A 7,017 HEBERLING, ROBER1 Bill Patient Collections No Bill Sent 1,191.00 1,124.05 66.95 2003-11-16 0012-A 9,327 HERNANDEZ, JOHN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-10-28 0029-A 8,734 LANG, COLIN Bill Patient Collections No Bill Sent 1,131.00 1,017.90 113.10 2003-10-03 0002-A 7,808 MARKUS, ASHLYN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-11-17 0019-A 9,358 MERAZ, MONICA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-10-20 0011-A 8,457 MEYER, JERRY Bill Patient Collections No Bill Sent 150.00 50.00 100.00 2003-10-11 0029-A 8,152 MORENO, ANA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-27 0024-A 8,686 MORGAN,WAYNN Bill Patient Collections No Bill Sent 1,311.00 770.00 541.00 2003-11-17 0025-A 9,364 MOYA, JOHN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-11 0006-A 9,192 NEHRING, LINDA Bill Patient Collections No Bill Sent 1,056.00 1,000.18 55.82 2003-10-21 0021-A 8,553 NICCOLI, CHARITY Bill Patient Collections No Bill Sent 1,101.00 605.00 496.00 2003-11-17 0002-A 9,333 ODUNCAN, KANDECE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-10 0020-A 9,170 PETERSEN, MARIO Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-11-15 0015-A 9,299 SATOR, ROBERT Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-10-21 0019-A 8,550 SMALL, CINDY Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-10-30 0010-A 8,788 SMITH, PATRICK Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-11-17 0016-A 9,355 TRUJILLO, DEBORAH Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-17 0027-A 9,368 VALADEZ, MARIA Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 Trip count: 25 25,101.00 6,069.23 19,031.77 Trip count: 25 25,101.00 6,069.23 1 77 Total trip count: 25 ' 25,101.00 I, 6,069.23 ' 19,031.77 RescueNetTM Printed on 4/15/2004 at 11:13:46AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,749 Batch date: 4/15/2004 11:26:35AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-11-27 0013-A 9,657 ALBERT, ROBIN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-27 0016-A 9,660 AULDRIDGE, KELLEY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-11-19 0003-A 9,404 BLOMBERG, JOHN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-11-23 0003-A 9,546 CARPENTER, JENNIF Bill Patient Collections No Bill Sent 996.00 946.50 49.50 2003-11-22 0004-A 9,486 CLINE, KERI Bill Patient Collections No Bill Sent 150,00 0.00 150.00 2003-11-27 0023-A 9,667 CROTTEAU, CLARA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-25 0011-A 9,605 DAVIS, AARON Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-11-24 0029-A 9,598 DRAKE, JIMMY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-22 0034-A 9,524 FLORES, SALVADOR Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 2003-11-22 0048-A 9,541 GALLEGOS, OLIVER Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-11-24 0015-A 9,584 GOODBAR, DEVIN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-23 0012-A 9,565 HAWKINS, SANDRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-24 0012-A 9,573 HAWKINS, SANDRA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-11-27 0005-A 9,648 LUCERO, JAVIER Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-11-22 0002-A 9,484 LUNA, JULIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-18 0018-A 9,386 MARQUEZ, PRISCILL,Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-22 0023-A 9,510 MUNOZ, MARCOS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-11-22 0029-A 9,519 PACHECO, RONALD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-24 0008-A 9,557 PAYNE, ELIZABETH Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-11-21 0017-A 9,472 PEREZ, JEFFREY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-18 0027-A 9,395 QUINONES, PAT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-22 0030-A 9,520 ROBLES, GABRIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-24 0019-A 9,588 SANDERS, DOUG Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-26 0022-A 9,678 SERNA, JESUS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-20 0017-A 9,440 SWENSON, KATHLEE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-11-22 0005-A 9,487 TEWSLEY, KAILI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-24 0021-A 9,590 VILLALOBOS, LETISH Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-11-19 0007-A 9,408 YANG, NOU Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-24 0031-A 9,600 YELVINGTON, MICHE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count: 29 24,465.00 946.50 23,518.50 Trip count: 29 24,465.00 946.50 23,51 .50 .` Total trip count: 29 1 24,465.00 ' 946.50 --23,518.6 RescueNetTM Printed on 4/15/2004 at 11:29:26AM Page 1 \\nw161rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,837 Batch date: 4/26/2004 9:21:15AM Trip Date Joh Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-28 0001-A 9,685 ARELLANO, PEDRO Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-09-22 0017-A 7,486 BRINKLEY, JARED Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-06-02 0016-A 3,838 CRUZ-GUEVARA, CEI Bill Patient Collections No Bill Sent 1,130.00 0.00 1,130.00 2003-09-11 0011-A 7,141 CUMMINGS, JOLENE Bill Patient Collections No Bill Sent 1,146.00 482.40 663.60 2003-10-31 0053-A 8,924 DICKSON,WILFRED Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-05-22 0022-A 3,533 ERICKSON, JENNIFEI Bill Patient Collections No Bill Sent 980.00 675.00 305.00 2003-09-30 0014-A 7,726 ERICKSON, JENNIFEI Bill Patient Collections No Bill Sent 1,116.00 75.00 1,041.00 2003-11-24 0017-A 9,586 GRAHAM, EDWARD Bill Patient Collections No Bill Sent 1,281.00 82.50 1,198.50 2003-10-16 0010-A 8,323 HICKS, ROBERT Bill Patient Collections No Bill Sent 1,236.00 662.40 573.60 2003-11-30 0001-A 9,727 JENSEN, DAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-11-29 0010-A x716 LODIZABEL-RUIZ, LUIBill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-11-13 0020-A 9,247 MEKELBURG, DAVID Bill Patient Collections No Bill Sent 1,401.00 320.80 1,080.20 2003-10-27 0017-A 8,669 NEWSOM, KENNETH Bill Patient Collections No Bill Sent 2,030.00 0.00 2,030.00 2003-11-29 0013-A 9,719 RAICHART, JOSEPH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-25 0009-A 6,565 RODNEY, CARRIE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 • 2003-09-06 0025-A 6,955 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,371.00 1,314.00 57.00 2003-11-14 0016-A 9,279 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,056.00 987.72 68.28 2003-10-13 0010-A 8,171 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,116.00 1,076.50 39.50 2003-11-28 0011-A 9,695 SERNA,JESUS Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-11-19 0015-A 9,417 SMALL, CINDY Bill Patient Collections No Bill Sent 1,341.00 1,000.00 341.00 2003-10-27 0010-A 8,649 TORRES, NEREYDA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-11-29 0014-A 9,720 VEGA, JEAN Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 Trip count: 22 24,837.00 6,676.32 18,160.68 Trip count: 22 24,837.00 6,676.32 18,160 Total trip count: 22 i 24,837.00 ' 6,676.32 18,160.68 RescueNetTM Printed on 4/26/2004 at 9:22:03AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 3,838 Batch date: 4/26/2004 10:01:33AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-12-04 0012-A 9,863 ALBERT, ROBIN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-12-03 0004-A 9,820 ALVARADO, SIMONA Bill Patient Collections No Bill Sent 180.00 0.00 180.00 2003-12-04 0001-A 9,851 BARHAM, GEORGE Bill Patient Collections No Bill Sent 180.00 0.00 180.00 2003-12-03 0032-A 9,849 BARKER, CLAIRE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-12-06 0025-A 9,958 BERNAL, CARMEN Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-12-10 0025-A 10,082 BROWN, JAKE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-08 0041-A 10,015 CARDENAS, HAZEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-01 0028-A 9,800 CRARY, BRADLEY Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2003-12-07 0001-A 9,898 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-12-09 0040-A 10,133 EITEL, JOEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-12-06 0027-A 9,960 FERNANDEZ, ANTON Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-12-03 0027-A 9,844 FOX, GAYTHEL Bill Patient Collections No Bill Sent 1,476.00 0.n0 1,476.00 2003-12-09 0037-A 10,057 GREEN, BREANNE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-12-02 0030-A 9,823 GRIFFITH, SUSAN Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2003-12-02 0028-A 9,815 HERNANDEZ, MARIO Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-12-08 0039-A 10,013 HILL, ERIC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-09 0029-A 10,044 JOSEPH, FRANK Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-12-09 0022-A 10,028 KENDRICK, ALLISON Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-12 0009-A 10,125 MARGHEIM, JOSEPH Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2003-12-11 0021-A 10,107 MARTINEZ, LARISSA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-07 0005-A 9,902 MUSSELWHITE, FRAP Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-12-02 0010-A 9,788 PEREZ, RICK Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-09 0039-A 10,062 ROJAS, VIRGINIA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-12-10 0002-A 10,041 SCATTERDAY, JANIC Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-05 0025-A 9,939 SPERSTAD, SAMMY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-10 0031-A 10,089 SWEENEY,VERLEE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-12 0001-A 10,113 TAKUMOTO, DENNIS Bill Patient Collections No Bill Sent 180.00 0.00 180.00 Trip count: 27 23,511.00 0.00 23,511.00 Trip count: 27 23,511.00 0.00 23,544700---„, Total trip count: 27 ' 23,511.00 l 0.00 23,511.00 I RescueNetTM Printed on 4/26/2004 at 10:02:30AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,041 Batch date: 5/12/2004 1:16:29PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-04-26 0024-A 2,696 CARRISALES, JOSEP Bill Patient Collections No Bill Sent 1,100.00 1,057.50 42.50 2003-02-03 0055-A 8,510 FUNK, JAY Bill Patient Collections No Bill Sent 930.00 50.00 880.00 2003-02-01 0048-A 7,994 GARCIA-ALACRON, Ji Bill Patient Collections No Bill Sent 765.00 150.00 615.00 2003-09-17 0016-A 7,325 HARRIS, ANNE Bill Patient Collections No Bill Sent 1,116.00 781.20 334.80 2003-03-05 0027-A 1,094 RENEGER, EVANGEL Bill Patient Collections No Bill Sent 1,025.00 970.00 55.00 2003-09-19 0028-A 7,395 HESS, DAMIEN Bill Patient Collections No Bill Sent 1,431.00 1,406.00 25.00 2003-09-27 0003-A 7,624 HORNE,JAMES Bill Patient Collections No Bill Sent 1,221.00 50.00 1,171.00 2003-08-25 0022-A 6,579 KING, LEE Bill Patient Collections No Bill Sent 1,251.00 1,178.49 72.51 2003-09-15 0011-A 7,262 KING, LIDA Bill Patient Collections No Bill Sent 1,191.00 100.00 1,091.00 2003-07-23 0020-A 5,499 KIRCHER, VICTORIA Bill Patient Collections No Bill Sent 1,341.00 639.20 701.80 2003-02-04 0053-A 8,740 KUTCHER, FRANK Bill Patient Collections No Bill Sent 124.00 75.00 49.00 I 2003-09-07 0025-A 6,995 LUCERO, BERTHA Bill Patient Collections No Bill Sent 1,431.00 0.00 ? 43? nn 2003-02-01 0058-A 8,029 MACKEY, DONALD Bill Patient Collections No Bill Sent 840.00 85.00 755.00 i 2003-07-16 0019-A 5,277 MARAIS, PETER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-30 0029-A 7,745 MARSH, DUSTIN Bill Patient Collections No Bill Sent 1,146.00 411.00 735.00 2003-09-22 0001-A 7,468 MAUNDER, GEORGE Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2003-06-15 0015-A 4,234 MOLINA, ALEJOS Bill Patient Collections No Bill Sent 1,085.00 1,010.68 74.32 2003-08-09 0011-A 6,033 MOSES, BEVERLY Bill Patient Collections No Bill Sent 1,161.00 1,075.96 85.04 2003-08-09 0013-A 6,035 MOSES, GARY Bill Patient Collections No Bill Sent 1,566.00 1,252.80 313.20 2003-06-14 0016-A 4,212 MUSE, GARY Bill Patient Collections No Bill Sent 980.00 106.00 874.00 2003-03-23 0014-A 1,680 PARRIS, LINDA Bill Patient Collections No Bill Sent 1,175.00 540.00 635.00 2003-09-28 0001-A 7,631 PENA, MARY Bill Patient Collections No Bill Sent 1,706.00 1,628.34 77.66 2003-02-01 0045-A 7,988 POMERANTZ, JUDY Bill Patient Collections No Bill Sent 504.00 200.00 304.00 2003-09-05 0021-A 6,922 RICHEY, ANNIE Bill Patient Collections No Bill Sent 1,356.00 200.00 1,156.00 2003-09-01 0008-A 6,799 SCHMITT, APRIL Bill Patient Collections No Bill Sent 1,236.00 977.78 258.22 2003-07-24 0017-A 5,518 STARWALT, SHANE Bill Patient Collections No Bill Sent 1,311.00 697.03 613.97 Trip count: 26 28,648.00 14,641.98 14,006.02 Trip count: 26 28,648.00 14,641.98 14,006.02 Total trip count: 26 I 28,648.00 I 14,641.98 I 14,006.02 RescueNet'"" Printed on 5/12/2004 at 1:17:21 PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\S ubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,042 Batch date: 5/12/2004 1:38:08PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-08 0007-A 9,078 BODELL, TARA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-10-16 0003-A 8,297 BRANDRUP, KENNET Bill Patient Collections No Bill Sent 1,221.00 25.00 1,196.00 2003-11-02 0008-A 8,957 BROWN, DARRELL Bill Patient Collections No Bill Sent 1,071.00 1,004.67 66.33 2003-10-11 0023-A 8,146 BUCKRIDGE,JAY Bill Patient Collections No Bill Sent 1,371.00 75.00 1,296.00 2003-11-10 0011-A 9,154 CORTES, MARY Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-10-06 0021-A 7,914 FRANK, PAUL Bill Patient Collections No Bill Sent 1,356.00 1,084.80 271.20 2003-10-16 0006-A 8,319 GLOVER, TIMOTHY Bill Patient Collections No Bill Sent 1,281.00 1,024.80 256.20 2003-11-12 0015-A 9,215 HARPER,TYLER Bill Patient Collections No Bill Sent 1,101.00 680.80 420.20 2003-11-06 0006-A 9,019 HEBERT, RANDEE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-11-04 0026-A 8,998 HERNANDEZ, ADRIAP Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 i 2003-10-18 0017-A 8,387 HEYSE, BERND Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-24 0032-A 9,601 HOLGUIN, DULCE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-11 0017-A 9,233 IBARRA, FERNANDO Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-11-02 0016-A 8,973 JENNEY, HOWARD Bill Patient Collections No Bill Sent 1,446.00 1,358.09 87.91 2003-10-20 0029-A 8,479 LARSON, ROBERT Bill Patient Collections No Bill Sent 1,008.00 0.00 1,008.00 2003-10-07 0008-A 7,933 LOPEZ, ROMULO Bill Patient Collections No Bill Sent 633.00 375.77 257.23 2003-11-02 0015-A 8,971 MALDONADO, CANDI Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-10-13 0014-A 8,176 NEWBURY, ZACHARI Bill Patient Collections No Bill Sent 1,356.00 1,158.92 197.08 2003-10-28 0035-A 8,752 RENFREW, DANIELLE Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-10-21 0005-A 8,472 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,056.00 987.72 68.28 2003-10-17 0002-A 8,341 SLAWSKI, MARK Bill Patient Collections No Bill Sent 1,581.00 1,211.22 369.78 2003-10-31 0030-A 8,878 STEWART, VERA Bill Patient Collections No Bill Sent 1,221.00 1,146.68 74.32 2003-10-09 0029-A 8,082 SULLIVAN, BLAKE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-25 0023-A 9,620 TORRES, SILVERIO Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2003-10-26 0024-A 8,693 TRUJILLO, ROSA Bill Patient Collections No Bill Sent 1,221.00 576.80 644.20 2003-10-30 0040-A 8,825 YERGLER, CHRISTIAI Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 Trip count: 26 30,915.00 10,710.27 20,204.73 Trip count: 26 30,915.00 10,710.27 : ' 14. Total trip count: 26 ' 30,915.00 ' 10,710.27 20,204.73 I RescueNeF" Printed on 5/122004 at 1:39:16PM Page 1 \\n w16 16\re s c u e n e t\reports 32\B i l l i n g\Miscellaneous\S u b B a tc h 7.r pt 1 Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,043 Batch date: 5/12/2004 1:54:51PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-12-19 0021-A 10,363 ARAGON, MICHAEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-21 0005-A 10,385 BEAUDREAU, CHRISIBill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-12-09 0027-A 10,036 BROWN, JEANNE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-12-22 0030-A 10,436 CHABEZ, AIREUS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-20 0015-A 10,352 CORRAL, IRMA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-08 0001-A 9,964 CRUZ, EMILIANO Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-19 0006-A 10,326 DAWSON, JANET Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2003-12-20 0001-A 10,334 DELGADO, DANIEL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-12-20 0004-A 10,338 DIMMITT, COREY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-12-03 0005-A 9,821 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,371.00 1,295.58 75.42 2003-12-21 0001-A 10,381 HERNANDEZ, MARTItBill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-12-01 0025-A 9,792 HUTCHINSON, ASHLE Bill Patient Collections No Bill Sent ? 236.00 541.17 694.83 2003-12-20 0031-A 10,378 JORDAN, MICHAEL Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2003-12-20 0029-A 10,373 MCCULLOUGH, VONE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-22 0022-A 10,427 NEHRING, LINDA Bill Patient Collections No Bill Sent 1,011.00 960.59 50.41 2003-12-22 0016-A 10,421 OROSVCO-OLIVAS, A Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-17 0031-A 10,285 PETTIT, RENEE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-21 0025-A 10,405 RAMOS, MELISSA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-12-18 0008-A 10,303 RODRIGUEZ, LYDIA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-12-22 0035-A 10,441 RODRIGUEZ, RAUL Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-12-19 0001-A 10,321 SALAZAR, JONI Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-12-17 0035-A 10,289 SASSO, AUGUSTINA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-05 0002-A 9,876 STEWART, VERA Bill Patient Collections No Bill Sent 1,161.00 1,093.11 67.89 2003-12-18 0014-A 10,309 TAVIZON, LUIS Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2003-12-21 0019-A 10,399 VASQUEZ-SANCHEZ, Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2003-12-20 0014-A 10,351 VELASQUEZ, EDWAR Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-12-20 0013-A 10,348 VELASQUEZ, MARIO Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 Trip count: 27 31,191.00 3,890.45 27,300.55 Trip count: 27 31,191.00 3,890.45 27,300.55 Total trip count: 27 p 31,191.00 + 3,890.45 , 27,300.55 RescueNeF'' Printed on 5/12/2004 at 1:55:39PM Page 1 \\n w16 16\res c u a n e t\reports32\Billing\Miscellaneous\S u b B atch 7.r p t Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,044 Batch date: 5/12/2004 2:15:05PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-12-27 0022-A 10,570 BECERRA, BLANCA Bill Patient Collections No Bill Sent 1,761.00 0.00 1,761.00 2003-12-28 0002-A 10,586 CLARK, JODY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-12-23 0030-A 10,485 CORDOVA, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-23 0028-A 10,483 CORDOVA, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-23 0029-A 10,484 CORDOVA, GLORIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-23 0012-A 10,467 CRUZ,ALEXZANDER Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-31 0010-A 10,683 FETTIG, ROLAND Bill Patient Collections No Bill Sent 1,581.00 0.00 1,581.00 2003-12-25 0006-A 10,515 GONZALES, SCOTT Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-12-31 0027-A 10,704 HART, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-29 0037-A 10,644 HUFF, HARRY Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2003-12-30 0016-A 10,663 KATHRINE, KATHRYN Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-12-28 0015-A 10,599 LUN° SAMUEL Rill Patient Collections No Rill Gent 1 951.0n 0.00 1,951.00 2003-12-27 0023-A 10,571 MORGAN, MARJORIE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-12-29 0032-A 10,638 NUNEZ, FRANCISCO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-12-25 0019-A 10,528 PESALL, JUDY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-24 0023-A 10,504 PINO,ANITA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-12-31 0025-A 10,702 REASON, STEVEN Bill Patient Collections No Bill Sent 1,640.00 0.00 1,640.00 2003-12-29 0021-A 10,624 REHM, GARY Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2003-12-31 0030-A 10,707 ROBLES, LYDIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-29 0018-A 10,621 ROSE, SUSAN Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-12-26 0016-A 10,546 SALINAS, RAMONA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-12-25 0005-A 10,514 SANCHEZ, YANET Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-31 0014-A 10,688 SEGURA, GABRIEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2003-12-28 0006-A 10,590 TANNER, JAMIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-31 0022-A 10,699 TAPIA, ALFONSO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-12-24 0020-A 10,501 TREVIZO, ADRIAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-29 0026-A 10,631 VIGIL, ANNA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 Trip count: 27 25,013.00 0.00 25,013.00 Trip count: 27 25,013.00 0.00 13......1:1L)) Total trip count: 27 II 25,013.00 I 0.00 25,013.00 RescueNetT" Printed on 5/12/2004 at 2:15:47PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report I WELD COUNTY PARAMEDIC SERVICES Batch 4,045 Batch date: 5/12/2004 2:28:09PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-01-29 0022-A 825 FULLER, JERRY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-30 0005-A 834 FULLER, JERRY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-04-28 0004-A 3,550 HERNANDEZ, OCTAV Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-16 0021-A 2,245 JOHNSON,ZACH Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-01-28 0017-A 796 KOZAK, STACIE Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-01-14 0027-A 415 LOCKWOOD, LONNIE Bill Patient Collections No Bill Sent 1,116.00 687.00 429.00 2004-03-28 0021-A 2,631 MENDOZA, RUBEN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-02-06 0022-A 1,082 PACHECO, ARTHUR Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-16 0004-A 2,219 PARKER, GLENN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-03-30 0002-A 2,654 PARKER, GLENN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-22 0020-A 3,397 PHELPS,TERRY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 I 2004-02-21 0028-A 1,503 VASQUEZ, ERMA Bill Patient Collections No Bill Sent 1,221.00 1;148.73 72.27 2004-02-02 0022-A 951 VASQUEZ, ERMA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-22 0029-A 1,539 VASQUEZ, ERMA Bill Patient Collections No Bill Sent 1,071.00 1,002.55 68.45 Trip count 14 16,629.00 2,838.28 13,790.72 Trip count 14 16,629.00 2,838.28 1 Total trip count: 14 ' 16,629.00 ' 2,838.28 4 13,790.72 1 RescueNet1" Printed on 5/12/2004 at 2:28:37PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,200 Batch date: 5/26/2004 12:51:41PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-10-12 0010-A 8,192 AHREND, ETHAN Bill Patient Collections No Bill Sent 1,398.00 0.00 1,398.00 2003-11-27 0024-A 9,668 BEELER, MARTY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-11-18 0014-A 9,382 CARLSON, TERRY Bill Patient Collections No Bill Sent 1,221.00 976.80 244.20 2003-11-30 0002-A 9,728 CENICEROS, LINDA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-11-27 0003-A 9,646 DELAFUENTE, LEON Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-10-15 0021-A 8,302 DYERSON, ROSE Bill Patient Collections No Bill Sent 1,341.00 1,141.00 200.00 2003-08-22 0015-A 6,475 KAVENY, MARY Bill Patient Collections No Bill Sent 1,206.00 582.00 624.00 2003-11-11 0015-A 9,231 LATHROP, CHERYL Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2003-09-10 0030-A 7,128 MARTINEZ, EDGAR Bill Patient Collections No Bill Sent 1,086.00 62.94 1,023.06 2003-11-03 0023-A 8,884 MARTINEZ, RICHARD Bill Patient Collections No Bill Sent 1,341.00 1,259.43 81.57 2003-09-03 0001-A 6,850 MUNHOLLAND, HEIDI Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-09-16 0002-A 7,275 NELSON, STEVEN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-11-18 0023-A 9,391 RAMOS, BEATRICE Bill Patient Collections No Bill Sent 1,416.00 798.00 618.00 2003-11-04 0020-A 8,992 REED, JOSHUA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-08-10 0034-A 6,113 RIVERA, ADRIENNE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2003-09-28 0016-A 7,669 RUNNER, LORETTA Bill Patient Collections No Bill Sent 1,236.00 50.00 1,186.00 2003-05-22 0040-A 3,572 TOLBERT, SARAH Bill Patient Collections No Bill Sent 1,130.00 1,058.17 71.83 2003-10-15 0013-A 8,292 TROUDT, ROGER Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2003-10-03 0015-A 7,835 VALLES-HERNANDE2Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2003-06-02 0026-A 3,864 VONFELDT, EDWARC Bill Patient Collections No Bill Sent 1,070.00 0.00 1,070.00 2003-11-28 0006-A 9,690 ZUNIGA, JESUS Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 Trip count: 21 25,891.00 5,928.34 19,962.66 Trip count 21 25,891.00 5,928.34 19,962.66 Total trip count: 21 ( 25,891.00 ' 5,928.34( ( 19,962.66 RescueNettM Printed on 5/26/2004 at 12:52:13PM P- \\nw 16\rescuenet\re ports32\Billing\Miscellaneous\SubBatch7.rpt i Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,201 Batch date: 5/26/2004 1:14:58PM Trip Date Job RunName Current Pavor Schedule Event Charges Credits Balance 2004-01-03 0021-A 86 ACEVEDO, PABLO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-02 0004-A 34 AUTOBEE, GEORGE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-11 0026-A 10,116 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,371.00 1,346.00 25.00 2003-12-01 0006-A 9,763 DICKSON, WILFRED Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-11-05 0021-A 9,040 GUZMAN, LORENE Bill Patient Collections No Bill Sent 1,236.00 1,013.80 222.20 2003-12-21 0002-A 10,382 HELD, DEBARA Bill Patient Collections No Bill Sent 1,251.00 1,125.90 125.10 2004-01-03 0007-A 69 IRVAN, GERALD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-27 0001-A 10,549 LOPEZ, MIKE Bill Patient Collections No Bill Sent 1,116.00 25.00 1,091.00 2003-12-02 0019-A 9,806 LUCERO, BERTHA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-01-02 0029-A 59 MACIAS, ERIKA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-03 0026-A 93 MATA, STEPHANIE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-01-03 0027-A 95 MEDIA, JANET Bill Patient Collections No Bill Sent 1.491.00 0.00 1,491.00 2004-01-02 0030-A 60 MOIR, LAURA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-27 0024-A 10,572 NAVARRO, CARMEN Bill Patient Collections No Bill Sent 1,511.00 0.00 1,511.00 2003-12-10 0016-A 10,068 PABLO-AGUILAR, DIA Bill Patient Collections No Bill Sent 1,146.00 15.00 1,131.00 2004-01-02 0002-A 32 PENA-MARTINEZ, ABI Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-12-16 0015-A 10,258 RANDOLPH, CHASE Bill Patient Collections No Bill Sent 1,146.00 802.20 343.80 2004-01-03 0010-A 72 RICE, KENNETH Bill Patient Collections No Bill Sent 1,416.00 25.00 1,391.00 2004-01-01 0027-A 29 RIVERA, SAMUEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-07 0011-A 9,908 ROWE, JOHN Bill Patient Collections No Bill Sent 1,251.00 1,177.62 73.38 2003-12-25 0008-A 10,517 TISCHENDORF, SHMBill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-12-15 0016-A 10,225 WRIGHT, KATHRINE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 Trip count: 22 23,318.00 5,530.52 17,787.48 Trip count: 22 23,318.00 5,530.52 17,78; Total trip count: 22 I 23,318.00 ' 5,530.52 I 17,787.48 RescueNetT"" Printed on 5/26/2004 at 1:15:42PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous1SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,202 Batch date: 5/26/2004 1:32:21PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-12-27 0028-A 10,576 ADAMS, LYNDA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-05 0008-A 144 AGUILAR, SERGIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-09 0027-A 274 ALVARADO, ROBIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-13 0006-A 341 AULDRIDGE, KELLEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-06 0006-A 165 CHAVEZ, VERONICA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-01-10 0014-A 283 CLARK, MICHELLE Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-01-11 0014-A 305 ESQUIBEL, EDDIE Bill Patient Collections No Bill Sent 1,281.00 ' 0.00 1,281.00 2003-12-29 0019-A 10,622 GEORGE, NELLENE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-10 0017-A 286 HARTSHORN, ROSE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-06 0003-A 152 HAWKINS, SANDRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-11 0015-A 306 JAENKE, STACEY Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-01-05 0016-A 155 KOEHLER,TIM Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-01 0017-A 19 LAIRD, KEVIN Bill Patient Collections No Bill Sent 1,656.00 0.00 1,656.00 2004-01-12 0025-A 357 LIGGETT, RAYMOND Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-11 0036-A 328 MARTINEZ-RODRIGU Bill Patient Collections No Bill Sent 918.00 0.00 918.00 2004-01-11 0028-A 320 MIKNEVICIUS, STEPI-Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-01-05 0023-A 163 MORADO, MARTIN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-04 0019-A 130 NARANJO, EDANIA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-01-01 0004-A 5 ORTIZ, ALBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-01 0003-A 4 ORTIZ, JOHNATHAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-13 0012-A 363 PEREA, MELISSA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-12 0026-A 358 RAMIREZ, DEBBIE . Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-01-01 0002-A 3 RAMOS, RAMIRO Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-01-11 0009-A 298 RIOS, ALBERT Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-10 0013-A 282 SEGURA, SAVANNA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-01-07 0013-A 205 VELAZQUEZ,ANTONI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-12 0021-A 353 WARE, MELISSA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-01-01 0007-A 8 WILLIAMS, KAMI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-04 0005-A 94 YOUNGBLOOD, JOHI\Bill Patient Collections No Bill Sent 918.00 0.00 918.00 Trip count: 29 28,152.00 0.00 28,152.00 Trip count: 29 28,152.00 0.00 28,152.00 Total trip count: 29 ' 28,152.00 1 0.00 ' 28,152.00 RescueNetTM Printed on 5/26/2004 at 1:32:59PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,203 Batch date: 5/26/2004 2:21:49PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-01-18 0019-A 519 BANKENSTEIN, ROBE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-01-14 0013-A 398 BARRON, JOSE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-01-16 0025-A 497 BELL, SHELLY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-21 0017-A 593 BUSTILLO, SOCORRC Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-01-14 0005-A 387 CONANT, LISA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-01-20 0005-A 547 DUNN, PATRICIA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-01-19 0027-A 541 EDWARDS, MICHAEL Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-01-15 0017-A 427 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-02-20 0024-A 1,494 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-14 0029-A 443 GALLEGOS, RUPERT Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-01-25 0013-A 696 GUTIERREZ, VICENTI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-16 0018-A 485 HARMON, COLLEEN Bill Patient Collections No Bill Sent 1,311.00 0.00 1,31 1.00 2004-01-21 0014-A 584 HAWKINS, SANDRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-17 0001-A 455 IBARRA, MARIA Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-04-09 0010-A 2,945 JONES, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-23 0018-A 1,562 LOZANO, MARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-18 0006-A 496 MESA, JERMAINE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-04 0031-A 3,789 PEREZ-HERNANDEZ, Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-23 0003-A 620 PINO,ANITA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-14 0002-A 384 PINO, ANITA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-16 0026-A 499 RODRIGUEZ, CARLOI Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-01-14 0001-A 383 RODRIGUEZ,WAYNE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-05-08 0037-A 3,983 VALENCIA, MANUEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-22 0010-A 1,520 VANSCHOIACK, RHOIBill Patient Collections No Bill Sent 1,116.00 10.00 1,106.00 2004-02-16 0004-A 1,324 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-18 0016-A 509 ZADRA, KRISTY Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 Trip count: 26 21,717.00 10.00 21,707.00 Trip count: 26 21,717.00 10.00 21,707.00 Total trip count: 26 I 21,717.00 I 10.00 I. 21,707.00 I RescueNet^^ Printed on 5/26/2004 at 2:22:21 PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,204 Batch date: 5/26/2004 2:40:54PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-02-08 0010-A 1,134 HANSEN, MARK Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-03-29 0010-A 2,608 HERRERA, DAVID Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-05-02 0005-A 3,684 MORALES-HERNAND Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-05 0029-A 3,903 OTERO, RAFAEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 4 4,434.00 0.00 4,434.00 Trip count: 4 4,434.00 0.00 4,434.00 Total trip count: 4 I 4,434.00 ' 0.00 ' \ 4,434.00 RescueNetTm Printed on 5/26/2004 at 2:41:02PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,369 Batch date: 6/15/2004 12:23:55PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-11-29 0005-A 9,711 ALEXANDER, KARLA Bill Patient Collections No Bill Sent 1,086.00 591.00 495.00 2003-08-04 0018-A 5,885 ALVAREZ, SUSAN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2003-08-26 0007-A 6,600 ALVAREZ, SUSAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-11-28 0019-A 9,703 ANTUNA, DONILIA Bill Patient Collections No Bill Sent 1,161.00 20.00 1,141.00 2003-10-29 0026-A 8,821 ARRENDONDO, IDELI Bill Patient Collections No Bill Sent 150.00 40.00 110.00 2003-12-10 0012-A 10,061 BAUMAN, MARY KAY Bill Patient Collections No Bill Sent 1,161.00 980.00 181.00 2003-03-11 0011-A 1,268 BOPP, CHRISTOPHEF Bill Patient Collections No Bill Sent 930.00 0.00 930.00 2003-12-09 0005-A 9,984 CHURCHILL, ERIN Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2003-12-24 0008-A 10,489 CONTRERAZ, DANIEL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2003-12-27 0010-A 10,558 CONTRERAZ, PAULIN Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2003-10-05 0006-A 7,863 GILLETT, HARRISION Bill Patient Collections No Bill Sent 1,356.00 200.00 1,156.00 2003-09-06 0016-A 6,946 HAYNER, DAVID Bill Patient Collections No Bill Sent 1,251.00 911.40 339.60 2003-12-06 0004-A 9,882 HERRERRA, MARTHA Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-12-01 0022-A 9,789 HIDALGO, PATRICIA Bill Patient Collections No Bill Sent 558.00 503.08 54.92 2003-12-21 0021-A 10,401 HINOJOSA, IRENE Bill Patient Collections No Bill Sent 1,056.00 1,006.00 50.00 2003-12-15 0011-A 10,220 HINSHAW, JOEL Bill Patient Collections No Bill Sent 1,281.00 603.18 677.82 2003-12-30 0005-A 10,651 KASPAR, SHERRI Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2003-11-27 0002-A 9,645 LOYA, ALBERTO Bill Patient Collections No Bill Sent 1,371.00 1,096.80 274.20 2003-11-10 0001-A 9,111 MAESTAS, JOSE Bill Patient Collections No Bill Sent 1,251.00 600.80 650.20 2003-11-15 0019-A 9,305 MANDEZ,VICTOR Bill Patient Collections No Bill Sent 1,446.00 1,156.80 289.20 2003-08-09 0012-A 6,034 MOSES, ROCKY Bill Patient Collections No Bill Sent 1,506.00 1,004.80 501.20 2003-10-31 0005-A 8,830 RIVERA, JULIAN Bill Patient Collections No Bill Sent 1,221.00 1,068.49 152.51 2003-12-25 0003-A 10,512 SALAZAR, JUANITA Bill Patient Collections No Bill Sent 1,251.00 1,178.49 72.51 2003-11-18 0016-A 9,384 SCHILLING,ANNI Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-10-30 0030-A 8,809 STRAUSHEIM, STEPI-Bill Patient Collections No Bill Sent 1,146.00 570.40 575.60 2003-02-02 0053-A 8,247 TUSSEY, KELLY Bill Patient Collections No Bill Sent 222.00 15.00 207.00 2003-10-10 0027-A 8,118 WALKER, BONNIE Bill Patient Collections No Bill Sent 1,133.60 1,033.60 100.00 2003-11-22 0057-A 9,542 WHITE, JOSEPH Bill Patient Collections No Bill Sent 513.00 0.00 513.00 Trip count: 28 30,548.60 12,579.84 17,968.76 Trip count: 28 30,548.60 12,579.84 17,968.76 Total trip count: 28 ' 30,548.60 I 12,579.84 ' 17,968.76 RescueNetTM Printed on 6/15/2004 at 12:24:45PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,370 Batch date: 6/15/2004 12:44:00PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-01-25 0017-A 700 BROWN, FREDA Bill Patient Collections No Bill Sent 1,371.00 1,346.00 25.00 2004-01-23 0013-A 630 CALDERON, CARMEN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-01-29 0006-A 809 CERVANTES, DELIA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-01-15 0028-A 446 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,356.00 1,281.00 75.00 2004-01-17 0006-A 460 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,281.00 1,206.00 75.00 2004-01-18 0017-A 510 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,341.00 1,266.00 75.00 2004-01-23 0029-A 646 COSTANTINO, RAFE.Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-01-29 0020-A 823 DEJESUS-GARCIA, LI Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-01-26 0025-A 751 GARCIA, ROY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-29 0003-A 806 GLADWIN, DOUGLAS Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-29 0007-A 810 GODDARD, CATHERII Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-14 0003-A 385 GONZALEZ,ALEJANE Bill Patient Collections No Bill Sent 1,326.00 1,060.80 265.20 2004-01-27 0011-A 761 HALL, MARK Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-01-17 0015-A 473 HILL, DIXIE Bill Patient Collections No Bill Sent 1,146.00 1,077.11 68.89 2004-01-16 0027-A 505 JARAMILLO, KRISTIN,Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-01-26 0017-A 743 KAMPEN, JESS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-14 0028-A 442 POYNER, MANUEL Bill Patient Collections No Bill Sent 1,686.00 1,191.00 495.00 2004-01-29 0016-A 819 RABIDEAU, RONALD Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-01-12 0020-A 352 SMALL, CINDY Bill Patient Collections No Bill Sent 1,326.00 476.08 849.92 2004-01-20 0018-A 560 SMITH,ASHLEY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-01-11 0032-A 324 STAROSIELEC, JILL Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-01-28 0021-A 800 TANA, FERNANDO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-24 0002-A 653 THOMAS, JAKE Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-01-28 0025-A 804 TRUJILLO, LISA Bill Patient Collections No Bill Sent 240.00 0.00 240.00 Trip count: 24 27,702.00 8,903.99 18,798.01 Trip count: 24 27,702.00 8,903.99 Total trip count 24 ' 27,702.00 ' 8,903.99 I71-8,798.01 . I 1 \ RescueNetTM Printed on 6/15/2004 at 12:44:35PM Page 1 \\nw 16\rescu en et\reports32\Billing\Miscellaneous\S u b Batc h 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,371 Batch date: 6/15/2004 12:57:08PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-02-05 0016-A 1,071 AULDRIDGE, KELLEY Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-02-15 0011-A 1,294 BARRAZA, JESSE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-30 0023-A 907 BRINK, CLINT Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-02-01 0017-A 927 CARDOSA, ALISA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-30 0017-A 889 COPPLE, MICHELLE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-02-24 0004-A 1,581 DRISKELL, CRAIG Bill Patient Collections No Bill Sent 1,760.00 0.00 1,760.00 2004-02-02 0011-A 940 ESQUIVEL, JEFFREY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-04 0008-A 987 FENDRICH, CHERYL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-02 0003-A 932 GARCIA, STACY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-07 0002-A 1,105 GUZMAN, PAULA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-02-04 0007-A 986 HERRERA-GARCIA, J Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-03-18 0024-A 2,312 HILL, DARLENE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-12 0034-A 2,162 HILL, DIXIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-31 0043-A 888 KOEHLER, JAMES Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-02-03 0016-A 969 MARTINEZ, ELMER Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-08 0002-A 1,995 MASCARENAS,ALEX,Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-08 0003-A 1,996 MASCARENAS, JERE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-08 0004-A 1,997 MASCARENAS, JOE Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-01-30 0001-A 830 MORADO, JOSEPH Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-02-02 0001-A 930 MORGAN, MARJORIE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-04 0002-A 981 MYERS, AMY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-30 0021-A 904 PECK, LAW Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-30 0029-A 917 RAY, LACEY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-02-01 0003-A 899 RUIZ, BRANDON Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-02-28 0007-A 1,723 SHAFFER, DEVON Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-02-04 0028-A 1,007 SVOBODA, JOHN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-02-07 0027-A 1,155 THARP, DAWN Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-01-31 0036-A 878 THORNTON, BROOKE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-02-02 0004-A 933 WESTLUND, SARA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-03 0023-A 976 WILLIAMS, JESSIE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 Trip count: 30 27,992.00 0.00 27 992.00 Trip count: 30 27,992.00 0.00 27,992.00 RescueNetT" Printed on 6/15/2004 at 12:57:43PM Page 1 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,372 Batch date: 6/15/2004 1:08:57PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-05-22 0003-A 4,446 AGUILAR-LIRA, CIRILI Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-06-02 0031-A 4,829 COOPER, SAMUEL Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-30 0020-A 4,735 MCNAMARA, WILLIAN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-22 0028-A 4,471 MEDINA, CARLOS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-05-21 0008-A 4,411 PAUL, JANINE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-04-04 0004-A 2,788 THARP, DAWN Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-05-27 0002-A 4,632 YOUNG, ROBERT Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 Trip count: 7 8,097.00 0.00 8,097.00 Trip count: 7 8,097.00 0.00 8 Total trip count: 7 8,097.00 1 0.00 8,097.00 li RescueNetT'A Printed on 6/15/2004 at 1:09:11 PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt I Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,521 Batch date: 6/29/2004 7:33:46AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2003-12-22 0031-A 10,437 BURGESS, SETH Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 i 2003-11-22 0022-A 9,509 CRANE, JONI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-10-22 0025-A 8,454 DELATORRE,ALFREE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2003-12-20 0016-A 10,354 KIPP, CODY Bill Patient Collections No Bill Sent 1,416.00 100.00 1,316.00 2003-10-11 0014-A 8,135 LAPORTE, RYAN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2003-12-24 0017-A 10,498 MEYER,AMANDA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2003-12-08 0032-A 10,006 MILLER, DAVID Bill Patient Collections No Bill Sent 1,131.00 21.00 1,110.00 2003-12-07 0024-A 9,922 MOTA, AMBROCIO Bill Patient Collections No Bill Sent 1,311.00 1,140.00 171.00 2003-12-17 0013-A 10,266 NEUKIRCH, WILLIAM Bill Patient Collections No Bill Sent 1,341.00 1,194.22 146.78 2003-08-11 0018-A 6,112 OROZCO, PEDRO Bill Patient Collections No Bill Sent 1,086.00 543.00 543.00 2003-12-27 0004-A 10,552 PALMER, CALLIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-08-26 0013-A 6,606 PEREGOY, GOLDIE Bill Patient Colle lions No Bill Sent 1,221.00 1,146.68 74.32 2003-12-04 0023-A 9,874 PHILLIPS, LYNDA Bill Patient Collections No Bill Sent 1,131.00 67.50 1,063.50 I 2003-08-25 0029-A 6,586 PREBISH, LORRAINE Bill Patient Collections No Bill Sent 1,011.00 952.36 58.64 2003-10-31 0010-A 8,836 REYNOSO, REYNOL Bill Patient Collections No Bill Sent 1,176.00 100.00 1,076.00 2003-12-12 0012-A 10,128 SISNEROS, EDWARD Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2003-12-03 0020-A 9,837 TAYLOR, BRIAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2003-12-17 0042-A 10,337 WELLS, RICHARD Bill Patient Collections No Bill Sent 1,281.00 1,034.80 246.20 2003-11-22 0038-A 9,529 WILLIAMS,TYLER Bill Patient Collections No Bill Sent 1,086.00 1,036.00 50.00 Trip count: 19 21,483.00 7,335.56 14,147.44 Trip count: 19 21,483.00 7,335.56 14,1 Total trip count: 19 ' 21,483.00 ' 7,335.56 14,147.44 RescueNetTM Printed on 6/29/2004 at 7:34:18AM Page 1 Wiwi 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,522 Batch date: 6/29/2004 7:52:32AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-02-06 0020-A 1,080 AMEN,ASHLEIGH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-21 0011-A 581 BEAN, KYLE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-02-07 0005-A 1,108 COMBS, ERIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-12 0010-A 339 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,356.00 1,281.00 75.00 2004-01-31 0016-A 856 CRAWFORD, DILMAN Bill Patient Collections No Bill Sent 1,296.00 1,220.49 75.51 2004-01-08 0013-A 224 CREASY, MARTHA Bill Patient Collections No Bill Sent 981.00 855.00 126.00 2004-02-05 0013-A 1,046 ELLIOTT, CHARLES Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-01-16 0011-A 464 GONZALES, FRANCE Bill Patient Collections No Bill Sent 996.00 921.00 75.00 2004-01-31 0026-A 866 GRAHAM, MARK Bill Patient Collections No Bill Sent 1,131.00 500.00 631.00 ' 2004-01-23 0010-A 627 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,132.74 73.26 2004-01-04 0004-A 92 HENRY, KIMBERLY Bill Patient Collections No Bill Sent 1,071.00 808.00 263.00 2004-01-22 0017-A 607 HILL, DIXIE Bill Patient Collections No Bill Sent 1,131.00 1,077.80 53.20 2004-01-03 0019-A 83 JACOBSON, JEANA Bill Patient Collections No Bill Sent 1,176.00 25.00 1,151.00 2004-02-07 0030-A 1,170 KING, HAUSCHAN Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-01-30 0010-A 847 LAGE, ETHAN Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-01-13 0005-A 340 LAMB, MYRL Bill Patient Collections No Bill Sent 1,461.00 1,383.99 77.01 2004-01-05 0012-A 148 LORENZINI, JILL Bill Patient Collections No Bill Sent 1,056.00 81.60 974.40 2004-01-26 0027-A 753 MILLER, JESSICA Bill Patient Collections No Bill Sent 1,281.00 927.90 353.10 2004-02-06 0014-A 1,070 ORTEGA, STEPHANIE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-16 0003-A 439 PATIN, AUDREY Bill Patient Collections No Bill Sent 1,086.00 30.00 1,056.00 2004-01-13 0016-A 367 PISANO, PAULITO Bill Patient Collections No Bill Sent 1,056.00 1,005.51 50.49 2004-02-06 0026-A 1,086 RICHARDSON, RUSSI Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-01-09 0008-A 243 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,056.00 988.54 67.46 2004-02-06 0033-A 1,094 VALAZQUEZ, SERGIC Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-01-15 0003-A 397 VILLA, JENNIFER Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-02-07 0032-A 1,172 WILSON, JOSEPH Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-02-05 0014-A 1,047 ZONZO, JOHN Bill Patient Collections No Bill Sent 1,146.00 1,075.17 70.83 Trip count: 27 29,460.00 13,313.74 16,146.26 Trip count: 27 29,460.00 13,313.74 16,146.26 Total trip count 27 j 29,460.00 II 13,313.74 16,146.26) RescueNetTM Printed on 6/29/2004 at 7:53:26AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,523 Batch date: 6/29/2004 8:06:08AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-18 0014-A 2,302 BABEON, DAVID Bill Patient Collections No Bill Sent 2,060 O0 0.00 2,060.00 2004-02-25 0018-A 1,631 BERG, GERALD Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-02-11 0023-A 1,232 BERNAL, LARRY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-01 0017-A 1,804 BISHOP, CAROL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-02-10 0004-A 1,177 DAVIS, RANDY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-03-01 0004-A 1,791 DAY, BECKY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-02 0003-A 1,818 GALLEGOS, OLIVER Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-03-01 0009-A 1,796 GIBBS, GAYLORD Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-02-16 0009-A 1,349 GUZMAN, ARTURO Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-17 0020-A 1,369 HAMILTON, GLEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-28 0006-A 1,701 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,132.74 73.26 2004-02-10 0035-A 1,258 HEVERN, JEANNETTE Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-03-02 0017-A 1,832 HICKEY, ANGEL Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-03-25 0016-A 2,492 HOLSCLAW, MARILYI Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-02-10 0034-A 1,257 MURILLO-RAMOS, JA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-02-13 0014-A 1,273 NUGENT, NATHAN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-02-14 0026-A 1,332 NUNEZ, FRANCISCO Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-02-14 0023-A 1,329 POPE, THOMAS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-02-12 0016-A 1,262 RABIDEAU, RONALD Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-02-09 0018-A 1,165 RAYMUNDO, MAGDAI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-15 0003-A 1,286 RODRIGUEZ, ROSALI Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-03-05 0027-A 1,916 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,056.00 988.54 67.46 2004-03-15 0026-A 2,248 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,251.00 1,178.47 72.53 2004-02-24 0021-A 1,598 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,221.00 1,148.73 72.27 2004-02-14 0006-A 1,305 VANMAANEN, RICK Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-17 0010-A 1,355 VARNER, RYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-16 0019-A 1,379 VEGA-HERNANDEZ, !Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-03-01 0025-A 1,812 VILELLA, HAYDIE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-02-14 0016-A 1,319 YANCEY, KATHY Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 Trip count: 29 32,135.00 4,448.48 27,686.52 Trip count: 29 32,135.00 4,448.48 27,686 Total trip count: 29 I 32,135.00 I. 4,448.48 I 27,686.52 I RescueNetTM Printed on 6/29/2004 at 8:07:03AM Page 1 \\nwl 61rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report • WELD COUNTY PARAMEDIC SERVICES Batch 4,524 Batch date: 6/29/2004 8:17:19AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-07 0030-A 5,011 AGUILAR, MIGUEL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-06-07 0038-A 5,019 GARZA, SANTOS Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-06-04 0013-A 4,881 HERRERA, DAVID Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-10 0021-A 3,020 KOCH, HOWARD Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-01 0031-A 3,674 MARKHAM, MITZI Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-06-09 0003-A 5,040 OTERO, RAFAEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-01 0033-A 4,797 PETERSON, KIM Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 Trip count: 7 7,737.00 0.00 7,737.00 Trip count: 7 7,737.00 0.00 7,73 Total trip count: 7 ! 7,737.00 ' 0.00 7,737.0 RescueNeF" Printed on 6/29/2004 at 8:17:30AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,650 Batch date: 7/9/2004 8:25:10AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-01-06 0004-A 154 ALVAREZ, MATEO Bill Patient Collections No Bill Sent 1,940.00 1,881.11 58.89 2003-12-05 0018-A 9,931 BENNETT, RENEA Bill Patient Collections No Bill Sent 1,101.00 883.00 218.00 2004-01-08 0019-A 230 CANCINO, JAIME Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-01-16 0004-A 440 CANCINO, JAIME Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-08-26 0026-A 6,619 CORCORAN, SHAUN Bill Patient Collections No Bill Sent 1,341.00 1,281.90 59.10 2004-01-25 0023-A 706 EHRLICK, JESSICA Bill Patient Collections No Bill Sent 981.00 596.00 385.00 2004-01-25 0029-A 712 EHRLICK, SARAH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-12-08 0005-A 9,968 FERGUSON, ANNE Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2003-10-29 0024-A 8,782 GARCIA, ANDREA Bill Patient Collections No Bill Sent 843.00 201.00 642.00 2003-12-04 0018-A 9,869 GONZALEZ, HIPOLITC Bill Patient Collections No Bill Sent 1,266.00 1,194.63 71.37 2003-12-27 0036-A 10,584 HERNANDEZ, MARIA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2003-12-30 0004-A 10,650 HINTZ, JOSFPH Bill Patient Collections No Bill Sent 1,533.00 0.00 1,533.00 2004-01-03 0048-A 123 HOLGUIN, JORGE Bill Patient Collections No Bill Sent 1,1 i6.U0 0.00 1,116.00 �11a�•OO 2004-01-01 0012-A 14 KNIGHT, BRUCE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-01-25 0009-A 692 LUEHRING, JOANN Bill Patient Collections No Bill Sent 1,146.00 1,077.11 68.89 2003-11-07 0004-A 9,051 ROLON, LORENA Bill Patient Collections No Bill Sent 1,281.00 55.00 1,226.00 2003-03-31 0015-A 1,877 ROSTIE, MICHAEL Bill Patient Collections No Bill Sent 1,025.00 0.00 1,025.00 2003-09-08 0023-A 7,030 SMELTZER, GEORGE Bill Patient Collections No Bill Sent 1,676.00 0.00 1,676.00 2004-01-27 0006-A 730 SPEAKER, HERBERT Bill Patient Collections No Bill Sent 1,356.00 1,283.09 72.91 2003-12-04 0004-A 9,855 THOMS, WILLIAM Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-11-16 0017-A 9,332 VASQUEZ, LUCIANO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-30 0030-A 918 WEIMER, THOMAS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-12-29 0005-A 10,608 YORK, PATRICIA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 Trip count: 23 27,114.00 8,452.84 18,661.16 Trip count: 23 27,114.00 8,452.84 18 • • _16 Total trip count: 23 1 27,114.00 i 8,452.84 18,661.16 RescueNetT"^ Printed on 7/9/2004 at 8:25:38AM Page 1 \\nw16\rescue net\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,651 Batch date: 7/9/2004 8:47:22AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance I 2004-02-26 0007-A 1,638 BETZNER, DEBRA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-02-20 0023-A 1,492 BURGERSS, CARLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-05 0003-A 1,036 CANCINO, JAIME Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-27 0006-A 1,678 CARRASCO-PAYEN, i Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-02-28 0013-A 1,740 CARREON, SANDRA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-02-22 0032-A 1,542 CHAVEZ, PAUL Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-02-27 0019-A 1,694 DESMOND, THOMAS Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-02-25 0011-A 1,616 GALINDO, FELIX Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-24 0017-A 1,594 GOMEZ-SALDANA, JE Bill Patient Collections No Bill Sent 1,116.00 892.80 223.20 2004-02-18 0021-A 1,409 GREGORY, KENNETI-Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-02-18 0005-A 1,387 HARRIS, EULA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-02-20 0028-A 1,509 HELD T,, WOODSON Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.nn 00 2004-02-18 0012-A 1,396 JACKSON, DALE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-02-23 0004-A 1,548 LAWSON, KARI Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-02-29 0013-A 1,728 LITTLEWOLF, ASHLE'Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-02-28 0023-A 1,759 MASLYN, AVALLON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-20 0001-A 1,445 MESTAS, LEROY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-03 0017-A 970 MOCK, LORETTA Bill Patient Collections No Bill Sent 1,221.00 775.00 446.00 2004-02-22 0009-A 1,519 MOLINA, FABIOLA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-02-26 0009-A 1,640 MONTOYA, KRISTINA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-02-27 0011-A 1,683 MORADO, JOSEPH Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-02-29 0047-A 1,778 MUNOZ, LOURDES Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-02-25 0009-A 1,614 MYERS, TODD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-25 0006-A 1,611 NEWMAN, HAROLD Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-02-20 0026-A 1,504 OLIVO, MARCIE Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-02-29 0011-A 1,726 PINEDA, ALVARO Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-28 0017-A 1,748 PINEDA, DANNY Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-02-29 0012-A 1,727 PINEDA, KARLA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-19 0018-A 1,444 ROMANI, PETE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-26 0029-A 1,660 SALAZAR, PETIE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-02-23 0005-A 1,549 SOLIS, DANIEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-02-27 0030-A 1,709 TAPIA, REBECCA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-20 0020-A 1,477 TAYLOR, PAMELA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-02-29 0042-A 1,773 TRYELS, RENEE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 RescueNetm Printed on 7/9/2004 at 8:48:11AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD (BOUNTY PARAMEDIC SERVICES 2004-02-23 0017-A 1,561 WHITEHORN, PENNY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 Trip count: 35 35,661.00 1,667.80 33,993.20 Trip count: 35 35,661.00 1,667.80 33,993. Total trip count: 35 ' 35,661.00 + 1,667.80 33,993.20 I) RescueNetTM Printed on 7/9/2004 at 8:48:11AM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,652 Batch date: 7/9/2004 9:02:46AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-02 0022-A 1,837 BEAR, PHYLLIS Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-21 0003-A 2,382 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-06-20 0036-A 5,443 ERRERO, DAVID Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-06-12 0018-A 5,152 EVANS,JENNIFER Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-07 0004-A 4,984 FLORES, THOMAS Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-03-22 0015-A 2,465 GUTIERREZ, RICARD Bill Patient Collections No Bill Sent 1,881.00 0.00 1,881.00 2004-06-18 0021-A 5,360 HERRERA, DAVID Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-15 0018-A 4,224 MARTINEZ, ANNETTE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-02 0007-A 2,746 MATA, ADAM Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-04-13 0001-A 3,072 MEDINA, CARLOS Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-10 0006-A 2,970 MEHRING, JOY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-17 0008-A 3,205 MELENDEZ, BRENDA Bill Patient Collections No Bill Sent 1,17R.00 0.00 1,176.00 2004-06-17 0025-A 5,327 PAUL, JANINE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-06 0023-A 2,870 RODRIGUEZ-NAZARI(Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-17 0009-A 3,207 SAENZ, LAURA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-06-11 0032-A 5,185 SOTELO, ISALTIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-09 0024-A 2,962 TYNAN, SHARON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-23 0030-A 4,542 VALDIVIESO, JOHN Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 Trip count: 18 17,820.00 0.00 17,820.00 Trip count: 18 17,820.00 0.00 17 820700-N? Total trip count: i 18 ' i 17,820.00 I 0.00 17,820.00 RescueNettM Printed on 7/9/2004 at 9:03:16AM Page 1 1\nw 16\rescuen ere ports321Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,800 Batch date: 7/27/2004 1:05:43PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-01-02 0018-A 48 ALANIZ, ROBERT Bill Patient Collections No Bill Sent 1,341.00 1,260.73 80.27 2003-11-18 0019-A 9,387 BANTIN-JOHNSON, MBill Patient Collections No Bill Sent 1,146.00 1,096.00 50.00 2003-08-12 0016-A 6,137 BERK, JASON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-09-11 0009-A 7,139 BRADY, BARBARA Bill Patient Collections No Bill Sent 1,386.00 1,153.00 233.00 2004-01-10 0011-A 277 CONTOS, ALEXIS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-16 0012-A 465 FLORES, MONICA Bill Patient Collections No Bill Sent 1,266.00 928.42 337.58 2003-08-13 0028-A 6,183 FOSKETT, PAUL Bill Patient Collections No Bill Sent 1,056.00 1,000.07 55.93 2003-09-14 0004-A 7,224 GALVIN, KRISTINA Bill Patient Collections No Bill Sent 1,116.00 781.20 334.80 2003-12-21 0010-A 10,390 GURULE, ILEEA Bill Patient Collections No Bill Sent 1,416.00 20.00 1,396.00 2003-03-26 0013-A 1,737 HANKS, DEBRA Bill Patient Collections No Bill Sent 1,355.00 716.87 638.13 2003-08-21 0004-A 6,421 HARMON, DUSTIN Bill Patient Collections No Bill Sent 1,428.00 300.00 1,128.00 I 2003-06-21 0029-A 4,483 HAWKINS, KAYELYN"Bill Patient Collections No Bill Sent 1,235.00 1,037.60 197.40 2004-01-03 0013-A 75 HIDDESSEN, JESSE Bill Patient Collections No Bill Sent 1,146.00 1,086.89 59.11 I 2003-11-20 0028-A 9,451 HOFF, SHARON Bill Patient Collections No Bill Sent 1,147.78 593.98 553.80 2004-01-07 0004-A 192 JAKUBIAK, JOHN Bill Patient Collections No Bill Sent 1,805.00 1,702.44 102.56 2004-01-19 0019-A 533 JAYNES, MELISSA Bill Patient Collections No Bill Sent 1,161.00 874.53 286.47 2004-01-10 0002-A 251 LANG, NICHOLAS Bill Patient Collections No Bill Sent 1,086.00 20.00 1,066.00 2003-07-08 0012-A 5,000 LOPEZ, STELLA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-01-12 0024-A 356 LUEHRING, BRYAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-05 0006-A 142 MARTINEZ, RICHARD Bill Patient Collections No Bill Sent 1,251.00 1,189.46 61.54 2003-11-07 0007-A 9,054 MYERS,ANDREW Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-01-15 0009-A 419 NOLLETT, KIMBERLY Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2003-09-12 0021-A 7,205 O'GUINN, MARY Bill Patient Collections No Bill Sent 1,116.00 1,056.50 59.50 2003-10-16 0012-A 8,325 RAMOS, LINDA Bill Patient Collections No Bill Sent 1,466.00 0.00 1,466.00 2003-11-24 0022-A 9,591 SALAZAR, TAMMY Bill Patient Collections No Bill Sent 1,251.00 25.00 1,226.00 2003-10-06 0017-A 7,909 WILSON, ABBY Bill Patient Collections No Bill Sent 1,191.00 25.00 1,166.00 Trip count: 26 30,159.78 14,867.69 15,292.09 Trip count: 26 30,159.78 14,867.69 Total trip count: 26 1 30,159.78 I 14,867.69 1 15,292.09 RescueNetTM Printed on 7/27/2004 at 1:06:15PM Page 1 \\nw 16\rescuenet\re ports32\Billing\Miscellaneous\Su b Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,801 Batch date: 7/27/2004 1:24:22PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-05 0033-A 1,922 ALVIDREZ, LETICIA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-02-02 0013-A 942 ASMUSSEN, THOMAE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-01-25 0002-A 685 BURNS, BETTY Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-02-28 0018-A 1,749 CERVANTES, ELIZAB Bill Patient Collections No Bill Sent 1,401.00 1,314.83 86.17 2004-03-05 0023-A 1,912 CORDOVA, DESIREE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-23 0013-A 1,557 ENRIQUEZ, MARIA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-02-06 0004-A 1,060 EURISTI, TELLY Bill Patient Collections No Bill Sent 1,221.00 776.80 444.20 2004-03-04 0003-A 1,871 FALK, ERICA Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-03-03 0014-A 1,864 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-05 0029-A 1,918 GOMBOS, JAMES Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-02-21 0026-A 1,501 HATFIELD, MARK Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 _ kio_ a ncn nn tan nn 2004-03-03 uu2u-A 1,930 JONES, DON Bill Patient C n'Collections Di Sent i vv.vv 0.00 vv.vv 2004-02-22 0002-A 1,512 KARCHMER, DAVID Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-01-31 0031-A 871 KARCHMER, DAVID Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-01-30 0002-A 831 POLLAND,ADAM Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-02-26 0011-A 1,642 RAMOS, LINDA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-03 0012-A 1,862 RODRIGUEZ, TALLINE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-05 0039-A 1,928 RODRIGUEZ-ZAMOR'Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-02-13 0021-A 1,280 SANDERS, LLOYD Bill Patient Collections No Bill Sent 1,281.00 1,206.75 74.25 2004-02-11 0002-A 1,211 SIEBENALER, CONNCBill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-02-23 0021-A 1,566 SIERRA, ANTHONY Bill Patient Collections No Bill Sent 2,180.00 0.00 2,180.00 2004-02-19 0013-A 1,439 SMALL, CINDY Bill Patient Collections No Bill Sent 1,341.00 1,326.28 14.72 2004-03-02 0021-A 1,836 STEELE, SHARON Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-02-16 0020-A 1,380 VEGA-HERNANDEZ, ',Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-01-24 0004-A 655 WAILES, CASEY Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-01-24 0003-A 654 WAILES, LEILA Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-01-25 0020-A 703 WERNER, ABNER Bill Patient Collections No Bill Sent 1,206.00 1,200.59 5.41 2004-01-26 0022-A 748 ZONZO, VITO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 Trip count: 28 31,775.00 5,825.25 25,949.75 Trip count: 28 31,775.00 5,825.25 25,94 Total trip count: 28 I 31,775.00 I 5,825.25 25,949.75 RescueNetTM Printed on 7/27/2004 at 1:25:10PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,802 Batch date: 7/27/2004 1:44:16PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-03-15 0023-A 2,242 AGUINA-MARTINEZ, JBill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-03-13 0034-A 2,173 AVEZZANO, DEBRA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-03-14 0002-A 2,177 AVILA, RUBEN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-15 0025-A 2,246 BATES, BRENDA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-12 0002-A 2,106 BRYAN, JAMES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-11 0014-A 2,088 CARRASCO, KEVIN Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-03-15 0008-A 2,194 CASTILLO, JUSTIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-08 0029-A 2,022 CERVANTES, MARGP Bill Patient Collections No Bill Sent 1,296.00 20.00 1,276.00 2004-03-12 0018-A 2,128 CHAVEZ, DEBI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-13 0015-A 2,145 CHRISTMAS, ERIC Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-06 0039-A 1,969 CRARY, BRADLEY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-03-14 0001-A 2,176 GALLEGOS, OLIVER Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-10 0016-A 2,065 GARCIA, DARLENE Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-03-06 0002-A 1,932 GONZALES, MARIA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-03-12 0001-A 2,105 HERNANDEZ, LEON Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-03-14 0010-A 2,187 JAQUEZ, GERARDO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-13 0023-A 2,159 KARR, DEAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-13 0024-A 2,161 KARR, LORI Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-03-08 0010-A 2,003 MARTINEZ, MARIA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-09 0019-A 2,046 MELENDEZ, LLUVIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-12 0031-A 2,157 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-09 0014-A 2,041 MONTOYA, LISA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-07 0022-A 1,992 MORGAN, FORREST Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-15 0028-A 2,250 OLIVAS, PAUL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-13 0036-A 2,175 PEREZ, ROY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-03-11 0027-A 2,104 POSS, JENNIFER Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-03-09 0010-A 2,037 READY, TAYLOR Bill Patient Collections No Bill Sent 1,611.00 0.00 1,611.00 2004-03-12 0013-A 2,117 THOMPSON, HEATHE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-09 0009-A 2,036 VALENCIA, ANTHONY Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-11 0008-A 2,082 VILLAREAL, SILVIA Bill Patient Collections No Bill Sent 1,316.00 0.00 1,316.00 2004-03-10 0019-A 2,095 WILSON, ANITA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-12 0021-A 2,134 WISSLER, JASON Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-07 0003-A 1,973 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-10 0004-A 2,051 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 RescueNetTM Printed on 7/27/2004 at 1:44:58PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-03-11 0020-A 2,097 ZAMARRIPA, ANTONI Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 Trip count 35 35,054.00 20.00 35,034.00 Trip count: 35 35,054.00 20.00 35,03 Total trip count: 35 ' 35,054.00 ! 20.00 35,034.00 I RescueNetTM Printed on 7/27/2004 at 1:44:58PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,803 Batch date: 7/27/2004 2:07:22PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-03-19 0019-A 2,347 CARRILLO, MICHELLE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-25 0028-A 2,518 CASE, CHAD Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-21 0002-A 2,381 CASTRO, GABRIEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-16 0016-A 2,237 COCKRILL, BENJAMIP Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-03-31 0015-A 2,698 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-31 0025-A 2,708 GALLEGOS, OLIVER Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-22 0011-A 2,461 GARCIA, BERNIECE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-03-18 0006-A 2,294 HAWKINS, MELISSA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-18 0005-A 2,293 HAWKINS, QUINCY Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-22 0003-A 2,450 HOWE, WILLIAM Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-03-19 0004-A 2,324 ITEN. BRIAN Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-16 0019-A 2,241 KAMAKELE, DAVID . Bill Patient Collections No Bill Sent 150.00 0.00 1`n nn 00 IJU.VV 2004-03-17 0017-A 2,269 LOZANO, THOMAS Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-03-28 0005-A 2,597 MARQUARDT,TOM Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-20 0029-A 2,371 MENDOZA, FELIPE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-22 0032-A 2,509 MOGUS, NATHANIEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-20 0015-A 2,357 PEREZ, EVETTE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-21 0023-A 2,454 REZA, JUAN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-03-20 0032-A 2,374 ROBBINS, RICK Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-21 0005-A 2,384 ROBBINS, RICK Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-03-20 0011-A 2,353 ROYBAL, WILLIAM Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-03-19 0015-A 2,343 SALAZAR, ANTHONY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-28 0019-A 2,629 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,341.00 1,268.47 72.53 2004-03-17 0018-A 2,270 SETTLE, BRYAN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-19 0018-A 2,346 SEVILLE, SEAN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-03-17 0001-A 2,253 SHAFFER, BRYON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-21 0009-A 2,434 SHANNON, RICHARD Bill Patient Collections No Bill Sent 1,421.00 0.00 1,421.00 2004-03-22 0001-A 2,446 SHUNK, AARON Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-03-22 0012-A 2,462 SHUNK,AARON Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-21 0018-A 2,443 UHRICH, HAROLD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-18 0001-A 2,289 WELCH, JUDY Bill Patient Collections No Bill Sent 1,131.00 0.00 1.131.00 2004-03-17 0025-A 2,277 WIPF, ADAM Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 Trip count: 32 33,218.00 1,268.47 31,949.53 RescueNetTM Printed on 7/27/2004 at 2:08:10PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Trip count: 32 33,218.00 1,268.47 31,949.53 Total trip count: 32 I 33,218.00 I 1,268.47 31,9:9> RescueNetTM Printed on 7/27/2004 at 2:08:10PM Page 2 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt j Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,804 Batch date: 7/27/2004 2:32:46PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-04-08 0024-A 2,927 CASE, CHAD Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-06-27 0004-A 5,632 CORTEZ, ARMANDO Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-06-27 0028-A 5,673 DADISMAN, KATHERI Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-08 0031-A 6,097 ESCALANTE, ROBER'Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-07-04 0031-A 5,944 ESQUIVEL, OSVALDC Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-21 0019-A 3,369 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-14 0016-A 3,124 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-02 0029-A 5,877 GARZA, SANTOS Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-04-12 0024-A 3,064 GONZALES, ROSALV,Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-06-24 0010-A 5,584 GUERA, GILBERT Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-05 0018-A 5,987 GUERRO, GILBERT Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-31 0025-A 4,763 GUITERREZ, LEONAF Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-04-12 0011-A 3,051 HANSING, CHRISTOP Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-04-17 0010-A 3,211 HENN, DANIEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-27 0001-A 4,631 HERRERA, ADRIAN Bill Patient Collections No Bill Sent 1,926.00 0.00 1,926.00 2004-04-15 0037-A 3,202 LANCKRIET, GREGOF Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-11 0027-A 3,011 LANCKRIET, GREGOF Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-04-15 0028-A 3,175 LOPEZ,ANTINIO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-16 0038-A 6,363 MARTINEZ,ANDRES Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-06-13 0022-A 5,207 MULLER, WILLIAM Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-26 0006-A 4,592 PEREZ, ROY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-28 0016-A 3,564 RAMIREZ, JULIANA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-04 0010-A 2,800 SCHANTZ, PAUL Bill Patient Collections No Bill Sent 1,191.00 1,133.43 57.57 2004-04-29 0020-A 3,600 SHUNK, AARON Bill Patient Collections No Bill Sent 2,105.00 0.00 2,105.00 2004-05-27 0012-A 4,642 SOLIS, GUADELUPE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-28 0034-A 5,726 WHITE, ROBIN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-27 0022-A 5,665 WHITESHIRT, GUY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-05-12 0024-A 4,096 YBARRA-ROGERS, BI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count: 28 32,546.00 1,133.43 31,412.57 Trip count: 28 32,546.00 1,133.43 31,412.57 Total trip count: 28 ' 32,546.00 ' 1,133.43 3f1,412.5 • RescueNetTM Printed on 7/27/2004 at 2:33:34PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES , Batch 4,988 Batch date: 8/11/2004 12:40:50PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-07 0001-A 1,971 AMAYA, PAUL Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-03-24 0023-A 2,429 BACA, MARY Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-11-12 0002-A 9,165 BRISENA, STEVE Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2003-12-22 0018-A 10,423 BUTTERBAUGH, SAM Bill Patient Collections No Bill Sent 1,296.00 627.20 668.80 2003-06-20 0020-A 4,400 CHACON, MARIA Bill Patient Collections No Bill Sent 1,460.00 240.00 1,220.00 2004-03-24 0026-A 2,432 CORTEZ, EDUARDO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-23 0013-A 2,400 ESPINOZA, CASEY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-03-04 0007-A 1,875 FERGUSON, PATRICM Bill Patient Collections No Bill Sent 981.00 935.88 45.12 2004-03-04 0009-A 1,877 FERGUSON, PATRICM Bill Patient Collections No Bill Sent 498.00 372.88 125.12 2004-03-24 0001-A 2,407 GAMEZ, WALDO Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-01-08 0022-A 233 GEORGE, KENNETH Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 nnnn n nn nnnI n o IIn I rnnl I GRANT 11 Patient n_,, \I_ •I O_ ♦ n OAn nI/�� C7-/ on 2003-10-22' VV 14-A 0,443 LEDALL, GRMIV I Bill Patient Collections IVV Bill Sent I,34 I.VV 763.20 31 I.VV 2004-03-24 0027-A 2,433 LEE,VICTORIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-16 0011-A 2,231 MARTIN, DARIN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-22 0002-A 2,447 MCCREATH, TODD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-25 0023-A 2,501 MORALES-LOZANO, F Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-02-29 0048-A 1,779 MUNOZ, LUZ Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-02-08 0005-A 1,125 NORRIS, JEFFREY Bill Patient Collections No Bill Sent 1,631.00 20.00 1,611.00 2004-02-10 0001-A 1,174 ORTEGA, KIRSTEN Bill Patient Collections No Bill Sent 1,308.00 0.00 1,308.00 2004-03-12 0010-A 2,114 RAMOS, TRINIDAD Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-02-05 0023-A 1,098 ROJAS, ANGEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-18 0015-A 2,303 ROSALES, CHRISTINI Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-02-17 0002-A 1,343 ROSAS, BENNY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-24 0012-A 1,589 SANCHEZ, AMADOR Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-02-25 0019-A 1,632 SCHNEIDER, JAN Bill Patient Collections No Bill Sent 1,311.00 887.22 423.78 2004-03-25 0017-A 2,494 TEPYO,ARASELEY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-11-18 0030-A 9,400 VARGAS, FRANSISCC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-10 0022-A 1,195 VILLEGAS, JOSE Bill Patient Collections No Bill Sent 1,191.00 1,131.97 59.03 2004-01-22 0004-A 588 WAGNER, ANDREW Bill Patient Collections No Bill Sent 1,116.00 51.20 1,064.80 2004-03-14 0011-A 2,191 YBARRA, GERARDO Bill Patient Collections No Bill Sent 1,296.00 1,216.78 79.22 Trip count: 30 31,381.00 6,366.33 2 Trip count: 30 31,381.00 6,366.33 25,014.67 RescueNettM Printed on 8/11/2004 at 12:42:39PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,989 Batch date: 8/11/2004 1:06:06PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-28 0004-A 2,595 ALVAREZ, DARIO Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-03-26 0045-A 2,586 BARNES, DIONTRE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-03-29 0023-A 2,643 BREDEHOFT, KAITLII`Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-27 0014-A 2,538 BURTON, SHANTEL Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-03-29 0001-A 2,596 CHAGOLLA,VENESS,Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-03-27 0024-A 2,549 CROSS, TERRI Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-03-26 0050-A 2,591 EMERY, BRANDI Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-04-01 0003-A 2,713 FLYNN, ADRIAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-02-25 0010-A 1,615 GALLEGOS, MONICA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-27 0003-A 2,524 GURULE, RAMON Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-03-28 0024-A 2,634 HILLMAN, DONNA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-03-28 0008-A 2,610 HUGHLEY, ELBERT Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-03-30 0025-A 2,677 LOPEZ-RODRIGUEZ, Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-04-01 0019-A 2,729 MARTINEZ, JIMMY Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-03-27 0015-A 2,539 MICHAUD, DANIEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-28 0007-A 2,609 MULLINS, JONATHAN Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-03-30 0029-A 2,681 PACHECO, JORGE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-03-27 0020-A 2,545 RODRIGUEZ, HIDALG Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-03-26 0006-A 2,516 RODRIQUEZ,JUNIOR Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-04-01 0006-A 2,716 ROGERS,VALERIE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-30 0007-A 2,659 SANDOVAL, ISABELLI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-03-30 0017-A 2,669 THACKER, PATRICK Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-26 0040-A 2,581 TRYON, RICHARD Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-03-28 0003-A 2,594 VANHAZEL,WILLIAM Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-03-31 0001-A 2,684 WEGLIN, DOUGLAS Bill Patient Collections No Bill Sent 1,011,00 0.00 1,011.00 2004-03-14 0004-A 2,179 WYERS, LARRY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 26 27,348.00 0.00 27,348.00 Trip count: 26 27,348.00 0.00 27,348.00 e Total trip count: 26 ( 27,348.00 ' 0.00 I 27,348.00 RescueNetnA Printed on 8/11/2004 at 1:06:37PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,990 Batch date: 8/11/2004 1:31:46PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-04-08 0012-A 2,915 ALVARADO, MARIA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-04-04 0007-A 2,796 ARNOLDY, JOHN Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-04-30 0021-A 3,625 ARROWSMITH, KARE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-04-16 0011-A 3,176 BARRIOS, ROCIO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-04-04 0024-A 2,814 CADENA, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-09 0022-A 2,957 CHERRY, DOUGLAS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-04-04 0023-A 2,813 DRISKELL, CRAIG Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-04-03 0025-A 2,794 EGAN,ALAINA Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-04-03 0026-A 2,795 ESPARZA, MARIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-11 0003-A 2,982 ESPINOZA, PABLO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-02 0022-A 2,761 ESTRADA, ALEJANDFBill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-30 0023-A 3,627 GALLEGOS, ROBERT Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-04-02 0004-A 2,743 GERVACIO, CAROLINBill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-04-05 0030-A 2,846 HERNANDEZ, CRISTII Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-04-02 0011-A 2,750 JIMENEZ, SERGIO Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-04-25 0012-A 3,481 KARCHMER, DAVID Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-06 0016-A 2,863 KEEVER, NICOLE Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-04-06 0008-A 2,855 KRIER, JEFF Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-04-06 0017-A 2,864 LECHUGA, DUSTIN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-04-09 0002-A 2,937 LIRA, JESSICA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-03 0009-A 2,772 LOPEZ, GILBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-09 0006-A 2,941 LOPEZ, JORGE Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-04-11 0019-A 3,003 MAYSHACK, ART Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-06 0011-A 2,858 MORGAN, JERRY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-09 0004-A 2,939 MORRIS, AMBER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-03 0027-A 2,797 OLIVAS, MONICA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-04-02 0009-A 2,748 ORONA, YESENIA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-09 0021-A 2,956 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-03 0021-A 2,787 PULIAFICO, MELISSA Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-08 0018-A 2,921 RENTERIA, EDDIE Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 I 2004-04-04 0003-A 2,782 RODRIGUEZ, HENRY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-02 0008-A 2,747 ROGERS, TIMOTHY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-26 0018-A 3,516 SANCHEZ-TOVAR, hi/Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-05 0029-A 2,845 SELLERS, JUANITA Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 RescueNettM Printed on 8/11/2004 at 1:32:30PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-04-15 0007-A 3,137 SHUMATE, TANYA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-07 0018-A 2,895 VIGIL, MICHELLE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count 36 35,664.00 0.00 35,664.00 Trip count 36 35,664.00 0.00 -- 35,664.90-----:N Total trip count 36 I 35,664.00 I 0.00 I I 35,664.00 I \-----________/ RescueNet"" Printed on 8/11)2004 at 1:32:30PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 4,991 Batch date: 8/11/2004 1:53:58PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-26 0032-A 5,687 ALARCON, REBECCA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-27 0018-A 5,659 BRINKLEY, SARAH Bill Patient Collections No Bill Sent 1,146.00 1,077.11 68.89 2004-05-11 0031-A 4,061 CLEMONS, CHAD Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-16 0035-A 6,359 CUEVAS, ALEJANDR(Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-06-21 0026-A 5,472 DEFOND, RONALD Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-16 0036-A 6,360 GARCIA-MESA, JAVIE Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-06-26 0020-A 5,674 GRAHAM, JAMES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-13 0006-A 4,114 KARCHMER, DAVID Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-16 0037-A 6,361 MARTINEZ, RAUL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-23 0026-A 6,594 RENCH, DON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-16 0002-A 5,276 RODGERS, DANIEL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-21 0029-A 5,475 SANCHEZ, TERRY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-03 0021-A 5,939 STUARD, LONNY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count 13 10,899.00 1,077.11 9,821.89 Trip count: 13 10,899.00 1,077.11 9,821.89 ( e Total trip count: 13 I 10,899.00 ' 1,077.11 821.89 RescueNetTM - Printed on 8/11/2004 at 1:54:16PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,193 Batch date: 8/27/2004 1:25:12PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-02-04 0027-A 1,006 ALLEN, ROBERT Bill Patient Collections No Bill Sent 1,371.00 1,096.80 274.20 2004-01-06 0013-A 172 CHAPARRO, EMILY Bill Patient Collections No Bill Sent 1,161.00 928.80 232.20 2003-06-26 0029-A 4,632 CROWLEY, JACQUEL Bill Patient Collections No Bill Sent 1,070.00 500.00 570.00 2003-11-26 0009-A 9,633 DELAFUENTE-CAZAR Bill Patient Collections No Bill Sent 1,101.00 660.60 440.40 2004-02-26 0039-A 1,710 DOUGLASS, REBECC Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2003-12-23 0027-A 10,482 DURAN, BRANDON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-18 0004-A 1,384 HOLLIDAY, GORDON Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-01-13 0027-A 378 MARTINEZ, LASARO Bill Patient Collections No Bill Sent 1,491.00 100.00 1,391.00 2004-02-24 0001-A 1,578 MEADS,ASHLEY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-01-07 0008-A 200 MILLER, YVONNE Bill Patient Collections No Bill Sent 1,281.00 1,039.80 241.20 2004-02-23 0032-A 1,577 MIRAMONTES-CHAVE Bill Patient Collections No Bill Sent 1,296.00 768.60 527.40 2003-08-16 0009-A 6,268 MITCHELL, AMANDA Bill Patient Collections No Bill Sent 1,131.00 180.00 951.00 2004-02-14 0021-A 1,325 OWNBY, PAMELA Bill Patient Collections No Bill Sent 1,347.57 957.87 389.70 2004-02-26 0025-A 1,656 RICHARDSON, ANN Bill Patient Collections No Bill Sent 1,191.00 0.27 1,190.73 2004-02-25 0012-A 1,617 SELLERS, CHRISTINE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-02-10 0027-A 1,200 SEYMOUR, SUSIE Bill Patient Collections No Bill Sent 1,131.00 75.00 1,056.00 2003-10-16 0015-A 8,328 SPENCER, TARA Bill Patient Collections No Bill Sent 1,101.00 1,076.00 25.00 2003-10-25 0003-A 8,615 TAYLOR, BRADLEY Bill Patient Collections No Bill Sent 1,056.00 75.00 981.00 2004-02-10 0014-A 1,187 TRUSTY,ANDREA Bill Patient Collections No Bill Sent 1,311.00 794.55 516.45 2004-01-18 0004-A 491 WAKEFIELD, TOMMY Bill Patient Collections No Bill Sent 1,116.00 1,066.00 50.00 Trip count: 20 22,904.57 9,319.29 13,585.28 Trip count: 20 22,904.57 9,319.29 13,585.28, Total trip count: 20 I 22,904.57 ' 9,319.29 I 13,585.28 • RescueNeF" Printed on 8/2712004 at 1:25:47PM Page 1 \\nw 16\rescuen et\reports32\Billing\Miscellaneous\S u bBatch 7.rpt i Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,194 Batch date: 8/27/2004 1:39:46PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-26 0026-A 2,566 BUTCHER, GARY Bill Patient Collections No Bill Sent 1,511.00 0.00 1,511.00 2004-03-09 0008-A 2,035 EILERS, LYDIA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-03-09 0007-A 2,034 EILERS, RUDY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-10 0011-A 2,984 EVANS, THELMA Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-03-05 0011-A 1,900 HARRIS, RUTH Bill Patient Collections No Bill Sent 1,086.00 1,025.01 60.99 2004-04-08 0011-A 2,914 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,176.00 1,104.73 71.27 2004-03-26 0032-A 2,573 JENNEY, HOWARD Bill Patient Collections No Bill Sent 1,371.00 1,286.82 84.18 2004-03-23 0014-A 2,401 JOHNSON, ZANE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-04-07 0006-A 2,883 KASPAR, SHERRI Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-03-26 0013-A 2,537 KUEKER, SARA Bill Patient Collections No Bill Sent 1,071.00 996.00 75.00 2004-04-08 0003-A 2,906 LEBLANC, RICHARD Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-03-30 0031-A 2,683 MARIN, RAYMOND Bill Patient Collections No Bill Sent 1,596.00 1,508.57 87.43 2004-03-29 0017-A 2,628 MATA, FRANCISCA Bill Patient Collections No Bill Sent 1,071.00 1,021.46 49.54 2004-03-07 0004-A 1,974 MAYES, JOSHUA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-21 0020-A 2,448 MILLER, SALLY Bill Patient Collections No Bill Sent 1,341.00 20.00 1,321.00 2004-03-30 0009-A 2,661 MIRELES, LETICIA Bill Patient Collections No Bill Sent 1,011.00 936.00 75.00 2004-02-29 0037-A 1,768 MORENO, ROLAND Bill Patient Collections No Bill Sent 1,341.00 1,178.80 162.20 2004-03-30 0018-A 2,670 NEVAREZ, CESAR Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-03 0014-A 2,779 ORTEGA, JOSE Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-03-31 0009-A 2,692 PATTERSON, EDWAF Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-03-21 0024-A 2,455 PHILLIPS, ANN MARIE Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-03-16 0015-A 2,236 SCHOTT, WILBUR Bill Patient Collections No Bill Sent 1,206.0O 1,156.00 50.00 2004-03-18 0029-A 2,317 SMART, AMBER Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-04-04 0012-A 2,802 WILSON, BRADY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-05 0031-A 1,920 YAMADA, BRETT Bill Patient Collections No Bill Sent 1,431.00 1,144.80 286.20 Trip count: 25 30,419.00 11,378.19 19,040.81 Trip count: 25 30,419.00 11,378.19 19 040.81 Total trip count: 25 ( 30,419.00 1 11,378.19 ( 19,04 80 1 "j. \ / RescueNetTM Printed on 8/27/2004 at 1:41:44PM Page 1 \\nw161rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,195 Batch date: 8/27/2004 2:16:24PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-04-17 0007-A 3,203 AGUILERA, MOISES Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-04-19 0027-A 3,317 ARMIJO-TORRES, CR Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-04-15 0010-A 3,148 BELTRAN, REGINALD Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-04-21 0021-A 3,371 CONLEY,JEREMY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-15 0042-A 3,228 CRUZ, ALBERT Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-28 0007-A 3,553 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-22 0001-A 3,378 ESPARZA, MARIA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-11 0014-A 2,996 FLORES,ANA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-04-29 0004-A 3,583 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-14 0023-A 3,138 GONZALEZ, DENISE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-04-20 0024-A 3,357 GUTIERREZ_, LEONAFBiII Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-14 0018-A 3,126 GUZMAN, GLORIA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-17 0002-A 3,180 HENDERLONG,ARTHBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-15 0030-A 3,179 HOUGH, MICHELE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-13 0005-A 3,076 JENNEY, HOWARD Bill Patient Collections No Bill Sent 1,356.00 1,268.28 87.72 2004-04-14 0024-A 3,139 JENNEY, HOWARD Bill Patient Collections No Bill Sent 1,371.00 1,282.64 88.36 2004-04-20 0015-A 3,336 JUAREZ, FERNANDO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-26 0012-A 3,510 KASPAR, SHERRI Bill Patient Collections No Bill Sent 1,368.00 0.00 1,368.00 2004-04-19 0033-A 3,327 LETT,TRAVIS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-19 0011-A 3,293 MARTINEZ, JESSE Bill Patient Collections No Bill Sent 888.00 0.00 888.00 2004-04-13 0014-A 3,085 MATA, ROSIE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-18 0001-A 3,241 MAUTZ, SEAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-21 0012-A 3,355 MONTELONGO, MARIBill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-04-20 0023-A 3,356 OCHOA, LUCIO Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-19 0004-A 3,286 OLGUIN, SHIRLEY Bill Patient Collections No Bill Sent 1,596.00 0.00 1,596.00 2004-04-21 0020-A 3,370 ORTIZ, CRYSTAL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-21 0018-A 3,368 PARKER, DENNIS Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-04-15 0035-A 3,197 PERALES, JUAN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-17 0034-A 3,262 RABIDEAU, RONALD Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-04-17 0025-A 3,239 RHODA, DAVID Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 2004-04-28 0006-A 3,552 RICE, KENNETH Bill Patient Collections No Bill Sent 1,161.00 0.00 1.161.00 2004-04-26 0010-A 3,508 RIVERA, ARNULFO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-11 0025-A 3,009 SENSENBACH, EMIL'Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-29 0016-A 3,596 SEPEDA, ROSENDO Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 RescueNetTM Printed on 8/27/2004 at 2:17:31 PM Page 1 \\nw 16\res cu enet\reports32\Billing\Miscellaneous\S ubBatch 7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-04-17 0013-A 3,218 TROMBLEY, CALVIN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-13 0030-A 3,102 TRUJILLO, MABEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-21 0009-A 3,352 VARELA, VANESSA Bill Patient Collections No Bill Sent 1,143.00 0.00 1,143.00 2004-04-11 0030-A 3,021 VELLES-ESQUEDERC Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-04-11 0036-A 3,028 WEAVER, RICHARD Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 2004-04-23 0015-A 3,419 WILLIAMS, ROSALYN Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-04-27 0001-A 3,522 YATES, RYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 41 42,030.00 2,550.92 39,479.08 Trip count: 41 42,030.00 2,550.92 39,p910—8--`,, i Total trip count: 41 I 42,030.00 I 2,550.92 I 39A79.08 I,/ TM Printed on 8/27/2004 at 2:17:31 PM RescueNetTM Page 2 1\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt i Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,196 Batch date: 8/27/2004 3:01:37PM Trio Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-18 0002-A 6,399 BONDS, MATHEW Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-01 0006-A 4,770 CABARETT, CHRIS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-27 0002-A 5,628 CANO, JAOQUIN Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-06-17 0036-A 5,339 CARPENTER, PHILLIF Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-05 0001-A 7,000 CHAVEZ, FRANK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-19 0028-A 4,354 CHAVEZ, KELLY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-07-19 0025-A 6,451 DEAN, SHANNON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-12 0034-A 4,106 FLESHMAN, BEVERL`Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-09 0008-A 5,045 GONZALES, ROSEAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-08 0022-A 6,087 GONZALEZ, NICHOLP Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 200004-06-11 0031-A 7,244 GUNIN, VL ADAMI.R Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-15 0002-A 6,288 LOPEZ, AMY Bill Patient Collections No Bill Sent 1,356.O0 0.00 1,356.00 2004-05-23 0020-A 4,519 MCNEELEY, JESSE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-31 0022-A 6,859 MCWILLIAMS, MIKE Bill Patient Collections No Bill Sent 1,271.00 0.00 1,271.00 2004-05-07 0031-A 3,929 MILLER, SALLY Bill Patient Collections No Bill Sent 1,311.00 10.00 1,301.00 2004-05-26 0029-A 4,617 NIRA, NATALIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-05 0008-A 7,008 RAMERA, ERLINDA Bill Patient Collections No Bill Sent 1,208.00 0.00 1,206.00 2004-08-14 0020-A 7,322 RIBERDY, RAY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-05-07 0028-A 3,923 ROMERO, BRIAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-31 0001-A 4,739 SERNA, JESUS Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-06-08 0003-A 5,025 SPARLING,JUSTIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-05 0015-A 7,015 TIDWELL-WOODS, TII Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-22 0028-A 6,568 VELASQUEZ-VARGAE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-06-27 0006-A 5,638 WILSON, JOHN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 Trip count: 24 19,565.00 10.00 19,555.00 Trip count: 24 19,565.00 10.00 19 . --- Total trip count: 24 I 19,565.00 1 10.00 i 19,555.00 RescueNetTM Printed on 8/27/2004 at 3:02:16PM Page 1 \\nw 16\rescue n et\re po rts32\Billing\Miscellaneous\S ubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,394 Batch date: 9/16/2004 8:32:11AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2003-08-21 0010-A 6,427 ALMEIDA, MARIA Bill Patient Collections No Bill Sent 1,341.00 175.00 1,166.00 2004-03-27 0010-A 2,532 BLANDA, LOUIS Bill Patient Collections No Bill Sent 1,236.00 1,154.57 81.43 2003-08-02 0016-A 5,834 CERVANTES, MICHAE Bill Patient Collections No Bill Sent 1,206.00 185.00 1,021.00 2004-03-28 0012-A 2,617 CORTEZ, VERONICA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-10 0015-A 3,012 DELGADO, RICHARD Bill Patient Collections No Bill Sent 1,011.00 879.68 131.32 2004-04-13 0017-A 3,088 GANN, CAROLYN Bill Patient Collections No Bill Sent 1,251.00 1,176.00 75.00 2004-02-27 0018-A 1,693 HERRERA, WINDY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-04-09 0017-A 2,952 HODGE, JAMIE Bill Patient Collections No Bill Sent 150.00 50.00 100.00 2004-03-25 0018-A 2,495 LOPEZ, LARRY Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2003-08-22 0017-A 6,477 LUEVANO-LABRA, MA Bill Patient Collections No Bill Sent 1,596.00 105.00 1,491.00 2003-08-04 0024-A 5,891 LUEVANO-LABRA, MA Bill Patient Collections No Bill Sent 1,146.00 221.00 925.00 2004=02=16 0016-A 1,372 MARSH,TRAVIS li H t r k II • 1 en., n 75 nn 1ARS Bill Pa.,en, Collections No ,,YJ,AV 1,4i6.v0 �.�� 2004-04-10 0028-A 3,035 MOORE, INA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-04-15 0041-A 3,217 NIGRA,JONATHAN Bill Patient Collections No Bill Sent 1,131.00 78.60 1,052.40 2004-04-06 0012-A 2,859 OZEE, BARBARA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-10 0016-A 3,015 PADILLA, MAX Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-03-20 0001-A 2,326 POPE, CLAYTON Bill Patient Collections No Bill Sent 1,566.00 50.00 1,516.00 2004-02-20 0025-A 1,500 PRATHER, CASEY Bill Patient Collections No Bill Sent 1,131.00 904.80 226.20 2004-03-24 0009-A 2,415 RIVERA, ESTHER Bill Patient Collections No Bill Sent 1,431.00 1,357.54 73.46 2004-03-13 0020-A 2,152 SAENZ, JOSE Bill Patient Collections No Bill Sent 1,206.00 444.80 761.20 2004-01-15 0031-A 449 SENA, DEBRA Bill Patient Collections No Bill Sent 1,191.00 50.00 1,141.00 2004-02-29 0018-A 1,736 SIEGER, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-06 0027-A 2,900 SWIFT, AURORA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-03-24 0006-A 2,412 VANATTA, PAMELA Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-03-22 0009-A 2,459 WILKINSON, DEBORA Bill Patient Collections No Bill Sent 1,191.00 1,141.00 50.00 2004-03-02 0024-A 1,839 WINKLER, DAVID Bill Patient Collections No Bill Sent 996.00 0.00 996.00 Trip count: 26 29,889.00 9,388.99 20,500.01 Trip count: 26 29,889.00 9,388.99 20,500.01 Total trip count: "_'.rte ••, . I`+."' t)4.*rr RescueNetT"" Printed on 9/16/2004 at 8:33:10AM Page 1 i \1nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,395 Batch date: 9/16/2004 8:51:55AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-04-20 0004-A 3,301 ALDEN, RASHAUN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-30 0022-A 3,626 ARIZMENDI, DETRIE Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-04-24 0038-A 3,466 BELL,WILLIAM Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-22 0007-A 3,384 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,356.00 1,281.00 75.00 2004-04-25 0007-A 3,476 CONWAY, MARVIN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-04-29 0017-A 3,597 DELGADO, MARY Bill Patient Collections No Bill Sent 1,206.00 1,152.74 53.26 2004-04-30 0008-A 3,612 FAHRNER, CHRIS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-24 0022-A 3,450 GAUSIN, YUDITH Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-28 0022-A 3,570 GONZALES-MARTINE Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-04-27 0023-A 3,544 HERRERA, JOHN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 200404.17 0016-A 3,230 KING. DONALD Bill Patient Collections No Bill Sent 1,026.00 496.80 529.20 2004-04-26 0007-A 3,505 LOGUE, LACIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-23 0020-A 3,424 MELENDEZ, MELVIN Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-04-30 0006-A 3,610 METOYER, KENNETH Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-16 0002-A 3,149 NIGRA, JONATHAN Bill Patient Collections No Bill Sent 828.00 496.80 331.20 2004-04-26 0009-A 3,507 ORTON, ALEX Bill Patient Collections No Bill Sent 1,536.00 0.00 1,536.00 2004-04-24 0024-A 3,452 REIDER, MICHELE Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-04-22 0013-A 3,390 SALAZAR, ARTURO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-23 0017-A 3,421 SPARKS, GAGE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-17 0036-A 3,267 TATE, DONALD Bill Patient Collections No Bill Sent 1,236.00 1,162.93 73.07 2004-04-25 0005-A 3,474 TERRAZAS, DIANA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-30 0026-A 3,630 VASQUEZ, ROSA Bill Patient Collections No Bill Sent 285.00 0.00 285.00 2004-04-24 0026-A 3,454 VIGIL, CLIFF Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 Trip count: 23 23,772.00 4,590.27 19,181.73 Trip count: 23 23,772.00 4,590.27 19,181.73 Total trip count ` ' , - 't w("7-; , _/ RescueNePn" Printed on 9/16/2004 at 8:52:31AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,396 Batch date: 9/16/2004 9:19:08AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance I 2004-05-07 0005-A 3,879 AGUILAR, SERGIO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-06 0029-A 3,833 AMAYA-CERVANTES, Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-07 0030-A 3,927 CARTER, RAINI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-14 0033-A 4,201 CASE, CHAD Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-05-10 0042-A 4,010 CHAVEZ, NOE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-05-10 0034-A 3,996 COLE,AMBER Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-05-10 0034-B 4,033 COLE,AMBER Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-05-12 0028-A 4,100 COLLINS, MARK Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-05-07 0020-A 3,909 COTTER, ROBERT Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-05-30 0017-A 4,732 DAVIS, JULIE Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-05-14 0012-A 4,149 DAVIS, JULIE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-14 0019-A 4,163 DRISKELL, CRAIG Bill Patient Collections No Bill Sent 1,431.00 0.00 1,431.00 2004-05-07 0022-A 3,913 GONZALES, GILBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-01 0007-A 3,650 GONZALES, ROBERT Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-05-24 0029-A 4,517 GONZALEZ, LUIS Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-02 0003-A 3,682 HUGHLEY, ELBERT Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-10 0044-A 4,014 KNAPP, DAVID Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-05-13 0001-A 4,109 LEE, KIM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-09 0020-A 4,185 LOYA, SHELLI Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-08 0006-A 3,928 MALDONADO, JOSEP Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-05-11 0032-A 4,087 MAURICIO, MARIA Bill Patient Collections No Bill Sent 1,083.00 0.00 1,083.00 2004-05-07 0021-A 3,911 MENDOZA, SANTOS Bill Patient Collections No Bill Sent 1,491.00 0.00 1,491.00 2004-05-07 0018-A 3,902 MILLER, KATIE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-05-02 0001-A 3,680 MORALES, SERGIO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-04 0029-A 3,787 NUMANN, PATRICIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-29 0004-A 4,683 ORTIZ, RAFAEL Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-05-02 0027-A 3,706 OSBORN, AVERY Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-05-06 0050-A 3,854 PEREZ, LORENZO Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-05-08 0022-A 3,955 REED, DENNIS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-04 0034-A 3,792 SENDGRAFF, ROBER Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-09 0033-A 4,205 SMITH, TODD Bill Patient Collections No Bill Sent 1,131.00 872.00 259.00 2004-05-04 0032-A 3,790 SMITH, TONYA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-05-06 0034-A 3,838 SPARKS, MISTY Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-05-02 0021-A 3,700 THACKER, PATRICK Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 RescueNetTM Printed on 9/16/2004 at 9:20:20AM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-05-04 0030-A 3,788 TOVAR, BENITO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-05-12 0022-A 4,094 WELCH, KENNETH Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-03 0045-A 3,755 WELCH, RACHEL Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 Trip count: 37 39,102.00 872.00 38,230.00 Trip count: 37 39,102.00 872.00 38,230:00,\ Total trip count: - . . - ` • Dr. � �� a3`a iVY`" RescueNett Printed on 9/16/2004 at 9:20.20AM Page 2 \\nw16\rescuen et\reports32\B i I I in g\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,397 Batch date: 9/16/2004 9:51:14AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-13 0004-A 6,228 AGUILAR, JUAN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-19 0011-A 5,387 AGUILAR, SERGIO Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-18 0001-A 6,398 CARO, HUGO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-16 0019-A 6,343 CARRILLO CAMPOS, •Bill Patient Collections No Bill Sent 1,805.00 0.00 1,805.00 2004-06-07 0016-A 4,996 COLLINS, CRYSTAL Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-15 0023-A 6,309 CORRAL, ENRIQUE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-04 0002-A 4,869 CRANMER, RICK Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-16 0030-A 6,354 EDENS, BRYAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-02 0020-A 7,967 FLORES, EFRAIN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-08-26 0003-A 7,695 FLORES, EFRAIN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-28 0019-A 6,752 GALLEGOS, DENNIS Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-06-26 0013-A 5,654 GURULE, RAMON Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-05 0034-A 4,939 GURULE, RAMON Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-26 0020-A 7,712 LOPEZ, JAVIER Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-07-20 0023-A 6,495 LOPEZ-VALDEZ, CAR Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-06-17 0002-A 5,304 MADRID, JULIAN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-18 0025-A 6,422 MAYLAND, GEORGE Bill Patient Collections No Bill Sent 2,345.00 0.00 2,345.00 2004-06-03 0002-A 4,834 PARKER, GLENN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-05 0008-A 4,910 PARKER, GLENN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-09 0022-A 6,125 PARKER, GLENN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-15 0003-A 6,289 PERRY, PAM Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-06-08 0015-A 5,037 PETERSON, KIM Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-22 0016-A 7,594 RIBERDY, RAY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-08-18 0020-A 7,452 SANTOS, SEVERO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-31 0014-A 6,851 TAYLOR, DONALD Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-08-21 0003-A 7,546 VASQUEZ-ESPARZA, Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 Trip count: 26 29,827.00 0.00 29,827.00 Trip count: 26 29,827.00 0.00 29,827.00 Total trip count: ." ,. , ;.)^^. m,a 4. ,,I,-qt:, .2 4 e RescueNetTm Printed on 9/16/2004 at 9:51:58AM Page 1 \\nw16\rescuen et\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,534 Batch date: 9/28/2004 1:31:04PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-05-03 0018-A 3,728 BRIGGS, ROBERT Bill Patient Collections No Bill Sent 1,191.00 1,038.72 152.28 2004-04-24 0030-A 3,458 BROWN, KAYLYNN Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-03-22 0029-A 2,503 CASADY, JASON Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-03-21 0017-A 2,442 CASTILLEGA, CRESP Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-04-28 0023-A 3,571 CERVANTES, MICHAE Bill Patient Collections No Bill Sent 1,116.00 286.34 829.66 2004-04-29 0018-A 3,598 CHACKO, JACOB Bill Patient Collections No Bill Sent 1,506.00 1,431.00 75.00 2004-04-11 0031-A 3,022 CHISHOLM, DARLA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-04-28 0008-A 3,554 COLLIER, LORRAINE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-04-16 0004-A 3,153 COLTER, VALERIE Bill Patient Collections No Bill Sent 1,221.00 1,146.00 75.00 2004-05-08 0026-A 3,962 DELACRUZ, JEREMY Bill Patient Collections No Bill Sent 1,176.00 140.80 1,035.20 2004-05-08 0023-A 3,957 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,132.74 73.26 2004-01-26 0019-A 745 HULL, TINA Bill Patient Collections No Bill Sent 1,161.00 928.80 232.20 2004-04-16 0013-A 3,182 KELLY, DAVID Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-17 0040-A 3,278 KESTER, MARY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-04-30 0005-A 3,609 KINGSTON, KERRELL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-08 0002-A 1,120 LESTER, TOMMY Bill Patient Collections No Bill Sent 1,836.00 0.00 1,836.00 2004-03-19 0009-A 2,333 MASDEN, SHELBY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-02-15 0005-A 1,288 MEADE, CASSANDRA Bill Patient Collections No Bill Sent 1,266.00 .20.00 1,246.00 I 2004-05-08 0020-A 3,952 MEAKINS, GENE Bill Patient Collections No Bill Sent 981.00 931.67 49.33 2004-02-25 0007-A 1,612 PATEA, TROY Bill Patient Collections No Bill Sent 1,116.00 571.20 544.80 2004-05-08 0035-A 3,980 SPEAKER, HERBERT Bill Patient Collections No Bill Sent 1,341.00 1,253.83 87.17 2004-04-17 0037-A 3,268 VIGIL, BAMBI Bill Patient Collections No Bill Sent 1,446.00 1,356.00 90.00 2004-05-08 0002-A 3,919 WARDE, CASEY Bill Patient Collections No Bill Sent 1,251.00 1,000.80 250.20 2004-05-06 0039-A 3,843 WIETING, MICAH Bill Patient Collections No Bill Sent 843.00 0.00 843.00 2004-04-07 0015-A 2,892 WILLIS, BARBARA Bill Patient Collections No Bill Sent 1,086.00 960.00 126.00 2004-04-01 0010-A 2,720 WILLIS, DIANNE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-08 0040-A 4,006 YBARRA, TRINIDAD Bill Patient Collections No Bill Sent 1,581.00 1,402.69 178.31 2004-04-02 0019-A 2,758 YOUNG, DAVE Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 Trip count: 28 33,024.00 13,600.59 19,423.41 Trip count: 28 33,024.00 13,600.59 19,423.4\ Total trip count: ': a oi.x. 't :ill s:,.tis.; -: . RescueNetTM Printed on 9/28/2004 at 1:31:53PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,535 Batch date: 9/28/2004 2:09:31PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-20 0028-A 5,435 'ANDERSON, RALPH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 - 2004-05-27 0016-A 4,646 "ANDERSON, RALPH Bill Patient Collections No Bill Sent 1,206.00 1,147.44 58.56 .- 2004-06-24 0025-A 5,616 ARROYO-PORTILLO, Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-06-24 0025-B 5,627 ARROYO-PORTILLO, Bill Patient Collections No Bill Sent 1,323.00 0.00 1,323.0O 2004-09-02 0034-A 7,994 BLOOMFIELD, VERNC Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00" 2004-05-31 0024-A 4,762 CAMPOS, BEATRIZ Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00-" 2004-05-17 0025-A 4,292 CASADY, JASON Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00' 2004-05-20 0021-A 4,382 DAY, BECKY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-14 0025-A 4,179 ECHTERMEYER, AMY Bill Patient Collections No Bill Sent 513.00 0.00 513.00-- 2004-05-13 0005-A 4,113 ESCH, KENNETH Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-11 0027-A 4,050 FLORES, JEFFREY Bill Patient Collections No Bill Sent 981.00 0.00 981.00-- 2004-05-17 0029-A 4,296 GRAHAM, WILLIAM Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00' 2004-05-09 0028-A 4,196 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,341.00 1,268.55 72.45 2004-07-12 0016-A 6,213 KAVENY, MARY Bill Patient Collections No Bill Sent 1,835.00 0.00 1,835.00.- 2004-07-28 0020-A 6,754 LANG, KRISTEN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00-- 2004-05-16 0012-A 4,249 LEAL, LUCIO Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00-- 2004-05-16 0027-A 4,264 LOZOYA, MARIO Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00' 2004-05-18 0020-A 4,320 LUCERO, DENNIS Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00- 2004-05-19 0003-A 4,324 LUCERO, DENNIS Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-05-17 0032-A 4,299 MADDOX, BEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00--- 2004-08-08 0012-A 7,116 MARAVILLA, MELECICBill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-09-13 0035-A 8,348 MARTINEZ, ANDRES Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-13 0024-A 6,248 MARTINEZ, JOSE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00- 2004-05-16 0019-A 4,256 PEREZ, GERALDO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 " 2004-05-15 0031-A 4,237 PUGA, SAMUEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-31 0008-A 4,746 REED, DENNIS Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-05-16 0026-A 4,263 SEPEDA, ROSENDO Bill Patient Collections No Bill Sent 996.00 0.00 996.00' 2004-08-30 0002-A 7,830 ST JOHN, JEFFREY Bill Patient Collections No Bill Sent 783.00 0.00 783.00 2004-05-26 0036-A 4,624 STAROSIELEC, JILL Bill Patient Collections No Bill Sent 996.00 0.00 996.00- 2004-05-12 0023-A 4,095 TYREE, LYNN Bill Patient Collections No Bill Sent 150.00 0.00 150.00- 2004-08-08 0001-A 7,105 VASQUEZ, NAOMIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00- 2004-05-17 0030-A 4,297 VELASQUEZ, NOE Bill Patient Collections No Bill Sent 150.00 0.00 150.00- 2004-05-18 0012-A 4,311 VELIC, JANET Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-14 0021-A 7,323 ZAMARRIPA,VISEN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 RescueNet1" Printed on 9/28/2004 at 2:10:23PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-05-16 0010-A 4,247 ZAPATA, GLORIA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-04 0020-A 8,048 ZAVALA-MORALES, A Bill Patient Collections No Bill Sent 1,331.00 0.00 1,331.00 Trip count: 36 33,745.00 2,415.99 31,329.01 Trip count: 36 33,745.00 2,415.99 31,32 Total trip count: w ' c RescueNeP1 Printed on 9/28/2004 at 2:10:23PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,667 Batch date: 10/11/2004 9:13:50AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-03-03 0019-A 1,929 ANSON, JEFF Bill Patient Collections No Bill Sent 1,281.00 25.00 1,256.00 2004-04-04 0014-A 2,804 BAUER, HOWARD Bill Patient Collections No Bill Sent 513.00 466.88 46.12 2004-03-06 0030-A 1,960 BLAS, JUAN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-03-01 0010-A 1,797 CIPOLLA, COLIN Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-01-23 0008-A 625 DANIEL, RONNIE Bill Patient Collections No Bill Sent 1,341.00 1,037.80 303.20 2004-04-05 0021-A 2,836 DISON, DAWN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-01-17 0021-A 481 DRAPEAU, STEVEN Bill Patient Collections No Bill Sent 1,176.00 939.60 236.40 2004-03-19 0017-A 2,345 GARCIA, MIGUEL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-04-16 0017-A 3,194 HAMILTON, TYLER Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2003-12-18 0017-A 10,312 HESSLER, MARGARE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-05-15 0021-A 3,296 IVIE, MARY Bill Patient Collections No Bill Sent 1,955.00 500.00 1,455.00 2004-04-02 0018-A 2,757 KAVENY, GRETA Bill Patient Collections No Bill Sent 1,1Q1.00 10.00 1,181.00 2004-03-07 0010-A 1,980 KINDVALL, JENNIFER Bill Patient Collections No Bill Sent 1,281.00 662.56 618.44 2004-02-11 0013-A 1,222 KRUEGER, JONATHA Bill Patient Collections No Bill Sent 1,206.00 1,181.00 25.00 2004-02-27 0010-A 1,682 LEGETTE, PAMELA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-04-01 0021-A 2,731 MAESTAS, ROBERT Bill Patient Collections No Bill Sent 1,461.00 1,376.61 84.39 2004-04-11 0010-A 2,992 MILLS, MELINDA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2003-07-19 0036-A 5,415 MORALES, LEHUA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-02-05 0027-A 1,102 MORENO, MARIA Bill Patient Collections No Bill Sent 1,266.00 1,146.94 119.06 2004-03-30 0027-A 2,679 PEARSON-ERSKINE, IBill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-03-12 0005-A 2,109 . RICKORDS, SELENA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-02-13 0011-A 1,270 RIGGINS, GARI Bill Patient Collections No Bill Sent 1,161.00 500.00 661.00 2003-12-17 0034-A 10,288 RYBUS, MARK Bill Patient Collections No Bill Sent 1,860.00 210.00 1,650.00 2004-04-05 0003-A 2,818 SHURCHAY, DEANNA Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-03-27 0028-A 2,553 THOMAS, JOHN Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 Trip count: 25 28,328.00 8,056.39 20,271.61 Trip count: 25 28,328 00 8,056 39 , 1 Total trip count: :©3- ' ? '1:- : noimmi, RescueNetn" Printed on 10/11/2004 at 9:14:49AM Page 1 \\nw 16\rescu en et\re ports32\B it l ing\Miscellaneous\Sub Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,668 Batch date: 10/11/2004 9:35:44AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-05-04 0035-A 3,793 ALDEN, RASHAUN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-01 0033-A 3,676 ALLEE, JOHN Bill Patient Collections No Bill Sent 1,431.00 1,356.00 75.00 2004-05-09 0002-A 4,002 BARRERA, RUCELI Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-04-24 0034-A 3,462 CONTRERAS-CALDEF Bill Patient Collections No Bill Sent 1,131.00 100.00 1,031.00 2004-04-26 0019-A 3,517 DAVIS,WILLIAM Bill Patient Collections No Bill Sent 633.00 0.00 633.00 2004-05-04 0033-A 3,791 ECKELS, MELISSA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-04-30 0003-A 3,607 GIFFORD, TERESA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-05-07 0025-A 3,917 LUEHRING, JOANN Bill Patient Collections No Bill Sent 1,146.00 1,091.80 54.20 2004-05-08 0036-A 3,982 LUKINS,VICTOR Bill Patient Collections No Bill Sent 996.00 0.00 996.00 I 2004-05-12 0004-A 4,075 MAESTAS, ROBERT Bill Patient Collections No Bill Sent 1,356.00 1,272.81 83.19 2004-05-02 0012-A 3,691 MALDONADO,ANITA Bill Patient Collections No Bill Sent 2,120.00 2,027.78 92.22 2004-05-06 0022-A 3,826 MATHEWS,JUNE Bill Patient Collections No Bill Sent 1,266.00 1,190.94 75.06 2004-05-02 0023-A 3,702 MAURICIO, EDGAR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-06 0001-A 3,796 MCDADE,TIMOTHY Bill Patient Collections No Bill Sent 1,386.00 1,098.00 288.00 2004-05-06 0007-A 3,802 MCDADE,TIMOTHY Bill Patient Collections No Bill Sent 1,458.00 1,312.20 145.80 2004-05-16 0005-A 4,242 MEJIA, MARIA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-05-14 0011-A 4,148 MORENO, JESUSA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-03 0015-A 3,725 NAYLOR, ADA Bill Patient Collections No Bill Sent 1,371.00 1,282.06 88.94 2004-05-06 0027-A 3,831 PRZYHOCKI, COURT/'Bill Patient Collections No Bill Sent 1,353.00 0.00 1,353.00 2004-05-20 0026-A 4,387 SCHNIEPP, GALVIN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-13 0009-A 4,117 SCOTT, DENISE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-04-28 0021-A 3,569 SERAYDARIAN, JASO Bill Patient Collections No Bill Sent 1,221.00 932.00 289.00 2004-05-06 0018-A 3,822 WAITS,WILLIAM Bill Patient Collections No Bill Sent 1,056.00 1,003.24 52.76 2004-05-06 0040-A 3,844 WATSON, ROBERT Bill Patient Collections No Bill Sent 498.00 452.88 45.12 2004-05-06 0024-A 3,828 WATSON, ROBERT Bill Patient Collections No Bill Sent 996.00 945.67 50.33 2004-04-21 0004-A 3,345 WEDDERBUM, PRISC Bill Patient Collections No Bill Sent 150.00 0.00 150.00 Trip count: 26 27,074.00 14,065.38 13,008.62 Trip count: 26 27,074.00 14,065.38 13,008.62 Total trip count: ..-,_""`� - ., . - ii+ '` I •a,ik O `.- • . 1 a a ri RescueNetTM Printed on 10/112004 at 9:36:27AM Page 1 \\nw 16\re scu enet\reports32\Billing\Miscellaneous\Sub Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,670 Batch date: 10/11/2004 9:56:32AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-05-24 0001-A 4,479 ANTHONY, CHRISTOI Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-05-27 0018-A 4,648 ARMIJO, JEDE Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-05-24 0017-A 4,495 BARCENAS, JOSE Bill Patient Collections No Bill Sent 1,206.00 1,132.74 73.26 2004-05-28 0012-A 4,670 BENAVIDEZ, MARVIN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-24 0006-A 4,484 ECHAVARRI'A, JORGE Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-05-23 0026-A 4,536 FINGER, STEVEN Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-05-21 0025-A 4,433 GARRETT, LONNIE Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-25 0040-A 4,585 GARZA, JUANITA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-05-27 0021-A 4,651 GONZALEZ, MARIA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-24 0004-A 4,482 HAWKINS, JOHN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-22 0002;A a 444 HOLGUIN, AMBER Bill Patient Collections No Bill Sent 1,116.00 869.40 246.60 2004-05-21 0005-A 4,408 HUCKFELDT, JOSHU1Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.0n I 2004-05-23 0004-A 4,472 KERR, ROBERT Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 I 2004-05-22 0026-A 4,469 LUJAN, ANTONIO Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-26 0016-A 4,604 LUJAN,VICTORIA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-05-21 0023-A 4,431 MACIAS, MARIA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-05-27 0023-A 4,653 MANNING, KIRSTEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 ' 2004-05-22 0008-A 4,451 MARTINEZ, JESSE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-21 0029-A 4,437 MCKEE, SEAN Bill Patient Collections No Bill Sent, 150.00 0.00 150.00 2004-05-23 0037-A 4,549 MILLER, CANDICE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-24 0034-A 4,524 MORENO, ANGEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-22 0022-A 4,465 MOYA, JOHN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-21 0027-A 4,435 MYERS,TAMMY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-21 0028-A 4,436 PAYNE, BRYCE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-23 0024-A 4,533 PORTILLO, CHRISTEP Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-05-25 0007-A 4,534 REINSTEIN, TEVIN Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-05-23 0033-A 4,545 REINSTEIN, TEVIN Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-05-21 0034-A 4,442 RODRIGUEZ, CARLO:Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-05-25 0023-A 4,566 ROGERS, NADINE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-05-27 0003-A 4,633 SAGERT, TRACY Bill Patient Collections No Bill Sent 1,925.00 0.00 1,925.00 2004-05-28 0035-A 5,110 SIFUENTEZ, DANIEL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 Trip count: 31 30,491.00 2,002.14 28 488 Trip count: 31 30,491.00 2,002.14 28,488.86 RescueNetTM Printed on 10/11/2004 at 9:57:26AM Page 1 \\nw 16\res cu e n et\reports32\Billing\Miscellaneous\Sub Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,672 Batch date: 10/11/2004 10:11:41AM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-04 0032-A 4,900 ALLISON, DIANE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-05-31 0020-A 4,758 ARAGON, ALEX Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-31 0021-A 4,759 ARAGON, NATASHA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-04 0030-A 4,898 ARREOLA, NAZAVIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-03 0033-A 4,865 ASHER, ALLEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-01 0001-A 4,765 CANO, LAZARO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-06-04 0001-A 4,868 CARRASQUEL, SANTI Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-06-01 0015-A 4,779 CISNEROS, STEPHAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-04 0007-A 4,875 COLLINS, GLEN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-06-02 0003-A 4,800 DARBY, JOEL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-03 0034-A 4,866 DOCKERY, DANIEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-05-31 0023-A 4,761 ESPARZA, JOSE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-05-29 0012-A 4,696 HAYES, WILLIAM Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-02 0026-A 4,824 HUTSON, BILLY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-05-29 0021-A 4,708 JACKSON, JESSY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 I 2004-06-03 0021-A 4,853 JARAMILLO, JOSE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-30 0018-A 4,733 LAW, JOHN Bill Patient Collections No Bill Sent 1,506.00 0.00 1,506.00 2004-06-07 0003-A 4,983 MAESTAS, ROBERT Bill Patient Collections No Bill Sent 1,521.00 1,436.24 84.76 2004-06-07 0040-A 5,021 MORALES, LEHUA Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-06-09 0011-A 5,048 NEVAREZ, BELLA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-01 0024-A 4,788 NEVAREZ, JUAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 I 2004-06-01 0035-A 4,810 PATTINARI, PAM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-04 0003-A 4,870 PHILLIPS, JONATHAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-03 0018-A 4,850 PUGA, SAMUEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-06-02 0015-A 4,813 QUINONES-VEGA, ZUBill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-06-05 0005-A 4,907 REYES, VICTOR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-29 0003-A 4,681 ROBLES, YANYS Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-04 0029-A 4,897 SALAYANDIA, LOREN Bill Patient Collections No Bill Sent 1,626.00 0.00 1,626.00 2004-06-04 0015-A 4,883 SCHERSCHLIST, BRA Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-06-04 0034-A 4,902 TOVAR, MANUEL Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-06-04 0026-A 4,894 YBARRA, CHRISTOPI-Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 Trip count: 31 28,137.00 1,436.24 26 700.76 Trip count: 31 28,137.00 1,436.24 26,700.76 RescueNetT"" Printed on 10/11/2004 at 10:12:27AM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,673 Batch date: 10/11/2004 10:23:21AM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-06-17 0040-A 5,372 ALANIZ, VIVIANA Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-09-18 0042-A 8,544 COOPER, SAMUEL Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-23 0029-A 6,597 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-30 0007-A 6,805 GALLEGOS, DONALD Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-08-17 0024-A 7,427 GARCIA, ANTHONY Bill Patient Collections No Bill Sent 1,775.00 0.00 1,775.00 2004-09-16 0037-A 8,466 GARCIA, ROBERTO Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-22 0020-A 6,559 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,146.00 1,072.68 73.32 2004-07-24 0008-A 6,606 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,206.00 1,128.31 77.69 2004-08-07 0026-A 7,104 HARVEY, HARRY Bill Patient Collections No Bill Sent 1,296.00 1,234.31 61.69 2004-08-18 0006-A 7,438 HELUS,WILLIAM Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 I 2004-07-03 0003-A 5,892 MARIN, RAYMOND Bill Patient Collections No Bill Sent 1,566.00 1,474.30 91.70 2004-08-02 0021-A 6,925 MICHAEL, GERALD Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-09-16 0038-A 8,467 PANSO, YOLANDA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-30 0005-A 6,803 PAYNE, ELIZABETH Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-07-04 0005-A 5,903 RAMIREZ,VANESSA Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-07-16 0033-A 6,357 RANGEL, ANTONIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-09 0029-A 6,171 ROBINSON, JIM Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-08-11 0020-A 7,233 SANTILLANES, ROBE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-15 0029-A 6,321 SOTO, JULIO Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-16 0036-A 8,465 TEMUSTLE, ROTILLIC Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-06-18 0011-A 5,350 WATSON, ROBERT Bill Patient Collections No Bill Sent 1,056.00 988.54 67.46 2004-07-09 0003-A 6,105 WISSLER, JAIMIE Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 Trip count: 22 25,445.00 5,898.14 19,546.86 Trip count: 22 25,445.00 5,898.14 19,5,46:86—' Total trip count ra^j. W__ , 1 4 ` °u" ..i is flj N i-ci,4, '5 RescueNet"' Printed on 10/11/2004 at 10:26:36AM Page 1 \\nw16\rescuenet\reports 32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,816 Batch date: 10/27/2004 1:27:13PM Trip Date Job Run Name Current Payor Schedule Event Charges Credits Balance 2004-05-27 0010-A 4,640 AAB, BETTY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-02-07 0031-A 1,171 ABADILLA, FAUSTINCBill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-05-04 0020-A 3,778 ARIAS, ROSA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-01-15 0011-A 421 BENAVIDES, ANTHON Bill Patient Collections No Bill Sent 1,131.00 1,081.00 50.00 2004-05-18 0019-A 4,319 BROWN, GEORGE Bill Patient Collections No Bill Sent 1,251.00 1,176.75 74.25 2004-04-03 0006-A 2,769 CHACON, RANULFO Bill Patient Collections No Bill Sent 843.00 608.80 234.20 2004-05-19 0029-A 4,355 CLAUS, THERESA Bill Patient Collections No Bill Sent 150,00 0.00 150.00 2003-10-10 0011-A 8,100 DAVIES, SARAH Bill Patient Collections No Bill Sent 1,251.00 1,100.80 150.20 2004-02-24 0002-A 1,579 DIXON, HAROLD Bill Patient Collections No Bill Sent 1,446.00 1,357.99 88.01 2004-05-30 0012-A 4,727 ELLIOTT, CLAUDIA Bill Patient Collections No Bill Sent 1,161.00 1,105.50 55.50 2004-02-18 0014-A 1,399 FLORES, TERESA Bill Patient Collections No Bill Sent 1,491.00 100.00 1,391.00 2004-04-24 0033-A 3,461 FREDERICK, MIKE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-03-29 0026-A 2,646 GOMEZ, FRED Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-20 0025-A 4,386 HARCUS, RYAN Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-05-10 0051-A 4,044 JUBINVILLA, DELORE Bill Patient Collections No Bill Sent 1,626.00 1,300.80 325.20 2004-05-21 0032-A 4,440 MARCOOT, CARY Bill Patient Collections No Bill Sent 1,476.00 980.80 495.20 2003-10-01 0013-A 7,763 MCBURNEY, NATHAN Bill Patient Collections No Bill Sent 1,071.00 856.80 214.20 2004-03-08 0027-A 2,020 MILBRATH, TROY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-09 0015-A 4,176 RODRIGUEZ, DANIEL Bill Patient Collections No Bill Sent 1,026.00 20.00 1,006.00 2004-01-24 0006-A 657 SELLMER, KATHY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2003-07-14 0022-A 5,233 SILVA, SOCORRO Bill Patient Collections No Bill Sent 1,131.00 150.00 981.00 2004-05-23 0011-A 4,499 SOWDER, DAVID Bill Patient Collections No Bill Sent 1,521.00 500.00 1,021.00 2004-05-08 0039-A 4,001 SUGIHARA, DAVID Bill Patient Collections No Bill Sent 1,146.00 915.00 231.00 2003-11-17 0013-A 9,351 TAYLOR, MELLISSA Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2003-11-18 0017-A 9,385 TAYLOR, MELLISSA Bill Patient Collections No Bill Sent 150.00 120.00 30.00 2004-03-15 0005-A 2,190 TREVINO, MIGUELA Bill Patient Collections No Bill Sent 1,131.00 992.88 138.12 2004-05-15 0019-A 4,225 VICENTE-PEREZ, AMI Bill Patient Collections No Bill Sent 1,221.00 538.40 682.60 2004-01-05 0013-A 149 VILLARREAL, MICHAE Bill Patient Collections No Bill Sent 558.00 250.00 308.00 2004-03-05 0009-A 1,898 VILLELA, ESEQUIL Bill Patient Collections No Bill Sent 1,281.00 1,044.80 236.20 Trip count: 29 27,441.00 14,320.32 13,120.68 Trip count 29 27,441.00 14,320.32 13,120.66- Total trip count: `x : - ` f' " kql' ,, a r:r w , r:"'144, ,,. \. � � " a� fit+ RescueNetTT Printed on 10/27/2004 at 1:27:51 PM Page 1 \\n w 16\re s cu e n et\reports 32\B i l I i n g\Miscellaneous\S u b B at c h 7.rp t Submission Batch Report WELD COUNTY PARAMEDIC SERVICES . Batch 5,817 Batch date: 10/27/2004 1:43:57PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-06 0003-A 4,946 ALVAREZ, JUAN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-05 0014-A 4,916 ATENCIO, SHARON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-06 0005-A 4,948 BARNES, FREDERICK Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-06-08 0001-A 5,023 BENAVIDES, MELISSFBill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-05 0033-A 4,938 CARRILLO, ADRIANA Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-06 0034-A 4,977 COLLINS, MARK Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-06-06 0017-A 4,960 ESTRADA, RENE Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-06-07 0009-A 4,989 GREEN, JASMIN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-05 0030-A 4,935 HUTSON, KENNETH Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-06-08 0017-A 5,082 JOHNSON, CAROLYN Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 I 2004-06-06 0006-A 4,949 KIRKLAND, KIMBERL' Bill Patient Collections No Bill Sent 180.00 0.00 180.00 2004-06-05 0019-A 4,923 LARSON, LEE Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 I 2004-06-07 0034-A 5,015 LILES, SUMMER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-05 0007-A 4,909 LOPEZ, RICARDO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-06-06 0019-A 4,962 MALDONADO, JOE Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-06-06 0007-A 4,950 MENDOZA, IRENE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-06 0036-A 4,979 MORENO, ANTONIO Bill Patient Collections No Bill Sent 1,611.00 0.00 1,611.00 2004-06-05 0036-A 4,941 MUTH, MIKE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-06 0026-A 4,969 ROBERTSON, MALTS:Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-06-05 0015-A 4,917 ROJAS,VIRGINIA Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-06-02 0025-A 4,823 SELLERS, JEFFREY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-02 0002-A 4,799 SELLERS, JEFFREY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-08 0007-A 5,029 TWITO, JEFF Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-07 0036-A 5,017 VILLALOBOS,ANGEL Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 Trip count: 24 21,477.00 0.00 21,477.00 Trip count: 24 21,477.00 0.00 21,4p,00..,_ L . Total trip count. ">7 °$'LL"'y' ,xy''''''27' 2i' `=i aa,iitI':C.; ' } RescueNetT"' Printed on 10/27/2004 at 1:44:39PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,818 Batch date: 10/27/2004 1:57:25PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-09 0013-A 5,050 AYALA, EUGENE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-06-10 0011-A 5,097 BERRY, LAUREN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-12 0017-A 5,150 BLUNT, MANDY Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-06-09 0023-A 5,060 BONILLA-CALDERON,Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-13 0020-A 5,205 CAMPBELL, CINDY Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-06-16 0021-A 5,297 CASTILLO, FERNAND Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-06-16 0020-A 5,294 CASTILLO, MARTIN Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-06-11 0010-A 5,162 CENICERAS, JUSTIN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-13 0026-A 5,211 COOK, JAMES Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-16 0014-A 5,288 ESCOBAR, MARIA Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-06-14 0022-A 5,240 GOMEZ, CHRISTOPHI Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-06-13 0019-A 5,204 ' GUADAGNOLI, CHRIS Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-06-14 0006-A 5,224 LOEWE, ROBERT Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-13 0031-A 5,216 MAIN, ASHLEY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-14 0014-A 5,232 MARTIN, RACHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-10 0023-A 5,111 MARTINEZ, RACQUET Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-09 0031-A 5,068 MIGUEL, OLIVER Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-06-11 0017-A 5,170 MILLER, MARK Bill Patient Collections No Bill Sent 150.00 0.00 150,00 2004-06-16 0001-A 5,275 MONSEES, MARQUE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-06-13 0023-A 5,208 MORGAN, CAROL Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-09 0002-A 5,039 MUNCH, ASHLEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-10 0003-A 5,083 NAJERA, VICTORIA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-06-09 0004-A 5,041 RICHARDSON, DAVID Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-06-09 0028-A 5,065 ROCKWELL, KRISTI Bill Patient Collections No Bill Sent 1,256.00 0.00 1,256.00 2004-06-16 0017-A 5,291 ROE, JUSTIN Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-06-15 0009-A 5,256 SEGO, CHRISTINE Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-14 0027-A 5,245 SWINGLE, CYNTHIA Bill Patient Collections No Bill Sent 1,611.00 0.00 1,611.00 Trip count: 27 25,520.00 0.00 25,520.00 Trip count: 27 25,520.00 0.00 25 520 10 Total trip count: : 1. _~ � ;n ]~1-, , �.-„G, ,: i`w., „ „1, RescueNetM Printed on 10/27t2004 at 1:57:58PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,819 Batch date: 10/27/2004 2:11:54PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-19 0007-A 5,383 ACOSTA, LORENZA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-28 0008-A 5,700 ALFARO, SHIRLEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-22 0028-A 5,522 BENSON, SHARON Bill Patient Collections No Bill Sent 1,461.00 0.00 1,461.00 2004-06-21 0003-A 5,448 BOYD, MICHAEL Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-06-24 0008-A 5,578 CHASE, RANDEE Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-20 0037-A 5,444 CORCHADO, FRANCI:Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-24 0030-A 5,621 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-06-18 0020-A 5,359 DIXON, HAROLD Bill Patient Collections No Bill Sent 1,416.00 1,328.84 87.16 2004-06-19 0026-A 5,402 GALLEGOS, ANTHON Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-06-20 0002-A 5,409 GALLEGOS, REANNA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 I 2004-06-24 0027-A 5,618 GESICK, DARRELL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-06-25 0004-A 5,567 GUTIERREZ, JAMES Bill Patient Collections No Bill Sent 996.00 0.00 996.00 I 2004-06-20 0027-A 5,434 HAVARD, STEVEN Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-06-22 0002-A 5,482 HAWKINS, SANDRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-17 0003-A 5,305 HERNANDEZ, ANGEL Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-06-18 0006-A 5,345 HERNANDEZ-OROZGBill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-22 0021-A 5,501 LECHUGA, LISA Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-06-21 0008-A 5,454 LOPEZ, TIOFILO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-22 0033-A 5,527 MARTINEZ, JESSICA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-25 0005-A 5,568 MCINTIRE, MARY Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-06-25 0009-A 5,577 OLIN, JULIA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-06-19 0019-A 5,395 ORNELAZ, ELENA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-06-23 0018-A 5,552 PINEDA,AURELIA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-06-29 0035-A 5,764 PINO,ANITA Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-17 0027-A 5,330 RIGGINS, MARK Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-17 0039-A 5,370 ROBLES, PEDRO Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-06-26 0014-A 5,656 RODRIGUEZ, JOSE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-21 0021-A 5,466 SESSIONS, STANLEY Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2004-06-25 0017-A 5,589 SEVER, RONALD Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-29 0008-A 5,736 SPARKS, MISTY Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-06-23 0003-A 5,530 STRASSELL, ROBERIBill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-06-25 0022-A 5,598 STRICHART, ROBERT Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041 2004-06-17 0017-A 5,319 WILSON, ROGER Bill Patient Collections No Bill Sent 1,311.00 0.00 -1;8ttO0 Trip count: 33 31,338.00 1,328.84 30,009.16 RescueNetTM Printed on 10/27/2004 at 2:13:02PM Page 1 \\nw 16\rescuen et\reports 32\Billing\Miscellaneous\S u b Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,820 Batch date: 10/27/2004 2:26:45PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-09-22 0008-A 8,675 AGUILAR, RAUL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-19 0020-A 8,574 BOATNER, BYRON Bill Patient Collections No Bill Sent 1,940.00 0.00 1,940.00 2004-09-06 0009-A 8,094 CASTELLON, ROSE Bill Patient Collections No Bill Sent 1,221.00 1,118.29 102.71 2004-07-19 0012-A 6,438 CASTILLO-FLORES, J Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0007-A 6,665 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-11 0012-A 8,257 FISHER, JEFFREY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-09-12 0008-A 8,289 FISHER, JEFFREY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-03 0025-A 6,968 GASPAR, EFRAIN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-03 0012-A 8,000 HACKETT, LANE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-03 0014-A 6,957 HARRISON, CLARENCBill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-08-21 0032-A 7,577 HERRERA, GINA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-03 0023-A 9,054 LUNA, PEDRO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-21 0013-A 6,513 MONDRAGON, MICHE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-28 0025-A 8,887 NEGLEY,TODD Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-07-23 0002-A 6,570 PARKER, GLENN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-11 0018-A 7,231 PARKER, GLENN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-24 0002-A 6,600 PARKER, GLENN Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-10-05 0016-A 9,113 PARKER, GLENN Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-09-23 0036-A 8,734 PARKER, GLENN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-08-24 0030-A 7,666 RODRIGUEZ, OMAR Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-21 0010-A 6,510 SAUCEDA, VENNESA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-08 0051-A 9,255 STROMSTA, PAUL Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-25 0024-A 6,654 TODD, GREGORY Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-09-25 0002-A 8,768 TORRES, DARLENE Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-08-26 0016-A 7,708 VALENCIA, MIGUEL Bill Patient Collections No Bill Sent 1,955.00 0.00 1,955.00 2004-10-02 0038-A 9,026 WESEMAN,TOM Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-03 0004-A 9,035 WHEATLEY, GEORGE Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 Trip count: 27 23,233.00 1,118.29 22,114.71 Trip count: 27 23,233.00 1,118.29 22,11 Total trip count: ^ r 1.V:Z•. icYst i .#3[µ1 a a .kfi RescueNerm Printed on 10/27/2004 at 2:27:37PM Page 1 Wiwi 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,947 Batch date: 11/9/2004 12:54:23PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-04-16 0016-A 3,191 BERGERON, SHAWN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-04-30 0027-A 3,631 BERNAL, NATHANIEL Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-05-27 0008-A 4,638 BLACKBURN, BREND,Bill Patient Collections No Bill Sent 1,146.00 425.00 721.00 2003-02-13 0003-A 384 BLACKWELL, KAYDEE Bill Patient Collections No Bill Sent 1,070.00 220.70 849.30 2004-04-26 0008-A 3,506 LANCY, SHERI Bill Patient Collections No Bill Sent 1,458.00 1,166.40 291.60 2004-04-12 0002-A 3,041 LAYBOURN, KYLEE Bill Patient Collections No Bill Sent 873.00 0.00 873.00 2004-05-08 0008-A 3,934 MATA-POBLANO, JOE Bill Patient Collections No Bill Sent 1,161.00 549.50 611.50 2004-03-12 0009-A 2,113 MIDDLETON, ROBER-Bill Patient Collections No Bill Sent 1,011.00 692.70 318.30 2004-01-26 0007-A 731 OLIVO, STEVEN Bill Patient Collections No Bill Sent 1,311.00 1,183.80 127.20 2004-05-14 0007-A 4,143 PAYNE, SETH Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-01-24 0021-A 672 PIERSON, TAMMY Bill Patient Collections No Bill Sent 1,086.00 893.00 193.00 2004-02-14 0008-A 1,308 REDEARTH, PATRICE Bill Patient Collections No Bill Sent 1,206.00 64880 557.20 2004-04-14 0025-A 3,140 REYES, MARY ANN Bill Patient Collections No Bill Sent 1,626.00 1,382.10 243.90 2004-05-25 0030-A 4,575 RODRIGUEZ, JEFFREBill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-05-05 0036-A 3,916 RUST,TERRY Bill Patient Collections No Bill Sent 1,146.00 20.00 1,126.00 2004-04-08 0002-A 2,905 VALDEZ, AUDREY Bill Patient 'Collections No Bill Sent 1,101.00 975.00 126.00 2004-01-09 0024-A 269 WALTER, CRAIG Bill Patient Collections No Bill Sent 1,086.00 651.60 434.40 2004-04-16 0028-A 3,219 WINDEN, SUSAN Bill Patient Collections No Bill Sent 1,356.00 846.00 510.00 2004-04-20 0028-A 3,364 WINDEN, SUSAN Bill Patient Collections No Bill Sent 1,086.00 1,009.00 77.00 Trip count: 19 21,386.00 10,663.60 10,722.40 Trip count: 19 21,386.00 10,663.60 10,72'An, Total trip count: : y c' ' ,5ti..€E4d1' i .. a,:1. a':1° - RescueNetm Printed on 11/9/2004 at 12:56:34PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,948 Batch date: 11/9/2004 1:26:03PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-22 0017-A 5,497 CANEVA, ANGELA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2003-10-15 0006-A 8,243 CEBALLOS, ISABEL Bill Patient Collections No Bill Sent 1,131.00 98.77 1,032.23 2004-06-07 0026-A 5,006 CLARK, KIMBERLY Bill Patient Collections No Bill Sent 1,356.00 1,230.00 126.00 2004-06-22 0010-A 5,490 DAVIS, ALFRED Bill Patient Collections No Bill Sent 1,191.00 1,133.43 57.57 2004-06-21 0011-A 5,457 DEVORA, ANTHONY Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-06-07 0008-A 4,988 DEVORA, ANTHONY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-06-11 0004-A 5,146 FERGUSON, CHARLE Bill Patient Collections No Bill Sent 996.00 930.97 65.03 2004-05-09 0016-A 4,177 FOX, MATTHEW Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2003-09-21 0004-A 7,442 HENDERSON, LEAH Bill Patient Collections No Bill Sent 1,176.00 180.00 996.00 2004-06-07 0031-A 5,012 HILL, SHANE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-24 0003-A 5.565 JIMENEZ, CARLOS Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-06-20 0029-A 5,436 KOCA, NICHOLAS Bill Patient Collections No Bill Sent 1,341.00 1,291.00 50.00 2004-06-17 0021-A 5,323 LAUER, DEVYN Bill Patient Collections No Bill Sent 1,071.00 456.80 614.20 2004-06-22 0008-A 5,488 MADSON, JAMES Bill Patient Collections No Bill Sent 558.00 0.00 558.00 2004-06-23 0001-A 5,528 MATHELY, BETTY Bill Patient Collections No Bill Sent 2,000.00 0.00 2,000.00 2004-05-06 0011-A 3,815 MCCULLOUGH, DAVIT Bill Patient Collections No Bill Sent 1,461.00 1,093.25 367.75 2004-06-04 0009-A 4,877 MORRIS, NORMAN Bill Patient Collections No Bill Sent 1,401.00 838.00 563.00 2004-06-07 0005-A 4,985 NAZARENUS, SUSAN Bill Patient Collections No Bill Sent 1,146.00 916.80 229.20 2004-06-10 0008-A 5,094 PEARSON, MARY Bill Patient Collections No Bill Sent 1,236.00 1,162.67 73.33 2004-05-25 0017-A 4,560 RAMIREZ, CRISTAL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-26 0038-A 4,626 RANEY, GARY Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-06-21 0034-A 5,480 SCHREIBER, ANGELA Bill Patient Collections No Bill Sent 1,446.00 0.00 1,446.00 2004-06-16 0008-A 5,282 SHEETS, JAMES Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-06-21 0012-A 5,458 TAVENNER, ROSELEI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-10 0026-A 5,116 VIGIL, REBECCA Bill Patient Collections No Bill Sent 1,311.00 50.00 1,261.00 2004-06-22 0014-A 5,494 WADE, BARRY Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 . Trip count: 26 29,024.00 9,381.69 19,642.31 Trip count: 26 29,024.00 9,381.69 19,642.31 Total trip count: s ,..1,5, 1E1 ', !si.. c4Q !;?A9O1 Sliti li RescueNetn1 Printed on 11/9/2004 at 1:27:02PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\Sub Batch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,949 Batch date: 11/9/2004 1:51:51PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-29 0004-A 5,732 ABRAMS, VICKI Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-03 0006-A 5,898 ARCHULETA, LUCAS Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-04 0010-A 5,908 BARELA, ENEDINA Bill Patient Collections No Bill Sent 1,386.00 1,302.31 83.69 2004-06-30 0024-A 5,789 BUCCIARELLI, PATRII Bill Patient Collections No Bill Sent 1,356.00 0.00 1,356.00 2004-06-30 0007-A 5,772 CASTENEDA, RONALI Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-02 0009-A 5,857 CRUM, LESLIE Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-07-10 0003-A 6,131 FLORES, ROMERO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-01 0026-A 5,821 FUTCH, CLIFFORD Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-02 0038-A 5,889 GALLAGHER, PETER Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-01 0025-A 5,820 GARCIA, BRENDA Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-07-04 0035-A 5,952 GARCIA, EDUARDO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-03 0030-A 5,954 GESICK, DARRELL Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-02 0021-A 5,869 GONZALEZ, ANGELA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-04 0022-A 5,925 GUTIERREZ, KAREN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-04 0013-A 5,911 HALL, MISTY Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-07-10 0015-A 6,143 HELMS, ROBERT Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-09 0017-A 6,119 HERNANDEZ, EDWAF Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-10 0002-A 6,130 JIMENEZ, JARDIL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-09 0042-A 6,218 LECLERE, DANNY Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-03 0019-A 5,937 LERMA, ELAINE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-09 0008-A 6,110 LOMA, JUAN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-02 0004-A 5,850 REEDER, GLENN Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-06-29 0033-A 5,762 REIDER, MICHELE Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-03 0028-A 5,950 RHYAN, FLETCHER Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-06-27 0026-A 5,671 ROBERTSON, RICHAI Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-05 0021-A 5,990 RODRIGUEZ, ELIZABE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-04 0004-A 5,902 RODRIGUEZ, JEFFREBill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-01 0031-A 5,833 SHERIN, TONY Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-07-09 0025-A 6,128 TREVINO, TONY Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-03 0012-A 5,919 URESTE, RICKY Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-03 0024-A 5,943 URESTE, RICKY Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2004-07-10 0004-A 6,132 VILLALOBOS-GARCIA Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-06-26 0033-A 5,688 VILLARREAL, JOSE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-09 0043-A 6,220 WILLIAMS, MICHELLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 RescueNetT"' Printed on 11/9/2004 at 1:52:49PM Page 1 l\nw 16\rescuenet\reports32\Billing\MiscellaneoustSubBatch 7.rpt WELD COUNTY PARAMEDIC SERVICES 2004-07-01 0021-A 5,816 WILSON, ROGER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-04 0028-A 5,935 YBARRA, PEDRO Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 Trip count: 36 31,689.00 1,302.31 30,386.69 Trip count: 36 31,689.00 1,302.31 30,3 6-69-- Total trip count .µr RescueNetTM Printed on 11/9/2004 at 1:52:49PM Page 2 \\nw 16\res cu e n et\re ports32\Billing\Miscellaneous\Su b Batch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 5,950 Batch date: 11/9/2004 2:19:42PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-08-02 0010-A 6,914 BARELA, ENEDINA Bill Patient Collections No Bill Sent 1,566.00 1,464.35 101.65 2004-09-18 0012-A 8,514 BLANCO, LUIS Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-07-11 0023-A 6,189 CAMPBELL, SHARA Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-21 0022-A 8,648 DIAZ-VAZQUEZ, RAE?Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-09-27 0004-A 8,831 FISHER, JEFFREY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-10-20 0011-A 9,664 FLORES, EFRAIN Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-09-22 0029-A 8,696 GARCIA, RICHARD Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-08-01 0003-A 6,874 GURROLA, LETICIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-11 0020-A 6,186 HANSON, MICHAEL Bill Patient Collections No Bill Sent 285.00 0.00 285.00 2004-07-08 0008-A 6,073 HUDSON, JUDY Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-07-12 VV IJ^015-/1 6,212 HUDSON, JUDY Bill Patient Collections No Bill Sent 1,326.00 0.00 1,326.00 2004-07-12 0008-A 6,204 KOT, VERONIKA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-31 0016-A 7,895 KOT, VERONIKA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-11 0009-A 7,222 LIRA, CIRILO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-19 0014-A 8,567 LOPEZ, ROBERT Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-08-17 0017-A 7,419 MARTINEZ, ANTHONI Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-31 0031-A 6,868 MARTINI, HEATHER Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-21 0033-A 8,663 MORRIS, CIPRIANO Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-09-21 0035-A 8,665 MORRIS, RAMON Bill Patient Collections No Bill Sent 1,296.00 0.00 1,296.00 2004-09-18 0033-A 8,535 NAVA, ALDO Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-09-18 0034-A 8,536 NAVA, JAQUELINE Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-09-18 0029-A 8,531 NAVA, JUAN Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-09-18 0032-A 8,534 NAVA, SANDRA Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-09-18 0035-A 8,537 NAVA, YENIFER Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-09-19 0015-A 8,568 RENTERIA, RENEE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-11 0005-A 6,161 SALINAS, SANTOS Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-10 0027-A 7,193 SPEAKER, JASON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-22 0009-A 8,676 STEINER, MITCHELL Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-10-17 0026-A 9,572 TUTTLE, RODNEY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-31 0012-A 7,890 VROOMAN, ROBERT Bill Patient Collections No Bill Sent 996.00 0.00 996.00 Trip count: 30 28,269.00 1,464.35 2 04. Trip count 30 28,269.00 1,464.35 26,804.65 RescueNeF" Printed on 11/9/2004 at 2:20:29PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,161 Batch date: 12/7/2004 12:35:01PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-05-08 0013-A 3,942 ANDERSON, MICHAEI Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-06-11 0003-A 5,144 ATENCIO, SHARON Bill Patient Collections No Bill Sent 1,236.00 988.80 247.20 2004-05-20 0035-A 4,396 BOWLES, JANIE Bill Patient Collections No Bill Sent 1,386.00 1,108.80 277.20 2004-06-15 0016-A 5,263 CARLSON, MICHAEL Bill Patient Collections No Bill Sent 1,101.00 880.80 220.20 2004-06-11 0021-A 5,174 CURRY, DAVID Bill Patient Collections No Bill Sent 150.00 100.00 50.00 2004-05-19 0019-A 4,345 DAVIS, REBEKKA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-05-13 0012-A 4,120 DUPONT, ADDIE Bill Patient Collections No Bill Sent 1,176.00 379.82 796.18 '2004-04=29- -OGt0-A- 3,59D _ FRIEND, MEGHAN BiH-Patient Collections No Bill-Sera__ - 1,-116:09 _ 892.80 223,20'' - 2004-06-09 0029-A 5,066 GRAUSE, KAREN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 i " 2003-09-09 0020-A 7,075 HELD,AMBER Bill Patient Collections No Bill Sent 1,101.00 220.00 881.00 ' 2004-05-19 0036-A 4,401 HIDALGO, PATRICIA Bill Patient Collections No Bill Sent 1,056.00 1,003.24 52.76 2004-05-07 0024-A 3,915 ISHMAEL, BRIAN Bill Patient Collections No Bill Sent 1,026.00 820.80 205.20 2004-05-22 0005-A 4,448 ISHMAEL, BRIAN Bill Patient Collections No Bill Sent 1,371.00 296.80 1,074.20 2004-03-18 0027-A 2,315 MARTINEZ, LEO Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-05-18 0009-A 4,308 MARTINEZ, MONICA Bill Patient Collections No Bill Sent 996.00 896.80 99.20 2004-04-15 0027-A 3,174 PINEDA, JUAN Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2003-02-01 0068-A 8,039 PUGA, ANSELMO Bill Patient Collections No Bill Sent 634.00 275.00 359.00 2004-05-30 0021-A 4,736 REYES, ESPERANZA Bill Patient Collections No Bill Sent 1,326.00 50.00 1,276.00 2004-03-19 0020-A 2,348 RODRIGUEZ,ADAM Bill Patient Collections No Bill Sent 1,176.00 940.80 235.20 2004-06-15 0002-A 5,249 SCHUMACHER, DOR/Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-06-10 0018-A 5,105 SHERIDAN, HERMIA Bill Patient Collections No Bill Sent 1,191.00 25.00 1,166.00 2004-06-10 0017-A 5,104 SHERIDAN, MARY Bill Patient Collections No Bill Sent 1,191.00 11.00 1,180.00 2003-08-16 0010-A 6,269 SMITH, BRANDON Bill Patient Collections No Bill Sent 1,011.00 200.00 811.00 2004-06-04 0024-A 4,892 TETER, CODY Bill Patient Collections No Bill Sent 150.00 105.00 45.00 2004-05-03 0049-A 3,794 VANBLARICOME, KRI:Bill Patient Collections No Bill Sent 1,281.00 100.00 1,181.00 Trip count: 25 24,379.00 9,295.46 15,083.54 Trip count: 25 24,379.00 9,295.46 15,083.54 Total trip count: ''b, , :,>; ,..1,-(:.., o1 ; "1 F e i N. ?, ,c . 1'`1 j RescueNetM Printed on 12/7/2004 at 12:35:31PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\Su bBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,162 Batch date: 12/7/2004 12:56:04PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-06-30 0008-A 5,773 ALANIZ, ROBERT Bill Patient Collections No Bill Sent 1,071.00 1,008.85 62.15 2004-07-06 0018-A 6,023 ATTWOOLL, TREVOR Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-05 0025-A 5,998 BREWER, JAMES Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-05 0024-A 5,997 BREWER, JAMES Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-06-26 0002-A 5,631 CHAIREZ, ANA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-06 0032-A 6,040 DELGADO, DEBRA Bill Patient Collections No Bill Sent 1,296.00 1,036.80 259.20 2004-07-06 0011-A 6,016 DREW, MARY Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-06-20 0035-A 5,442 DURAN, ANTONIETA Bill Patient Collections No Bill Sent 1,071.00 945.00 126.00 2004-07-03 0047-A 6,555 GONZALES, DANIEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-06-20 0025-A 5,432 GREEN, FELICIA Bill Patient Collections No Bill Sent 618.00 568.00 50.00 2004-07-03 0013-A 5,922 LICKLITER, ALYSSA Bill Patient Collections No Bill Sent 1,056.00 444.75 611.25 2004-06-22 0029-A 5,523 LYNCH, GREGORY Bill Patient Collections No Bill Sent 1,386.00 n nn 1,386.00 2004-07-04 0034-A 5,951 MARTINEZ, JOSE Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-03 0045-A 6,027 MEDINA, DIANA Bill Patient Collections No Bill Sent 1,191.00 0.00 1,191.00 2004-07-06 0019-A 6,024 MIRELES,EUSEBIA Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-05 0002-A 5,959 MOORE, SIERRA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-04 0002-A 5,896 MORALES, SALVADOI Bill Patient Collections No Bill Sent 1,221.00 1,158.75 62.25 2004-07-02 0034-A 5,885 MORRIS, NORMAN Bill Patient Collections No Bill Sent 2,151.00 1,436.00 715.00 2004-06-22 0012-A 5,492 RICHARDSON,ANN Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-07-03 0010-A 5,914 SANCHEZ, LA REE Bill Patient Collections No Bill Sent 1,131.00 504.80 626.20 2004-06-28 0010-A 5,702 SANCHEZ, MARTHA Bill Patient Collections No Bill Sent 1,236.00 819.55 416.45 2004-06-30 0009-A 5,774 STAHL, SYLVIA Bill Patient Collections No Bill Sent 1,326.00 1,060.80 265.20 2004-07-05 0009-A 5,978 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-03 0031-A 5,955 TRIMBLE, SUSAN Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-06-22 0001-A 5,481 TRUJILLO, LISA Bill Patient Collections No Bill Sent 1,266.00 0.00 1,266.00 2004-07-06 0029-A 6,036 WARD,ALEX Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-07-06 0029-B 6,039 WARD, ALEX Bill Patient Collections No Bill Sent 933.00 0.00 933.00 2004-07-01 0001-A 5,796 WINTERS, EDWIN Bill Patient Collections No Bill Sent 1,221.00 1,144.14 76.86 2004-07-02 0039-A 5,891 YOUNG, KRISTA Bill Patient Collections No Bill Sent 1,041.00 991.00 50.00 Trip count: 29 33,537.00 11,118.44 22,418.56 Trip count: 29 33,537.00 11,118.44 22,418.56 Total trip count: aF§.-1,°,0 '' - ^,tLs i° __i ..1 E ..,j --,.,, 249: +,. RescueNetTM Printed on 12/7/2004 at 12:57:06PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch 7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,163 Batch date: 12/7/2004 1:17:06PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-09 0040-A 6,210 ANDERSON, CODY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-18 0018-A 6,415 ATKINSON, NAOMI Bill Patient Collections No Bill Sent 1,566.00 0.00 1,566.00 2004-07-13 0028-A 6,252 BACA, VALERIE Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-07 0011-A 6,051 BARAN, MARK Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-08 0001-A 6,066 BEYER, ANTHONY Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-13 0023-A 6,247 BIRCHWELL, KALEB Bill Patient Collections No Bill Sent 1,236.00 0.00 1,236.00 2004-07-16 0034-A 6,358 BROTHERTON, LAWF Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-14 0024-A 6,282 DEINES, MARY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-17 0010-A 6,373 DRISKELL, CRAIG Bill Patient Collections No Bill Sent 1,416.00 0.00 1,416.00 2004-07-07 0019-A 6,059 GUTIERREZ, MIGUEL Bill Patient Collections No Bill Sent 981.00 0.00 981.00 2004-07-08 0004-A 6,069 HERNANDEZ, FELIX Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-18 0006-A 6,403 HERNANDEZ-URIAS, IBill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-07-18 0005-A 6,402 KLEIN, BRIAN Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-07-13 0015-A 6,239 LANCKRIET, GREGOF Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-15 0008-A 6,294 LOPEZ, ANGELICA Bill Patient Collections No Bill Sent. 1,551.00 0.00 1,551.00 2004-07-15 0009-A 6,295 LOZANO, RITA Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-18 0010-A 6,407 LUGERO, EVA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-14 0020-A 6,278 MARQUEZ, FAUSTINC Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-17 0023-A 6,386 MARQUEZ, HUGO Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-07-16 0009-A 6,333 MEDINA, JASON Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-07-10 0020-A 6,148 •NEHRING, LINDA Bill Patient Collections No Bill Sent 1,101.00 1,045.55 55.45 2004-07-08 0018-A 6,083 OLIVAS, MICHAEL Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-07 0001-A 6,041 QUICK, BARBARA Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-15 0026-A 6,318 RAMIREZ, MARIA DEL Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-07-17 0002-A 6,365 RATLIFF, LARRY Bill Patient Collections No Bill Sent 1,311.00 0.00 1,311.00 2004-07-14 0001-A 6,258 RODRIGUEZ JR, JUN Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-16 0024-A 6,348 RODRIGUEZ, JOANNI Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-14 0002-A 6,259 RODRIGUEZ, NANCY Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-14 0014-A 6,272 SMITH, RICKEY Bill Patient Collections No Bill Sent 1,221.00 976.80 244.20 2004-07-14 0016-A 6,274 TRIMBLE, SUSAN Bill Patient Collections No Bill Sent 1,368.00 0.00 1,368.00 2004-07-07 0014-A 6,054 VIGIL, CHANTELLE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-16 0005-A 6,329 VILLARREAL, MICHAE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-13 0012-A 6,236 YBARRA, SANTOS Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 Trip count: 33 32,838.00 2,022.35 30,815.65 RescueNetT" Printed on 12/7/2004 at 1:18:19PM Page 1 • \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Trip count: 33 32,838.00 2,022.35 3! , • Total trip count•. < �' ' gyrn RescueNetTM Printed on 12/7/2004 at 1:18.19PM Page 2 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,164 Batch date: 12/7/2004 1:47:11PM Trip Date Job Run Name Current Pavor Schedule Event Chartres Credits Balance 2004-07-19 0017-A 6,443 ALFARO, SHIRLEY Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-07-21 0003-A 6,492 BARNES, JAMES Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-07-20 0002-A 6,467 EUBANKS, CLIFF Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-24 0003-A 6,601 FOWLER, CHRISTINA Bill Patient Collections No Bill Sent 513.00 0.00 513.00 2004-07-20 0026-A 6,498 GALLEGOS, CARLOS Bill Patient Collections No Bill Sent 1,551.00 0.00 1,551.00 2004-07-25 0005-A 6,633 HAMBLEN, DALE Bill Patient Collections No Bill Sent 1,386.00 0.00 1,386.00 2004-07-25 0008-A 6,636 HARKLESS,ADAM Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-24 0015-A 6,613 HARRIS, DAVID Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-25 0018-A 6,646 JACKSON, STEVE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-23 0003-A 6,571 JOHNSON, CLAUDIO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-21 0031-A 6,532 KIZER, CHRISTINE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-19 0036-A 6,501 LEE, SCHANEL Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-19 0001-A 6,427 LLAMAS, EZEKIEL Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-07-22 0006-A 6,544 LOPEZ, ANTONIO Bill Patient Collections _ No Bill Sent 1,146.00 0.00 1,146.00 2004-07-19 0038-A 6,503 LUEVANO-LABRA, MA Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-07-21 0027-A 6,528 MALDONADO, UZZIEI Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-24 0001-A 6,599 MARKHEIM, JOEL Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-07-24 0025-A 6,623 MEJIA, ROSALVO Bill Patient Collections No Bill Sent 996.00 0.00 996.00 ' 2004-07-24 0004-A. 6,602 PECH, KHEAN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-24 0024-A 6,622 PRZYHOCKI, COURTP Bill Patient Collections No Bill Sent 1,476.00 0.00 1,476.00 2004-07-22 0025-A 6,565 REED, JOSHUA Bill Patient Collections No Bill Sent 1,251.00 0.00 1,251.00 2004-07-23 0006-A 6,574 RODRIGUEZ, HENRY Bill Patient Collections No Bill Sent 1,221.00 0.00 1,221.00 2004-07-21 0020-A 6,520 SANDERS, RHONDA Bill Patient Collections No Bill Sent 1,581.00 0.00 1,581.00 2004-07-24 0005-A 6,603 SILVA, GILBERTO Bill Patient Collections No Bill Sent 1,671.00 0.00 1,671.00 2004-07-21 0018-A 6,518 STANTON, KIM Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-20 0005-A 6,472 STAPLETON, ROBER'Bill Patient Collections No Bill Sent 1,521.00 0.00 1,521.00 2004-07-24 0016-A 6,614 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-21 0024-A 6,524 TEICH, JOSEPH Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 2004-07-19 0011-A 6,437 VAROLA, MANUELA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-20 0024-A 6,496 VIALPANDO, NAOMI Bill Patient Collections No Bill Sent 1,281.00 0.00 1,281.00 2004-07-24 0028-A 6,626 ZAVALA, MARISELA Bill Patient Collections No Bill Sent 1,161.00 0.00 1,161.00 Trip count 31 30,486.00 0.00 30, Trip count: 31 30,486.00 0.00 30,486.00 RescueNetTM Printed on 12/7/2004 at 1:48:14PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,165 Batch date: 12/7/2004 2:06:53PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-07-27 0036-A 6,730 ARCHULETA, LOREN:Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-07-30 0003-A 6,801 DELVE, LYNNE Bill Patient Collections No Bill Sent 2,106.00 0.00 2,106.00 2004-07-27 0002-A 6,696 DRISKELL, CRAIG Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-08-03 0004-A 6,947 EDWARDS, KENNETI-Bill Patient . Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-07-26 0006-A 6,664 GALLARDO, ROXANN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0018-A 6,678 GILMORE, KRISTEL Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-02 0020-A 6,924 GONZALEZ, NOLBER"Bill Patient Collections No Bill Sent 1,371.00 0.00 1,371.00 2004-07-31 0025-A 6,862 GUERRERO, MICHAE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-27 0023-A 6,717 HALLSTED,VALETA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0029-A 6,689 HAYES, KATHRYN Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-07-30 0036-A 6,835 HERRERA, SET Bill Patient Collections No Bill Sent 1,206.00 590.79 615.21 2004-08-13 0018-A 7,293 HOFFMAN, JUNIOR Bill Patient Collections No Bill Sent 1,101.00 0.00 1,101.00 2004-07-30 0035-A 6,834 JONES, JAIDEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-30 0020-A 6,818 KERRIGAN, BYRON Bill Patient Collections,. No Bill Sent 1,146.00 0.00 1,146.00 2004-07-26 0014-A 6,674 LONG, NORMA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0033-A 6,694 LOPEZ-CAMPOS, REl Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-02 0014-A 6,918 LOREULO, ALVIA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-27 0030-A 6,724 MADDOX, BEN Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-26 0017-A 6,677 MARTIN, JOSHUA Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-27 0031-A 6,725 METCALF, JOE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-08-13 0025-A 7,301 MORENO, DAVID Bill Patient Collections No Bill Sent 1,026.00 0.00 1,026.00 2004-08-02 0016-A 6,920 PINEDA, ALFONSO Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-08-13 0017-A 7,292 TIMPE, JAMES Bill Patient Collections No Bill Sent 1,176.00 0.00 1,176.00 2004-07-31 0027-A 6,864 TRIMBLE,ANN Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-07-26 0012-A 6,672 VARNER, STANLEY Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-07-28 0028-A 6,762 WRIGHT, JOAN Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 Trip count: 26 19,890.00 590.79 19,299.21 Trip count: 26 19,890.00 590.79 19,2 . 1 Total trip count: ,`- o E e, €.°211?:':' * r ¢ RescueNetTM Printed on 12/7/2004 at 2:07:38PM Page 1 \\nw 16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Submission Batch Report WELD COUNTY PARAMEDIC SERVICES Batch 6,166 Batch date: 12/7/2004 2:23:43PM Trip Date Job Run Name Current Pavor Schedule Event Charges Credits Balance 2004-10-11 0037-A 9,368 AMADO, JERMAINE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-10-06 0017-A 9,148 CALEL, DOINICIO Bill Patient Collections No Bill Sent 1,086.00 0.00 1,086.00 2004-09-09 0023-A 8,208 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,281.00 1,206.00 75.00 2004-09-08 0006-A 8,164 CONTRERAS, SERGI(Bill Patient Collections No Bill Sent 1,356.00 1,281.00 75.00 2004-11-10 0005-A 10,334 CRANMER, RICK Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-26 0013-A 7,705 CRUZ, DIANA Bill Patient Collections No Bill Sent 1,176.00 144.23 1,031.77 2004-09-29 0005-A 8,903 DINKEL, NICKOLAS Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-08-30 0017-A 7,845 GARCIA, SARAH Bill Patient Collections No Bill Sent 1,131.00 0.00 1,131.00 2004-09-20 0026-A 8,622 GARZA, ALFREDO Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-08-30 0040-A 7,876 GARZA, SANTOS Bill Patient Collections No Bill Sent 1,206.00 0.00 1,206.00 2004-09-04 0019-A 8,046 JIMENEZ, JUAN Bill Patient Collections No Bill Sent 678.00 0.00 678.00 2004-10-08 0050-A 9,254 JOHNSON, CODY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-08-26 0033-A 7,729 KENNY, DEBORAH Bill Patient Collections No Bill Sent 1,536.00 0.00 1,5q6.00 2004-10-03 0006-A 9,037 LISZEWSKI, JEFF Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-08-23 0029-A 7,631 LOPEZ, ANTONIO Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 2004-10-06 0032-A 9,163 MINO, ISIAH Bill Patient Collections No Bill Sent 1,041.00 0.00 1,041.00 2004-08-21 0028-A 7,573 ORTIZ-PACHECO, DC Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-09-20 0028-A 8,624 PARKER-DOWNING, ,Bill Patient Collections No Bill Sent 1,835.00 0.00 1,835.00 2004-08-16 0019-A 7,380 PHILLIPS, AARON Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-11 0009-A 8,254 PHILLIPS, MICHAEL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-08-14 0022-A 7,324 QUEVEDO, LINO Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-11-13 0031-A 10,477 RANGEL, RICKY Bill Patient Collections No Bill Sent 996.00 0.00 996.00 2004-11-12 0039-A 10,438 RASCON, RAUL Bill Patient Collections No Bill Sent 1,116.00 0.00 1,116.00 2004-11-13 0001-A 10,443 RASCON, RAUL Bill Patient Collections No Bill Sent 1,341.00 0.00 1,341.00 2004-08-15 0029-A 7,358 RITCHIE, JAMIE Bill Patient Collections No Bill Sent 150.00 0.00 150.00 2004-09-03 0001-A 7,987 SANCHEZ, JOSE Bill Patient Collections No Bill Sent 1,056.00 0.00 1,056.00 2004-10-03 0005-A 9,036 STEETER, WILLIAM Bill Patient Collections No Bill Sent 1,401.00 0.00 1,401.00 2004-10-07 0018-A 9,182 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-11-02 0022-A 10,097 TAYLOR, JAMES Bill Patient Collections No Bill Sent 1,146.00 0.00 1,146.00 2004-08-25 0021-A 7,686 TRYELS, ALONZO Bill Patient Collections No Bill Sent 1,071.00 0.00 1,071.00 2004-08-19 0022-A 7,506 WHITE, MARYELLEN Bill Patient Collections No Bill Sent 663.00 0.00 663.00 2004-10-04 0028-A 9,087 WILLIAMS, TAMMIE Bill Patient Collections No Bill Sent 1,011.00 0.00 1,011.00 Trip count 32 32,711.00 2,631.23 30,079.77 I RescueNetT"" Printed on 12/7/2004 at 2:24:38PM Page 1 \\nw16\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Trip count: 32 32,711.00 2,631.23 +, '. 7 Total trip count: • RescueNetTM Printed on 12/7/2004 at 2.24:38PM Page 2 \\nwt 6\rescuenet\reports32\Billing\Miscellaneous\SubBatch7.rpt Hello