API Data Explorer (Athletic)
Choose an endpoint and browse pulled athletic records with export support.
API Endpoints
Total rows: 99,149
| created_at | updated_at | id | athelas_task_id | cmds_task_id | payer_id | payer_name | provider_npi | trace_number | provider_name | subscriber_dob | date_of_service | subscriber_gender | service_type_codes_1 | subscriber_last_name | subscriber_member_id | subscriber_first_name | service_type_codes_2 | raw_response_url | check_source | has_error | created_by | date_of_service | parsed_data_url | parsed_data | oon_parsed_data | suggested_copay_amt | is_deductible_met | is_in_network | plan_info_member_id | plan_info_plan_type | plan_info_group_name | plan_info_payer_name | plan_info_payer_note | plan_info_patient_dob | plan_info_plan_number | plan_info_group_number | plan_info_insurance_type | plan_info_plan_type_code | plan_info_enrolled_in_qmb | plan_info_patient_last_name | plan_info_plan_sponsor_name | plan_info_patient_first_name | plan_info_patient_middle_name | plan_info_date_time_period_end | plan_info_date_time_period_start | plan_info_plan_coverage_description | plan_info_relationship_to_subscriber | service_type_codes_1 | service_type_codes_2 | is_proactive_visit | is_archived | failed_to_parse_response_reason | payer_plan_info | medicare_part | waystar_inquiry_id | created_by_user_id | appointment_id | patient_insurance_info_id | site_id | facility_id | eligibility_coverage_id | mapped_insurance_company_id | patient_id | eligibility_checks_updated_at | patients_updated_at |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-10-14 05:16:52.938735 | 2025-10-15 00:45:57.352147 | 13394070 | N/A | N/A | 62308 | American Specialty Health | 1114042165 | 13394070 | Athletic Physical Therapy Inc | 2001-11-21 | 2025-10-17 | M | AD | LYKIDIS | U1221753503 | JOHN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5541552/check_13394070_27803560-6dad-4cf9-ba48-b6d9cd2ef162.json | N/A | N/A | N/A | N/A | N/A | U1221753503 | N/A | DISNEY WORLDWIDE SERVICES, INC. | CHLIC | PROVIDER IS IN NETWORK BASED ON NPI ID PROVIDED IN REQUEST COMPLETE CARE MANAGEMENT | 2001-11-21 | N/A | 3207160 | N/A | N/A | false | LYKIDIS | N/A | JOHN | N/A | N/A | N/A | OPEN ACCESS PLUS | N/A | AD | N/A | N/A | N/A | N/A | N/A | N/A | 9017059573 | N/A | N/A | 5541552 | 2222 | 4802 | 13691032 | N/A | 4213562 | 2025-10-15 00:45:57.352147 | 2025-05-13 04:29:37.227895 |
| 2025-10-14 05:16:52.639922 | 2025-10-15 00:49:11.655023 | 13394060 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13394060 | Athletic Physical Therapy Inc | 1963-07-22 | 2025-10-15 | F | PT | ZIA AMIRHOSSEINI | XED911835748 | PARNIAN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-15 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5541314/check_13394060_bacbcd91-e86c-4325-90e2-c7a79c66a7c1.json | N/A | N/A | N/A | N/A | N/A | XED911835748 | Preferred Provider Organization (PPO) | IFP ON EXCHANGE | BLUE SHIELD CALIFORNIA | N/A | 1963-07-22 | 2001ZK002186 | X0001004 | N/A | PR | false | HARRIS | N/A | ROBERT | N/A | 9999-12-31 | 2023-01-01 | IFP EMB PED VISION | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059572 | N/A | N/A | 5541314 | 2222 | 4793 | 13692340 | N/A | 4213343 | 2025-10-15 00:49:11.655023 | 2025-06-06 02:21:37.603701 |
| 2025-10-14 05:16:51.848794 | 2025-10-15 00:48:41.699791 | 13394035 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13394035 | Athletic Physical Therapy Inc | 1995-06-07 | 2025-10-17 | U | PT | GREATHOUSE | MPI30458946Q | KHEPERAN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5540871/check_13394035_2e00ed8e-1bc0-4b7f-81e2-c3bad91ae92f.json | N/A | N/A | N/A | N/A | N/A | MPI30458946Q | N/A | N/A | BLUE CROSS CALIFORNIA | N/A | 1995-06-07 | N/A | N/A | N/A | N/A | false | GREATHOUSE | N/A | KHEPERAN | N/A | N/A | N/A | N/A | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059571 | N/A | N/A | 5540871 | 2222 | 4793 | 13692134 | N/A | 4212959 | 2025-10-15 00:48:41.699791 | 2025-10-17 20:08:21.136268 |
| 2025-10-14 05:16:51.220256 | 2025-10-15 00:43:35.978965 | 13394012 | N/A | N/A | 60054 | Aetna | 1114042165 | 13394012 | Athletic Physical Therapy Inc | 1982-07-27 | 2025-10-17 | M | AE | BOKHTIER | W275493875 | GOLAM | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5540723/check_13394012_fd9b8f6a-073b-455e-ae10-224ca9ea2b0e.json | N/A | N/A | N/A | N/A | N/A | W275493875 | Exclusive Provider Organization | AMERICAN EXPRESS COMPANY | AETNA | N/A | 1982-07-27 | 0169631 | 016963101100001 | N/A | EP | false | BOKHTIER | N/A | SUMMER | N/A | N/A | N/A | OPEN ACCESS AETNA SELECT | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059570 | N/A | N/A | 5540723 | 2222 | 4793 | 13690054 | N/A | 4212833 | 2025-10-15 00:43:35.978965 | 2025-05-28 20:46:35.079848 |
| 2025-10-14 05:16:50.933060 | 2025-10-15 00:43:36.925735 | 13393995 | N/A | N/A | 60054 | Aetna | 1114042165 | 13393995 | Athletic Physical Therapy Inc | 1948-11-01 | 2025-10-16 | F | AE | TUCKER | 101632234800 | EILEEN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5540116/check_13393995_c012af5f-ad82-4877-b23a-539a333a61e3.json | N/A | N/A | N/A | N/A | N/A | 101632234800 | Preferred Provider Organization (PPO) | STATE OF ILLINOIS RETIREES - MAPD | AETNA | MEDICARE | 1948-11-01 | 100512-01EG0001 | 100512-01 | N/A | PR | false | TUCKER | N/A | EILEEN | N/A | N/A | N/A | MEDICARE (C05) ESA PPO PLAN | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059569 | N/A | N/A | 5540116 | 2222 | 4801 | 13690059 | N/A | 4212312 | 2025-10-15 00:43:36.925735 | 2025-05-13 04:29:37.226651 |
| 2025-10-14 05:16:50.659132 | 2025-10-15 00:47:12.712739 | 13393984 | N/A | N/A | 68069 | Lakeside Medical Group | 1114042165 | 13393984 | Athletic Physical Therapy Inc | 1973-07-11 | 2025-10-16 | M | AE | HERMAN | 95836743G | BRETT | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5540113/check_13393984_d5e862f5-763c-4761-b5fd-c02e012b0112.json | N/A | N/A | N/A | N/A | N/A | 95836743G | N/A | N/A | HEALTH NET, LLC | N/A | 1973-07-11 | N/A | N/A | N/A | N/A | false | HERMAN | N/A | BRETT | N/A | N/A | N/A | KCW MCALSTD | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059568 | N/A | N/A | 5540113 | 2222 | 4801 | 13691526 | N/A | 4212315 | 2025-10-15 00:47:12.712739 | 2025-12-29 21:20:15.158611 |
| 2025-10-14 05:16:50.369532 | 2025-10-15 00:48:11.819564 | 13393972 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393972 | Athletic Physical Therapy Inc | 1936-06-28 | 2025-10-16 | F | PT | BOYLAN | MBL857M98403 | JOAN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5540074/check_13393972_91df8100-9c12-4b55-89a2-09ad61d46ede.json | N/A | N/A | N/A | N/A | N/A | MBL857M98403 | N/A | LOS ANGELES UNIFIED SCHOOL DISTRICT (LAUSD) | ANTHEM BLUE CROSS | N/A | 1936-06-28 | 040 | CAEGR005 | N/A | N/A | false | BOYLAN | N/A | JOAN | N/A | 2025-12-31 | 2021-01-01 | CA GRS LAUSD H4036-802 ANTHEM MEDICARE PREFERRED M | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059567 | N/A | N/A | 5540074 | 2222 | 4802 | 13691919 | N/A | 4212282 | 2025-10-15 00:48:11.819564 | 2025-05-13 04:29:37.226623 |
| 2025-10-14 05:16:49.827714 | 2025-10-15 00:48:12.754563 | 13393956 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393956 | Athletic Physical Therapy Inc | 1991-07-13 | 2025-10-17 | M | PT | FINNLEY | NGO832M81089 | ZEV | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5539664/check_13393956_cdd297df-101a-40a6-ab3f-a7165fdf8966.json | N/A | N/A | N/A | N/A | N/A | NGO832M81089 | Preferred Provider Organization (PPO) | NORTHROP GRUMMAN CORP | ANTHEM BLUE CROSS | N/A | 1991-07-13 | 040 | 174022MJAC | N/A | PR | false | FINNLEY | N/A | ZEV | N/A | 9999-12-31 | 2022-01-01 | CDHP CA GENERIC HLTH SAVINGS ACCT | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059566 | N/A | N/A | 5539664 | 2222 | 4793 | 13691924 | N/A | 4211935 | 2025-10-15 00:48:12.754563 | 2025-05-13 04:29:37.226259 |
| 2025-10-14 05:16:49.010373 | 2025-10-15 00:48:13.916287 | 13393923 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393923 | Athletic Physical Therapy Inc | 1975-10-23 | 2025-10-17 | F | PT | MAGEE | SRYHC0157512 | JENNIFER | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5539606/check_13393923_8d23a124-76f1-47be-80a0-4ac8f42723de.json | N/A | N/A | N/A | N/A | N/A | SRYHC0157512 | Preferred Provider Organization (PPO) | SURVEYMONKEY PPO IN STATE | ANTHEM BLUE CROSS | N/A | 1975-10-23 | 040 | L12152M001 | N/A | PR | false | MAGEE | N/A | JENNIFER | N/A | 9999-12-31 | 2025-01-01 | PPO PRUDENT BUYER INCENTIVE | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059565 | N/A | N/A | 5539606 | 2222 | 4793 | 13691934 | N/A | 4211886 | 2025-10-15 00:48:13.916287 | 2026-02-06 19:09:03.082684 |
| 2025-10-14 05:16:48.720310 | 2025-10-15 00:48:13.056343 | 13393910 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393910 | Athletic Physical Therapy Inc | 1980-04-11 | 2025-10-15 | M | PT | Hurst | JQY695A75359 | Gregory | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-15 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5539085/check_13393910_b292229e-f555-46e2-be35-83d5a86520a9.json | N/A | N/A | N/A | N/A | N/A | JQY695A75359 | Preferred Provider Organization (PPO) | YALE MANAGEMENT SERVICES | ANTHEM BLUE CROSS | N/A | 1980-04-11 | 040 | 342584 | N/A | PR | false | HURST | N/A | GREGORY | N/A | 9999-12-31 | 2024-12-01 | ANTHEM SILVER SELECT PPO 50/2200/40% | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059564 | N/A | N/A | 5539085 | 2222 | 4793 | 13691927 | N/A | 4211408 | 2025-10-15 00:48:13.056343 | 2025-09-18 00:42:48.586801 |
| 2025-10-14 05:16:48.320576 | 2025-10-15 00:47:18.578344 | 13393897 | N/A | N/A | 72261 | Regal Medical Group | 1114042165 | 13393897 | Athletic Physical Therapy Inc | 1951-08-02 | 2025-10-17 | M | AE | CHADIDA | 40060913601 | DAVID | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5538674/check_13393897_eff16eb7-0749-45ea-8edf-965506e2d39c.json | N/A | N/A | N/A | N/A | N/A | 40060913601 | N/A | N/A | SCAN HEALTH PLAN | CONTACT THE PAYER FOR SPECIFIC BENEFIT DETAILS | 1951-08-02 | 2025H5425001 | H5425M | N/A | N/A | false | CHADIDA | N/A | DAVID | N/A | N/A | N/A | SCAN CLASSIC (HMO), VENTURA | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059563 | N/A | N/A | 5538674 | 2222 | 4793 | 13691581 | N/A | 4211039 | 2025-10-15 00:47:18.578344 | 2025-05-13 04:29:37.225444 |
| 2025-10-14 05:16:48.040393 | 2025-10-15 00:49:10.495550 | 13393884 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13393884 | Athletic Physical Therapy Inc | 1974-06-04 | 2025-10-17 | F | PT | NAIMI | KSI73549599C | ERIN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5537507/check_13393884_3c54a27c-e2fd-4860-9fc8-4363a704677c.json | N/A | N/A | N/A | N/A | N/A | KSI73549599C | Preferred Provider Organization (PPO) | KARL STORZ ENDOSCOPY AMERICA INC | BLUE SHIELD CALIFORNIA | N/A | 1974-06-04 | 1000PPOX0003 | W8002382 | N/A | PR | false | ABI MALHAB | N/A | NADIM | N/A | N/A | N/A | KARL STORZ ENDOSCOPY AMERICA INC SHARED ADVANTAGE | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059562 | N/A | N/A | 5537507 | 2222 | 4802 | 13692332 | N/A | 4210057 | 2025-10-15 00:49:10.495550 | 2025-05-13 04:29:37.224477 |
| 2025-10-14 05:16:47.487072 | 2025-10-15 00:47:18.956792 | 13393862 | N/A | N/A | 72261 | Scan Health Plan - California | 1114042165 | 13393862 | Athletic Physical Therapy Inc | 1957-02-16 | 2025-10-16 | F | AE | OSE | 40050866601 | KAREN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5537366/check_13393862_0633ec7b-f511-410d-918c-f58e1a514786.json | N/A | N/A | N/A | N/A | N/A | 40050866601 | N/A | N/A | SCAN HEALTH PLAN | CONTACT THE PAYER FOR SPECIFIC BENEFIT DETAILS | 1957-02-16 | 2025H5425001 | H5425M | N/A | N/A | false | OSE | N/A | KAREN | N/A | N/A | N/A | SCAN CLASSIC (HMO), VENTURA | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059561 | N/A | N/A | 5537366 | 2222 | 4793 | 13691584 | N/A | 4209945 | 2025-10-15 00:47:18.956792 | 2025-08-13 22:24:17.841096 |
| 2025-10-14 05:16:46.750577 | 2025-10-15 00:47:51.372018 | 13393829 | N/A | N/A | 95567 | Health Net of California and Oregon | 1114042165 | 13393829 | Athletic Physical Therapy Inc | 1974-07-27 | 2025-10-17 | F | AE | GOLDBERG | R03673351FM1 | SHARI | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5537209/check_13393829_085ec48c-cd09-40e1-9903-b5e89233c80c.json | N/A | N/A | N/A | N/A | N/A | R03673351FM1 | N/A | N/A | HEALTH NET OF CALIFORNIA | PLEASE NOTE THAT THE PERIOD END DATE ABOVE (DTP 194) INDICATES THE CLAIMS PAID THROUGH DATE. TO DETERMINE IF A PRIOR AUTHORIZATION IS REQUIRED, PLEASE CHECK THE HEALTH PLAN'S WEBSITE. | 1974-07-27 | 67138CA0520015-05 | N/A | N/A | N/A | false | GOLDBERG | N/A | SHARI | N/A | N/A | N/A | SILVER 87 AMBETTER HMO | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059560 | N/A | N/A | 5537209 | 2222 | 4802 | 13691811 | N/A | 4209812 | 2025-10-15 00:47:51.372018 | 2025-05-13 04:29:37.224237 |
| 2025-10-14 05:16:46.272061 | 2025-10-15 00:48:15.173706 | 13393815 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393815 | Athletic Physical Therapy Inc | 1964-10-19 | 2025-10-17 | M | PT | NIELSEN | XDP057A76330 | ROY | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5537188/check_13393815_166a6a42-1bbe-4ce6-af85-bcd10abf27ff.json | N/A | N/A | N/A | N/A | N/A | XDP057A76330 | Preferred Provider Organization (PPO) | ADP TOTALSOURCE INC | ANTHEM BLUE CROSS | N/A | 1964-10-19 | 040 | 280629MN16 | N/A | PR | false | NIELSEN | N/A | ROY | N/A | 2025-11-01 | 2025-06-01 | PPO PRUDENT BUYER CLASSIC | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059559 | N/A | N/A | 5537188 | 2222 | 4802 | 13691942 | N/A | 4209789 | 2025-10-15 00:48:15.173706 | 2025-05-13 04:29:37.224215 |
| 2025-10-14 05:16:46.008979 | 2025-10-15 00:48:14.503176 | 13393806 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393806 | Athletic Physical Therapy Inc | 1954-03-31 | 2025-10-17 | M | PT | MILES | MBL835W05431 | KEITH | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5536896/check_13393806_eb0ebe7f-713c-4dd0-931c-db72820044a8.json | N/A | N/A | N/A | N/A | N/A | MBL835W05431 | N/A | LOS ANGELES UNIFIED SCHOOL DISTRICT (LAUSD) | ANTHEM BLUE CROSS | N/A | 1954-03-31 | 040 | CAEGR005 | N/A | N/A | false | MILES | N/A | KEITH | N/A | 2025-12-31 | 2021-01-01 | CA GRS LAUSD H4036-802 ANTHEM MEDICARE PREFERRED M | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059557 | N/A | N/A | 5536896 | 2222 | 4793 | 13691937 | N/A | 4209567 | 2025-10-15 00:48:14.503176 | 2025-05-13 04:29:37.223990 |
| 2025-10-14 05:16:45.618723 | 2025-10-15 00:48:17.257295 | 13393792 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13393792 | Athletic Physical Therapy Inc | 1964-11-18 | 2025-10-16 | F | PT | TATE | CAI433A55164 | SANDRA | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5536427/check_13393792_2719d5d7-e5db-4c7d-875a-87c569d1faa6.json | N/A | N/A | N/A | N/A | N/A | CAI433A55164 | Health Maintenance Organization (HMO) | CALPERS CA RGION TWO - SO CA | ANTHEM BLUE CROSS | N/A | 1964-11-18 | 040 | HTB070HT | N/A | HM | false | TATE | N/A | SANDRA | N/A | 9999-12-31 | 2022-01-01 | PREMIER TRADITIONAL HMO NETWORK NON DURATIONAL | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017059556 | N/A | N/A | 5536427 | 2222 | 4793 | 13691957 | N/A | 4209167 | 2025-10-15 00:48:17.257295 | 2025-10-02 14:46:41.026614 |
| 2025-10-14 05:16:45.027294 | 2025-10-15 00:47:19.266102 | 13393769 | N/A | N/A | 72261 | Lakeside Medical Group | 1114042165 | 13393769 | Athletic Physical Therapy Inc | 1941-04-16 | 2025-10-17 | F | AE | RYAN | 31026142401 | CAROL | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102542376.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5535455/check_13393769_4fdc2ad9-a1d2-4ac6-9c5b-a7ea856f5310.json | N/A | N/A | N/A | N/A | N/A | 31026142401 | N/A | N/A | SCAN HEALTH PLAN | CONTACT THE PAYER FOR SPECIFIC BENEFIT DETAILS | 1941-04-16 | 2025H5425001 | H5425M | N/A | N/A | false | RYAN | N/A | CAROL | N/A | N/A | N/A | SCAN CLASSIC (HMO), VENTURA | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017059555 | N/A | N/A | 5535455 | 2222 | 4793 | 13691587 | N/A | 4208375 | 2025-10-15 00:47:19.266102 | 2025-08-08 21:08:12.459471 |
| 2025-10-14 05:16:27.546007 | 2025-10-15 00:31:48.360675 | 13393107 | N/A | N/A | 36273 | AARP Medicare Supplement by UnitedHealthcare | 1114042165 | 13393107 | Athletic Physical Therapy Inc | 1941-12-12 | 2025-10-17 | M | AE | ABARTA | 03851837911 | STEVEN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9929497/check_13393107_cd113ea4-4054-41a7-b2c5-d42712c48a6c.json | N/A | N/A | N/A | N/A | N/A | 03851837911 | Supplemental Policy | N/A | AARP SUPPLEMENTAL HEALTH PLANS FROM UNITEDHEALTHCARE | THE ELIGIBILITY AND BENEFIT INFORMATION PROVIDED IS NOT A GUARANTEE OR PROMISE OF PAYMENT. PAYMENT DETERMINATION ONLY OCCURS AFTER THE CLAIM IS PROCESSED BY MEDICARE AND BY THE SUPPLEMENTAL PLAN ACCORDING TO THE MEMBER'S BENEFITS. | 1941-12-12 | N/A | N/A | N/A | SP | false | ABARTA | N/A | STEVE | N/A | N/A | N/A | AARP MEDICARE SUPPLEMENT PLAN F | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017033241 | N/A | N/A | 9929497 | 2222 | 4801 | 13682637 | N/A | 8313339 | 2025-10-15 00:31:48.360675 | 2025-10-02 18:29:23.013167 |
| 2025-10-14 05:16:23.959742 | 2025-10-15 00:34:21.900852 | 13392958 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13392958 | Athletic Physical Therapy Inc | 1957-07-19 | 2025-10-16 | F | AE | JALALI | XEM911510070 | SOHEILA | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9904333/check_13392958_45674c56-03e5-4a12-a4d8-8df52b300a75.json | N/A | N/A | N/A | N/A | N/A | XEM911510070 | Other | MEDICARE SUPPLEMENT | MEDICARE PART A AND B | N/A | 1957-07-19 | 2002SF000028 | X0001002 | N/A | OT | false | JALALI | N/A | SOHEILA | N/A | N/A | N/A | MEDICARE SUPPLEMENT PLAN G | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017033161 | N/A | N/A | 9904333 | 2222 | 4802 | 13684778 | N/A | 8177726 | 2025-10-15 00:34:21.900852 | 2025-09-26 21:46:59.613569 |
| 2025-10-14 05:16:16.463231 | 2025-10-15 00:35:59.864064 | 13392672 | N/A | N/A | SB040 | ANTHEM BLUE CROSS | 1114042165 | 13392672 | Athletic Physical Therapy Inc | 1952-08-31 | 2025-10-16 | M | PT | VACA | JQS284W10343 | STEVEN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9258711/check_13392672_49ba21b1-a3cb-4ee9-acf2-5b363273f207.json | N/A | N/A | N/A | N/A | N/A | JQS284W10343 | Medicare Primary | CA MEDICARE | ANTHEM BLUE CROSS | N/A | 1952-08-31 | 040 | CAMCRWP0 | N/A | MP | false | VACA | N/A | STEVEN | N/A | 9999-12-31 | 2025-01-01 | CA H0544-063-000 ANTHEM MEDICARE ADVANTAGE (HMO-PO | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017049698 | N/A | N/A | 9258711 | 2222 | 4801 | 13686052 | 4184 | 7768967 | 2025-10-15 00:35:59.864064 | 2025-09-17 16:11:31.615033 |
| 2025-10-14 05:16:16.026803 | 2025-10-15 00:34:12.682121 | 13392658 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13392658 | Athletic Physical Therapy Inc | 1953-11-15 | 2025-10-16 | M | AE | REISMAN | WRXA13289369 | MARK | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9868746/check_13392658_93399a61-842e-46d1-98c4-1473e9fffb11.json | N/A | N/A | N/A | N/A | N/A | WRXA13289369 | Preferred Provider Organization (PPO) | WRITERS GUILD INDUSTRY HEALTH FUND | ANTHEM BLUE CROSS | N/A | 1953-11-15 | 040 | 277242M003 | N/A | PR | false | REISMAN | N/A | MARK | N/A | 9999-12-31 | 2025-04-01 | PPO PRUDENT BUYER INCENTIVE | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017032421 | N/A | N/A | 9868746 | 2222 | 4802 | 13684645 | N/A | 8262262 | 2025-10-15 00:34:12.682121 | 2025-09-30 22:45:25.940454 |
| 2025-10-14 05:16:13.174508 | 2025-10-15 00:34:12.111468 | 13392548 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13392548 | Athletic Physical Therapy Inc | 1947-07-23 | 2025-10-17 | F | AE | JOHNSON | JQE472A77522 | JUANITA | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9862555/check_13392548_272fd6c8-9709-445a-89d3-ccd14315622a.json | N/A | N/A | N/A | N/A | N/A | JQE472A77522 | N/A | CA MED-SUPP | ANTHEM BLUE CROSS | N/A | 1947-07-23 | 040 | CASUPWP0 | N/A | N/A | false | JOHNSON | N/A | JUANITA | N/A | 9999-12-31 | 2016-12-01 | CA MODERNIZED PLAN F | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017032408 | N/A | N/A | 9862555 | 2222 | 4801 | 13684635 | N/A | 8258095 | 2025-10-15 00:34:12.111468 | 2025-09-30 21:32:44.934397 |
| 2025-10-14 05:16:12.831024 | 2025-10-15 00:34:45.540390 | 13392534 | N/A | N/A | 72261 | Lakeside Medical Group | 1114042165 | 13392534 | Athletic Physical Therapy Inc | 1956-07-11 | 2025-10-16 | M | AE | ROGERS | 40066658301 | JOHN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9256747/check_13392534_86076ef8-66e1-4532-b83b-c7a7232d9ded.json | N/A | N/A | N/A | N/A | N/A | 40066658301 | N/A | N/A | SCAN HEALTH PLAN | CONTACT THE PAYER FOR SPECIFIC BENEFIT DETAILS | 1956-07-11 | 2025H5425001 | H5425M | N/A | N/A | false | ROGERS | N/A | JOHN | N/A | N/A | N/A | SCAN CLASSIC (HMO), VENTURA | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017049681 | N/A | N/A | 9256747 | 2222 | 4793 | 13685126 | N/A | 7767584 | 2025-10-15 00:34:45.540390 | 2025-09-09 21:16:10.468472 |
| 2025-10-14 05:16:09.840923 | 2025-10-15 00:48:34.115333 | 13392423 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13392423 | Athletic Physical Therapy Inc | 1998-10-29 | 2025-10-16 | M | PT | MARSHALL | AGSAH0066119 | THOMAS | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102619578.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7003223/check_13392423_195c42db-14c1-4def-a4c1-24dc291ae249.json | N/A | N/A | N/A | N/A | N/A | AGSAH0066119 | N/A | PEPPERDINE UNIVERSITY | ANTHEM BLUE CROSS | N/A | 1998-10-29 | 040 | 276500MG04 | N/A | N/A | false | MARSHALL | N/A | THOMAS | N/A | N/A | N/A | N/A | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017067247 | N/A | N/A | 7003223 | 2222 | 4793 | 13692078 | N/A | 6021448 | 2025-10-15 00:48:34.115333 | 2025-07-14 23:05:51.728886 |
| 2025-10-14 05:16:09.755551 | 2025-10-15 00:34:12.926692 | 13392420 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13392420 | Athletic Physical Therapy Inc | 1967-01-16 | 2025-10-16 | F | AE | Wesel | QUC628W15332 | Ellen | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9854973/check_13392420_403c1f1a-90a0-4339-aa37-3664f66d6253.json | N/A | N/A | N/A | N/A | N/A | QUC628W15332 | Preferred Provider Organization (PPO) | UNIVERSITY OF CALIFORNIA | CIGNA | N/A | 1967-01-16 | 040 | 280509A420 | N/A | PR | false | WESEL | N/A | RICHARD | N/A | 9999-12-31 | 2023-01-01 | UC CORE | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017032390 | N/A | N/A | 9854973 | 2222 | 4802 | 13684649 | N/A | 8205288 | 2025-10-15 00:34:12.926692 | 2025-09-30 16:15:04.552446 |
| 2025-10-14 05:16:08.237330 | 2025-10-15 00:32:11.028842 | 13392372 | N/A | N/A | 14163 | Wellcare Health Plans | 1114042165 | 13392372 | Athletic Physical Therapy Inc | 1948-01-19 | 2025-10-16 | F | AE | Machleit | 29029580 | Terri | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9253541/check_13392372_d0e4ad4a-7b46-49fb-9859-38223814bb13.json | N/A | N/A | N/A | N/A | N/A | 29029580 | N/A | N/A | WELLCARE HEALTH PLANS | N/A | 1948-01-19 | 406-024-000 | N/A | N/A | N/A | false | MACHLEIT | N/A | TERRI | N/A | N/A | N/A | N/A | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017049662 | N/A | N/A | 9253541 | 2222 | 4793 | 13682927 | N/A | 7764252 | 2025-10-15 00:32:11.028842 | 2025-09-11 22:35:02.402934 |
| 2025-10-14 05:15:53.974204 | 2025-10-15 02:35:52.606811 | 13391824 | N/A | N/A | 87726 | Regal Medical Group | 1114042165 | 13391824 | Athletic Physical Therapy Inc | 1959-11-18 | 2025-10-17 | M | AE | PEREZ | 205330201 | JUAN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081629871.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9935305/check_13391824_4559b53f-1e03-410d-9749-9906d5d5ea6c.json | N/A | N/A | N/A | N/A | N/A | 205330201 | Health Maintenance Organization (HMO) - Medicare Risk | N/A | UNITEDHEALTHCARE | PCP TO SUBMIT A SPECIALIST REFERRAL | 1959-11-18 | N/A | HCFA21 | N/A | HN | false | PEREZ MEDINA | N/A | JUAN | N/A | N/A | N/A | AARP MEDICARE ADVANTAGE FROM UHC CA-004P (HMO-POS) | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017064700 | N/A | N/A | 9935305 | 2222 | 4802 | 13697106 | N/A | 8316227 | 2025-10-15 02:35:52.606811 | 2025-10-02 19:18:17.311007 |
| 2025-10-14 05:15:41.705535 | 2025-10-15 00:55:14.826221 | 13391368 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13391368 | Athletic Physical Therapy Inc | 1972-01-12 | 2025-10-17 | M | PT | MAGEN | B6YE01199897 | OFIR | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102226770.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6917703/check_13391368_cd35738b-2e21-48ca-8ca4-b87065b6869f.json | N/A | N/A | N/A | N/A | N/A | B6YE01199897 | Preferred Provider Organization (PPO) | CHARTERLIFE-2015 HIGH EPO | ANTHEM BLUE CROSS | N/A | 1972-01-12 | 040 | L06598M023 | N/A | PR | false | MAGEN | N/A | LIMOR | N/A | 9999-12-31 | 2025-01-01 | PPO PRUDENT BUYER INCENTIVE | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017047943 | N/A | N/A | 6917703 | 2222 | 4793 | 13694284 | N/A | 5949095 | 2025-10-15 00:55:14.826221 | 2025-07-28 22:15:30.266976 |
| 2025-10-14 05:15:33.806500 | 2025-10-15 00:48:33.552405 | 13391078 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13391078 | Athletic Physical Therapy Inc | 1936-09-29 | 2025-10-17 | M | AE | JAUDE | JQE122A53874 | KARIM | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102619578.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6821574/check_13391078_78a563e9-0720-439e-a495-dd72219f41c0.json | N/A | N/A | N/A | N/A | N/A | JQE122A53874 | N/A | CA MED-SUPP | ANTHEM BLUE CROSS | N/A | 1936-09-29 | 040 | CASUPWP0 | N/A | N/A | false | JAUDE | N/A | KARIM | N/A | 9999-12-31 | 2023-12-01 | CA MODERNIZED PLAN G | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017066923 | N/A | N/A | 6821574 | 2222 | 4802 | 13692074 | N/A | 4214191 | 2025-10-15 00:48:33.552405 | 2025-05-13 04:29:37.228525 |
| 2025-10-14 05:15:31.371246 | 2025-10-15 00:35:58.354105 | 13390984 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390984 | Athletic Physical Therapy Inc | 1966-04-15 | 2025-10-17 | M | PT | BAZARGAN | M9Z898859038 | AFSHIN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9134247/check_13390984_b8c9c17c-9a15-4e21-bd4c-2eb93657803e.json | N/A | N/A | N/A | N/A | N/A | M9Z898859038 | Preferred Provider Organization (PPO) | N/A | ANTHEM BLUE CROSS | N/A | 1966-04-15 | N/A | 55060 | N/A | PR | false | BAZARGAN | N/A | AFSHIN | N/A | N/A | N/A | PREFERRED CARE | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017050545 | N/A | N/A | 9134247 | 2222 | 4801 | 13686036 | N/A | 7655437 | 2025-10-15 00:35:58.354105 | 2025-09-09 21:12:34.622876 |
| 2025-10-14 05:15:30.981004 | 2025-10-15 00:35:58.652175 | 13390975 | N/A | N/A | SB040 | Regal Medical Group | 1114042165 | 13390975 | Athletic Physical Therapy Inc | 1952-01-13 | 2025-10-17 | M | PT | BLANCO ESCOBAR | JQW106W18304 | SAMUEL | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9134245/check_13390975_4f5d586d-e19b-46c8-bcfe-7d0a307f2320.json | N/A | N/A | N/A | N/A | N/A | JQW106W18304 | Medicare Primary | CA MEDICARE | ANTHEM BLUE CROSS | N/A | 1952-01-13 | 040 | CAMCRWP0 | N/A | MP | false | BLANCO ESCOBAR | N/A | SAMUEL | N/A | 2025-12-31 | 2024-01-01 | CA H4471-005-000 ANTHEM DUAL ADVANTAGE (HMO D-SNP) | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017050544 | N/A | N/A | 9134245 | 2222 | 4801 | 13686038 | N/A | 7655426 | 2025-10-15 00:35:58.652175 | 2025-09-08 18:14:46.984181 |
| 2025-10-14 05:15:24.518602 | 2025-10-15 00:35:58.063152 | 13390737 | N/A | N/A | SB040 | Regal Medical Group | 1114042165 | 13390737 | Athletic Physical Therapy Inc | 1963-04-21 | 2025-10-17 | F | PT | ARREGUIN | NCF356A67636 | LETICIA | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9131826/check_13390737_0ed3a978-ee13-4bb2-bb8d-a0532b86d11d.json | N/A | N/A | N/A | N/A | N/A | NCF356A67636 | Health Maintenance Organization (HMO) | LAUSD | ANTHEM BLUE CROSS | N/A | 1963-04-21 | 040 | 57AJCA | N/A | HM | false | ARREGUIN | N/A | LETICIA | N/A | 9999-12-31 | 2010-01-01 | POWER SELECT HMO NETWORK 126+ | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017050405 | N/A | N/A | 9131826 | 2222 | 4801 | 13686033 | N/A | 7652862 | 2025-10-15 00:35:58.063152 | 2025-09-19 19:09:46.068421 |
| 2025-10-14 05:15:22.921241 | 2025-10-15 00:35:18.515414 | 13390677 | N/A | N/A | 68069 | Lakeside Medical Group | 1114042165 | 13390677 | Athletic Physical Therapy Inc | 1949-01-02 | 2025-10-17 | F | AE | TARASEVYCH | 90733231H | VIRA | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.103229014.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/8050658/check_13390677_4ec73f34-0771-490c-a851-344527b50ed9.json | N/A | N/A | N/A | N/A | N/A | 90733231H | N/A | N/A | HEALTH NET, LLC | N/A | 1949-01-02 | N/A | N/A | N/A | N/A | false | TARASEVYCH | N/A | VIRA | N/A | N/A | N/A | KCW MCALSTD | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017089271 | N/A | N/A | 8050658 | 2222 | 4793 | 13685603 | N/A | 6845945 | 2025-10-15 00:35:18.515414 | 2025-08-20 15:30:30.230373 |
| 2025-10-14 05:15:17.283287 | 2025-10-15 00:44:33.122670 | 13390473 | N/A | N/A | 60054 | Aetna | 1114042165 | 13390473 | Athletic Physical Therapy Inc | 1976-05-10 | 2025-10-16 | M | AE | RAMIREZ | 9537353099 | ROY | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102226770.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6865171/check_13390473_eec6855a-25b7-4925-a3ed-ff4eefa3ed4e.json | N/A | N/A | N/A | N/A | N/A | 9537353099 | Group Policy | N/A | AETNA INC | PLEASE CALL MEMBER SERVICES NUMBER ON ID CARD FOR IND. DEDUCTIBLE, FAMILY DEDUCTIBLE, IND. OUT OF POCKET, FAMILY OUT OF POCKET INFORMATION | 1976-05-10 | A01 | 20086 | N/A | GP | false | RAMIREZ | N/A | ROY | N/A | N/A | N/A | OUT OF NETWORK MEDICAL | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017047610 | N/A | N/A | 6865171 | 2222 | 4801 | 13690414 | N/A | 5902840 | 2025-10-15 00:44:33.122670 | 2025-07-28 18:58:27.354873 |
| 2025-10-14 05:15:12.876298 | 2025-10-15 00:36:09.945369 | 13390324 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390324 | Athletic Physical Therapy Inc | 1971-08-10 | 2025-10-16 | M | PT | DEIPOLA | JQY979A63776 | GUSTAVO | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081638518.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9611372/check_13390324_c792b929-af6f-45c1-b09d-3bb7d3b74e1f.json | N/A | N/A | N/A | N/A | N/A | JQY979A63776 | Preferred Provider Organization (PPO) | SIERRA CREDIT CORP | ANTHEM BLUE CROSS | N/A | 1971-08-10 | 040 | Q32873 | N/A | PR | false | DEIPOLA | N/A | ANDREA | N/A | 9999-12-31 | 2025-01-01 | CA SG SELECT HSA | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017069582 | N/A | N/A | 9611372 | 2222 | 4801 | 13686155 | N/A | 8042516 | 2025-10-15 00:36:09.945369 | 2025-09-24 17:27:04.210921 |
| 2025-10-14 05:15:11.763506 | 2025-10-15 00:48:33.283537 | 13390294 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390294 | Athletic Physical Therapy Inc | 1959-07-23 | 2025-10-16 | M | AE | Harvey | LFYHC0062508 | Roy | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102619578.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6714942/check_13390294_f435b457-21a0-468a-be99-79ef9e2c7810.json | N/A | N/A | N/A | N/A | N/A | LFYHC0062508 | Preferred Provider Organization (PPO) | LOS ANGELES FIREMENS RELIEF ASSOCIATION - RETIREE | ANTHEM BLUE CROSS | N/A | 1959-07-23 | 040 | 282527M002 | N/A | PR | false | HARVEY | N/A | ROY | N/A | 9999-12-31 | 2020-02-01 | PPO PRUDENT BUYER INCENTIVE | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017066667 | N/A | N/A | 6714942 | 2222 | 4802 | 13692072 | N/A | 5316172 | 2025-10-15 00:48:33.283537 | 2025-07-02 15:09:36.678003 |
| 2025-10-14 05:15:11.033322 | 2025-10-15 00:48:32.422518 | 13390274 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390274 | Athletic Physical Therapy Inc | 1951-10-16 | 2025-10-17 | F | AE | GARRETT | JQE702W20596 | KATHLEEN | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102619578.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6714934/check_13390274_51d57e30-3339-4663-8b7b-ddc068a06c19.json | N/A | N/A | N/A | N/A | N/A | JQE702W20596 | N/A | CA MED-SUPP | ANTHEM BLUE CROSS | N/A | 1951-10-16 | 040 | CASUPWP0 | N/A | N/A | false | GARRETT | N/A | KATHLEEN | N/A | 9999-12-31 | 2024-07-01 | CA PLAN F INNOVATIVE | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017066666 | N/A | N/A | 6714934 | 2222 | 4793 | 13692066 | N/A | 5316176 | 2025-10-15 00:48:32.422518 | 2025-07-01 18:44:12.927482 |
| 2025-10-14 05:15:09.213723 | 2025-10-15 00:36:40.626473 | 13390234 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13390234 | Athletic Physical Therapy Inc | 1992-09-26 | 2025-10-17 | F | PT | WU | 60277172101 | ZEQIU | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9106039/check_13390234_b85f40e6-3b75-4b43-a46a-e23882ee5473.json | N/A | N/A | N/A | N/A | N/A | 60277172101 | N/A | N/A | BLUE SHIELD CALIFORNIA | N/A | 1992-09-26 | N/A | N/A | N/A | N/A | false | WU | N/A | ZEQIU | N/A | N/A | N/A | N/A | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017050117 | N/A | N/A | 9106039 | 2222 | 4802 | 13686443 | N/A | 7625945 | 2025-10-15 00:36:40.626473 | 2025-09-26 19:56:46.569009 |
| 2025-10-14 05:15:07.640408 | 2025-10-15 00:35:50.585414 | 13390187 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390187 | Athletic Physical Therapy Inc | 1997-05-14 | 2025-10-17 | F | PT | SCHRODT | XDP041W16673 | CLARE | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.103229014.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/8026784/check_13390187_f3da652f-ce7a-4610-8abf-62be62d131d2.json | N/A | N/A | N/A | N/A | N/A | XDP041W16673 | Preferred Provider Organization (PPO) | REGENTS OF THE UNIVERSITY OF CALIFORNIA | ANTHEM BLUE CROSS | N/A | 1997-05-14 | 040 | 281636M037 | N/A | PR | false | SCHRODT | N/A | CLARE | N/A | 9999-12-31 | 2023-06-12 | UC RESIDENTS AND FELLOWS PPO | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017089209 | N/A | N/A | 8026784 | 2222 | 4802 | 13685957 | N/A | 6828383 | 2025-10-15 00:35:50.585414 | 2025-08-12 22:27:19.278771 |
| 2025-10-14 05:15:03.509295 | 2025-10-15 00:32:58.464847 | 13390111 | N/A | N/A | 57115 | Blue Shield of California Promise Health Plan | 1588406342 | 13390111 | override_provider | 1960-06-14 | 2025-10-16 | F | PT | VERWEY | R61817302 | CAREN | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.103229014.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/8025542/check_13390111_51ded1d7-0c0c-48ed-a038-bee427496d87.json | N/A | N/A | N/A | N/A | N/A | R61817302 | Preferred Provider Organization (PPO) | N/A | BLUE SHIELD OF CALIFORNIA | N/A | 1960-06-14 | N/A | 35C | N/A | PR | false | VERWEY | N/A | CAREN | N/A | 9999-12-31 | 2025-01-01 | FEP BLUE FOCUS | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017089199 | N/A | N/A | 8025542 | 2222 | 4801 | 13683596 | N/A | 6826965 | 2025-10-15 00:32:58.464847 | 2025-08-13 02:28:19.717631 |
| 2025-10-14 05:15:00.651292 | 2025-10-15 00:35:59.535562 | 13390089 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13390089 | Athletic Physical Therapy Inc | 2009-01-14 | 2025-10-16 | F | PT | OBACZ | JQV897A63197 | KLOIE | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081707015.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9102655/check_13390089_2cbf7303-e334-471f-a838-aab13ce3e085.json | N/A | N/A | N/A | N/A | N/A | JQV897A63197 | Health Maintenance Organization (HMO) | EVOLVED NOVELTIES INC | ANTHEM BLUE CROSS | N/A | 2009-01-14 | 040 | F45883 | N/A | HM | false | OBACZ | N/A | JUSTIN | N/A | 9999-12-31 | 2025-01-01 | CA SG SELECT HMO | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017050095 | N/A | N/A | 9102655 | 2222 | 4801 | 13686049 | N/A | 7621062 | 2025-10-15 00:35:59.535562 | 2025-09-12 19:10:20.936695 |
| 2025-10-14 05:14:45.195696 | 2025-10-15 00:59:50.153218 | 13389927 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13389927 | Athletic Physical Therapy Inc | 1976-09-20 | 2025-10-16 | M | PT | Bolton | XEK910377236 | Stephen | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102226770.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6814151/check_13389927_9252a65a-8091-46f2-9d7a-85536ce613fd.json | N/A | N/A | N/A | N/A | N/A | XEK910377236 | Preferred Provider Organization (PPO) | IFP OFF EXCHANGE | BLUE SHIELD CALIFORNIA | N/A | 1976-09-20 | 2001ZJ002648 | X0001000 | N/A | PR | false | BOLTON | N/A | STEPHEN | N/A | 9999-12-31 | 2021-02-01 | IFP EMB PED DPPO JAN15 | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017047340 | N/A | N/A | 6814151 | 2222 | 4793 | 13694506 | N/A | 5856522 | 2025-10-15 00:59:50.153218 | 2025-07-10 02:16:48.328344 |
| 2025-10-14 05:14:38.854158 | 2025-10-15 00:34:12.418397 | 13389828 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13389828 | Athletic Physical Therapy Inc | 1958-10-22 | 2025-10-17 | F | AE | Lee | MBL500W17666 | Gisele | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.101915062.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9810738/check_13389828_2b8df32c-f5ac-437b-b731-1bf271ea54c6.json | N/A | N/A | N/A | N/A | N/A | MBL500W17666 | N/A | LOS ANGELES UNIFIED SCHOOL DISTRICT (LAUSD) | ANTHEM BLUE CROSS | N/A | 1958-10-22 | 040 | CAEGR005 | N/A | N/A | false | LEE | N/A | GISELE | N/A | 2025-12-31 | 2023-10-01 | CA GRS LAUSD H4036-802 ANTHEM MEDICARE PREFERRED M | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017032524 | N/A | N/A | 9810738 | 2222 | 4802 | 13684639 | N/A | 8217179 | 2025-10-15 00:34:12.418397 | 2025-10-02 19:02:27.583990 |
| 2025-10-14 05:14:27.708763 | 2025-10-15 00:35:49.587371 | 13389604 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13389604 | Athletic Physical Therapy Inc | 1971-05-04 | 2025-10-16 | F | PT | MAHAARACHCHI | EXHAN7912598 | MELONY | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.103229014.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7988722/check_13389604_f908f431-78e5-4bf8-a12d-e6aa612222f7.json | N/A | N/A | N/A | N/A | N/A | EXHAN7912598 | N/A | N/A | ANTHEM BLUE CROSS | N/A | 1971-05-04 | N/A | N/A | N/A | N/A | false | MAHAARACHCHI | N/A | MELONY | N/A | N/A | N/A | N/A | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017088904 | N/A | N/A | 7988722 | 2222 | 4793 | 13685951 | N/A | 6798209 | 2025-10-15 00:35:49.587371 | 2025-10-29 15:15:17.952230 |
| 2025-10-14 05:14:25.533554 | 2025-10-15 00:44:33.684108 | 13389565 | N/A | N/A | 60054 | AETNA | 1114042165 | 13389565 | Athletic Physical Therapy Inc | 1940-12-29 | 2025-10-16 | M | AE | TRUNNELL | 101505559100 | WAYNE | PT | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.102226770.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6786642/check_13389565_4f9d94c9-7200-4c61-98b6-55df77b5b987.json | N/A | N/A | N/A | N/A | N/A | 101505559100 | Point of Service (POS) | MA INDIVIDUAL - CALIFORNIA | AETNA | MEDICARE | 1940-12-29 | 000003-CA000074 | 000003-CA | N/A | PS | false | TRUNNELL | N/A | WAYNE | N/A | N/A | N/A | AETNA MEDICARE PLUS (HMO-POS) | N/A | AE | PT | N/A | N/A | N/A | N/A | N/A | 9017047236 | N/A | N/A | 6786642 | 2222 | 4793 | 13690419 | 3939 | 5818009 | 2025-10-15 00:44:33.684108 | 2025-07-15 23:19:05.900633 |
| 2025-10-14 05:14:06.762646 | 2025-10-15 02:36:18.504932 | 13389185 | N/A | N/A | SB040 | Blue Cross California | 1114042165 | 13389185 | Athletic Physical Therapy Inc | 1961-05-16 | 2025-10-16 | F | PT | GARCIA | JQU725A51750 | THERESA | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081629871.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9895640/check_13389185_ac6fb2b9-b91a-43eb-9508-3d6b7a6c3e29.json | N/A | N/A | N/A | N/A | N/A | JQU725A51750 | Preferred Provider Organization (PPO) | HARRISON EICHENBERG AND MURPHY LLP | ANTHEM BLUE CROSS | N/A | 1961-05-16 | 040 | H82608 | N/A | PR | false | GARCIA | N/A | THERESA | N/A | 9999-12-31 | 2025-09-01 | CA SG ANTHEM PPO | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017064203 | N/A | N/A | 9895640 | 2222 | 4793 | 13697191 | N/A | 8285172 | 2025-10-15 02:36:18.504932 | 2025-10-06 14:32:40.429816 |
| 2025-10-14 05:14:06.086940 | 2025-10-15 02:37:16.427579 | 13389171 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13389171 | Athletic Physical Therapy Inc | 2000-04-05 | 2025-10-16 | F | PT | ERLIG | NCF707A22419 | KATHERINE | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081629871.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9895277/check_13389171_612f06d4-429a-49e0-af9e-3a4d0e160b74.json | N/A | N/A | N/A | N/A | N/A | NCF707A22419 | Health Maintenance Organization (HMO) | CALTECH JPL HMO ADVANTAGE | BLUE SHIELD OF CALIFORNIA | N/A | 2000-04-05 | 040 | 175104H220 | N/A | HM | false | ERLIG | N/A | HERNAN | N/A | 9999-12-31 | 2020-01-01 | BLUE CROSS ADVANTAGE HMO | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017064202 | N/A | N/A | 9895277 | 2222 | 4793 | 13697373 | N/A | 8284820 | 2025-10-15 02:37:16.427579 | 2025-10-02 18:42:34.968101 |
| 2025-10-14 05:14:02.708395 | 2025-10-15 00:36:46.465812 | 13389111 | N/A | N/A | SB542 | Blue Shield California | 1114042165 | 13389111 | Athletic Physical Therapy Inc | 1962-05-29 | 2025-10-17 | F | PT | LARSON | XEA913804058 | DEBRA | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.081638518.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-17 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/9562148/check_13389111_bf6376bc-d899-4360-9ca8-c3d1319bb82c.json | N/A | N/A | N/A | N/A | N/A | XAN913804058 | Preferred Provider Organization (PPO) | PUBLIC EMPLOYEES BENEFIT RETIREMENT SYSTEM | BLUE SHIELD CALIFORNIA | N/A | 1962-05-29 | 1480PPOX0002 | W0051411 | N/A | PR | false | LARSON | N/A | DEBRA | N/A | N/A | N/A | CALPERS ASO PLATINUM PPO GROUP BILL | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017069383 | N/A | N/A | 9562148 | 2222 | 4793 | 13686492 | N/A | 7997320 | 2025-10-15 00:36:46.465812 | 2025-10-02 21:07:14.563938 |
| 2025-10-14 05:14:02.178886 | 2025-10-15 00:35:50.892600 | 13389102 | N/A | N/A | SB040 | Regal Medical Group | 1114042165 | 13389102 | Athletic Physical Therapy Inc | 1963-09-19 | 2025-10-16 | M | PT | SENKUS | XDM878M77372 | TONY | N/A | https://storage.googleapis.com/normandy-eligibility-checks/batches/272741.20251014.103229014.ELG.271.edi.txt | WAYSTAR | N/A | BATCH | 2025-10-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7964946/check_13389102_b71bb6c6-ece9-4c19-80aa-b76f7c8f5afe.json | N/A | N/A | N/A | N/A | N/A | XDM878M77372 | Health Maintenance Organization (HMO) | TEAMSTERS MISC SECURITY TRUST - EARLY RETIREE | ANTHEM BLUE CROSS | N/A | 1963-09-19 | 040 | 278680H052 | N/A | HM | false | SENKUS | N/A | TONY | N/A | 9999-12-31 | 2024-10-01 | CLASSIC TRADITIONAL HMO NETWORK NON DURATIONAL | N/A | PT | N/A | N/A | N/A | N/A | N/A | N/A | 9017088856 | N/A | N/A | 7964946 | 2222 | 4801 | 13685962 | N/A | 6247001 | 2025-10-15 00:35:50.892600 | 2025-07-25 21:24:35.111542 |