API Data Explorer (Athletic)
Choose an endpoint and browse pulled athletic records with export support.
API Endpoints
Total rows: 4,911
| created_at | updated_at | id | prior_authorization_status | patient_id | appointment_id | insurance_company_id | insurance_priority | prior_authorization_number | mode_of_request | reason | notes | prior_authorization_result | expiration_date | effective_date | prior_auth_requested_id | icd_10_codes | cpt_codes | visits_total | visits_remaining | prior_auth_type | medical_records_attachment_url | urgency | encounter_id | patient_insurance_info_id | is_archived | total_billable_units | remaining_billable_units | prior_auth_category | referring_provider_id | encounter_visits_total | encounter_visits_remaining | referring_facility_id | prior_auth_tracking_type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-06-17 23:26:38.594616 | 2025-10-16 22:12:29.985953 | 363036 | NOT_INITIATED | 4214918 | N/A | N/A | PRIMARY | 20250514L0101966 | N/A | N/A | N/A | N/A | 2025-08-12 14:00:00 | 2025-05-14 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5543082 | True | N/A | N/A | PRE_CERT | N/A | 9 | 7 | N/A | VISITS |
| 2025-06-17 23:26:17.065344 | 2025-06-17 23:26:17.065348 | 363035 | NOT_INITIATED | 4213724 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-19 07:00:00 | 2025-05-19 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 224853 | 10 | 10 | N/A | VISITS |
| 2025-06-17 23:14:18.556174 | 2025-06-17 23:15:53.881095 | 363029 | NOT_INITIATED | 4766950 | N/A | N/A | PRIMARY | 20250514P0107608 | N/A | N/A | N/A | N/A | 2025-08-12 07:00:00 | 2025-05-14 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6231672 | True | N/A | N/A | PRE_CERT | N/A | 2 | 2 | N/A | VISITS |
| 2025-06-17 23:03:29.884404 | 2025-11-17 23:24:17.211712 | 363022 | NOT_INITIATED | 5085675 | N/A | N/A | PRIMARY | 20250506P0106390 | N/A | N/A | N/A | N/A | 2025-08-04 07:00:00 | 2025-05-06 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6445982 | True | N/A | N/A | PRE_CERT | N/A | 5 | 5 | N/A | VISITS |
| 2025-06-17 22:25:35.012380 | 2025-06-17 22:25:35.012389 | 362992 | NOT_INITIATED | 4219577 | N/A | N/A | PRIMARY | 2025060P0104520 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5550613 | N/A | N/A | N/A | PRE_CERT | N/A | 1 | 1 | N/A | VISITS |
| 2025-06-17 22:19:25.090079 | 2025-06-25 23:44:39.663680 | 362967 | NOT_INITIATED | 4215211 | N/A | N/A | PRIMARY | 20250617P0106420 | N/A | N/A | N/A | N/A | 2025-09-15 07:00:00 | 2025-06-17 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5543425 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-17 21:55:57.441124 | 2025-06-17 21:55:57.441131 | 362954 | NOT_INITIATED | 4219752 | N/A | N/A | PRIMARY | 20250617P0106068 | N/A | N/A | N/A | N/A | 2025-09-15 07:00:00 | 2025-06-17 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6193347 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-17 21:45:27.145046 | 2025-09-18 17:07:12.386517 | 362950 | NOT_INITIATED | 4214861 | N/A | N/A | PRIMARY | 20250613P0105724 | N/A | N/A | N/A | N/A | 2025-09-11 07:00:00 | 2025-06-13 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5543011 | True | N/A | N/A | PRE_CERT | N/A | 18 | 18 | N/A | VISITS |
| 2025-06-17 21:29:27.559243 | 2025-09-16 21:30:43.958896 | 362942 | NOT_INITIATED | 4219721 | N/A | N/A | PRIMARY | 20250617L0101655 | N/A | N/A | N/A | N/A | 2025-09-15 07:00:00 | 2025-06-17 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5550862 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-17 21:24:35.988753 | 2025-06-17 21:24:46.489599 | 362935 | NOT_INITIATED | 4213672 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2025-07-28 14:00:00 | 2025-04-29 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 243519 | 9 | 10 | N/A | VISITS |
| 2025-06-17 21:17:59.027574 | 2025-06-17 21:17:59.027580 | 362928 | NOT_INITIATED | 5083952 | N/A | N/A | PRIMARY | 20250614P0100279 | N/A | N/A | N/A | N/A | 2025-09-12 07:00:00 | 2025-06-14 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6444130 | N/A | N/A | N/A | PRE_CERT | N/A | 1 | 1 | N/A | VISITS |
| 2025-06-17 20:29:10.678706 | 2025-06-17 20:29:10.678717 | 362897 | NOT_INITIATED | 5083596 | N/A | N/A | PRIMARY | 20250613L0100840 | N/A | N/A | N/A | N/A | 2025-09-12 07:00:00 | 2025-06-13 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6441910 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-17 20:23:07.255322 | 2025-11-12 18:26:55.353442 | 362893 | NOT_INITIATED | 4209603 | N/A | N/A | PRIMARY | 25051A0101 | N/A | N/A | N/A | N/A | 2025-09-08 14:00:00 | 2025-03-12 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5536948 | True | N/A | N/A | PRE_CERT | N/A | 6 | 7 | N/A | VISITS |
| 2025-06-17 19:24:32.874409 | 2026-01-06 16:11:19.419475 | 362795 | NOT_INITIATED | 4213662 | N/A | N/A | PRIMARY | 20250527P0106535 | N/A | N/A | N/A | N/A | 2025-08-25 14:00:00 | 2025-05-27 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5541664 | True | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-06-17 18:55:19.870885 | 2025-06-17 18:55:19.870894 | 362752 | NOT_INITIATED | 5082425 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-30 07:00:00 | 2025-05-30 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 224853 | 10 | 10 | N/A | VISITS |
| 2025-06-17 17:26:55.661391 | 2025-06-17 17:26:55.661402 | 362636 | NOT_INITIATED | 5081184 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-30 07:00:00 | 2025-05-30 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 243461 | 10 | 10 | N/A | VISITS |
| 2025-06-17 17:08:51.133747 | 2025-10-15 15:25:25.913767 | 362623 | NOT_INITIATED | 5079832 | N/A | N/A | PRIMARY | 20250613P0102464 | N/A | N/A | N/A | N/A | 2025-09-11 14:00:00 | 2025-06-13 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6434660 | True | N/A | N/A | PRE_CERT | N/A | 4 | 4 | N/A | VISITS |
| 2025-06-17 16:52:22.227675 | 2025-06-17 16:52:22.227685 | 362608 | NOT_INITIATED | 4209950 | N/A | N/A | PRIMARY | 20250611P0104951 | N/A | N/A | N/A | N/A | 2025-09-09 07:00:00 | 2025-06-11 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5537371 | N/A | N/A | N/A | PRE_CERT | N/A | 25 | 25 | N/A | VISITS |
| 2025-06-17 16:34:53.765904 | 2025-06-17 16:34:53.765912 | 362592 | NOT_INITIATED | 4218966 | N/A | N/A | PRIMARY | 20250515P0102112 | N/A | N/A | N/A | N/A | 2025-08-13 07:00:00 | 2025-05-15 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5549263 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-16 23:28:53.217900 | 2026-05-31 23:32:25.811790 | 361603 | NOT_INITIATED | 5065923 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2025-12-31 15:00:00 | 2025-03-04 16:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | True | N/A | N/A | REFERRAL | 82541 | 18 | 18 | N/A | VISITS |
| 2025-06-16 23:00:09.092545 | 2025-06-16 23:00:09.092554 | 361588 | NOT_INITIATED | 4210415 | N/A | N/A | PRIMARY | 20250603L0102072 | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5537911 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-16 22:38:24.623624 | 2025-11-26 22:37:49.818825 | 361573 | NOT_INITIATED | 4213093 | N/A | N/A | PRIMARY | 20250616P0106010 | N/A | N/A | N/A | N/A | 2025-09-14 07:00:00 | 2025-06-16 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5541023 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-06-16 22:00:19.332497 | 2026-01-29 22:16:10.469806 | 361522 | NOT_INITIATED | 5065602 | N/A | N/A | PRIMARY | 20250611P0105934 | N/A | N/A | N/A | N/A | 2025-09-09 07:00:00 | 2025-06-11 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6417892 | True | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-06-16 19:29:18.874310 | 2025-06-16 19:29:18.874319 | 361257 | NOT_INITIATED | 5063399 | N/A | N/A | PRIMARY | 20250404P0101642 | N/A | N/A | N/A | N/A | 2025-07-03 07:00:00 | 2025-04-04 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6415606 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-16 18:35:57.812575 | 2025-06-16 18:35:57.812582 | 361204 | NOT_INITIATED | 5062890 | N/A | N/A | PRIMARY | 20250523P0104954 | N/A | N/A | N/A | N/A | 2025-08-21 07:00:00 | 2025-05-23 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6415249 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-16 18:25:13.454248 | 2025-06-16 18:25:13.454256 | 361192 | NOT_INITIATED | 5062851 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-28 07:00:00 | 2025-05-28 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 243659 | 10 | 10 | N/A | VISITS |
| 2025-06-16 18:15:37.679346 | 2025-10-06 17:56:44.362519 | 361181 | NOT_INITIATED | 5062825 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-21 07:00:00 | 2025-05-21 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | True | N/A | N/A | REFERRAL | 224853 | 10 | 10 | N/A | VISITS |
| 2025-06-16 17:53:29.271547 | 2025-06-16 17:53:29.271555 | 361161 | NOT_INITIATED | 4212617 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2080-06-16 07:00:00 | 2025-06-02 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 243707 | 36 | 36 | N/A | VISITS |
| 2025-06-16 17:46:01.590318 | 2025-06-16 17:46:01.590324 | 361156 | NOT_INITIATED | 5062697 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-15 07:00:00 | 2025-05-15 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 409034 | 10 | 10 | N/A | VISITS |
| 2025-06-16 16:36:30.862820 | 2025-06-16 16:36:30.862828 | 361063 | NOT_INITIATED | 5062225 | N/A | N/A | PRIMARY | 20250506P0102535 | N/A | N/A | N/A | N/A | 2025-08-04 07:00:00 | 2025-05-06 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6414703 | N/A | N/A | N/A | PRE_CERT | N/A | 4 | 4 | N/A | VISITS |
| 2025-06-16 15:53:44.986210 | 2025-06-16 15:53:44.986218 | 361009 | NOT_INITIATED | 4534565 | N/A | N/A | PRIMARY | 20250527L0101586 | N/A | N/A | N/A | N/A | 2025-08-25 07:00:00 | 2025-05-27 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5993931 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-16 15:28:29.461197 | 2025-06-16 15:28:29.461204 | 360760 | NOT_INITIATED | 4219732 | N/A | N/A | PRIMARY | 20250528P0104705 | N/A | N/A | N/A | N/A | 2025-08-26 07:00:00 | 2025-05-28 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5550875 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-06-16 00:05:49.081749 | 2025-06-16 00:05:49.081760 | 358776 | NOT_INITIATED | 5046190 | N/A | N/A | PRIMARY | 20250602P0100672 | N/A | N/A | N/A | N/A | 2025-08-31 07:00:00 | 2025-06-02 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6398632 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-06-16 00:05:37.123332 | 2025-06-16 00:05:37.123344 | 358770 | NOT_INITIATED | 5046305 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-05-16 07:00:00 | 2025-05-16 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 243461 | 10 | 10 | N/A | VISITS |
| 2025-06-16 00:05:27.586542 | 2025-06-18 15:59:58.774103 | 358766 | NOT_INITIATED | 4213018 | N/A | N/A | PRIMARY | 20250613L0102132 | N/A | N/A | N/A | N/A | 2025-09-11 14:00:00 | 2025-06-13 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5550301 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-06-16 00:04:45.924292 | 2025-09-11 17:17:15.370449 | 358744 | NOT_INITIATED | 4884170 | N/A | N/A | PRIMARY | 20250611P0106985 | N/A | N/A | N/A | N/A | 2025-09-09 21:00:00 | 2025-06-11 21:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6236212 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-06-16 00:04:35.399404 | 2025-06-16 00:04:35.399422 | 358739 | NOT_INITIATED | 5046269 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2025-08-07 07:00:00 | 2025-04-07 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 82541 | 12 | 12 | N/A | VISITS |
| 2025-06-16 00:02:11.669189 | 2025-06-16 00:02:11.669205 | 358669 | NOT_INITIATED | 5046307 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2026-06-04 07:00:00 | 2025-06-04 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 172095 | 10 | 10 | N/A | VISITS |
| 2025-06-16 00:01:34.694875 | 2025-09-15 22:23:48.689153 | 358648 | NOT_INITIATED | 4213243 | N/A | N/A | PRIMARY | 20250603P0102669 | N/A | N/A | N/A | N/A | 2025-09-01 21:00:00 | 2025-06-03 21:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5541202 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-06-16 00:00:03.280139 | 2025-06-16 00:00:03.280155 | 358605 | NOT_INITIATED | 4534566 | N/A | N/A | PRIMARY | 20250407P0106970 | N/A | N/A | N/A | N/A | 2025-07-09 11:00:00 | 2025-04-08 11:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5874439 | N/A | N/A | N/A | PRE_CERT | N/A | 5 | 5 | N/A | VISITS |
| 2025-06-15 23:58:57.049347 | 2025-10-22 17:49:04.366062 | 358574 | NOT_INITIATED | 4219772 | N/A | N/A | PRIMARY | 20250613P0102895 | N/A | N/A | N/A | N/A | 2025-09-11 07:00:00 | 2025-06-13 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5550925 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-15 23:58:40.025746 | 2025-08-20 21:29:08.390243 | 358568 | NOT_INITIATED | 5046278 | N/A | N/A | PRIMARY | 20250522L0102366 | N/A | N/A | N/A | N/A | 2025-08-20 07:00:00 | 2025-05-22 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6398725 | True | N/A | N/A | PRE_CERT | N/A | 19 | 19 | N/A | VISITS |
| 2025-06-15 23:58:35.413884 | 2025-11-03 18:10:04.262598 | 358566 | NOT_INITIATED | 4214447 | N/A | N/A | PRIMARY | 20250613L0100960 | N/A | N/A | N/A | N/A | 2025-09-11 07:00:00 | 2025-06-13 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5542555 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-06-15 23:58:28.487789 | 2025-06-15 23:58:28.487805 | 358561 | NOT_INITIATED | 4214567 | N/A | N/A | PRIMARY | 16936826 | N/A | N/A | N/A | N/A | 2025-06-28 07:00:00 | 2025-05-28 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5542688 | N/A | N/A | N/A | PRE_CERT | N/A | 4 | 4 | N/A | VISITS |
| 2025-06-15 23:58:03.631236 | 2025-06-15 23:58:03.631253 | 358549 | NOT_INITIATED | 4219119 | N/A | N/A | PRIMARY | N/A | N/A | N/A | N/A | N/A | 2080-06-13 07:00:00 | 2025-06-10 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | N/A | N/A | N/A | N/A | REFERRAL | 107595 | 12 | 12 | N/A | VISITS |
| 2025-06-15 23:57:49.968571 | 2025-06-15 23:57:49.968577 | 358541 | NOT_INITIATED | 4713007 | N/A | N/A | PRIMARY | 20250505P0102232 | N/A | N/A | N/A | N/A | 2025-08-03 14:00:00 | 2025-05-05 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6068067 | N/A | N/A | N/A | PRE_CERT | N/A | 2 | 2 | N/A | VISITS |
| 2025-06-15 23:57:18.022262 | 2025-07-14 16:06:36.199961 | 358526 | NOT_INITIATED | 4214923 | N/A | N/A | PRIMARY | 20250613L0101970 | N/A | N/A | N/A | N/A | 2025-09-11 21:00:00 | 2025-06-13 21:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5543087 | N/A | N/A | N/A | PRE_CERT | N/A | 6 | 6 | N/A | VISITS |
| 2025-06-15 23:56:47.759568 | 2025-06-15 23:56:47.759580 | 358510 | NOT_INITIATED | 4213867 | N/A | N/A | PRIMARY | 20250613P0106871 | N/A | N/A | N/A | N/A | 2025-09-11 07:00:00 | 2025-06-13 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5541889 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-06-15 23:56:21.486221 | 2025-06-15 23:56:21.486236 | 358499 | NOT_INITIATED | 4209126 | N/A | N/A | PRIMARY | 20250612P0103153 | N/A | N/A | N/A | N/A | 2025-09-10 07:00:00 | 2025-06-12 07:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 5536371 | N/A | N/A | N/A | PRE_CERT | N/A | 24 | 24 | N/A | VISITS |
| 2025-06-15 23:56:06.477999 | 2025-06-17 16:51:23.731130 | 358490 | NOT_INITIATED | 4866524 | N/A | N/A | PRIMARY | 20250613P0103099 | N/A | N/A | N/A | N/A | 2025-09-11 14:00:00 | 2025-06-13 14:00:00 | N/A | N/A | N/A | N/A | N/A | PRIOR_AUTH | N/A | N/A | N/A | 6222331 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |