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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-05-23 21:33:22.524063 | 2025-06-30 20:39:11.748232 | 189716 | PENDING | 4213820 | N/A | 21916 | PRIMARY | 20250416P0100302 | N/A | N/A | N/A | N/A | 2025-07-15 07:00:00 | 2025-05-07 07:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5541836 | N/A | N/A | N/A | PRE_CERT | N/A | 5 | 4 | N/A | VISITS |
| 2025-05-23 21:33:22.466757 | 2025-05-23 21:33:22.466763 | 189715 | PENDING | 4214367 | N/A | 21916 | PRIMARY | 20250507L0101400 | N/A | N/A | N/A | N/A | 2025-08-05 00:00:00 | 2025-05-07 00:00:00 | N/A | N/A | N/A | 12 | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5542461 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:22.359491 | 2025-06-09 23:23:42.601370 | 189714 | PENDING | 4211481 | N/A | 21916 | PRIMARY | 20241022P0104068 | N/A | N/A | N/A | N/A | 2025-08-05 00:00:00 | 2025-05-07 00:00:00 | N/A | N/A | N/A | 8 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5539141 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:22.298378 | 2025-11-05 16:15:55.472961 | 189713 | PENDING | 4214627 | N/A | 21916 | PRIMARY | 20250506P0106537 | N/A | N/A | N/A | N/A | 2025-08-04 00:00:00 | 2025-05-06 00:00:00 | N/A | N/A | N/A | 12 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5542752 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:22.233953 | 2025-12-01 17:29:09.526151 | 189712 | PENDING | 4219743 | N/A | 21916 | PRIMARY | 20250311L0101753 | N/A | N/A | N/A | N/A | 2025-06-09 07:00:00 | 2025-05-06 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5676362 | True | N/A | N/A | PRE_CERT | N/A | 11 | 9 | N/A | VISITS |
| 2025-05-23 21:33:22.167377 | 2025-11-03 18:02:13.040530 | 189711 | PENDING | 4214447 | N/A | 21916 | PRIMARY | 20250506L0102211 | 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 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5542555 | True | N/A | N/A | PRE_CERT | N/A | 12 | 7 | N/A | VISITS |
| 2025-05-23 21:33:22.106893 | 2025-05-23 21:33:22.106901 | 189710 | PENDING | 4213817 | N/A | 21916 | PRIMARY | 8 visits | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-05-06 00:00:00 | N/A | N/A | N/A | 8 | 3 | PRIOR_AUTH | N/A | N/A | N/A | 5874435 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:22.044020 | 2025-06-06 22:06:03.359741 | 189709 | PENDING | 4534570 | N/A | 21916 | PRIMARY | 20250506L0101320 | 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 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5874444 | N/A | N/A | N/A | PRE_CERT | N/A | 11 | 9 | N/A | VISITS |
| 2025-05-23 21:33:21.985609 | 2025-08-12 20:00:35.635948 | 189708 | PENDING | 4343449 | N/A | 21916 | PRIMARY | 20250506P0105511 | 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 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5676397 | True | N/A | N/A | PRE_CERT | N/A | 8 | 7 | N/A | VISITS |
| 2025-05-23 21:33:21.875770 | 2025-05-23 21:33:21.875778 | 189707 | PENDING | 4215112 | N/A | 21916 | PRIMARY | 20250505P0106507 | N/A | N/A | N/A | N/A | 2025-08-03 00:00:00 | 2025-05-05 00:00:00 | N/A | N/A | N/A | 8 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543301 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:21.820344 | 2026-01-02 22:47:31.428602 | 189706 | PENDING | 4214757 | N/A | 21916 | PRIMARY | 20250505P0104082 | N/A | N/A | N/A | N/A | 2025-08-03 07:00:00 | 2025-05-05 07:00:00 | N/A | N/A | N/A | N/A | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5542894 | True | N/A | N/A | PRE_CERT | N/A | 8 | 6 | N/A | VISITS |
| 2025-05-23 21:33:21.754164 | 2025-05-23 21:33:21.754174 | 189705 | PENDING | 4343465 | N/A | 21916 | PRIMARY | 20250328L0102240 | N/A | N/A | N/A | N/A | 2025-06-26 00:00:00 | 2025-05-05 00:00:00 | N/A | N/A | N/A | 13 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5993902 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:21.688557 | 2025-06-01 23:38:04.097835 | 189704 | PENDING | 4212605 | N/A | 21916 | PRIMARY | 20250430P0103334 | N/A | N/A | N/A | N/A | 2025-07-30 07:00:00 | 2025-05-05 07:00:00 | N/A | N/A | N/A | N/A | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5540446 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 5 | N/A | VISITS |
| 2025-05-23 21:33:21.631248 | 2025-06-10 14:54:27.973674 | 189703 | PENDING | 4214003 | N/A | 21916 | PRIMARY | 20250505L0101073 | N/A | N/A | N/A | N/A | 2025-08-03 07:00:00 | 2025-05-05 07:00:00 | N/A | N/A | N/A | N/A | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5542048 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 4 | N/A | VISITS |
| 2025-05-23 21:33:21.574023 | 2025-06-10 15:07:58.679138 | 189702 | PENDING | 4343455 | N/A | 21916 | PRIMARY | 20250505P0105672 | N/A | N/A | N/A | N/A | 2025-08-03 07:00:00 | 2025-05-05 07:00:00 | N/A | N/A | N/A | N/A | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5676396 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 4 | N/A | VISITS |
| 2025-05-23 21:33:21.483898 | 2025-05-31 16:29:31.701044 | 189701 | PENDING | 4219812 | N/A | 21916 | PRIMARY | 20250502P0101745 | N/A | N/A | N/A | N/A | 2025-07-30 14:00:00 | 2025-05-02 14:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5550987 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:21.428603 | 2025-11-11 17:39:39.098873 | 189700 | PENDING | 4343462 | N/A | 21916 | PRIMARY | 20250411L0102042 | N/A | N/A | N/A | N/A | 2025-07-10 00:00:00 | 2025-05-02 00:00:00 | N/A | N/A | N/A | 13 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5874419 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:21.373978 | 2025-05-30 03:17:59.818057 | 189699 | PENDING | 4219656 | N/A | 21916 | PRIMARY | 20250502P0104030 | N/A | N/A | N/A | N/A | 2025-07-31 07:00:00 | 2025-05-02 07:00:00 | N/A | N/A | N/A | N/A | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5550758 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 5 | N/A | VISITS |
| 2025-05-23 21:33:21.320709 | 2025-07-02 21:04:13.363239 | 189698 | PENDING | 4343454 | N/A | 21916 | PRIMARY | 20250501P0102637 | N/A | N/A | N/A | N/A | 2025-07-30 21:00:00 | 2025-05-02 21:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5676399 | True | N/A | N/A | PRE_CERT | N/A | 9 | 2 | N/A | VISITS |
| 2025-05-23 21:33:21.263176 | 2025-06-11 18:49:11.501042 | 189697 | PENDING | 4534562 | N/A | 21916 | PRIMARY | Current - Visits: 13 Remaining: 9 End Date: 7/3/2025 | N/A | N/A | N/A | N/A | 2025-07-03 14:00:00 | 2025-05-02 14:00:00 | N/A | N/A | N/A | N/A | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5874433 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 7 | N/A | VISITS |
| 2025-05-23 21:33:21.206008 | 2025-05-23 21:33:21.206015 | 189696 | PENDING | 4343447 | N/A | 21916 | PRIMARY | 8 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-05-01 00:00:00 | N/A | N/A | N/A | 8 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5676391 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:21.152470 | 2025-05-23 21:33:21.152478 | 189695 | PENDING | 4215080 | N/A | 21916 | PRIMARY | 20250501L0100926 | N/A | N/A | N/A | N/A | 2025-07-30 00:00:00 | 2025-05-01 00:00:00 | N/A | N/A | N/A | 12 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5543264 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:21.096406 | 2025-05-23 21:33:21.096413 | 189694 | PENDING | 4343439 | N/A | 21916 | PRIMARY | MEDICAL REVIEW 25TH VISIT | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-05-01 00:00:00 | N/A | N/A | N/A | 25 | 19 | PRIOR_AUTH | N/A | N/A | N/A | 5676385 | N/A | N/A | N/A | PRE_CERT | N/A | 25 | 25 | N/A | VISITS |
| 2025-05-23 21:33:21.034474 | 2025-10-31 20:20:34.531331 | 189693 | PENDING | 4642900 | N/A | 21916 | PRIMARY | 20250201P0102834 | N/A | N/A | N/A | N/A | 2025-07-30 07:00:00 | 2025-05-01 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 8046575 | True | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:20.953597 | 2025-05-23 21:33:20.953603 | 189692 | PENDING | 4213839 | N/A | 21916 | PRIMARY | 20250501L0102302 | N/A | N/A | N/A | N/A | 2025-07-30 00:00:00 | 2025-05-01 00:00:00 | N/A | N/A | N/A | 8 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5993580 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:20.851060 | 2025-06-26 16:47:35.191494 | 189691 | PENDING | 4215110 | N/A | 21916 | PRIMARY | 20250430P0107092 | N/A | N/A | N/A | N/A | 2025-07-29 07:00:00 | 2025-04-30 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5543296 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 8 | N/A | VISITS |
| 2025-05-23 21:33:20.793445 | 2025-05-23 21:33:20.793453 | 189690 | PENDING | 4212456 | N/A | 21916 | PRIMARY | 20250430L0100841 | N/A | N/A | N/A | N/A | 2025-07-29 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 12 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5993502 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:20.735718 | 2025-05-23 21:33:20.735726 | 189689 | PENDING | 4211547 | N/A | 21916 | PRIMARY | 8 visits - ash | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 8 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5676345 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:20.678621 | 2025-05-23 21:33:20.678629 | 189688 | PENDING | 4642867 | N/A | 21916 | PRIMARY | 20250430P0106987 | N/A | N/A | N/A | N/A | 2025-07-29 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 12 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5993929 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:20.622310 | 2025-05-23 21:33:20.622318 | 189687 | PENDING | 4343442 | N/A | 21916 | PRIMARY | 20250418P0102057 | N/A | N/A | N/A | N/A | 2025-07-17 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 17 | 14 | PRIOR_AUTH | N/A | N/A | N/A | 5676383 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:20.562213 | 2025-05-23 21:33:20.562220 | 189686 | PENDING | 4534569 | N/A | 21916 | PRIMARY | 20250430P0105303 | N/A | N/A | N/A | N/A | 2025-07-29 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 13 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5874442 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:20.507923 | 2025-05-30 22:07:48.630602 | 189685 | PENDING | 4214528 | N/A | 21916 | PRIMARY | 20250430P0101084 | N/A | N/A | N/A | N/A | 2025-07-29 21:00:00 | 2025-04-30 21:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5542652 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 2 | N/A | VISITS |
| 2025-05-23 21:33:20.448141 | 2025-05-30 19:48:11.643512 | 189684 | PENDING | 4219796 | N/A | 21916 | PRIMARY | 20250411p0105365 | N/A | N/A | N/A | N/A | 2025-07-10 07:00:00 | 2025-04-30 07:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5550966 | N/A | N/A | N/A | PRE_CERT | N/A | 10 | 10 | N/A | VISITS |
| 2025-05-23 21:33:20.391187 | 2025-05-23 21:33:20.391194 | 189683 | PENDING | 4214490 | N/A | 21916 | PRIMARY | 20241107P0104422 | N/A | N/A | N/A | N/A | 2025-06-26 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 9 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5542611 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:20.331947 | 2026-03-24 21:19:02.294157 | 189682 | PENDING | 4214160 | N/A | 21916 | PRIMARY | 25120A0000 | N/A | N/A | N/A | N/A | 2025-10-30 00:00:00 | 2025-04-30 00:00:00 | N/A | N/A | N/A | 10 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5542211 | True | N/A | N/A | PRE_CERT | N/A | 10 | 10 | N/A | VISITS |
| 2025-05-23 21:33:20.276461 | 2025-06-01 03:25:16.748192 | 189681 | PENDING | 4534575 | N/A | 21916 | PRIMARY | 20250428P0101278 | N/A | N/A | N/A | N/A | 2025-07-28 07:00:00 | 2025-04-29 07:00:00 | N/A | N/A | N/A | N/A | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5874452 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 11 | N/A | VISITS |
| 2025-05-23 21:33:20.215693 | 2025-10-06 16:32:34.788555 | 189680 | PENDING | 4219649 | N/A | 21916 | PRIMARY | 31651475 | N/A | N/A | N/A | N/A | 2025-05-27 00:00:00 | 2025-04-29 00:00:00 | N/A | N/A | N/A | 8 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5550750 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:20.154134 | 2025-05-23 21:33:20.154143 | 189679 | PENDING | 4212024 | N/A | 21916 | PRIMARY | 31619057 | N/A | N/A | N/A | N/A | 2025-06-06 00:00:00 | 2025-04-29 00:00:00 | N/A | N/A | N/A | 10 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5539785 | N/A | N/A | N/A | PRE_CERT | N/A | 10 | 10 | N/A | VISITS |
| 2025-05-23 21:33:20.094157 | 2025-05-23 21:33:20.094163 | 189678 | PENDING | 4213265 | N/A | 21916 | PRIMARY | 20250429L0100067 | N/A | N/A | N/A | N/A | 2025-07-28 00:00:00 | 2025-04-29 00:00:00 | N/A | N/A | N/A | 6 | 3 | PRIOR_AUTH | N/A | N/A | N/A | 5541232 | N/A | N/A | N/A | PRE_CERT | N/A | 6 | 6 | N/A | VISITS |
| 2025-05-23 21:33:20.020242 | 2025-05-23 21:33:20.020249 | 189677 | PENDING | 4219827 | N/A | 21916 | PRIMARY | 20250428P0100412 | N/A | N/A | N/A | N/A | 2025-07-27 00:00:00 | 2025-04-28 00:00:00 | N/A | N/A | N/A | 4 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5551009 | N/A | N/A | N/A | PRE_CERT | N/A | 4 | 4 | N/A | VISITS |
| 2025-05-23 21:33:19.960338 | 2025-06-03 05:33:22.565718 | 189676 | PENDING | 4208856 | N/A | 21916 | PRIMARY | 20250428L0100066 | N/A | N/A | N/A | N/A | 2025-07-25 07:00:00 | 2025-04-28 07:00:00 | N/A | N/A | N/A | N/A | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5536041 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 6 | N/A | VISITS |
| 2025-05-23 21:33:19.903250 | 2025-05-23 21:33:19.903258 | 189675 | PENDING | 4219594 | N/A | 21916 | PRIMARY | 20250428P0101821 | N/A | N/A | N/A | N/A | 2025-07-27 00:00:00 | 2025-04-28 00:00:00 | N/A | N/A | N/A | 24 | 24 | PRIOR_AUTH | N/A | N/A | N/A | 5550660 | N/A | N/A | N/A | PRE_CERT | N/A | 24 | 24 | N/A | VISITS |
| 2025-05-23 21:33:19.833711 | 2026-02-13 15:49:59.623943 | 189674 | PENDING | 4534582 | N/A | 21916 | PRIMARY | 20250428P0102302 | N/A | N/A | N/A | N/A | 2025-07-27 07:00:00 | 2025-04-28 07:00:00 | N/A | N/A | N/A | N/A | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5874458 | True | N/A | N/A | PRE_CERT | N/A | 9 | 8 | N/A | VISITS |
| 2025-05-23 21:33:19.778047 | 2025-05-23 21:33:19.778055 | 189673 | PENDING | 4212475 | N/A | 21916 | PRIMARY | 20250428P0101278 | N/A | N/A | N/A | N/A | 2025-07-27 00:00:00 | 2025-04-28 00:00:00 | N/A | N/A | N/A | 8 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5540301 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:19.719554 | 2025-11-25 19:28:40.400329 | 189672 | PENDING | 4210531 | N/A | 21916 | PRIMARY | 20250428L0101952 | N/A | N/A | FOOT, LT | N/A | 2025-07-28 04:00:00 | 2025-04-29 04:00:00 | N/A | N/A | N/A | N/A | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5676340 | True | N/A | N/A | PRE_CERT | N/A | 17 | 9 | N/A | VISITS |
| 2025-05-23 21:33:19.659188 | 2025-05-30 20:06:55.424262 | 189671 | PENDING | 4219822 | N/A | 21916 | PRIMARY | 20250409L0100828 | N/A | N/A | N/A | N/A | 2025-07-08 07:00:00 | 2025-04-25 07:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5676368 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 3 | N/A | VISITS |
| 2025-05-23 21:33:19.598308 | 2025-05-23 21:33:19.598316 | 189670 | PENDING | 4215085 | N/A | 21916 | PRIMARY | 18 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-04-25 00:00:00 | N/A | N/A | N/A | 18 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5543268 | N/A | N/A | N/A | PRE_CERT | N/A | 18 | 18 | N/A | VISITS |
| 2025-05-23 21:33:19.540318 | 2025-07-11 21:05:46.972543 | 189669 | PENDING | 4219820 | N/A | 21916 | PRIMARY | 20250404P0106476 | N/A | N/A | N/A | N/A | 2025-07-03 07:00:00 | 2025-04-25 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5550997 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:19.473073 | 2025-08-07 16:59:21.178857 | 189668 | PENDING | 4534583 | N/A | 21916 | PRIMARY | 22234024518 | N/A | N/A | N/A | N/A | 2025-07-24 00:00:00 | 2025-04-25 00:00:00 | N/A | N/A | N/A | 9 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5874461 | True | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:19.414226 | 2025-06-01 21:01:06.246019 | 189667 | PENDING | 4219644 | N/A | 21916 | PRIMARY | 31635185 | N/A | N/A | N/A | N/A | 2025-06-06 07:00:00 | 2025-04-25 07:00:00 | N/A | N/A | N/A | N/A | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5550740 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 7 | N/A | VISITS |