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 21:33:15.987534 | 2025-05-23 21:33:15.987541 | 189616 | PENDING | 4219738 | N/A | 21916 | PRIMARY | 17 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-04-11 00:00:00 | N/A | N/A | N/A | 17 | 14 | PRIOR_AUTH | N/A | N/A | N/A | 5550881 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:15.933392 | 2025-05-23 21:33:15.933399 | 189615 | PENDING | 4219662 | N/A | 21916 | PRIMARY | 20250411L0100355 | N/A | N/A | N/A | N/A | 2025-07-10 00:00:00 | 2025-04-11 00:00:00 | N/A | N/A | N/A | 8 | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5550766 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:15.871360 | 2025-06-19 18:20:13.331011 | 189614 | PENDING | 4219614 | N/A | 21916 | PRIMARY | 20250411L0100364 | N/A | N/A | N/A | N/A | 2025-07-10 18:00:00 | 2025-04-11 18:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 6417552 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 3 | N/A | VISITS |
| 2025-05-23 21:33:15.759875 | 2025-05-23 21:33:15.759882 | 189613 | PENDING | 4219731 | N/A | 21916 | PRIMARY | 20250326P0101598 | N/A | N/A | N/A | N/A | 2025-06-24 00:00:00 | 2025-04-11 00:00:00 | N/A | N/A | N/A | 13 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5993896 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:15.703863 | 2025-05-30 19:44:11.355405 | 189612 | PENDING | 4214430 | N/A | 21916 | PRIMARY | 20250410L0102188 | N/A | N/A | N/A | N/A | 2025-07-09 07:00:00 | 2025-04-10 07:00:00 | N/A | N/A | N/A | N/A | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5542565 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 6 | N/A | VISITS |
| 2025-05-23 21:33:15.643396 | 2025-05-23 21:33:15.643404 | 189611 | PENDING | 4213956 | N/A | 21916 | PRIMARY | 20250410P0101650 | N/A | N/A | N/A | N/A | 2025-07-09 00:00:00 | 2025-04-10 00:00:00 | N/A | N/A | N/A | 8 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5541989 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:15.585071 | 2025-05-30 14:53:22.813139 | 189610 | PENDING | 4214936 | N/A | 21916 | PRIMARY | 20250410L0101268 | N/A | N/A | N/A | N/A | 2025-07-09 07:00:00 | 2025-04-10 07:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543107 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 4 | N/A | VISITS |
| 2025-05-23 21:33:15.522617 | 2025-05-23 21:33:15.522625 | 189609 | PENDING | 4214955 | N/A | 21916 | PRIMARY | 20250409P0105098 | N/A | N/A | N/A | N/A | 2025-07-08 00:00:00 | 2025-04-09 00:00:00 | N/A | N/A | N/A | 6 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543125 | N/A | N/A | N/A | PRE_CERT | N/A | 6 | 6 | N/A | VISITS |
| 2025-05-23 21:33:15.469251 | 2025-05-23 21:33:15.469258 | 189608 | PENDING | 4214851 | N/A | 21916 | PRIMARY | 16803415 | N/A | N/A | N/A | N/A | 2025-05-09 00:00:00 | 2025-04-09 00:00:00 | N/A | N/A | N/A | 6 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5543007 | N/A | N/A | N/A | PRE_CERT | N/A | 6 | 6 | N/A | VISITS |
| 2025-05-23 21:33:15.410913 | 2025-06-24 15:13:32.519427 | 189607 | PENDING | 4219705 | N/A | 21916 | PRIMARY | 20250409P0105935 | N/A | N/A | N/A | N/A | 2025-07-08 07:00:00 | 2025-04-09 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5550836 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 8 | N/A | VISITS |
| 2025-05-23 21:33:15.350212 | 2025-05-23 21:33:15.350219 | 189606 | PENDING | 4219704 | N/A | 21916 | PRIMARY | 20250409P0100746 | N/A | N/A | N/A | N/A | 2025-07-08 00:00:00 | 2025-04-09 00:00:00 | N/A | N/A | N/A | 8 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5550831 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:15.289354 | 2025-05-23 21:33:15.289362 | 189605 | PENDING | 4209547 | N/A | 21916 | PRIMARY | 20250409P0105193 | N/A | N/A | N/A | N/A | 2025-07-08 00:00:00 | 2025-04-09 00:00:00 | N/A | N/A | N/A | 11 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5536875 | N/A | N/A | N/A | PRE_CERT | N/A | 11 | 11 | N/A | VISITS |
| 2025-05-23 21:33:15.231662 | 2025-05-23 21:33:15.231674 | 189604 | PENDING | 4215226 | N/A | 21916 | PRIMARY | 20250404L0100936 | N/A | N/A | N/A | N/A | 2025-07-03 00:00:00 | 2025-04-08 00:00:00 | N/A | N/A | N/A | 9 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5550855 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:15.171718 | 2025-05-30 23:40:28.260990 | 189603 | PENDING | 4215192 | N/A | 21916 | PRIMARY | 20250326P0105243 | N/A | N/A | N/A | N/A | 2025-06-24 07:00:00 | 2025-04-08 07:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543392 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 4 | N/A | VISITS |
| 2025-05-23 21:33:15.114326 | 2025-05-23 21:33:15.114333 | 189602 | PENDING | 4214760 | N/A | 21916 | PRIMARY | U94121830 | N/A | N/A | N/A | N/A | 2025-05-09 00:00:00 | 2025-04-08 00:00:00 | N/A | N/A | N/A | 6 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5542901 | N/A | N/A | N/A | PRE_CERT | N/A | 6 | 6 | N/A | VISITS |
| 2025-05-23 21:33:15.042752 | 2025-07-10 14:53:04.848285 | 189601 | PENDING | 4219830 | N/A | 21916 | PRIMARY | 20250408P0105604 | N/A | N/A | N/A | N/A | 2025-07-07 00:00:00 | 2025-04-08 00:00:00 | N/A | N/A | N/A | 25 | 18 | PRIOR_AUTH | N/A | N/A | N/A | 5550998 | True | N/A | N/A | PRE_CERT | N/A | 25 | 25 | N/A | VISITS |
| 2025-05-23 21:33:14.972294 | 2025-05-23 21:33:14.972301 | 189600 | PENDING | 4215180 | N/A | 21916 | PRIMARY | 20250311L0100146 | N/A | N/A | N/A | N/A | 2025-06-09 00:00:00 | 2025-04-07 00:00:00 | N/A | N/A | N/A | 13 | 13 | PRIOR_AUTH | N/A | N/A | N/A | 5543380 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:14.918047 | 2025-10-27 17:15:02.632836 | 189599 | PENDING | 4210532 | N/A | 21916 | PRIMARY | 20250407P0100337 | N/A | N/A | N/A | N/A | 2025-07-06 00:00:00 | 2025-04-07 00:00:00 | N/A | N/A | N/A | 8 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5538050 | True | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:14.860292 | 2025-05-23 21:33:14.860299 | 189598 | PENDING | 4214786 | N/A | 21916 | PRIMARY | 20250407P0100351 | N/A | N/A | N/A | N/A | 2025-07-06 00:00:00 | 2025-04-07 00:00:00 | N/A | N/A | N/A | 8 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5542939 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:14.799299 | 2025-05-23 21:33:14.799308 | 189597 | PENDING | 4209647 | N/A | 21916 | PRIMARY | 20250407L0101972 | N/A | N/A | N/A | N/A | 2025-07-10 00:00:00 | 2025-04-07 00:00:00 | N/A | N/A | N/A | 13 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5549278 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:14.735431 | 2025-05-23 21:33:14.735439 | 189596 | PENDING | 4215177 | N/A | 21916 | PRIMARY | 17 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-04-04 00:00:00 | N/A | N/A | N/A | 17 | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5543377 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:14.674519 | 2025-05-23 21:33:14.674526 | 189595 | PENDING | 4215204 | N/A | 21916 | PRIMARY | 205310L0101228 | N/A | N/A | N/A | N/A | 2025-06-08 00:00:00 | 2025-04-04 00:00:00 | N/A | N/A | N/A | 13 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5543404 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:14.612154 | 2025-05-23 21:33:14.612161 | 189594 | PENDING | 4215171 | N/A | 21916 | PRIMARY | 17 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-04-04 00:00:00 | N/A | N/A | N/A | 17 | 14 | PRIOR_AUTH | N/A | N/A | N/A | 5543372 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:14.549635 | 2025-05-23 21:33:14.549642 | 189593 | PENDING | 4215187 | N/A | 21916 | PRIMARY | 20250404P0103194 | N/A | N/A | N/A | N/A | 2025-07-03 00:00:00 | 2025-04-04 00:00:00 | N/A | N/A | N/A | 13 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5543387 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:14.487945 | 2025-05-23 21:33:14.487953 | 189592 | PENDING | 4214863 | N/A | 21916 | PRIMARY | 20250404P0100767 | N/A | N/A | N/A | N/A | 2025-07-03 00:00:00 | 2025-04-04 00:00:00 | N/A | N/A | N/A | 9 | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5543015 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:14.380151 | 2025-11-14 16:30:24.121863 | 189591 | PENDING | 4215172 | N/A | 21916 | PRIMARY | 20250321L0101865 | N/A | N/A | N/A | N/A | 2025-06-19 07:00:00 | 2025-04-03 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5543371 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:14.320765 | 2025-05-23 21:33:14.320772 | 189590 | PENDING | 4209050 | N/A | 21916 | PRIMARY | 20250403P0106405 | N/A | N/A | N/A | N/A | 2025-07-02 00:00:00 | 2025-04-03 00:00:00 | N/A | N/A | N/A | 12 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5536280 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:14.264543 | 2025-05-23 21:33:14.264550 | 189589 | PENDING | 4215168 | N/A | 21916 | PRIMARY | 20250403L0100485 | N/A | N/A | N/A | N/A | 2025-07-02 00:00:00 | 2025-04-03 00:00:00 | N/A | N/A | N/A | 12 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5543366 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:14.197433 | 2025-06-04 17:08:17.218512 | 189588 | PENDING | 4219347 | N/A | 21916 | PRIMARY | 20250403P0103553 | N/A | N/A | N/A | N/A | 2025-07-02 07:00:00 | 2025-04-03 07:00:00 | N/A | N/A | N/A | N/A | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5549748 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 7 | N/A | VISITS |
| 2025-05-23 21:33:14.069132 | 2025-05-23 21:33:14.069140 | 189587 | PENDING | 4215126 | N/A | 21916 | PRIMARY | 20250402P0106822 | N/A | N/A | N/A | N/A | 2025-07-01 00:00:00 | 2025-04-02 00:00:00 | N/A | N/A | N/A | 12 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5543316 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:14.008835 | 2025-06-25 23:44:42.146935 | 189586 | PENDING | 4215211 | N/A | 21916 | PRIMARY | 20250402P0106639 | N/A | N/A | N/A | N/A | 2025-07-01 07:00:00 | 2025-04-02 07:00:00 | N/A | N/A | N/A | N/A | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5543425 | True | N/A | N/A | PRE_CERT | N/A | 17 | 6 | N/A | VISITS |
| 2025-05-23 21:33:13.948587 | 2025-05-23 21:33:13.948598 | 189585 | PENDING | 4213565 | N/A | 21916 | PRIMARY | 20250402P0106773 | N/A | N/A | N/A | N/A | 2025-07-01 00:00:00 | 2025-04-02 00:00:00 | N/A | N/A | N/A | 8 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5541556 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:13.893079 | 2025-05-23 21:33:13.893086 | 189584 | PENDING | 4215166 | N/A | 21916 | PRIMARY | 20250326P0103468 | N/A | N/A | N/A | N/A | 2025-06-24 00:00:00 | 2025-04-01 00:00:00 | N/A | N/A | N/A | 17 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5993892 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:13.840102 | 2025-08-08 21:37:45.935807 | 189583 | PENDING | 4211585 | N/A | 21916 | PRIMARY | 20250225L0100500 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-04-01 00:00:00 | N/A | N/A | N/A | 13 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5539261 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.778289 | 2025-12-12 16:27:12.805382 | 189582 | PENDING | 4215163 | N/A | 21916 | PRIMARY | 20250319P0103582 | N/A | N/A | N/A | N/A | 2025-06-17 00:00:00 | 2025-04-01 00:00:00 | N/A | N/A | N/A | 13 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5543363 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.712442 | 2025-05-23 21:33:13.712449 | 189581 | PENDING | 4214350 | N/A | 21916 | PRIMARY | ASH AUTH 7 VISITS | N/A | N/A | N/A | N/A | 2025-05-01 00:00:00 | 2025-04-01 00:00:00 | N/A | N/A | N/A | 7 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5542446 | N/A | N/A | N/A | PRE_CERT | N/A | 7 | 7 | N/A | VISITS |
| 2025-05-23 21:33:13.651868 | 2025-06-01 03:56:30.635979 | 189580 | PENDING | 4219752 | N/A | 21916 | PRIMARY | 20250401P0107274 | N/A | N/A | N/A | N/A | 2025-06-30 07:00:00 | 2025-04-01 07:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5550894 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 4 | N/A | VISITS |
| 2025-05-23 21:33:13.595225 | 2025-05-23 21:33:13.595231 | 189579 | PENDING | 4219711 | N/A | 21916 | PRIMARY | 222233666478 | N/A | N/A | N/A | N/A | 2025-06-30 00:00:00 | 2025-04-01 00:00:00 | N/A | N/A | N/A | 11 | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5550843 | N/A | N/A | N/A | PRE_CERT | N/A | 11 | 11 | N/A | VISITS |
| 2025-05-23 21:33:13.538201 | 2025-07-28 17:24:22.570059 | 189578 | PENDING | 4215161 | N/A | 21916 | PRIMARY | 20250310L0102179 | N/A | N/A | N/A | N/A | 2025-06-08 07:00:00 | 2025-03-31 07:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543360 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 14 | N/A | VISITS |
| 2025-05-23 21:33:13.481060 | 2025-05-23 21:33:13.481067 | 189577 | PENDING | 4215162 | N/A | 21916 | PRIMARY | 24 VISITS PER CALENDER YEAR | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-31 00:00:00 | N/A | N/A | N/A | 24 | 20 | PRIOR_AUTH | N/A | N/A | N/A | 5543361 | N/A | N/A | N/A | PRE_CERT | N/A | 24 | 24 | N/A | VISITS |
| 2025-05-23 21:33:13.415966 | 2025-06-01 03:12:46.673447 | 189576 | PENDING | 4213985 | N/A | 21916 | PRIMARY | 20250331P0102155 | N/A | N/A | N/A | N/A | 2025-06-29 00:00:00 | 2025-03-31 00:00:00 | N/A | N/A | N/A | 13 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5542028 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.358924 | 2025-05-23 21:33:13.358931 | 189575 | PENDING | 4214926 | N/A | 21916 | PRIMARY | 20250331P0104562 | N/A | N/A | N/A | N/A | 2025-06-29 00:00:00 | 2025-03-31 00:00:00 | N/A | N/A | N/A | 8 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5543089 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:13.301607 | 2025-05-23 21:33:13.301614 | 189574 | PENDING | 4219755 | N/A | 21916 | PRIMARY | 20250331P0106568 | N/A | N/A | N/A | N/A | 2025-06-29 00:00:00 | 2025-03-31 00:00:00 | N/A | N/A | N/A | 13 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5550901 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.238641 | 2025-05-23 21:33:13.238671 | 189573 | PENDING | 4215078 | N/A | 21916 | PRIMARY | 20250313L0100392 | N/A | N/A | N/A | N/A | 2025-06-11 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 8 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5543263 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:13.179784 | 2025-05-23 21:33:13.179793 | 189572 | PENDING | 4215152 | N/A | 21916 | PRIMARY | 20250328P0101695 | N/A | N/A | N/A | N/A | 2025-06-26 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 25 | 16 | PRIOR_AUTH | N/A | N/A | N/A | 5543350 | N/A | N/A | N/A | PRE_CERT | N/A | 25 | 25 | N/A | VISITS |
| 2025-05-23 21:33:13.121261 | 2025-05-23 21:33:13.121267 | 189571 | PENDING | 4215150 | N/A | 21916 | PRIMARY | 20250225L0100500 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 13 | 13 | PRIOR_AUTH | N/A | N/A | N/A | 5543341 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.060022 | 2025-07-01 18:34:38.214436 | 189570 | PENDING | 4215154 | N/A | 21916 | PRIMARY | 20250207L0101986 | N/A | N/A | N/A | N/A | 2025-05-21 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 13 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5543345 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:13.003233 | 2025-05-23 21:33:13.003240 | 189569 | PENDING | 4215153 | N/A | 21916 | PRIMARY | 17 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 17 | 13 | PRIOR_AUTH | N/A | N/A | N/A | 5543349 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:12.948389 | 2025-05-23 21:33:12.948397 | 189568 | PENDING | 4215151 | N/A | 21916 | PRIMARY | 17 | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-28 00:00:00 | N/A | N/A | N/A | 17 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5543339 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:12.887741 | 2025-10-15 15:28:10.148954 | 189567 | PENDING | 4210069 | N/A | 21916 | PRIMARY | 20250327P0105160 | N/A | N/A | N/A | N/A | 2025-06-26 04:00:00 | 2025-03-28 04:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5537537 | True | N/A | N/A | PRE_CERT | N/A | 12 | 9 | N/A | VISITS |