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 21:33:09.879211 | 2025-05-23 21:33:09.879218 | 189516 | PENDING | 4212608 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-17 00:00:00 | N/A | N/A | N/A | 17 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5540447 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:09.819612 | 2025-05-23 21:33:09.819620 | 189515 | PENDING | 4219745 | N/A | 21916 | PRIMARY | 20250314L0100714 | N/A | N/A | N/A | N/A | 2025-06-12 00:00:00 | 2025-03-14 00:00:00 | N/A | N/A | N/A | 13 | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5550886 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:09.763521 | 2025-05-23 21:33:09.763529 | 189514 | PENDING | 4219705 | N/A | 21916 | PRIMARY | 20250314P0105724 | N/A | N/A | N/A | N/A | 2025-06-12 00:00:00 | 2025-03-14 00:00:00 | N/A | N/A | N/A | 13 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5550836 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:09.707722 | 2025-05-23 21:33:09.707729 | 189513 | PENDING | 4214874 | N/A | 21916 | PRIMARY | 20250314P0101969 | N/A | N/A | N/A | N/A | 2025-06-12 00:00:00 | 2025-03-14 00:00:00 | N/A | N/A | N/A | 12 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5543035 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:09.644573 | 2025-05-23 21:33:09.644582 | 189512 | PENDING | 4215067 | N/A | 21916 | PRIMARY | 20250227P0106787 | N/A | N/A | N/A | N/A | 2025-05-28 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 13 | 13 | PRIOR_AUTH | N/A | N/A | N/A | 5543256 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:09.582811 | 2025-06-04 17:10:21.401688 | 189511 | PENDING | 4219841 | N/A | 21916 | PRIMARY | 20250313P0101332 | N/A | N/A | N/A | N/A | 2025-06-11 07:00:00 | 2025-03-13 07:00:00 | N/A | N/A | N/A | N/A | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5551018 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 9 | N/A | VISITS |
| 2025-05-23 21:33:09.525472 | 2025-05-23 21:33:09.525479 | 189510 | PENDING | 4219699 | N/A | 21916 | PRIMARY | 20250313L0102440 | N/A | N/A | N/A | N/A | 2025-06-11 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 1 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5550821 | N/A | N/A | N/A | PRE_CERT | N/A | 1 | 1 | N/A | VISITS |
| 2025-05-23 21:33:09.463849 | 2025-05-23 21:33:09.463856 | 189509 | PENDING | 4219784 | N/A | 21916 | PRIMARY | 20250409P005022 | N/A | N/A | N/A | N/A | 2025-07-08 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 4 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5550949 | N/A | N/A | N/A | PRE_CERT | N/A | 4 | 4 | N/A | VISITS |
| 2025-05-23 21:33:09.412365 | 2025-05-23 21:33:09.412371 | 189508 | PENDING | 4213059 | N/A | 21916 | PRIMARY | 20250313P0104410 | N/A | N/A | N/A | N/A | 2025-06-11 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 5 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5540984 | N/A | N/A | N/A | PRE_CERT | N/A | 5 | 5 | N/A | VISITS |
| 2025-05-23 21:33:09.361162 | 2025-05-23 21:33:09.361169 | 189507 | PENDING | 4219661 | N/A | 21916 | PRIMARY | 20250313P0105527 | N/A | N/A | N/A | N/A | 2025-06-11 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 9 | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5550765 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:09.306362 | 2025-05-23 21:33:09.306369 | 189506 | PENDING | 4212853 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-13 00:00:00 | N/A | N/A | N/A | 17 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5540755 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:09.248421 | 2025-05-31 16:13:08.616064 | 189505 | PENDING | 4215064 | N/A | 21916 | PRIMARY | 20250307P0101759 | N/A | N/A | N/A | N/A | 2025-06-05 07:00:00 | 2025-03-12 07:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5543251 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 2 | N/A | VISITS |
| 2025-05-23 21:33:09.189067 | 2025-05-23 21:33:09.189075 | 189504 | PENDING | 4219727 | N/A | 21916 | PRIMARY | 20250312P0101377 | N/A | N/A | N/A | N/A | 2025-06-10 00:00:00 | 2025-03-12 00:00:00 | N/A | N/A | N/A | 12 | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5550870 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:09.134297 | 2025-05-23 21:33:09.134305 | 189503 | PENDING | 4219666 | N/A | 21916 | PRIMARY | 20250312L0102369 | N/A | N/A | N/A | N/A | 2025-06-10 00:00:00 | 2025-03-12 00:00:00 | N/A | N/A | N/A | 2 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5550773 | N/A | N/A | N/A | PRE_CERT | N/A | 2 | 2 | N/A | VISITS |
| 2025-05-23 21:33:09.030572 | 2025-05-30 16:27:50.916933 | 189502 | PENDING | 4212810 | N/A | 21916 | PRIMARY | 20250113L0100359 | N/A | N/A | N/A | N/A | 2025-06-10 00:00:00 | 2025-03-12 00:00:00 | N/A | N/A | N/A | 12 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5540701 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:08.975971 | 2025-06-17 20:22:10.367094 | 189501 | PENDING | 4209603 | N/A | 21916 | PRIMARY | 24198A0446 | N/A | N/A | N/A | N/A | 2025-09-08 00:00:00 | 2025-03-12 00:00:00 | N/A | N/A | N/A | 10 | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5536948 | True | N/A | N/A | PRE_CERT | N/A | 10 | 10 | N/A | VISITS |
| 2025-05-23 21:33:08.918881 | 2025-10-02 16:29:20.385113 | 189500 | PENDING | 4211528 | N/A | 21916 | PRIMARY | 20250311P0103993 | N/A | N/A | N/A | N/A | 2025-06-09 07:00:00 | 2025-03-11 07:00:00 | N/A | N/A | N/A | N/A | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5539195 | True | N/A | N/A | PRE_CERT | N/A | 12 | 6 | N/A | VISITS |
| 2025-05-23 21:33:08.820550 | 2025-05-23 21:33:08.820558 | 189499 | PENDING | 4214722 | N/A | 21916 | PRIMARY | 20250310P0102804 | N/A | N/A | N/A | N/A | 2025-06-08 00:00:00 | 2025-03-10 00:00:00 | N/A | N/A | N/A | 8 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5542859 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:08.754686 | 2025-05-23 21:33:08.754694 | 189498 | PENDING | 4215045 | N/A | 21916 | PRIMARY | 20250303P0101998 | N/A | N/A | N/A | N/A | 2025-06-01 00:00:00 | 2025-03-07 00:00:00 | N/A | N/A | N/A | 1 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5543228 | N/A | N/A | N/A | PRE_CERT | N/A | 1 | 1 | N/A | VISITS |
| 2025-05-23 21:33:08.700914 | 2025-05-23 21:33:08.700924 | 189497 | PENDING | 4212554 | N/A | 21916 | PRIMARY | 20250217P0105153 | N/A | N/A | N/A | N/A | 2025-05-18 00:00:00 | 2025-03-07 00:00:00 | N/A | N/A | N/A | 13 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5540387 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:08.647824 | 2025-05-23 21:33:08.647831 | 189496 | PENDING | 4215041 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-07 00:00:00 | N/A | N/A | N/A | 17 | 16 | PRIOR_AUTH | N/A | N/A | N/A | 5543222 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:08.587763 | 2025-06-01 02:44:43.464028 | 189495 | PENDING | 4219684 | N/A | 21916 | PRIMARY | 20250307P0101249 | N/A | N/A | N/A | N/A | 2025-06-05 07:00:00 | 2025-03-07 08:00:00 | N/A | N/A | N/A | N/A | 15 | PRIOR_AUTH | N/A | N/A | N/A | 5550802 | N/A | N/A | N/A | PRE_CERT | N/A | 25 | 15 | N/A | VISITS |
| 2025-05-23 21:33:08.533967 | 2025-05-23 21:33:08.533975 | 189494 | PENDING | 4214835 | N/A | 21916 | PRIMARY | 20250307P0104665 | N/A | N/A | N/A | N/A | 2025-06-05 00:00:00 | 2025-03-07 00:00:00 | N/A | N/A | N/A | 8 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5542986 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:08.476504 | 2025-05-30 22:23:24.477968 | 189493 | PENDING | 4215036 | N/A | 21916 | PRIMARY | 20250306L0102407 | N/A | N/A | N/A | N/A | 2025-06-04 07:00:00 | 2025-03-06 08:00:00 | N/A | N/A | N/A | N/A | 5 | PRIOR_AUTH | N/A | N/A | N/A | 5543220 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 3 | N/A | VISITS |
| 2025-05-23 21:33:08.414230 | 2025-05-23 21:33:08.414237 | 189492 | PENDING | 4214862 | N/A | 21916 | PRIMARY | 20250306P0104200 | N/A | N/A | N/A | N/A | 2025-06-04 00:00:00 | 2025-03-06 00:00:00 | N/A | N/A | N/A | 8 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5543017 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:08.360279 | 2025-05-23 21:33:08.360287 | 189491 | PENDING | 4215034 | N/A | 21916 | PRIMARY | 24199A0307 | N/A | N/A | N/A | N/A | 2025-05-31 00:00:00 | 2025-03-06 00:00:00 | N/A | N/A | N/A | 11 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5543210 | N/A | N/A | N/A | PRE_CERT | N/A | 11 | 11 | N/A | VISITS |
| 2025-05-23 21:33:08.303883 | 2025-05-23 21:33:08.303891 | 189490 | PENDING | 4215020 | N/A | 21916 | PRIMARY | 20250207P0105479 | N/A | N/A | N/A | N/A | 2025-05-08 00:00:00 | 2025-03-05 00:00:00 | N/A | N/A | N/A | 24 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5543194 | N/A | N/A | N/A | PRE_CERT | N/A | 24 | 24 | N/A | VISITS |
| 2025-05-23 21:33:08.249777 | 2025-05-23 21:33:08.249787 | 189489 | PENDING | 4215024 | N/A | 21916 | PRIMARY | 17 VISITS PER YEAR | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-03-05 00:00:00 | N/A | N/A | N/A | 17 | 16 | PRIOR_AUTH | N/A | N/A | N/A | 5543203 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:08.192730 | 2025-05-23 21:33:08.192738 | 189488 | PENDING | 4219654 | N/A | 21916 | PRIMARY | 25064A0109 | N/A | N/A | N/A | N/A | 2025-09-01 00:00:00 | 2025-03-05 00:00:00 | N/A | N/A | N/A | 2 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5550753 | N/A | N/A | N/A | PRE_CERT | N/A | 2 | 2 | N/A | VISITS |
| 2025-05-23 21:33:08.135494 | 2025-05-23 21:33:08.135505 | 189487 | PENDING | 4214762 | N/A | 21916 | PRIMARY | 20250305P0100567 | N/A | N/A | N/A | N/A | 2025-06-03 00:00:00 | 2025-03-05 00:00:00 | N/A | N/A | N/A | 8 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5542903 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:08.078088 | 2025-05-23 21:33:08.078096 | 189486 | PENDING | 4215122 | N/A | 21916 | PRIMARY | 20250304L0101012 | N/A | N/A | N/A | N/A | 2025-06-02 00:00:00 | 2025-03-04 00:00:00 | N/A | N/A | N/A | 13 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5543307 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:08.016488 | 2025-05-30 18:17:46.673663 | 189485 | PENDING | 4214980 | N/A | 21916 | PRIMARY | 20250228l0101063 | N/A | N/A | N/A | N/A | 2025-11-26 00:00:00 | 2025-03-01 00:00:00 | N/A | N/A | N/A | N/A | 7 | PRIOR_AUTH | N/A | N/A | N/A | 5676359 | N/A | N/A | N/A | PRE_CERT | N/A | 11 | 6 | N/A | VISITS |
| 2025-05-23 21:33:07.964954 | 2025-05-23 21:33:07.964962 | 189484 | PENDING | 4214985 | N/A | 21916 | PRIMARY | 20250225L0100173 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-02-27 00:00:00 | N/A | N/A | N/A | 13 | 13 | PRIOR_AUTH | N/A | N/A | N/A | 5543154 | N/A | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:07.907213 | 2025-05-23 21:33:07.907222 | 189483 | PENDING | 4214972 | N/A | 21916 | PRIMARY | 20250227P0100962 | N/A | N/A | N/A | N/A | 2025-05-28 00:00:00 | 2025-02-27 00:00:00 | N/A | N/A | N/A | 25 | 24 | PRIOR_AUTH | N/A | N/A | N/A | 5543139 | N/A | N/A | N/A | PRE_CERT | N/A | 25 | 25 | N/A | VISITS |
| 2025-05-23 21:33:07.849307 | 2025-05-23 21:33:07.849314 | 189482 | PENDING | 4214558 | N/A | 21916 | PRIMARY | 20250227L0104837 | N/A | N/A | N/A | N/A | 2025-06-01 00:00:00 | 2025-02-27 00:00:00 | N/A | N/A | N/A | 8 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5542681 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:07.749719 | 2025-05-23 21:33:07.749729 | 189481 | PENDING | 4214982 | N/A | 21916 | PRIMARY | 20250217P0104790 | N/A | N/A | N/A | N/A | 2025-05-18 00:00:00 | 2025-02-26 00:00:00 | N/A | N/A | N/A | 9 | 9 | PRIOR_AUTH | N/A | N/A | N/A | 5543153 | N/A | N/A | N/A | PRE_CERT | N/A | 9 | 9 | N/A | VISITS |
| 2025-05-23 21:33:07.690540 | 2025-05-23 21:33:07.690565 | 189480 | PENDING | 4214970 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-26 00:00:00 | N/A | N/A | N/A | 17 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5543143 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:07.633316 | 2025-05-23 21:33:07.633324 | 189479 | PENDING | 4214965 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-26 00:00:00 | N/A | N/A | N/A | 17 | 16 | PRIOR_AUTH | N/A | N/A | N/A | 5543136 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:07.577621 | 2025-09-15 22:23:53.595931 | 189478 | PENDING | 4213243 | N/A | 21916 | PRIMARY | 20250225P0101470 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-02-25 00:00:00 | N/A | N/A | N/A | 13 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5541202 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:07.520023 | 2025-06-04 16:22:48.181054 | 189477 | PENDING | 4219064 | N/A | 21916 | PRIMARY | 20250225L0100360 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-02-25 00:00:00 | N/A | N/A | N/A | 13 | 1 | PRIOR_AUTH | N/A | N/A | N/A | 5549398 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:07.468870 | 2025-11-10 21:44:52.914553 | 189476 | PENDING | 4219622 | N/A | 21916 | PRIMARY | 20250225P0103249 | N/A | N/A | N/A | N/A | 2025-05-26 00:00:00 | 2025-02-25 00:00:00 | N/A | N/A | N/A | 13 | 6 | PRIOR_AUTH | N/A | N/A | N/A | 5550714 | True | N/A | N/A | PRE_CERT | N/A | 13 | 13 | N/A | VISITS |
| 2025-05-23 21:33:07.375953 | 2025-06-02 02:43:21.400732 | 189475 | PENDING | 4219432 | N/A | 21916 | PRIMARY | 20250224P0105748 | N/A | N/A | N/A | N/A | 2025-05-26 07:00:00 | 2025-02-24 08:00:00 | N/A | N/A | N/A | N/A | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5549949 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 8 | N/A | VISITS |
| 2025-05-23 21:33:07.320965 | 2025-05-23 21:33:07.320973 | 189474 | PENDING | 4219234 | N/A | 21916 | PRIMARY | 20241010P0101356 | N/A | N/A | N/A | N/A | 2025-05-25 00:00:00 | 2025-02-24 00:00:00 | N/A | N/A | N/A | 12 | 8 | PRIOR_AUTH | N/A | N/A | N/A | 5549606 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:07.255336 | 2025-05-23 21:33:07.255342 | 189473 | PENDING | 4214959 | N/A | 21916 | PRIMARY | 30 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-21 00:00:00 | N/A | N/A | N/A | 30 | 12 | PRIOR_AUTH | N/A | N/A | N/A | 5543128 | N/A | N/A | N/A | PRE_CERT | N/A | 30 | 30 | N/A | VISITS |
| 2025-05-23 21:33:07.192424 | 2025-05-23 21:33:07.192431 | 189472 | PENDING | 4214940 | N/A | 21916 | PRIMARY | ASH AUTH AFTER 12TH VISIT | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-20 00:00:00 | N/A | N/A | N/A | 12 | 11 | PRIOR_AUTH | N/A | N/A | N/A | 5543110 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:07.129892 | 2025-05-23 21:33:07.129901 | 189471 | PENDING | 4214954 | N/A | 21916 | PRIMARY | AMERICAN SPECIALTY HEALTH (ASH) | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-20 00:00:00 | N/A | N/A | N/A | 8 | 2 | PRIOR_AUTH | N/A | N/A | N/A | 5543124 | N/A | N/A | N/A | PRE_CERT | N/A | 8 | 8 | N/A | VISITS |
| 2025-05-23 21:33:07.067415 | 2025-05-23 21:33:07.067424 | 189470 | PENDING | 4214947 | N/A | 21916 | PRIMARY | 17 VISITS | N/A | N/A | N/A | N/A | 2025-12-31 00:00:00 | 2025-02-19 00:00:00 | N/A | N/A | N/A | 17 | 16 | PRIOR_AUTH | N/A | N/A | N/A | 5543111 | N/A | N/A | N/A | PRE_CERT | N/A | 17 | 17 | N/A | VISITS |
| 2025-05-23 21:33:07.005190 | 2025-05-30 18:46:13.205384 | 189469 | PENDING | 4343470 | N/A | 21916 | PRIMARY | 200250219P0104253 | N/A | N/A | N/A | N/A | 2025-05-20 00:00:00 | 2025-02-19 00:00:00 | N/A | N/A | N/A | 12 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5676415 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:06.946401 | 2025-05-23 21:33:06.946410 | 189468 | PENDING | 4214345 | N/A | 21916 | PRIMARY | 20250218L0100771 | N/A | N/A | N/A | N/A | 2025-05-19 00:00:00 | 2025-02-18 00:00:00 | N/A | N/A | N/A | 12 | 10 | PRIOR_AUTH | N/A | N/A | N/A | 5542430 | N/A | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |
| 2025-05-23 21:33:06.891862 | 2026-04-20 17:28:57.641734 | 189467 | PENDING | 4212252 | N/A | 21916 | PRIMARY | 20250218P0107320 | N/A | N/A | N/A | N/A | 2025-05-19 00:00:00 | 2025-02-18 00:00:00 | N/A | N/A | N/A | 12 | 4 | PRIOR_AUTH | N/A | N/A | N/A | 5540039 | True | N/A | N/A | PRE_CERT | N/A | 12 | 12 | N/A | VISITS |