1Jcbc 2831000645.1 0000003100Rogers Latonya 1961 Karen Cricle Po Box 30031 Decatur Ga 30031

1JCBC 2831000645.1 0000003100ROGERS LATONYA 1961 KAREN CRICLE PO BOX 30031 DECATUR GA 30031 404906405507218229256418471F3061912786.50 3854 VIJAY K MAHATHRE MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000US ARMY 0000000000US ARMY UNK MILLEDGEVILLE GA 31061 00000000007101026 06191202 JOHN H PENUEL,MD BA 1918 22831000645.1 C99 06191202 JOHN H PENUEL,MD C OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 1JCBC 2831002319.1 0000014600HAWKINS TAMEKIA M 169 MOORE ST MILLEDGEVILLE GA 31061 478234536408187437252255997F3062312346.90 3817 TAYYAB B BHUTTA MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000MCDONALDS 106 OAK ST EATONTON GA 31024 7064853533MCDONALDS 106 OAK ST EATONTON GA 31024 70648535337045026 06221202 JOHN H PENUEL,MD BA 1918 22831002319.1 C99 06221202 JOHN H PENUEL,MD C OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 1JCBC 2831003016.1 0000039600BAILEY DEBBIE K 125 SPORTSMAN CIRCLE MILLEDGEVILLE GA 31061 478454823112205358253024941F3062612959.01V71.4 3854 VIJAY K MAHATHRE MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000TRUSS SPECIALITIES 107 SPORTSMAN CLUB MILLEDGEVILLE GA 31061 4784533520TRUSS SPECIALITIES 107 SPORTSMAN CLUB MILLEDGEVILLE GA 31061 47845335207212526 06251203 LAURENCE STEINFELD,MD BA 1918 22831003016.1 C99 06251203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7212526 CT CERVICAL SPINE000100000197003 22831003016.1 C99 06251203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7205026 CERV SPINE AP/ODO000100000053003 22831003016.1 C99 06251203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 1JCBC 2831003465.1 0000014600JUSTICE GREGORY T 135 CRANFORD DR MILLEDGEVILLE GA 31061 478414607002066844267490655M1062612331.9 3523 JEFFERY I JOHNSON MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007045026 06261203 LAURENCE STEINFELD,MD BA 1918 22831003465.1 A99 06261203 LAURENCE STEINFELD,MD A OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 1JCBC 2831004370.1 0000020800BROWN CONNIE 134 RANDALL DR MILLEDGEVILLE GA 31061 478453849007016250253355508F3062912719.41786.50784.0 179 EARLE M TAYLOR MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007101026 06291203 LAURENCE STEINFELD,MD BA 1918 22831004370.1 C99 06291203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 22831004370.1 C99 06291203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 22831004370.1 C99 06291203 LAURENCE STEINFELD,MD C OCONEE REGIONAL MED CNT 7303026 SHOULDER COMPLETE000100000031003 1JCBC 2831008277.1 0000040400JUSTICE GREGORY T 135 CRANFORD DR MILLEDGEVILLE GA 31061 478414607002066844267490655M1071112780.97793.6 3523 JEFFERY I JOHNSON MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007417726 07111203 LAURENCE STEINFELD,MD BA 1918 22831008277.1 A99 07101204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7688226 US EXTREMITY NON 000100000069003 22831008277.1 A99 07101203 LAURENCE STEINFELD,MD A OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 22831008277.1 A99 07111203 LAURENCE STEINFELD,MD A OCONEE REGIONAL MED CNT 7417726 CT ABD & PELVIS W000100000304003 1JCBC 2831026.1 0000019700POOLE JENNIFER D 441 TAYLOR ROAD SANDERSVILLE GA 31082 478553002504017636000000000F3042012V71.4 178 LISA A COUNSELL MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000 0000000000MICRO CLEAN SANDERSVILLE GA 31082 47825186307212526 04151203 LAURENCE STEINFELD,MD CO 1918 22831026.1 F219 04151203 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7212526 CT CERVICAL SPINE000100000197003 1JCBC 283105385.1 0000002366VINSON EMILY V 1174 FUNDERBURG DR MONTICELLO GA 31064 706476126311015259258845239F3021712784.0 189 HEATHER HALL MD 0000000000 4733Y876887355 742857 VINSON CARL E 00000000000000000100 00000025000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007045026 02171204 WILLIAM A WILLOUGHBY,MCO 190118 UNITED HEALTHCARE P O BOX 740800 ATLANTA GA 30374 2283105385.1 I99 02171204 WILLIAM A WILLOUGHBY,MI JASPER MEMORIAL HOSPITA 7045026 CT HEAD W/O CONTR000100000146003 2283105385.1 I99 02171204 WILLIAM A WILLOUGHBY,MI JASPER MEMORIAL HOSPITA 7102026 CHEST,TWO VIEWS,F000100000038003 2283105385.1 P95 03061204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 2283105385.1 P95 03061204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 4799 COMMERCIAL LOA 0001-0000135346 2283105385.1 P95 03061204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 2283105385.1 P116 05161204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000025004 1JCBC 283105616.1 0000003100THOMAS DARRYL E 1668 MLK DR MONTICELLO GA 31064 706468562708308526260552278M3022712786.50 3817 TAYYAB B BHUTTA MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000 0000000000 00000000007101026 02271203 LAURENCE STEINFELD,MD CO 1918 2283105616.1 I99 02271203 LAURENCE STEINFELD,MD I JASPER MEMORIAL HOSPITA 7101026 CHEST,SINGLE VIEW000100000031003 1JCBC 283105681.1 0000004418HARDEMAN BEVERLY B PO BOX 251 MONTICELLO GA 31064 706468298209046150258175172F0022812722.4 723.1 171 SHANNON T BARTON MD HARDEMAN BEVERLY A PO BOX 251 MONTICELLO GA 31064 70646829822581751724733Y965429595 712820 00000176740000000100 00000000000000000000 0000000000000000GEORGIA PACIFIC P O BOX 270 MONTICELLO GA 31064 7064688811GEORGIA PACIFIC P O BOX 270 MONTICELLO GA 31064 70646888117215626 02281202 JOHN H PENUEL,MD CO 191818 UNITED HEALTHCARE P O BOX 740800 ATLANTA GA 30374 2283105681.1 H99 02281202 JOHN H PENUEL,MD H JASPER MEMORIAL HOSPITA 7215626 MRI CERVICAL SPIN000100000439003 2283105681.1 P95 03201202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA0001-0000176744 2283105681.1 P95 03201202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 4799 COMMERCIAL LOA 0001-0000218086 1JCBC 283105896.1 0000001413PEARSON LARRY L P O BOX 639 MONTICELLO GA 31064 706468112708234170256669364M0030612724.2 195 LEIGH ANNA THOMPSON 0000000000 1100Y256669364A 00000056520000004733Y000711648 705619 00000000000000000100 0000000000000000RETIRED 0000000000RETIRED 00000000007214826 03061204 WILLIAM A WILLOUGHBY,MCO 19181818MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 UNITED HEALTHCARE P O BOX 740800 ATLANTA GA 30374 2283105896.1 H99 03061204 WILLIAM A WILLOUGHBY,MH JASPER MEMORIAL HOSPITA 7214826 MRI LUM SPINE SCR000100000254003 2283105896.1 P99 03221204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000056524 2283105896.1 P99 03221204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000183356 2283105896.1 P95 04031204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 2283105896.1 P95 04031204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 1JCBC 283106334.1 0000015654DAVIS SHEENA R 316 BILTMORE RD MANSFIELD GA 30055 678315671507175952255132787F0032012722.4 714 REGINALD S FOWLER MD 0000000000 5695YR8530857901 DAVIS SHEENA R 00000000000000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007214126 03201204 WILLIAM A WILLOUGHBY,MCO 19G818 CIGNA P O BOX 182223 CHATTANOOGA TN 37422 2283106334.1 H99 03201204 WILLIAM A WILLOUGHBY,MH JASPER MEMORIAL HOSPITA 7214126 MRI CERVICAL SPIN000100000275003 2283106334.1 P203 04031204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 5695 UHC PAYMENT 000100000000004 2283106334.1 P203 04031204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 5699 LIMIT OF ALLOWANCE W0001-0000118466 1JCBC 283106817.1 0000001670ELROD MARIE C PO BOX 654 MONTICELLO GA 31064 706468234911152190260300594F3040412724.5 719.45 190 REGINALD D SMITH MD 0000000000 1100Y260402647D 00000066820000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007370026 04031202 JOHN H PENUEL,MD CO 191818 MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 2283106817.1 I99 04031202 JOHN H PENUEL,MD I JASPER MEMORIAL HOSPITA 7370026 CT LOWER EXTREMIT000100000185003 2283106817.1 I99 04031202 JOHN H PENUEL,MD I JASPER MEMORIAL HOSPITA 7213126 CT LUM SPINE W/O 000100000197003 2283106817.1 P99 04191202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000066824 2283106817.1 P99 04191202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000298486 1JCBC 283107131.1 0000003800HUNT WILLIAM 268 BETHEL CHURCH ROAD MONTICELLO GA 31064 770367915910296942257193027M3041412780.4 780.79 3817 TAYYAB B BHUTTA MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000JIMMY HARRIS TRUCKING 8193 OLD COVINGTON HWY COVINGTON GA 30014 7707863585JIMMY HARRIS TRUCKING 8193 OLD COVINGTON HWY COVINGTON GA 30014 77078635857102026 04141203 LAURENCE STEINFELD,MD CO 1918 2283107131.1 I99 04141203 LAURENCE STEINFELD,MD I JASPER MEMORIAL HOSPITA 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 283107135.1 0000003800STRICKLAND ALYSSA J PO BOX 19 SHADY DALE GA 31085 706318450208061001000000000F3041512780.60 186 VARMA MEKA MD STRICKLAND AMBER PO BOX 19 SHADY DALE GA 31085 70631845022607554350100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000EL GIRO 1196 147TH STREET MONTICELLO GA 31064 70646888857102026 04141203 LAURENCE STEINFELD,MD CO 2018 2283107135.1 I99 04141203 LAURENCE STEINFELD,MD I JASPER MEMORIAL HOSPITA 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 283107367.1 0000002300BELL JOHNATHAN C 561 NORTHEAST STREET MONTICELLO GA 31064 706468040901149319259852771M0042312816.02 171 SHANNON T BARTON MD 0000000000 0140Y0017005236 170 BELL JEREMY 00000000000000000100 00000000000000000000 0000000000000000STUDENT 0000000000STUDENT 00000000007314026 04231201 FREDERICK S FALCHOOK,MCO 191918 OTHER1 PO BOX 1317 MATTHEWS NC 28106 2283107367.1 H99 04231201 FREDERICK S FALCHOOK,MH JASPER MEMORIAL HOSPITA 7314026 FINGERS 2 VIEWS 000100000023003 1JCBC 283107372.1 0000003800AMMONS DELORES LINDA 232 STROZ DR MONTICELLO GA 31064 706468988802155557254020005F0042312401.9 191 LAURA B MOORE MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007102026 04231202 JOHN H PENUEL,MD CO 1918 2283107372.1 H99 04231202 JOHN H PENUEL,MD H JASPER MEMORIAL HOSPITA 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 283107940.1 0000003800MORGAN JOHNNY R 1726 WEHUNT RD MONTICELLO GA 31064 706468625707118724252712656M3051012786.2 3817 TAYYAB B BHUTTA MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007102026 05101203 LAURENCE STEINFELD,MD CO 1918 2283107940.1 I99 05101203 LAURENCE STEINFELD,MD I JASPER MEMORIAL HOSPITA 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 28310815.1 0000003000FARMER TARA B PO BOX 31 OCONEE GA 31067 478552390010208031000000000F3042512813.43 101 THEODORE LEON YARBOR 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000 0000000000UNEMPLOYED 00000000007311026 04251202 JOHN H PENUEL,MD CO 1918 228310815.1 F330 04251202 JOHN H PENUEL,MD F WASHINGTON CO REGIONAL 7311026 WRIST COMPLETE 000100000030003 1JCBC 28311642.1 0000021100ROBERSON LATUOUCHE M 2348 WATERMELON RD TENNILLE GA 31089 478240944309166744000000000F0051112611.72 117 NORA MARIE HALL NP ROBERSON MICHELLE L 2348 WATERMELON RD TENNILLE GA 31089 47824094431135628070100 00000000000000000000 00000000000000000000 0000000000000000 0000000000UNEMPLOYED 00000000007705626 05111204 WILLIAM A WILLOUGHBY,MCO 1918 228311642.1 E215 05111204 WILLIAM A WILLOUGHBY,ME WASHINGTON CO REGIONAL 7705626 MAMMO DIAG BILATE000100000118003 228311642.1 E215 05111204 WILLIAM A WILLOUGHBY,ME WASHINGTON CO REGIONAL 7664526 ECHO,BREAST(S) (U000100000093003 1JCBC 28311850.1 0000003100GILMORE JOHNNY 504 EVANS STREET SANDERSVILLE GA 31082 478232081803174963000000000M3042912496 182 ROBERT B LITTLE MD 0000000000 0100 00000000000000000000 00000000000000000000 0000000000000000 0000000000UNEMPLOYED 00000000007101026 04291202 JOHN H PENUEL,MD CO 1918 228311850.1 F202 04291202 JOHN H PENUEL,MD F WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 1JCBC 283144627.1 0000017700RENFROE WILLIE 310 ELDER STREET SANDERSVILLE GA 31082 478552253408036644258136125M3012211428.0 786.05780.79 178 LISA A COUNSELL MD 0000000000 4001Y258136125 JF2 00000000000000000100 00000000000000000000 0000000000000000 0000000000DAIRYLANE 839 S HARRIS ST SANDERSVILLE GA 31082 47855224827101026 01171102 JOHN H PENUEL,MD CO 191818 BENEFIT PLANERS P.O. BOX 690450 SAN ANTONIO TX 78269-0450 2283144627.1 F037 01171103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 2283144627.1 F037 01171102 JOHN H PENUEL,MD F WASHINGTON CO REGIONAL 7045026 CT HEAD W/O CONTR000100000146003 1JCBC 283145078.1 0000012800RENFROE WILLIE 310 ELDER STREET SANDERSVILLE GA 31082 478552253408036644258136125M1012711428.0 401.9 178 LISA A COUNSELL MD 0000000000 4001Y258136125 JF2 00000000000000000100 00000000000000000000 0000000000000000 0000000000DAIRYLANE 839 S HARRIS ST SANDERSVILLE GA 31082 47855224827677026 01191102 JOHN H PENUEL,MD CO 191818 BENEFIT PLANERS P.O. BOX 690450 SAN ANTONIO TX 78269-0450 2283145078.1 D038 01191102 JOHN H PENUEL,MD D WASHINGTON CO REGIONAL 7677026 ECHO,RETROPERI,B-000100000128003 1JCBC 283145367.1 0000003100RENFROE WILLIE 310 ELDER STREET SANDERSVILLE GA 31082 478552253408036644258136125M3012711428.0 729.81 178 LISA A COUNSELL MD 0000000000 4001Y258136125 JF2 00000000000000000100 00000000000000000000 0000000000000000 0000000000DAIRYLANE 839 S HARRIS ST SANDERSVILLE GA 31082 47855224827101026 01271102 JOHN H PENUEL,MD CO 191818 BENEFIT PLANERS P.O. BOX 690450 SAN ANTONIO TX 78269-0450 2283145367.1 F041 01271102 JOHN H PENUEL,MD F WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 1JCBC 283146361.1 0000009969KNIGHT LAQUANNA 153 WESTBROOK ST APT J2 GORDON GA 31031 478251425107277931258336032F3021511723.1 V71.4 224 JOHN R MCLAREN MD 0000000000 4733 833656951 702030 00000000000000000000 00000000000000000000 0000000000000000CENTRAL STATE HOSPITAL VINSON HWY MILLEDGEVILLE GA 31061 0000000000CENTRAL STATE HOSPITAL VINSON HWY MILLEDGEVILLE GA 31061 00000000007212526 02151102 JOHN H PENUEL,MD BA 1918 UNITED HEALTHCARE STMRT PO BOX 740806 ATLANTA GA 30374 2283146361.1 C99 02151102 JOHN H PENUEL,MD C OCONEE REGIONAL MED CNT 7212526 CT CERVICAL SPINE000100000197003 2283146361.1 P95 05241102 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 2283146361.1 P95 05241102 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 4799 COMMERCIAL LOA 0001-0000097316 2283146361.1 P95 05241102 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 4733 UNITED HEALTHCARE PA000100000000004 1JCBC 283147787.1 0000003000JORDAN KIERRA M 210 RAILROAD STREET DAVISBORO GA 31018 478552963004169614000000000F3030511719.47 182 ROBERT B LITTLE MD BRIDGES JULIE A 210 RAILROAD STREET DAVISBORO GA 31018 47855296302535998914394YAPV24459710005 NOLAN DAVID MICHAEL 00000000000000000100 00000000000000000000 0000000000000000 0000000000OCONEE NURSING AGENCY 00000000007361026 03051103 LAURENCE STEINFELD,MD BA 19G818 GEORGIA FARM BUREAU PO BOX 7777 MACON GA 31209 2283147787.1 F054 03051103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7361026 ANKLE, COMPLETE 000100000030003 1JCBC 28315028.1 0000003100HOGHESSR B L HERITAGE INN 652 FERNCREST DSANDERSVILLE GA 31082 478552301504142883255380189M3022512285.9 2848 GINA DIANE KUBICZ M 0000000000 1145Y976881442 Y 00000000000000001103Y255380189A 00000000000000001148Y872608870 35040 HODGESSR B L 0000000000000000 0000000000FARMER SANDERSVILLE GA 31082 00000000007101026 02251201 FREDERICK S FALCHOOK,MCO 19181818EVERCARE GEORGIA P.O. BOX 31350 SALT LAKE CITY UT 84131-0350 MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 228315028.1 F401 02251201 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 1JCBC 283151145.1 0000026200BROOKS PATRICIA ANN 1285 BROWN TERRACE RD LOUISVILLE GA 30434 478625972405115951253139397F0032311611.72610.0 615 SHALU R TAYLOR WHNP 0000000000 5594YBBRXXPPA 404389 00000000000000004002Y253139397 00000000000000000100 0000007500000000 0000000000ZORLU MFG INC., LLC 741 KAOLIN ROAD ATTN: BRESANDERSVILLE GA 31082 478552151519000 PUNCTURE ASPIRATION OF CYST,BREAST 03231101 FREDERICK S FALCHOOK,MCO 19181818AETNA LIFE INS CO P. O. BOX 14079 LEXINGTON KY 40512 ZORLU MFG INC. LLC 710 MACON HIGHWAY ATTN: NENA MAYO WARRENTON GA 30828 2283151145.1 E059 03231101 FREDERICK S FALCHOOK,ME WASHINGTON CO REGIONAL 19000 PUNCTURE ASPIRATION000100000220003 2283151145.1 E059 03231101 FREDERICK S FALCHOOK,ME WASHINGTON CO REGIONAL 7694226 US GDNCE NEEDLE P000100000117003 2283151145.1 P116 02161201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000020004 2283151145.1 P115 03151201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000025004 2283151145.1 P416 07161201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000030004 1JCBC 283151174.1 0000020246MEEKS REBECCA P 447 SPRING LAKE RD SANDERSVILLE GA 31082 478552766111257040000000000F0020111239.6 104 MARK R HARVEY MD MEEKS REBECCA 447 SPRING LAKE RD SANDERSVILLE GA 31082 47855276612581920394001Y331030040001 00000000000000000303YXKC045A7385002 10451390MEEKS RODNEY N 00000000000000000100 0000000000000000 000000000015 SPEEDWAY SOUTH HARRIS ST SANDERSVILLE GA 31082 47855250807055326 02011103 LAURENCE STEINFELD,MD CO 19180118SOUTHCARE REPRICING P.O. BOX 8530 KANSAS CITY MO 64114-8530 BLUE CROSS 101 - PPO P.O. BOX 9907 ATTN: BLUE CROSS CLAIMS DEPT COLUMBUS GA 31908 2283151174.1 E042 02011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7055326 MRI BRAIN W & W/O000100000406003 2283151174.1 P00 07201103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4006 COMMERCIAL PAYMENT F000100000000004 2283151174.1 P00 07201103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4099 COMMERCIAL LOA 0001-0000203546 1JCBC 283151342.1 0000002600FLOOD ALIM W 2053 N JEFFERSON ST APT B MILLEDGEVILLE GA 31061 478453486501199219534259606M3020611723.1 719.42 224 JOHN R MCLAREN MD 0000000000 5423Y534259606 00000000000000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007307026 02061101 FREDERICK S FALCHOOK,MBA 191818 STATE FARM 3006-D HERITAGE RD STE D MILLEDGEVILLE GA 31061 2283151342.1 C99 02061101 FREDERICK S FALCHOOK,MC OCONEE REGIONAL MED CNT 7307026 ELBOW 2 VIEWS 000100000026003 1JCBC 283151865.1 0000001604CHAPMAN CARNARIA 420 SHOALS ROAD SPARTA GA 31087 478456397711220010000000000F3042311959.01959.11 3577 EWANE C NGONE MD CHAPMAN TWOI 420 SHOALS ROAD SPARTA GA 31087 47845639772593947590303YZCS6025322 STATESC CHAPMAN CARNARD E 00000000000000000100 00000000000000000000 0000000000000000 0000000000T T T SALON SPARTA GA 31087 47844499337045026 04231101 FREDERICK S FALCHOOK,MCO 201918 BCBS OF SOUTH CAROLINA P O BOX 100605 ATTN: BLUE CROSS CLAIMS DEPT COLUMBIA SC 29260-0605 2283151865.1 F071 04231101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7045026 CT HEAD W/O CONTR000100000146003 2283151865.1 F071 04231101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7110026 RIBS, UNILATERAL 000100000039003 2283151865.1 P98 05191101 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0347 BLUE SHIELD PYMT 000100000000004 2283151865.1 P98 05191101 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0399 BCBS LOA 0001-0000022966 2283151865.1 P98 05191101 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0347 BLUE SHIELD PYMT 000100000000004 2283151865.1 P317 01311201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 0240 NO PRE-CERT/AUTHO OB0001-0000146006 1JCBC 283152639.1 0000001456DOUGLAS GAYLE 647 FERNCREST DR APT 3D SANDERSVILLE GA 31082 478247645702165358000000000F0050511722.52 120 BRIDGETT C BAILEY DO 0000000000 1100Y550880271A 00000058250000004603Y550880271 00000000000000000100 0000000000000000 0000000000DISABLED 00000000007214826 05051104 WILLIAM A WILLOUGHBY,MCO 19181818MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 VA FEE BASIS 1826 VETERANS BLVD ATTN 136F DUBLIN GA 31021 2283152639.1 E076 05051104 WILLIAM A WILLOUGHBY,ME WASHINGTON CO REGIONAL 7214826 MRI LUM SPINE SCR000100000254003 2283152639.1 P99 05241104 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000058254 2283152639.1 P99 05241104 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000181196 2283152639.1 P317 07091204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1599 MEDICAID LOA 000100000000006 1JCBC 283154133.1 0000006100DICKSON MARCUS TYRONE 138 WALKER DAIRY ROAD WARTHEN GA 31094 478357954601207536000000000M0052911724.5 729.5 719.46 101 THEODORE LEON YARBOR 0000000000 4611Y1411813502 TILLMAN JAMES 00000000000000000100 00000000000000000000 0000000000000000 0000000000DIESEL DEPOT SANDERSVILLE GA 31082 47855295107359026 05291103 LAURENCE STEINFELD,MD CO 19G818 GEICO ONE GEICO CTR MACON GA 31201-0001 2283154133.1 E082 05291103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7359026 TIBIA & FIBULA 2 000100000029003 2283154133.1 E082 05291103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7356226 KNEE AP&LAT W/OBL000100000032003 1JCBC 283159095.1 0000019700LOVETT DEBORAH A 711 HAGAN CIR TENNILLE GA 31089 478552324812086545255218811F3081911719.46723.1 621 JAMES H TINLEY MD 00000000002552188115538YU3800441701 3331749 00000000000000000100 00000000000000000000 0000000000000000 0000000000MOHAWK COMMERCIAL CARPET MILLEDGEVILLE GA 31059 47827277117212526 08191103 LAURENCE STEINFELD,MD CO 191818 CIGNA HEALTHCARE P.O. BOX 182223 CHATTANOOGA TN 37422-7223 2283159095.1 F107 08191103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7212526 CT CERVICAL SPINE000100000197003 1JCBC 283159111.1 0000019400MONROE RONNIE L 6246 HWY 24 WEST SANDERSVILLE GA 31082 478232324511108129593095846M3081811959.09 621 JAMES H TINLEY MD MONROE RONNIE L P O BOX 5065 SANDERSVILLE GA 31082 47823232455930958460595Y593095846 00000000000000000100 00000000000000000000 0000000000000000 0000000000HOWARD SHEPPARD INC P.O. BOX 797 755 WACO DR SANDERSVILLE GA 31082 47855251277048626 08181103 LAURENCE STEINFELD,MD CO 191818 UNDERWRITTERS SAFYT T CLMS 5105 PAULSEN ST SAVANNAH GA 31405 2283159111.1 F107 08181103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7048626 CT MAXILLOFACIAL 000100000194003 1JCBC 283160149.1 0000001246DOUGLAS GAYLE 647 FERNCREST DR APT 3D SANDERSVILLE GA 31082 213400284702165358000000000F0090111722.52789.00788.20 120 BRIDGETT C BAILEY DO 00000000005508802711100Y550880271A 00000049800000004603Y550880271 00000000000000000100 0000000000000000 0000000000DISABLED 00000000007670526 09011103 LAURENCE STEINFELD,MD CO 19181818MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 VA FEE BASIS 1826 VETERANS BLVD ATTN 136F DUBLIN GA 31021 2283160149.1 E213 09011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7670526 ECHO,ABD,B-SCAN/R000100000101003 2283160149.1 E213 09011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7685626 ECHO, PELVIC, COM000100000120003 2283160149.1 P99 01231203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000049804 2283160149.1 P99 01231203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000158746 1JCBC 283160195.1 0000001570WEAVER CHARLES 6637 NEWS BRIDGE RD P O BOX 364 SANHARRISON GA 31035 478552296512264070259607904M0090711723.1 729.2 116 WILLIAM RAWLINGS,JR WEAVER CHARLES P O BOX 364 POBOX 364, S'SVSANDERSVILLE GA 31082 47855229652596079041100Y259607904A WEAVER CHARLES E 00000062780000005423YHE1655201111 00000000000000000100 0000000000000000 0000000000UNEMPLOYED/CONTRACTOR 00000000007214126 09071103 LAURENCE STEINFELD,MD CO 19181818MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 STATE FARM HEALTH INSURANCE P.O. BOX 3070 NEWARK OH 43058-3070 2283160195.1 E006 09071103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7214126. MRI CERV000100000275003 2283160195.1 P99 01231203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000062784 2283160195.1 P99 01231203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000196526 1JCBC 283161663.1 0000003022WARTHEN MARY J 7584 S SPARTA DSBORO RD WARTHEN GA 31094 478348306107105754000000000F0092011784.0 119 DAVID N HARVEY MD 0000000000 4207Y906455751 702030 WARTHEN MARY JULIA 00000000000000000100 00000065000000000000 0000000000000000 0000000000HANCOCK STATE PRISO SPARTA GA 31087 70644470777055326 09071103 LAURENCE STEINFELD,MD CO 191818 UNITED HEALTHCARE P O BOX 740806 ATLANTA GA 30374-0806 2283161663.1 E001 09071103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7055326 MRI BRAIN W & W/O000100000406003 2283161663.1 P95 10121103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4207 UHC PAYMENT 000100000000004 2283161663.1 P95 10121103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4299 COMMERCIAL LOA 0001-0000298746 2283161663.1 P95 10121103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4207 UHC PAYMENT 000100000000004 2283161663.1 P104 12011103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000010004 2283161663.1 P100 02101203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0169 BAL. TRANSFER CREDIT0001-0000012046 2283161663.1 P113 02131203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000010004 2283161663.1 P209 03091203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000025004 2283161663.1 P416 04161203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000010004 2283161663.1 P214 05141203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 0100 CASH PAYMENT 0001-0000010004 1JCBC 283162470.1 0000015600ROBERSON APRIL S 67 WIMBERLY COURT TENNILLE GA 31089 478247372804019219256718396F3101511789.00574.20789.07 101 THEODORE LEON YARBOR 0000000000 1500 111317402244 00000000000000000000 00000000000000000000 0000000000000000 0000000000SONIC 00000000007670526 09301102 JOHN H PENUEL,MD CO 1918 2283162470.1 F104 09301101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7670526 ECHO,ABD,B-SCAN/R000100000101003 2283162470.1 F404 09301102 JOHN H PENUEL,MD F WASHINGTON CO REGIONAL 7402226 ADB COMPLETE W/PA000100000055003 1JCBC 283164129.1 0000019400MILLS TYNESHIA J 519 SUNHILL ROAD SANDERSVILLE GA 31082 478553129107297635260375624F3102411789.00 111 RICHARD NELSON EATONMILLS TYNESHIA J 614 PEACHTREE STREET SANDERSVILLE GA 31082 47823263082603756241531Y4544617021 00000000000000000100 00000000000000000000 0000000000000000 0000000000UNEMPLOYED 00000000007670026 10241101 FREDERICK S FALCHOOK,MCO 191818 AMERIGROUP PO BOX 61010 VIRGINA BEACH VI 23466-1010 2283164129.1 F228 10241101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7670026 ECHO,ADB,B-SCAN/R000100000139003 2283164129.1 F228 10241101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7402226 ADB COMPLETE W/PA000100000055003 1JCBC 283164178.1 0000015800RYBACK DAVID S 108 RIVER N RD SE UNIT 8 MILLEDGEVILLE GA 31061 770778259908056150151667144M1082611789.00577.0 3523 JEFFERY I JOHNSON MD 0000000000 0347YXKA186A5419709 IP07158 00000000000000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 000000000074330 COMBINED ENDOSCOPIC CATH BILIARY & PANCREATI08261104 WILLIAM A WILLOUGHBY,MCO 191818 BLUE CROSS OF GEORGIA P O BOX 9907 COLUMBUS GA 31908 2283164178.1 A99 08261104 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 74330. COMBINED ENDOSCO000100000158003 1JCBC 283164282.1 0000010800DARRISAW KAY 50 SMITH ROAD P O BOX 73 TENNILLE GA 31089 478552292911185555259923795F0101811786.2 V76.12 102 ERIC S VON HOLTEN MD DARRISAW KAY G P O BOX 73 P O BOX 73 OCONEE GA 31067 47823272682599237954007Y323195388695 383650 00000000000000000303YHBX3HZN1565579075906000DARRISAWJR C 00000000000000000100 0000000000000000 0000000000WASHINGTON COUNTY RE P.O. BOX 636 610 SPARTA RSANDERSVILLE GA 31082 47824021257705226 10181103 LAURENCE STEINFELD,MD CO 19180118CONSUMERS LIFE INSURANCE CO P.O. BOX 94875 ATT BLUE CROSS CLAIMS DEPT CLEVELAND OH 44101-4875 BLUE CROSS 101 - PPO P.O. BOX 9907 ATTN: BLUE CROSS CLAIMS DEPT COLUMBUS GA 31908 2283164282.1 E101 10181103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7705226 COMPUTER AIDED DE000100000011003 2283164282.1 E101 10181103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 00 7705726 SCREENING MAMMOGR000100000097003 2283164282.1 E101 10181103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 00 3342F MAMMO ASSESSMENT BE000000000000003 2283164282.1 E101 10181103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 00 7025F PT REMINDER GIVEN F000000000000003 1JCBC 283164739.1 0000031600COLLIER DINEASHIA L UNKNOW MILLEDGEVILLE GA 31061 478445106001127734254297133F1110111300.9 724.5 786.50 174 OLUSHESAN M OGUNDIPE 0000000000 0347YXKC005018222 10463790 00000000000000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000 00000000007211026 11011104 WILLIAM A WILLOUGHBY,MCO 191818 BALDWIN COUNTY SHERIFF 119 OLD MONTICELLO RD MILLEDGEVILLE GA 31061 2283164739.1 A99 11011104 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7211026 LUMBORSACRAL SPIN000100000053003 2283164739.1 A99 11011104 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7845226 MYOCARDIAL PERFUS000100000263003 1JCBC 283165101.1 0000014600CHATMAN RUBY 5095 PUMPING STATION RD SPARTA GA 31087 706444624610243576254800451F1110711154.0 780.2 3531 MYSORE S SHILPA MD 0000000000 0112Y254800451A 00000000000000000100 00000000000000000000 0000000000000000RETIRED 0000000000RETIRED 00000000007045026 11071102 JOHN H PENUEL,MD CO 191818 MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 2283165101.1 A99 11071102 JOHN H PENUEL,MD A OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 1JCBC 283166512.1 0000005500CARTER LASHONDA C 228 STEEL CREEK RD DAVISBORO GA 31018 478348534101029120254799796F3111511789.07789.04 182 ROBERT B LITTLE MD 0000000000 4241YF00825622 FV1040 00000000000000000100 00000000000000000000 0000000000000000 0000000000FAMILY DOLLAR SANDERVILLE TECH SANDERSVILLE GA 31082 47855266327402226 11151101 FREDERICK S FALCHOOK,MCO 191818 NATIONWIDE INSURANCE P.O. BOX 1612 ALPHARETTA GA 30009 2283166512.1 F323 11151101 FREDERICK S FALCHOOK,MF WASHINGTON CO REGIONAL 7402226 ADB COMPLETE W/PA000100000055003 1JCBC 283166554.1 0000027500EAGLE STARLEXUS K 319 E CHURCH STREET R41 SANDERSVILLE GA 31082 478247427006020506000000000F0111611786.50724.1 124 CHRISTY M MOUNTAIN MDWALKER BRITTANY S 319 E CHURCH ST APT R41 SANDERSVILLE GA 31082 47824742702575395504028Y175641701 WALKER BRITTANY S 00000000000000001531Y711559177 00000000000000000100 0000000000000000 0000000000CVS DRUG STORE 642 S HARRIS ST SANDERSVILLE GA 31082 47855205597214626 11161101 FREDERICK S FALCHOOK,MCO 20191818PROGRESSIVE INS CO 3920 ARKWRIGHT RD SUITE 175 MACON GA 31210 AMERIGROUP PO BOX 61010 VIRGINA BEACH VI 23466-1010 2283166554.1 E323 11161101 FREDERICK S FALCHOOK,ME WASHINGTON CO REGIONAL 7214626 MRI THORACIC SPIN000100000275003 1JCBC 283167171.1 0000012000RAYFORD CLEVELAND WRIGHTSVILLE MANOR P O BOX 209 WRIGHTSVILLE GA 31096 478864228612042288248129935M1112911V55.1 562.10 4516 WILLIAM A REID MD RAYFORD CLEVELAND P O BOX 209 WRIGHTSVILLE GA 31096 47886422862481299351100Y248129935A 00000000000000004001Y248129935A 00000000000000001599Y111323122252 0000000000000000 0000000000UNEMPLOYED 00000000007427026 11291104 WILLIAM A WILLOUGHBY,MCO 19181818MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 WRIGHTSVILLE MANOR 608 W. COURT ST WRIGHTSVILLE GA 31096 2283167171.1 D202 11291104 WILLIAM A WILLOUGHBY,MD WASHINGTON CO REGIONAL 7427026 BARIUM ENEMA 000100000120003 1JCBC 283167251.1 0000003100BROWN HENRY ARTHUR 141 CAMELLIA LN, APT 32 SANDERSVILLE GA 31082 478357760902044863000000000M0112311401.9 719.47719.46 1512 KENT D FORD DO 0000000000 0100 00000031000000000000 00000000000000000000 0000000000000000 0000000000 RETIRED 00000000007361026 11231102 JOHN H PENUEL,MD CO 1918 2283167251.1 E329 11231102 JOHN H PENUEL,MD E WASHINGTON CO REGIONAL 7361026 ANKLE, COMPLETE 000100000030003 2283167251.1 E329 11231102 JOHN H PENUEL,MD E WASHINGTON CO REGIONAL 7356226 KNEE AP&LAT W/OBL000100000032003 2283167251.1 P314 02141202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000031004 1JCBC 283167570.1 0000026300WEST,JR AUSTIN E 151 W COOMBS AVE SE MILLEDGEVILLE GA 31061 478451090311235457257949672M1120211780.4 786.50 3599 MARIA R DEGUZMAN MD 0000000000 4503Y31131261311 WEST AUSTIN E 00000000000000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007845226 12021103 LAURENCE STEINFELD,MD CO 191818 AARPUNITED HEALTH CARE PO BOX 740819 ATLANTA FA 30374-0819 2283167570.1 A99 12021103 LAURENCE STEINFELD,MD A OCONEE REGIONAL MED CNT 7845226 MYOCARDIAL PERFUS000100000263003 1JCBC 283167742.1 0000001172MIXON MARY E 608 W COURT STREET WVILLE MANOR WRIGHTSVILLE GA 31096 478864228604272487252420246F1120511780.97486 434.91 178 LISA A COUNSELL MD 0000000000 1100Y252420246A 00000046880000000303YXKM016A6423501 IPO94770 00000000000000001599Y111227164153 0000000000000000 0000000000RETIRED SPRING CITY WRIGHTSVILLE GA 31096 00000000007101026 12051103 LAURENCE STEINFELD,MD CO 19181818MEDICARE P.O. BOX 9048 COLUMBUS GA 31908-9048 BLUE CROSS 101 P.O. BOX 9907 ATTN: BLUE CROSS CLAIMS DEPT COLUMBUS GA 31908 2283167742.1 D108 12051104 WILLIAM A WILLOUGHBY,MD WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 2283167742.1 D308 12031103 LAURENCE STEINFELD,MD D WASHINGTON CO REGIONAL 7045026 CT HEAD W/O CONTR000100000146003 2283167742.1 D308 12031103 LAURENCE STEINFELD,MD D WASHINGTON CO REGIONAL 7101026 CHEST,SINGLE VIEW000100000031003 2283167742.1 P199 12221103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000046884 2283167742.1 P199 12221103 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000149406 1JCBC 283167868.1 0000003100BUTTS HENRY L 512 REEVES STREET SANDERSVILLE GA 31082 478553944303204269256643599M3120211786.05V44.1 182 ROBERT B LITTLE MD BUTTS HENRY L 512 REEVES STREET SMITH MEDICAL NSANDERSVILLE GA 31082 47855394432566435994001Y256643599A 00000000000000001599Y111266974193 00000000000000000100 0000000000000000 0000000000DISABLED 00000000007400026 12021104 WILLIAM A WILLOUGHBY,MCO 19181818SMITH MEDICAL NURSING CENTER 501 EAST MCCARTY ST SANDERSVILLE GA 31082 MEDICAID P.O. BOX 5000 GHP MC RAE GA 31055 2283167868.1 F408 12021104 WILLIAM A WILLOUGHBY,MF WASHINGTON CO REGIONAL 7400026 ABDOMEN SINGLE VI000100000031003 1JCBC 283168322.1 0000003800HARRIS MORGAN 5893 TENNILLE OCONEE ROAD TENNILLE GA 31089 478552933505181001000000000F0121311786.05786.07 101 THEODORE LEON YARBORMERRELL APRIL 5893 TENNILLE OCONEE ROAD TENNILLE GA 31089 47855293352570602384061YJ00821748 SSL13796HARRISANDCHILDREN CHICO 00000000000000001533Y10183894 00000000000000000100 0000000000000000 0000000000LABCORP DUBLIN GA 31021 47827516177102026 12101101 FREDERICK S FALCHOOK,MCO 20191818STANDARD LIFE AND ACCIDENT IHC. P O BOX 21156 ST PAUL MN 55121 WELLCARE OF GEORGIA P. O. BOX 31372 P O BOX 21156 TAMPA FL 33631-3372 2283168322.1 E215 12101101 FREDERICK S FALCHOOK,ME WASHINGTON CO REGIONAL 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 283168409.1 0000039400BROWN DERRICK 503 COLLEGE STREET SANDERSVILLE GA 31082 478251764103055952256217025M3120911784.0 723.1 724.2 184 LANA S ONEAL MD 0000000000 4028Y563287881 00000000000000001599Y111178478104 00000000000000000100 0000000000000000 0000000000UNEMPLOYED 00000000007212526 12091103 LAURENCE STEINFELD,MD CO 19181818PROGRESSIVE INS CO 3920 ARKWRIGHT RD SUITE 175 GHP MACON GA 31210 MEDICAID P.O. BOX 5000 GHP MC RAE GA 31055 2283168409.1 F115 12091103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7212526 CT CERVICAL SPINE000100000197003 2283168409.1 F115 12091103 LAURENCE STEINFELD,MD F WASHINGTON CO REGIONAL 7213126 CT LUM SPINE W/O 000100000197003 1JCBC 283168432.1 0000010800LATTIMORE IRMA 819 IVEY LANE SANDERSVILLE GA 31082 478240087212035556000000000F0120111V76.12 119 DAVID N HARVEY MD 0000000000 5957Y258966644 00000000000000000100 00000000000000000000 0000000000000000 0000000000UNEMPLOYED 00000000007705726 12011103 LAURENCE STEINFELD,MD CO 191818 BREASTEST MAMMOGRAMS NORTH CENTRAL HEALTH DISTRICT 811 HEMLOCK STREET MACON GA 31201 2283168432.1 E115 12011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7705726 SCREENING MAMMOGR000100000097003 2283168432.1 E115 12011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 3342F MAMMO ASSESSMENT BE000000000000003 2283168432.1 E115 12011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7025F PT REMINDER GIVEN F000000000000003 2283168432.1 E115 12011103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7705226 COMPUTER AIDED DE000100000011003 1JCBC 283168473.1 0000001702HOUSTON SANDRA VERNELL 187 SILVERLEAF DR TENNILLE GA 31089 478240994206236348255290614F0120911V76.12722.52793.80 111 RICHARD NELSON EATON 0000000000 4207Y845981021 702030 HOUSTON SANDRA VERNE 00000096440000004002Y255290614 00000000000000004003YCLAIM530036 0000000000000000 0000000000DEPARTMENT OF TRANSP P.O. BOX 8 TENNILLE GA 31089 47855287397214826 12091103 LAURENCE STEINFELD,MD CO 19181818UNITED HEALTHCARE P O BOX 740806 ATLANTA GA 30374-0806 DEPARTMENT OF TRANSPORTATION MEDTOX LABORATORIES 402 WEST COUNTY RD D SAINT PAUL MN 55112 2283168473.1 E315 12091103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7214826 MRI LUM SPINE SCR000100000254003 2283168473.1 E115 12091103 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 7705526 MAMMOGRAM UNILATE000100000096003 2283168473.1 P95 01041203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4207 UHC PAYMENT 0001-0000096444 2283168473.1 P95 01041203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 4299 COMMERCIAL LOA 0001-0000236546 1JCBC 283168700.1 0000003800KENDRICK TREYLONE R 609 FERNCREST DRIVE APT LP O BOX 275 WARSANDERSVILLE GA 31082 478357078002271100000000000M0120711786.07 124 CHRISTY M MOUNTAIN MDGLADDIN CANDACE P O BOX 275 WARTHEN GA 31094 47835707802594946164014YGA006022361 GLADDIN CANDACE 00000000000000001531Y715369769 00000000000000000100 0000000000000000 0000000000UNEMPLOYED 00000000007102026 12071101 FREDERICK S FALCHOOK,MCO 20181818SOUTHERN GENERAL P.O. BOX 28155 ATLANTA GA 30358-0155 AMERIGROUP PO BOX 61010 VIRGINA BEACH VI 23466-1010 2283168700.1 E220 12071101 FREDERICK S FALCHOOK,ME WASHINGTON CO REGIONAL 7102026 CHEST,TWO VIEWS,F000100000038003 1JCBC 283168768.1 0000005300THOMPSON MELISSA ANN 3568 VEAL RD SANDERSVILLE GA 31082 478357521110268031257633049F0121511724.5 104 MARK R HARVEY MD THOMPSON MELISSA A 3568 VEAL RD SANDERSVILLE GA 31082 47835752112576330494801Y945753292 57899 00000000000000000303YHIB811170978 57899 THOMPSON MELISSA A 00000000000000000100 0000000000000000 0000000000HIBBETT SPORT VIDALIA GA 30474 91253732347211026 12151102 JOHN H PENUEL,MD CO 19181818ALLSTATE INSURANCE ALL STATE INSURANCE 26661 N COLUMBIA ST MILLEDGEVILLE GA 31061 BLUE CROSS 101 - PPO P.O. BOX 9907 ATTN: BLUE CROSS CLAIMS DEPT COLUMBUS GA 31908 2283168768.1 E720 12151102 JOHN H PENUEL,MD E WASHINGTON CO REGIONAL 7211026 LUMBORSACRAL SPIN000100000053003 1JCBC 28316918.1 0000003879KNOWLES KATHRYN L 6621 NEWS BRIDGE RD HARRISON GA 31035 478552157702135557000000000F0031512785.9 106 WENTZELLE KIM KITCHE 0000000000 5538YU4468456701 702030 KNOWLES KATHYRN L 00000000000000000100 00000000000000000000 0000000000000000 0000000000WASH STATE PRISON P.O. BOX 206 DAVISBORO GA 31018 47834858149388026 03151203 LAURENCE STEINFELD,MD CO 191818 CIGNA HEALTHCARE P.O. BOX 16531 COLUMBUS OH 43216-6531 228316918.1 E121 03151203 LAURENCE STEINFELD,MD E WASHINGTON CO REGIONAL 9388026 DUPLEX SCAN, EXTR000100000114003 228316918.1 P317 05091203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 5558 CIGNA PAYMENT 000100000000004 228316918.1 P317 05091203 LAURENCE STEINFELD,MD P PAYMENTS & ADJUSTMENT 5599 LIMIT OF ALLOWANCE W0001-0000075216 1JCBC 283169544.1 0000001503DEAL DEBRA 133 LATA TERACE PO BOX 1262 MILLEDGEVILLE GA 31059 478452492201185457252043353F1122911786.00729.5 780.97 2000 MINCS E CALIXTE MD 0000000000 1100Y252043353A 00000060090000000347YXKF025A75780 00000000000000000100 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000009397026 12291104 WILLIAM A WILLOUGHBY,MBA 19181818MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 BLUE CROSS OF GEORGIA P O BOX 9907 COLUMBUS GA 31908 2283169544.1 A99 12291104 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 9397026 U/S DOPPLER VENOU000100000126003 2283169544.1 A99 12291104 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7045026 CT HEAD W/O CONTR000100000146003 2283169544.1 P99 01171204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000033024 2283169544.1 P99 01171204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000104726 2283169544.1 P127 01271204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 0347 BLUE SHIELD PYMT 000100000000004 2283169544.1 P99 04091204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000027074 2283169544.1 P99 04091204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000092166 1JCBC 283169596.1 0000001997HISKY OLIVIA T 392 HENDERSON MILL RD COVINGTON GA 30014 678712968809022982000000000F3123111959.01959.19 3817 TAYYAB B BHUTTA MD 0000000000 1100Y461406299D 00000079850000000100 00000000000000000000 0000000000000000UNEMPLOYED 0000000000UNEMPLOYED 00000000007213126 12301101 FREDERICK S FALCHOOK,MCO 191818 MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 2283169596.1 I99 12301101 FREDERICK S FALCHOOK,MI JASPER MEMORIAL HOSPITA 7213126 CT LUM SPINE W/O 000100000197003 2283169596.1 I99 12301101 FREDERICK S FALCHOOK,MI JASPER MEMORIAL HOSPITA 7045026 CT HEAD W/O CONTR000100000146003 2283169596.1 I99 12301101 FREDERICK S FALCHOOK,MI JASPER MEMORIAL HOSPITA 7101026 CHEST,SINGLE VIEW000100000031003 2283169596.1 P99 01171201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000033024 2283169596.1 P99 01171201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000104726 2283169596.1 P99 04061201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000046834 2283169596.1 P99 04061201 FREDERICK S FALCHOOK,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000169466 1JCBC 283169814.1 0000085600MCDONALD JONATHAN 4588 PLEASANT PLAINS RD P O BOX 92 WRIGHTSVILLE GA 31096 478232524102128724258736552M1010312780.60787.02 104 MARK R HARVEY MD MCDONALD JONATHAN 4588 PLEASANT PLAINS ROAD WRIGHTSVILLE GA 31096 47823252412587365520100 00000090000000000000 00000000000000000000 0000000000000000 0000000000HARVEST TIME CABINETS GORDON GA 31031 00000000007822326 12271102 JOHN H PENUEL,MD CO 1918 2283169814.1 D505 12271102 JOHN H PENUEL,MD D WASHINGTON CO REGIONAL 7822326 HEPATOBILIARY IMA000100000299003 2283169814.1 P100 03051202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0168 BAL. TRANSFER DEBIT 000100000101005 2283169814.1 P100 03051202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0168 BAL. TRANSFER DEBIT 000100000515005 2283169814.1 P100 03051202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0168 BAL. TRANSFER DEBIT 000100000031005 2283169814.1 P305 03051202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000040004 2283169814.1 P326 03261202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000010004 2283169814.1 P324 04241202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000010004 2283169814.1 P324 04241202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000010004 2283169814.1 P013 06131202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 0104 PAYMENT, CREDIT CARD0001-0000020004 1JCBC 283170051.1 0000002381WOOD GLENDA T 730 BEAUMONT CIR MILLEDGEVILLE GA 31061 478452245001294368253606718F1010812434.91V58.81789.00786.05212 GEORGE E MARTINEZ MD 0000000000 1100Y253606718A 00000095180000000347YURYAN3236472 00600001WOOD BOBBY R 00000000000000000100 0000000000000000RETIRED 0000000000RETIRED 00000000007400026 01081204 WILLIAM A WILLOUGHBY,MCO 19180118MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 BLUE CROSS OF GEORGIA P O BOX 9907 COLUMBUS GA 31908 2283170051.1 A99 01051201 FREDERICK S FALCHOOK,MA OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 2283170051.1 A99 01061204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7417726 CT ABD & PELVIS W000100000304003 2283170051.1 A99 01061204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 2283170051.1 A99 01071204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7400026 ABDOMEN SINGLE VI000100000031003 2283170051.1 A99 01081204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7400026 ABDOMEN SINGLE VI000100000031003 2283170051.1 P99 01231204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000095184 2283170051.1 P99 01231204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000309016 1JCBC 283170165.1 0000001693WOOD GLENDA T 730 BEAUMONT CIR MILLEDGEVILLE GA 31061 478452245001294368253606718F1011112434.91553.20 212 GEORGE E MARTINEZ MD 0000000000 1100Y253606718A 00000067740000000347YURYAN3236472 00600001WOOD BOBBY R 00000000000000000100 0000000000000000RETIRED 0000000000RETIRED 00000000007417726 01111204 WILLIAM A WILLOUGHBY,MCO 19180118MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 BLUE CROSS OF GEORGIA P O BOX 9907 COLUMBUS GA 31908 2283170165.1 A99 01111204 WILLIAM A WILLOUGHBY,MA OCONEE REGIONAL MED CNT 7417726 CT ABD & PELVIS W000100000304003 2283170165.1 P99 01261204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000067744 2283170165.1 P99 01261204 WILLIAM A WILLOUGHBY,MP PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000219336 1JCBC 283170197.1 0000001374WOOD GLENDA T 730 BEAUMONT CIR MILLEDGEVILLE GA 31061 478452245001294368253606718F1011212434.91786.05 212 GEORGE E MARTINEZ MD 0000000000 1100Y253606718A 00000054950000000347YURYAN3236472 00600001WOOD BOBBY R 00000000000000000100 0000000000000000RETIRED 0000000000RETIRED 00000000007047026 01121202 JOHN H PENUEL,MD CO 19180118MEDICARE P O BOX 12847 BIRMINGHAM AL 35202-2847 BLUE CROSS OF GEORGIA P O BOX 9907 COLUMBUS GA 31908 2283170197.1 A99 01121202 JOHN H PENUEL,MD A OCONEE REGIONAL MED CNT 7047026 CT HEAD W/WO CONT000100000217003 2283170197.1 A99 01121202 JOHN H PENUEL,MD A OCONEE REGIONAL MED CNT 7101026 CHEST,SINGLE VIEW000100000031003 2283170197.1 P99 01301202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 1100 MEDICARE PAYMENT (PA0001-0000054954 2283170197.1 P99 01301202 JOHN H PENUEL,MD P PAYMENTS & ADJUSTMENT 1199 MEDICARE LOA 0001-0000179316 1JCBC 283170263.1 0000001604DARRISAW MARY P 201 ZETA ST TENNILLE GA 31089 478552085406246546252392380F3010512V76.12722.52 135 MOHAN PAPUDESU MD 0000000000 0303YXKC622A7647901 10530130DARRISAW MARY 00000000000000004007Y326564973380 393650 DARRISAW MARY 00000000000000000100 0000000000000000 0000000000WASHINGTON COUNTY RE P.O.