Provider Details
Texan Cardiovascular Institute PA
Primary Care Provider:
Yes
|
Specialty Type:
Internal Medicine
|
Tax
ID:
12-3456789
Provider Type:
Physician
In Network:
Yes
Accept New Patient:
Yes
Contact Information
Office Phone
Number:
(915) 216-8365
Office Fax
Number:
(915) 216-8745
Clinic
Email:
jason.doe@gmail.com
Clinic
Address:
7924 Gateway East Blvd,
EL PASO, TX, USA
79915
| Claim Number | Member | Member ID | Date of Service | Status | Total Charge | Allowed Charge | Member Responsibility | Five Point Responsibility |
|---|---|---|---|---|---|---|---|---|
| 222-027-R-000168-005 | John Smith | 2547895 | 1/17/2024 | In Process | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
| 222-027-R-000168-010 | Michael Brown | 9587489 | 1/17/2024 | Paid | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
| 222-027-R-000168-025 | James Anderson | 2547896 | 1/17/2024 | Denied | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
| 222-027-R-000168-040 | Amelia Clark | 7895478 | 1/17/2024 | Paid | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
| 222-027-R-000168-105 | Ella King | 9854789 | 1/17/2024 | In Process | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
| 222-027-R-000168-085 | Amelia Clark | 3685478 | 1/17/2024 | Denied | $1,344.00 | $0.0 | $1,344.00 | $0.0 |
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| Patient Name | Member ID | Date of Birth | Home Phone | Plan Status | |
|---|---|---|---|---|---|
| Emma Bold | 2547895 | 1/17/1985 | (915) 216-8365 | emma@intenso.com | Active |
| Ana Crown | 2547896 | 10/25/1986 | (915) 254-9875 | ana.cf@limtel.com | Active |
| Robert Doe | 7895478 | 8/12/1990 | (915) 965-4789 | robert@benko.com | Active |
| John Miller | 9854789 | 11/18/1995 | (915) 317-8957 | miller@mapple.com | Active |
| Max Smith | 3685478 | 2/17/1998 | (915) 325-1458 | max@kt.com | Active |