Your claims file has now been processed by Office Ally, claims that are accepted

below have been forwarded to the appropriate payer(s)for final processing.

Processing results for your claim file are as follows.

==============================================================================
The file 1074231381_03.31.23.txt was split into 4 file(s)
for processing. These file(s) are:

File ID Payer (PayerID) Claims Totals

------------------------------------------------------------------------------
1074243641 WEBTPA (75261) 1 $115.00
1074243642 BCBSofOklahoma(HCSC) (00840) 28 $5,720.00
1074243643 MedicareOklahoma (04312) 18 $1,130.00
1074243644 HealthChoiceOklahoma (71064) 2 $230.00
Total:
$7,195.00
==============================================================================

Claims Upload File Summary

File Name:1074231381_03.31.23.txt
Date Uploaded: 4/21/2023
Type of File: HCFA
Date Processed: 4/21/2023
44 # of Claims Initially Accepted
5 # of Claims Rejected
+---> 1 # errors FE144 - Diagnosis code 8(H) is not billable (further
specification required)
+---> 2 # errors FE357 - Subscriber Zip Invalid For State
+---> 2 # errors LC1762 - Claim Missing Diagnosis Codes

==============================================================================

===================================================================================
===============================================================================
-------ERROR CLAIM DETAIL
-----------------------------------------------------------------------------------
-------------------------------------------------------------------------------
CLAIM# OA CLAIMID PATIENT ID LAST,FIRST DOB FROM DOS TO
DOS CPT DIAG TAX ID ACCNT# PHYS.ID PAYER ERRORS
-----------------------------------------------------------------------------------
-------------------------------------------------------------------------------
1) 3035833982 442429260A HARRIS JACQULYN 04/11/1942 03/27/2023
03/29/2023 98941 274670303 1728 1316244064 04312 LC1762

2) 3035834019 HBT838873545 NEWCOMB STACEY 10/31/1966 03/29/2023

03/29/2023 98941 274670303 28568 1316244064 00840 LC1762

3) 3035834044 F4WH33620527 DYSART CHET 07/12/1982 03/27/2023

03/27/2023 98941 M532X7 274670303 29673 1316244064 00840 FE144

4) 3035834104 HBT837392504 BARNARD MARIA 06/22/1964 03/27/2023

03/29/2023 98941 M5136 274670303 30530 1316244064 00840 FE357

5) 3035834108 YUQ927929913 HILL RICHARD 07/23/1976 03/28/2023

03/28/2023 98941 M4722 274670303 30548 1316244064 00840 FE357
===================================================================================
===============================================================================

===================================================================================
===============================================================================
-------ACCEPTED CLAIM DETAIL
-----------------------------------------------------------------------------------
-------------------------------------------------------------------------------
CLAIM# OA CLAIMID PATIENT ID LAST,FIRST DOB FROM DOS TO
DOS CPT DIAG TAX ID ACCNT# PHYS.ID PAYER
-----------------------------------------------------------------------------------
-------------------------------------------------------------------------------
6) 3035834050 0006632971 BYRD JACKSON 11/30/1999 03/30/2023
03/30/2023 98941 M9901 274670303 30260 1316244064 75261
7) 3035833974 YUP845919900 ENSEY TELISE 01/26/1979 03/28/2023
03/30/2023 97140 M5010 274670303 883 1316244064 00840
8) 3035833984 HBT846634565 STEPHENSON JEREMY 01/16/1983 03/28/2023
03/28/2023 98941 M47897 274670303 1784 1316244064 00840
9) 3035833987 HBT903427142 GLOVER JUSTIN 10/30/1981 03/27/2023
03/27/2023 98941 M5137 274670303 2502 1316244064 00840
10) 3035834004 YUQ927814368 LOLAR KRISTA 05/24/1982 03/27/2023
03/30/2023 97110 M4306 274670303 27322 1316244064 00840
11) 3035834006 YUQ927814368 LOLAR KRISTA 05/24/1982 03/30/2023
03/30/2023 97112 M4306 274670303 27322 1316244064 00840
12) 3035834007 HBT828505060 SHOCKLEY TREY 05/08/1991 03/27/2023
03/27/2023 97110 M47814 274670303 27323 1316244064 00840
13) 3035834011 HBT903426246 JACKSON MICHAEL 01/10/1963 03/30/2023
03/30/2023 98941 M4306 274670303 28062 1316244064 00840
14) 3035834014 YET800754348 MILLER RYLAN 11/15/2005 03/27/2023
03/29/2023 98941 M25572 274670303 28174 1316244064 00840
15) 3035834022 HBT834905202 WALKER REGINALD 04/16/1963 03/29/2023
03/29/2023 98941 M4306 274670303 28575 1316244064 00840
16) 3035834024 HBT820512391 MARTINEZ SHEEYLA 07/28/1994 03/28/2023
03/28/2023 98941 M532X7 274670303 28918 1316244064 00840
17) 3035834030 YUN837303991 JENKINS BRAD 11/18/1987 03/28/2023
03/28/2023 98941 M5136 274670303 29214 1316244064 00840
18) 3035834033 YUP836746881 HOLMES MATTHEW 08/12/1972 03/29/2023
03/29/2023 98941 M532X7 274670303 29395 1316244064 00840
19) 3035833977 5CX5U50QY56 WEBER JACKIE 03/13/1954 03/28/2023
03/28/2023 98940 M9901 274670303 1058 1316244064 04312
20) 3035834037 HBT843125170 REYNOLDS SPENCE 03/19/1980 03/28/2023
03/28/2023 98941 G44209 274670303 29608 1316244064 00840
21) 3035834048 HBT820655098 PRICE CASEY 07/10/1989 03/28/2023
03/28/2023 98941 M4302 274670303 30013 1316244064 00840
22) 3035834052 HBT834576095 SEVCIK KENDALL 10/08/1994 03/28/2023
03/30/2023 97530 M9903 274670303 30321 1316244064 00840
23) 3035834057 HBT903856776 BEENE BRANDON 11/18/1977 03/29/2023
03/29/2023 98941 M4306 274670303 30369 1316244064 00840
24) 3035834061 YUH822485773 RYAN MIKE 04/08/1965 03/29/2023
03/30/2023 98941 M4726 274670303 30373 1316244064 00840
25) 3035834067 YUQ947061901 CONDIT AUDI 08/26/1989 03/28/2023
03/28/2023 98941 M5136 274670303 30389 1316244064 00840
26) 3035834071 HBT837525170 PAYNE BRETT 05/19/1982 03/28/2023
03/28/2023 98941 M9901 274670303 30471 1316244064 00840
27) 3035834075 YUN822052442 MARMADUKE KRISTEN 07/26/1990 03/30/2023
03/30/2023 98941 M40292 274670303 30480 1316244064 00840
28) 3035834082 R59845530 AMELO SHELLY 12/01/1971 03/27/2023
03/27/2023 98941 M4316 274670303 30486 1316244064 00840
29) 3035834090 HBT830642838 MUNOZ ELINOR 10/18/1981 03/29/2023
03/29/2023 98941 M532X7 274670303 30500 1316244064 00840
30) 3035834097 YUN834911616 HAMMACK KEVIN 09/07/1971 03/30/2023
03/30/2023 98941 M4304 274670303 30528 1316244064 00840
31) 3035834106 HBT903426873 ARMSTRONG PAM 08/09/1958 03/28/2023
03/30/2023 98941 M4302 274670303 30541 1316244064 00840
32) 3035833978 7CW8GT7PA65 BELL RITA 04/29/1951 03/27/2023
03/27/2023 98940 M9902 274670303 1282 1316244064 04312
33) 3035833981 4YP1HX4QE13 WILCOX BYRON 08/26/1948 03/29/2023
03/29/2023 98940 M9901 274670303 1444 1316244064 04312
34) 3035833989 1QA2JQ0UW06 BROWN D"ANN 09/25/1957 03/29/2023
03/29/2023 98940 M532X7 274670303 4230 1316244064 04312
35) 3035833999 5UE5Q32AF56 DAVIS EDNA 03/23/1941 03/28/2023
03/28/2023 98940 M47893 274670303 4342 1316244064 04312
36) 3035834001 04187825 HOUCK AUBREY 11/04/1994 03/30/2023
03/30/2023 98941 M4126 274670303 4870 1316244064 71064
37) 3035834009 8H56TX4EC45 KALK (E) ALAINE 03/23/1950 03/27/2023
03/27/2023 98940 M9903 274670303 27781 1316244064 04312
38) 3035834012 2Q25H52QE83 GADDIS JAN 03/15/1946 03/29/2023
03/29/2023 98940 M9901 274670303 28167 1316244064 04312
39) 3035834015 5G47T91XH59 GOSSETT SHERRY 03/08/1954 03/27/2023
03/27/2023 98940 M9901 274670303 28183 1316244064 04312
40) 3035834016 6N14CV5EC71 JONES PRISCILLA 09/15/1963 03/27/2023
03/27/2023 98940 M9901 274670303 28523 1316244064 04312
41) 3035834020 04018531 TARRANT KASEY 03/18/1986 03/28/2023
03/28/2023 98941 M9901 274670303 28574 1316244064 71064
42) 3035834026 4CJ0V21MX34 BROWN NELSON 10/09/1964 03/30/2023
03/30/2023 98940 M9901 274670303 29073 1316244064 04312
43) 3035834028 4QQ3CG3GH87 STAGNER DEBBIE 12/24/1954 03/29/2023
03/29/2023 98940 M9903 274670303 29174 1316244064 04312
44) 3035834032 6DD8U75FN41 CRAIN LORETTA 03/25/1950 03/27/2023
03/27/2023 97110 G609 274670303 29236 1316244064 04312
45) 3035834035 9W98M12FG33 WILLIAMS MELVA 05/07/1937 03/28/2023
03/30/2023 98940 M9903 274670303 29442 1316244064 04312
46) 3035834039 2JX2EA3EN27 STEWART JAMES 02/13/1949 03/27/2023
03/27/2023 98940 M9903 274670303 29640 1316244064 04312
47) 3035834054 8Y34KX4YM91 HARPER MIKE 11/26/1952 03/28/2023
03/28/2023 97530 M4726 274670303 30365 1316244064 04312
48) 3035834069 9QX9CK3CC20 HART DARRELL 04/24/1949 03/27/2023
03/27/2023 98940 M9903 274670303 30413 1316244064 04312
49) 3035834074 3E04WF5YW86 JOHNSON LAURA 02/08/1940 03/29/2023
03/29/2023 98940 M9901 274670303 30476 1316244064 04312
===================================================================================
===============================================================================

==============================================================================
This summary is regarding the master file with fileID:1074231381
please track each individual file by their unique file ID.
==============================================================================
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