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 1076993880_04.07.23.txt was split into 3 file(s)
for processing. These file(s) are:

File ID Payer (PayerID) Claims Totals

------------------------------------------------------------------------------
1076994511 BCBSofOklahoma(HCSC) (00840) 26 $4,315.00
1076994512 MedicareOklahoma (04312) 22 $1,590.00
1076994513 HealthChoiceOklahoma (71064) 5 $575.00
Total:
$6,480.00
==============================================================================

Claims Upload File Summary

File Name:1076993880_04.07.23.txt
Date Uploaded: 4/28/2023
Type of File: HCFA
Date Processed: 4/28/2023
49 # of Claims Initially Accepted
4 # of Claims Rejected
+---> 1 # errors FE144 - Diagnosis code 8(H) is not billable (further
specification required)
+---> 1 # errors FE357 - Subscriber Zip Invalid For State
+---> 1 # errors LC1762 - Claim Missing Diagnosis Codes
+---> 1 # errors RC66 - Claim Contains Invalid Diagnosis Code References in
Line Items

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

===================================================================================
===============================================================================
-------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) 3042239576 5HJ6UT8VQ48 WILDER STEPHEN LYNN 06/03/1946 04/05/2023
04/05/2023 98940 M9903 274670303 1725 1316244064 04312 FE144

2) 3042239579 442429260A HARRIS JACQULYN 04/11/1942 04/03/2023

04/04/2023 98941 274670303 1728 1316244064 04312 LC1762

3) 3042239637 3A39GH3NC33 JAMIN DAVID 12/30/1952 04/06/2023

04/06/2023 98940 M9901 274670303 30391 1316244064 04312 RC66

4) 3042239663 HBT837392504 BARNARD MARIA 06/22/1964 04/03/2023

04/05/2023 98941 M5136 274670303 30530 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
-----------------------------------------------------------------------------------
-------------------------------------------------------------------------------
5) 3042239568 YUN843810637 SMITH ROGER 08/22/1960 04/05/2023
04/05/2023 97110 M25672 274670303 291 1316244064 00840
6) 3042239569 YUP845919900 ENSEY TELISE 01/26/1979 04/03/2023
04/04/2023 97530 M5010 274670303 883 1316244064 00840
7) 3042239570 YUP845919900 ENSEY TELISE 01/26/1979 04/05/2023
04/05/2023 97530 M5010 274670303 883 1316244064 00840
8) 3042239580 HBT846634565 STEPHENSON JEREMY 01/16/1983 04/03/2023
04/04/2023 98941 M47897 274670303 1784 1316244064 00840
9) 3042239582 HBT903427142 GLOVER JUSTIN 10/30/1981 04/04/2023
04/04/2023 98941 M5137 274670303 2502 1316244064 00840
10) 3042239584 YUP831970237 CHURCHMAN BRIAN 12/04/1967 04/05/2023
04/05/2023 98941 M47893 274670303 3721 1316244064 00840
11) 3042239588 YUQ927814368 LOLAR KRISTA 05/24/1982 04/03/2023
04/03/2023 97110 M4306 274670303 27322 1316244064 00840
12) 3042239593 HBT903426246 JACKSON MICHAEL 01/10/1963 04/04/2023
04/04/2023 98941 M4306 274670303 28062 1316244064 00840
13) 3042239596 YET800754348 MILLER RYLAN 11/15/2005 04/03/2023
04/03/2023 98941 M25572 274670303 28174 1316244064 00840
14) 3042239601 HBT823949103 TAYLOR KRISTOFER 11/02/1994 04/03/2023
04/03/2023 98941 M4306 274670303 28868 1316244064 00840
15) 3042239602 MPI01387965Q ASKINS ADRIAN 10/06/1978 04/04/2023
04/04/2023 98941 M4302 274670303 28871 1316244064 00840
16) 3042239603 YUP832509604 HICKMAN BRIAN 09/29/1990 04/04/2023
04/04/2023 98941 M9901 274670303 29147 1316244064 00840
17) 3042239604 YUN837303991 JENKINS BRAD 11/18/1987 04/03/2023
04/03/2023 98941 M5136 274670303 29214 1316244064 00840
18) 3042239610 HBT843125170 REYNOLDS SPENCE 03/19/1980 04/04/2023
04/04/2023 98941 G44209 274670303 29608 1316244064 00840
19) 3042239571 5U18F58JR53 HODGES DIXIE (JW) 06/06/1948 04/05/2023
04/05/2023 98940 M9903 274670303 1276 1316244064 04312
20) 3042239572 7CW8GT7PA65 BELL RITA 04/29/1951 04/04/2023
04/04/2023 98940 M9902 274670303 1282 1316244064 04312
21) 3042239573 2NY2KW3FC00 HOWELL PHYLLIS 05/07/1949 04/06/2023
04/06/2023 98940 M9901 274670303 1406 1316244064 04312
22) 3042239615 YUP836746881 HOLMES JANIS 01/17/1969 04/03/2023
04/03/2023 98941 M9903 274670303 29824 1316244064 00840
23) 3042239616 HBT903711036 ELSER JAY 07/17/2002 04/06/2023
04/06/2023 98941 M4302 274670303 29884 1316244064 00840
24) 3042239619 HBT820655098 PRICE CASEY 07/10/1989 04/04/2023
04/04/2023 98941 M4302 274670303 30013 1316244064 00840
25) 3042239622 HBT834576095 SEVCIK KENDALL 10/08/1994 04/03/2023
04/03/2023 97530 M9903 274670303 30321 1316244064 00840
26) 3042239624 HBT903856776 BEENE SIERA 01/27/2005 04/05/2023
04/05/2023 98941 M9903 274670303 30344 1316244064 00840
27) 3042239625 CJT903422664 MCDANIEL BRENDA 06/15/1957 04/04/2023
04/04/2023 97530 M4726 274670303 30354 1316244064 00840
28) 3042239627 YUH822485773 RYAN MIKE 04/08/1965 04/04/2023
04/04/2023 98941 M4726 274670303 30373 1316244064 00840
29) 3042239636 YUQ947061901 CONDIT AUDI 08/26/1989 04/04/2023
04/04/2023 98941 M5136 274670303 30389 1316244064 00840
30) 3042239640 HBT837525170 PAYNE BRETT 05/19/1982 04/04/2023
04/04/2023 98941 M9901 274670303 30471 1316244064 00840
31) 3042239662 HBT830642838 MUNOZ ELINOR 10/18/1981 04/04/2023
04/04/2023 98941 M532X7 274670303 30500 1316244064 00840
32) 3042239665 HBT903426873 ARMSTRONG PAM 08/09/1958 04/03/2023
04/03/2023 98941 M4302 274670303 30541 1316244064 00840
33) 3042239581 5VP5XQ6CK98 MCLAIN JAMIE 09/29/1953 04/05/2023
04/05/2023 98940 M4722 274670303 2229 1316244064 04312
34) 3042239583 9J77G15AK34 LILES JANICE 11/13/1951 04/05/2023
04/05/2023 98940 M9903 274670303 3297 1316244064 04312
35) 3042239585 6QJ1DF0NV11 EARNHART VICKIE 06/23/1943 04/06/2023
04/06/2023 98940 M9903 274670303 4847 1316244064 04312
36) 3042239589 03866470 MCREYNOLDS MARY 07/12/1978 04/05/2023
04/05/2023 98941 M5136 274670303 27407 1316244064 71064
37) 3042239590 8H56TX4EC45 KALK (E) ALAINE 03/23/1950 04/03/2023
04/03/2023 98940 M9903 274670303 27781 1316244064 04312
38) 3042239592 04062027 HERREN JANET 12/28/1983 04/05/2023
04/05/2023 98941 M9903 274670303 28014 1316244064 71064
39) 3042239595 4VP0GM6CK18 CASTLEMAN WYVONA 06/24/1947 04/06/2023
04/06/2023 98941 M9901 274670303 28142 1316244064 04312
40) 3042239597 7FV6R35UM64 WATERS BARBARA 05/03/1953 04/05/2023
04/05/2023 98940 M9901 274670303 28443 1316244064 04312
41) 3042239598 1CH3VR4DD07 WATERS EDWARD 01/13/1959 04/05/2023
04/05/2023 98940 M9903 274670303 28452 1316244064 04312
42) 3042239599 5C15TK3PV65 PARRISH JERRETTA 05/13/1950 04/04/2023
04/04/2023 98940 M9903 274670303 28465 1316244064 04312
43) 3042239600 03686752 STONE SCOTT 01/30/1959 04/03/2023
04/03/2023 98941 M4302 274670303 28677 1316244064 71064
44) 3042239605 8U96RM1MJ55 MABRY RECIL 04/04/1957 04/05/2023
04/05/2023 98940 M532X7 274670303 29394 1316244064 04312
45) 3042239606 9W98M12FG33 WILLIAMS MELVA 05/07/1937 04/06/2023
04/06/2023 98940 M9903 274670303 29442 1316244064 04312
46) 3042239608 04190580 WREN KELSEY 03/09/1998 04/03/2023
04/03/2023 98941 M9901 274670303 29544 1316244064 71064
47) 3042239609 04057865 DYSART ELIZABETH 11/11/1986 04/05/2023
04/05/2023 98941 M4302 274670303 29580 1316244064 71064
48) 3042239614 4UQ9FA3NV56 ELDREDGE JUDY 02/16/1942 04/04/2023
04/04/2023 98940 M9903 274670303 29613 1316244064 04312
49) 3042239617 3WJ3WK9GX74 SIMMONS DIANNA 02/07/1957 04/04/2023
04/04/2023 98940 M5010 274670303 29900 1316244064 04312
50) 3042239621 4AN5HQ1QJ86 WALKER WADE 09/22/1956 04/05/2023
04/05/2023 97110 M9901 274670303 30300 1316244064 04312
51) 3042239626 8Y34KX4YM91 HARPER MIKE 11/26/1952 04/04/2023
04/04/2023 97530 M4726 274670303 30365 1316244064 04312
52) 3042239638 9QX9CK3CC20 HART DARRELL 04/24/1949 04/04/2023
04/06/2023 98940 M9903 274670303 30413 1316244064 04312
53) 3042239639 2AA5RH7MU83 BISHOP GARY 06/16/1948 04/05/2023
04/05/2023 98940 M9901 274670303 30455 1316244064 04312
===================================================================================
===============================================================================

==============================================================================
This summary is regarding the master file with fileID:1076993880
please track each individual file by their unique file ID.
==============================================================================
-----------------------------------------------------------------------------------
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