|
---- > |
1000 |
02/14/2008 |
2/21/2011 8:16:54 AM |
| |
|
|
|
| |
|
02142008 |
|
| |
|
test,
tester
n |
|
| |
|
kkjlaskdf;alsflkajlk |
|
| |
|
lkjalkjflkj,
ga
12345 |
|
| |
|
123456767
|
12345667 |
| |
|
23451245145
|
2342351 |
| |
|
040417
|
Male |
| |
|
123456789 |
|
| |
|
Yes |
|
| |
|
Medicaid - Mcade
|
12311241 |
| |
|
|
432523542 |
| |
|
12 |
|
| |
|
fdgfgadads |
|
| |
|
asdfaefadefdf |
|
|
|
---- > |
1000 |
04/22/2008 |
7/19/2011 7:38:13 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CANELI
MARAN |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-66-547 |
| |
|
08-08-1982
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
RES 78 STATE STREET COMMERCE GA 30529 |
|
| |
|
HOSP. BJC COMMERCE GA 30529 |
|
|
|
---- > |
1000 |
04/21/2008 |
7/19/2011 7:40:42 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
HOPE ,
ELIZABETH
LEIGH |
|
| |
|
1954 HWY 51 SOUTH |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353-26-0432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE GA MED CENTER GAINESVILLE GA 30501 |
|
|
|
---- > |
1000 |
04/07/2008 |
7/19/2011 7:43:14 AM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
STEVENS,
ANN
MARIE |
|
| |
|
25 SCENIC DRIVE |
|
| |
|
HOSCHTON,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/071970
|
Female |
| |
|
123-78-9200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
HWY 60 & HWY 124 BRASELTON GA 30417 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
1000 |
07/28/2008 |
7/19/2011 7:45:49 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
GRAGG,
DOTTIE
P. |
|
| |
|
1625 BLUEBERRY LANE |
|
| |
|
ALTO ,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12/06/1993
|
Female |
| |
|
247-60-5863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER ST. CLARKESVILLE GA 30523 |
|
| |
|
NE GA MED CTR GAINESVILLE GA 30501 |
|
|
|
---- > |
1000 |
04/29/1998 |
7/19/2011 7:48:21 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
WOMELSDORF,
BILL
N |
|
| |
|
55 STATE ST |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04/11/1967
|
Male |
| |
|
123-946-3377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278A |
| |
|
14 |
|
| |
|
864 SILVER SHOALS RD NORCROSS GA 30113 |
|
| |
|
GWINNETTE MEDICAL CENTER NORCROSS GA 30449 |
|
|
|
---- > |
1000 |
04/21/2008 |
7/19/2011 7:50:14 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GRIFFITH,
KATRINKA
DENISE |
|
| |
|
3132 SAMPLE SCALES RD |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-677-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253-80-2859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 SAMPLE SCALES RD HOMER GA |
|
| |
|
NE GA MEDICAL CENTER GAINESVILLE GA |
|
|
|
---- > |
1000 |
04/21/2008 |
7/19/2011 7:52:04 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDINER,
HOLLY
MCDANIEL |
|
| |
|
1288 ERVIN CHAMBERS RD |
|
| |
|
MASYVILLE,
GA
30558 |
|
| |
|
706-677-3863
|
706-335-1419 |
| |
|
706-499-9442
|
706-336-8405 |
| |
|
04/23/1956
|
Female |
| |
|
249-26-7942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
7494627493 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
1000 |
05/01/2008 |
7/19/2011 7:54:13 AM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
R |
|
| |
|
125 MILLSTONE DRIVE |
|
| |
|
COMMERCE,
GA
30530 |
|
| |
|
706-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08-08-1942
|
Female |
| |
|
423-25-8950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DRIVE COMMERCE GA 30530 |
|
| |
|
NEGMC GAINESVILLE GA 30501 |
|
|
|
---- > |
1000 |
04/21/2008 |
7/19/2011 7:56:26 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
RHOLETTER,
HOPE
ASHLEY |
|
| |
|
912 WESLEY CHAPEL RD |
|
| |
|
DANIELSVILLE,
GA
30533 |
|
| |
|
706-789-0100
|
706-335-0123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369-41-2837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 HWY 98 DANIELSVILLE GA 30533 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
1000 |
04/22/2008 |
7/19/2011 7:58:16 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS ,
CANELI
MARAN |
|
| |
|
55 STATES STREET |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-879
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA. 30529 |
|
|
|
---- > |
1000 |
07/26/2011 |
7/26/2011 2:37:58 PM |
| |
|
|
|
| |
|
07/26/2011 |
|
| |
|
WEHUNT,
KAREN
DENISE |
|
| |
|
221 GLENN FULLER CIRCLE |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
770-530-6546
|
|
| |
|
770-530-6546
|
|
| |
|
02/09/1961
|
Female |
| |
|
253963201 |
|
| |
|
No |
|
| |
|
None Listed
|
|
| |
|
|
|
| |
|
75 |
|
| |
|
221 GLENN FULLER CIRCLE COMMERCE GA 30529 |
|
| |
|
2200 MAIN STREET ATLANTA GA 30518 |
|
|
|
---- > |
1000 |
10/08/2011 |
10/8/2011 6:53:41 PM |
| |
|
|
|
| |
|
10/02/2011 |
|
| |
|
MARTINEZ,
MICHELLE
LEWIS |
|
| |
|
115 VALLEY VIEW DR |
|
| |
|
JEFFERSON,
GA
30549 |
|
| |
|
706-387-5234
|
706-677-2293 |
| |
|
813-610-4662
|
706-677-9321 |
| |
|
07/02/1969
|
Female |
| |
|
594142036 |
|
| |
|
Yes |
|
| |
|
Aflac
|
123456 |
| |
|
|
321654 |
| |
|
112 |
|
| |
|
bjc |
|
| |
|
athens regional |
|
|
|
---- > |
1000 |
4/22/08 |
1/30/2012 12:15:15 PM |
| |
|
|
|
| |
|
4/10/08 |
|
| |
|
EVANS,
CAMELIA
MARAN |
|
| |
|
SS STATE STREET |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
7063355126
|
706555878 |
| |
|
706888-876
|
70666-547 |
| |
|
8-8-82
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
6543674881 |
| |
|
|
11187658711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
1000 |
04/07/2008 |
1/30/2012 12:24:13 PM |
| |
|
|
|
| |
|
4/4/2008 |
|
| |
|
STEVENS,
ANN
MARIE |
|
| |
|
25 SCENIC DRIVE |
|
| |
|
HOSCHTON,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-3350129 |
| |
|
04/07/70
|
Female |
| |
|
123-78-9200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456AA7890 |
| |
|
40 |
|
| |
|
HWY 60& HWY 124 BBRASELTON GA 30417 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
1000 |
7/28/2008 |
1/30/2012 12:27:20 PM |
| |
|
|
|
| |
|
6-25-08 |
|
| |
|
GRAGG,
DOTTIE
P. |
|
| |
|
1625 BLUE BERRY LANE. |
|
| |
|
ALTO ,
GA
30510 |
|
| |
|
706-426-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12-6-93
|
Female |
| |
|
247-60-5863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER STREET CLARKESVILLE GA 30523 |
|
| |
|
NE GA MEDICAL CENTER GAINSVILLE GA 30501 |
|
|
|
---- > |
1000 |
4/29/98 |
1/30/2012 12:30:40 PM |
| |
|
|
|
| |
|
4-17-98 |
|
| |
|
WOMELSDORF,
BILL
N |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE ,
GA
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04-11-67
|
Male |
| |
|
123-946-3377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278A |
| |
|
14 |
|
| |
|
864 SILVVERSHOALS RD. NORCROSS GA 30113 |
|
| |
|
GWINNET MEDICAL CENTER NORCROSS GA 30442 |
|
|
|
---- > |
1000 |
4-21-08 |
1/30/2012 12:33:34 PM |
| |
|
|
|
| |
|
4-21-08 |
|
| |
|
GRIFFITH ,
KATRINKA
DENISE |
|
| |
|
3132 SAMPLE SCALES RD. |
|
| |
|
HOMER ,
GA
30547 |
|
| |
|
706-677-275
|
|
| |
|
|
|
| |
|
10*08/63
|
Female |
| |
|
253-80-2859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 SAMPLE SCALS RD. HOMER GA30547 |
|
| |
|
NE GA MED CENTER GAINSVILLE GA |
|
|
|
---- > |
1000 |
7-28-2008 |
1/30/2012 12:42:09 PM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
GRAGG,
DOTTIE
P. |
|
| |
|
1625 BLUEBERRY LANE |
|
| |
|
ALTO,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7665
|
706-335-0129 |
| |
|
12-06-2003
|
Female |
| |
|
247605863 |
|
| |
|
Yes |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER ST. CLARKSVILLE GA 30523 |
|
| |
|
NE GA MED CTR GAINESVILLE GA .0501 |
|
|
|
---- > |
2000 |
4/21/2008 |
1/30/2012 12:20:46 PM |
| |
|
|
|
| |
|
4/03/2008 |
|
| |
|
HOPE,
ELIZABETH
LEIGH |
|
| |
|
1954 HWY 51 SOUTH |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-870-6176
|
706335-0123 |
| |
|
|
706-335-0129 |
| |
|
1-18-1920
|
Female |
| |
|
353-26-0432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE GA MEDICAL CENTER GAINSVILLE GA 30501 |
|
|
|
---- > |
2000 |
04/22/2008 |
1/30/2012 12:46:39 PM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CAMELII
MARAN |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
999-99-999 |
|
| |
|
No |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
3000 |
04/22/208 |
9/30/2011 6:43:46 AM |
| |
|
|
|
| |
|
4/10/2008 |
|
| |
|
evans,
canebi
maran |
|
| |
|
55 state street |
|
| |
|
commerce,
ga
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
8-8-1982
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654397881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
3000 |
04/21/2008 |
9/30/2011 6:46:11 AM |
| |
|
|
|
| |
|
04-03-2008 |
|
| |
|
hope,
elizabeth
leigh |
|
| |
|
1954 Hwy 51 South |
|
| |
|
Homer,
ga
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01-18-1920
|
Female |
| |
|
353-26-0432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1951 Hwy 51 South Homer Ga 30547 |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
3000 |
04/07/2008 |
9/30/2011 6:48:43 AM |
| |
|
|
|
| |
|
04/04/20008 |
|
| |
|
Stevens,
Ann
Marie |
|
| |
|
25 Scenic dr |
|
| |
|
Hoschton,
Ga
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123-78-9200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
Hwy 60 & Hwy 124 Braselton Ga 30417 |
|
| |
|
ARMC Athens Ga 30606 |
|
|
|
---- > |
3000 |
7/28/2008 |
9/30/2011 6:51:02 AM |
| |
|
|
|
| |
|
06-14-2008 |
|
| |
|
Gragg,
Dottie
P. |
|
| |
|
1625 Blueberry lane |
|
| |
|
alto,
Ga
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12-06-1993
|
Female |
| |
|
247-60-5863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 Flower St Clarkesville, Ga 30523 |
|
| |
|
NE Ga Med Ctr Gainesville Ga 30501 |
|
|
|
---- > |
3000 |
04/22/2008 |
9/30/2011 6:58:28 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
evans,
canebi
maran |
|
| |
|
55 State Street |
|
| |
|
Commerce,
Ga
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
11876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
3000 |
04/21/2008 |
9/30/2011 7:00:11 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
Hope,
elizabeth
leigh |
|
| |
|
1954 Hwy 51 South |
|
| |
|
Homer,
GA
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353-26-0432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
3000 |
04/07/2008 |
9/30/2011 7:01:51 AM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
Stevens,
Ann
Marie |
|
| |
|
25 Scenic Dr |
|
| |
|
Hoschton ,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123-78-9200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
Hwy 60 & Hwy 124 Braselton Ga 30417 |
|
| |
|
ARMC Athens Ga 30606 |
|
|
|
---- > |
3000 |
07/28/2008 |
9/30/2011 7:03:30 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
Gragg,
Dottie
P |
|
| |
|
1625 Blueberry Lane |
|
| |
|
Alto,
Ga
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12-06-1993
|
Female |
| |
|
247-60-5863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 Flower St Clarkesville, Ga 30523 |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
3000 |
04/29/1998 |
9/30/2011 7:05:12 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
Womelsdorf,
Bill
n |
|
| |
|
55 state st |
|
| |
|
Commerce,
Ga
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04-11-1967
|
Male |
| |
|
123-946-3377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278a |
| |
|
14 |
|
| |
|
864 Silver Shoals Rd Norcross Ga 30113 |
|
| |
|
GWINNETT MEDICAL CENTER NORCROSS GA 30449 |
|
|
|
---- > |
3000 |
04/21/2008 |
9/30/2011 7:06:31 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GRIFFITH,
KATRINKA
DENISE |
|
| |
|
3132 Sample Scales Rd |
|
| |
|
Homer,
Ga
30547 |
|
| |
|
706-667-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253-80-2859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 SAMPLE SCALES ROAD HOMER GA |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
3000 |
04/21/2008 |
9/30/2011 7:08:30 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDNER,
HOLLY
MCDANIEL |
|
| |
|
1288 evan chambers rd |
|
| |
|
maysville,
Ga
30558 |
|
| |
|
706-667-3863
|
706-335-1719 |
| |
|
706-499-9442
|
706-336-8405 |
| |
|
04/23/1956
|
Female |
| |
|
249-26-7942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
7494624793 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
3000 |
05/01/2008 |
9/30/2011 7:10:19 AM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
R |
|
| |
|
125 millstone drive |
|
| |
|
commerce,
ga
30530 |
|
| |
|
706-423-0000
|
706-335-0515- |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423-25--8950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DRIVE COMMERCE GA 30530 |
|
| |
|
NEGMC GAINESVILLE GA 30501 |
|
|
|
---- > |
3000 |
04/21/2008 |
9/30/2011 7:11:54 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
RHOLETTER,
HOPE
ASHLEY |
|
| |
|
912 Wesley Chapel Rd |
|
| |
|
Danielveille ,
ga
30533 |
|
| |
|
706-789-3475
|
706-3350123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369-41-2837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 HWY 98 DANIELSVILLE GA 30533 |
|
| |
|
ARMC Athens Ga 30606 |
|
|
|
---- > |
3000 |
04/22/2008 |
9/30/2011 7:13:25 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
evans,
CANDI
Marie |
|
| |
|
55 state street |
|
| |
|
commerce ,
ga
30529 |
|
| |
|
706-335-5126
|
706-555-878- |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
11876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
3000 |
04/21/2008 |
1/30/2012 12:49:36 PM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDINER,
HOLLT
MCDANIEL |
|
| |
|
1288 ERVIN CHAMBERS ROAD |
|
| |
|
MAYSVILLE,
GA
30558 |
|
| |
|
706-677-3863
|
706-335-1419 |
| |
|
706-499-9442
|
706-336-8405 |
| |
|
04-23-1956
|
Female |
| |
|
04-23-1956 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
7494624793 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
4000 |
04/22/2008 |
7/8/2011 11:02:37 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
Evans,
Caneli
Maran |
|
| |
|
55 State Street |
|
| |
|
Commerce,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 State Street Commerce GA 30529 |
|
| |
|
BJC Commerce GA 30529 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/8/2011 11:04:41 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
Hope,
Elizabeth
Leigh |
|
| |
|
1954 Hwy 51 South |
|
| |
|
Homer,
GA
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353260432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 Hwy 51 South Homer GA 30547 |
|
| |
|
NE GA Med Center Gainesville GA 30501 |
|
|
|
---- > |
4000 |
04/07/2008 |
7/8/2011 11:07:02 AM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
Stevens,
Ann
Marie |
|
| |
|
25 Scenic Dr |
|
| |
|
Hoschton,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123789200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
Hwy 60 and Hwy 124 Braselton GA 30417 |
|
| |
|
GRMC Athens GA 30606 |
|
|
|
---- > |
4000 |
07/28/2008 |
7/8/2011 11:09:05 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
Gragg,
Dottie
P |
|
| |
|
1625 Blueberry Lane |
|
| |
|
Alto,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12/06/1993
|
Female |
| |
|
247605863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 Flower st Clarkesville GA 30523 |
|
| |
|
NE GA Med Ctr Gainesville GA 30501 |
|
|
|
---- > |
4000 |
04/29/1998 |
7/8/2011 11:11:16 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
Womelsdorf,
Bill
W |
|
| |
|
55 State st |
|
| |
|
Commerce,
GA
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04/11/1967
|
Male |
| |
|
1239463377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278A |
| |
|
14 |
|
| |
|
864 Silver Shoals Rd Norcross GA 30113 |
|
| |
|
Gwinnette Medical Center Norcross GA 30448 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/8/2011 11:12:57 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
Griffith,
Katrinka
Denise |
|
| |
|
3132 Sample Scales Rd |
|
| |
|
Homer,
GA
30547 |
|
| |
|
706-677-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253802859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 Sample Scales Rd Homer GA |
|
| |
|
NE GA Medical center Gainesville GA |
|
|
|
---- > |
4000 |
04/21/2008 |
7/8/2011 11:14:58 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
Gardiner,
Holly
McDaniel |
|
| |
|
1288 Ervin Chambers Rd |
|
| |
|
Maysville,
GA
30558 |
|
| |
|
706-677-3863
|
706-335-1419 |
| |
|
706-499-9442
|
706-336-8405 |
| |
|
04/23/1956
|
Female |
| |
|
249267942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
7494624793 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC Commerce GA 30529 |
|
|
|
---- > |
4000 |
05/01/2008 |
7/8/2011 11:16:54 AM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
West,
Gina
R |
|
| |
|
125 Millstone Drive |
|
| |
|
Commerce,
GA
30530 |
|
| |
|
706-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423258950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 Millstone Drive Commerce GA 30530 |
|
| |
|
NEGMC Gainesville GA 30501 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/8/2011 11:18:55 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
Rholetter,
Hope
Ashley |
|
| |
|
912 Wesley Chapel Rd |
|
| |
|
Danielsville,
GA
30533 |
|
| |
|
706-789-3475
|
706-335-0123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369412837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 Hwy 98 Danielsville GA 30533 |
|
| |
|
ARMC Athens GA 30606 |
|
|
|
---- > |
4000 |
04/22/2008 |
7/8/2011 11:20:50 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
Evans,
Caneli
Maran |
|
| |
|
55 State Street |
|
| |
|
Commerce,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 State Street Commerce GA 30529 |
|
| |
|
BJC Commerce GA 30529 |
|
|
|
---- > |
4000 |
04/22/2008 |
7/12/2011 11:59:41 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CANDI
M |
|
| |
|
55 STATE ST |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-8788 |
| |
|
706-888-8766
|
706-777-5477 |
| |
|
08/08/1982
|
Female |
| |
|
999999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881A |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/12/2011 12:03:01 PM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
HOPE,
ELIZABETH
LEIGH |
|
| |
|
1954 HWY 51 SOUTH |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353260432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
0003427836424 |
| |
|
28 |
|
| |
|
1054 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE GA MED CTR GAINESVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/07/2008 |
7/12/2011 12:06:42 PM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
STEVENS,
ANN
MARIE |
|
| |
|
25 SCENIC DR |
|
| |
|
HOSCHTON,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123789200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
HWY 60 AND HWY 124 BRASELTON GA 30417 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
4000 |
07/28/2008 |
7/12/2011 12:10:11 PM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
GRAGG,
DOTTIE
P |
|
| |
|
1625 BLUEBERRY LN |
|
| |
|
ALTO,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
06/25/2008
|
Female |
| |
|
247605863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER ST CLARKESVILLE GA 30523 |
|
| |
|
NE GA MED CTR GAINESVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/29/1998 |
7/12/2011 12:13:52 PM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
WOMELSDORF,
BILLL
N |
|
| |
|
55 STATE ST |
|
| |
|
COMMERCE,
GQ
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04/11/1967
|
Male |
| |
|
123946337 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278A |
| |
|
14 |
|
| |
|
864 SILVERSHOALS RD NORCROSS GA 30113 |
|
| |
|
GWINETT MED.CTR NORCROSS GA 30448 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/12/2011 12:16:37 PM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GRIFFITH,
KATRINKA
DENISE |
|
| |
|
3132 SAMPLE SCALES RD |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-677-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253902859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 SAMPLE SCALES RD HOMER GA 30547 |
|
| |
|
NE GA MED CTR GAINESVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/12/2011 12:20:08 PM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDINER,
HOLLY
MCDANIEL |
|
| |
|
1288 ERVIN CHAMBERS RD |
|
| |
|
MAYSVILLE,
GA
30558 |
|
| |
|
706-677-3863
|
706-335-1419 |
| |
|
706-409-9482
|
706-336-8405 |
| |
|
04/23/1956
|
Female |
| |
|
249267942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
749624793 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC MED CTR COMMERCE GA 30529 |
|
|
|
---- > |
4000 |
05/01/2008 |
7/12/2011 12:23:43 PM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
R |
|
| |
|
125 MILLSTONE DR |
|
| |
|
COMMERCE,
GA
30530 |
|
| |
|
706-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423258950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DR COMMERCE GA 30530 |
|
| |
|
NEGA MC GAINESVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/21/2008 |
7/12/2011 12:27:27 PM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
RHOLETTER,
HOPE
ASHLEY |
|
| |
|
912 WESLEY CHAPEL RD |
|
| |
|
DANIELSVILLE,
GA
30633 |
|
| |
|
706-789-3475
|
706-335-0123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369412837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 HWY 98 DANIELSVILLE GA 30633 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
4000 |
04/22/2008 |
7/12/2011 12:30:48 PM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CANDI
M |
|
| |
|
55 STATE ST |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-8788 |
| |
|
706-888-8766
|
706-666-5477 |
| |
|
08/08/1982
|
Female |
| |
|
999999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881A |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC MED CTR COMMERCE GA 30529 |
|
|
|
---- > |
4000 |
07/26/2011 |
7/26/2011 2:41:33 PM |
| |
|
|
|
| |
|
07/26/2011 |
|
| |
|
JONES,
TIMOTHY
RYAN |
|
| |
|
3649 DEADWYLER DR |
|
| |
|
MAYSVILLE,
GA
30518 |
|
| |
|
|
|
| |
|
678-299-5697
|
|
| |
|
09/11/1955
|
Male |
| |
|
1234567899 |
|
| |
|
No |
|
| |
|
Cigna
|
338673028 |
| |
|
|
|
| |
|
39 |
|
| |
|
3649 DEADWYLER DR MAYSVILLE GA 30558 |
|
| |
|
1100 HILLS COURT GAINESVILLE GA 30507 |
|
|
|
---- > |
4000 |
4/22/2008 |
10/3/2011 6:42:51 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
evans,
canebi
maran |
|
| |
|
55 state street |
|
| |
|
Commerce,
ga
30529 |
|
| |
|
7063355126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08-08-1982
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
11876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
4000 |
04/21/2008 |
10/3/2011 6:44:18 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
Hope,
elizabeth
leigh |
|
| |
|
1954 hwy 51 south |
|
| |
|
homer,
ga
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353-26-0432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
4000 |
04/07/2008 |
10/3/2011 6:45:39 AM |
| |
|
|
|
| |
|
04/04/20008 |
|
| |
|
Stevens,
Ann
Marie |
|
| |
|
25 scenic dr |
|
| |
|
hoschton,
ga
30548 |
|
| |
|
706-555-1235
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123-78-9200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
Hwy 60 & Hwy 124 Braselton Ga 30417 |
|
| |
|
ARMC Athens Ga 30606 |
|
|
|
---- > |
4000 |
07/28/2008 |
10/3/2011 6:47:03 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
Gragg,
Dottie
p |
|
| |
|
1625 blueberry lan |
|
| |
|
alto,
ga
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12/06/1993
|
Female |
| |
|
247-60-5863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 Flower St Clarkesville, Ga 30523 |
|
| |
|
NE Ga Med Center Gainseville Ga 30501 |
|
|
|
---- > |
4000 |
04/29/1998 |
10/3/2011 6:48:27 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
Womelsdorf,
Bill
n |
|
| |
|
55 state street |
|
| |
|
commerce,
ga
30529 |
|
| |
|
704-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04/11/1967
|
Male |
| |
|
123-946-3377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278a |
| |
|
14 |
|
| |
|
864 Silver Shoals Rd Norcross Ga 30113 |
|
| |
|
GWINNETT MEDICAL CENTER NORCROSS GA 30449 |
|
|
|
---- > |
4000 |
04/21/2008 |
10/3/2011 6:49:36 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
GRIFFITH,
KATRINKA
DENISE |
|
| |
|
3132 sample scales rd |
|
| |
|
homer,
ga
30547 |
|
| |
|
706-667-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253802859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
3132 SAMPLE SCALES ROAD HOMER GA |
|
| |
|
NEGA MED CENTER GAIENSVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/21/2008 |
10/3/2011 6:51:04 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDNER,
HOLLY
MCDANIEL |
|
| |
|
1288 ervn chambers rd |
|
| |
|
maysville,
ga
30558 |
|
| |
|
706-667-3861
|
706-335-1419 |
| |
|
706-449-6442
|
706-336-8405 |
| |
|
04-23-1956
|
Female |
| |
|
249-26-7942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
7494624793 |
| |
|
|
|
| |
|
8 |
|
| |
|
1288 ERVIN CHAMEBRS ROAD MAYSVILLE GA 30558 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
4000 |
05/01/2008 |
10/3/2011 6:52:26 AM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
r |
|
| |
|
125 millstone drive |
|
| |
|
commerce,
ga
30530 |
|
| |
|
406-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423-25--8950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DRIVE COMMERCE GA 30530 |
|
| |
|
NEGA MED CENTER GAIENSVILLE GA 30501 |
|
|
|
---- > |
4000 |
04/21/2008 |
10/3/2011 6:53:47 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
RHOLETTER,
HOPE
ASHLEY |
|
| |
|
912 wesley caple rd |
|
| |
|
danelville,
ga
60533 |
|
| |
|
706-789-3478
|
706-335-0123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369-41-2837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 HWY 98 DANIELSVILLE GA 30533 |
|
| |
|
ARMC Athens Ga 30606 |
|
|
|
---- > |
4000 |
04/22/208 |
10/3/2011 6:55:13 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
evans,
canebi
maran |
|
| |
|
55 state street |
|
| |
|
commerce ,
ga
30529 |
|
| |
|
706-335-5126
|
706-333-878- |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1992
|
Female |
| |
|
999-99-999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMEMRCE GA 30529 |
|
|
|
---- > |
4000 |
05/01/2008 |
1/30/2012 12:53:32 PM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
R |
|
| |
|
125 MILLSTONE DRIVE |
|
| |
|
COMMERCE,
GA
30530 |
|
| |
|
706-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423-25-8950 |
|
| |
|
No |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DR. COMMERCE GA 30530 |
|
| |
|
NEGMC GAINESVILLE GA 30501 |
|
|
|
---- > |
5000 |
04/22/2008 |
6/21/2011 7:35:46 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CANELI
MARAN |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE ,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1989
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE, GA 30529 |
|
| |
|
BJC COMMERCE, GA 30529 |
|
|
|
---- > |
5000 |
04/21/2008 |
6/21/2011 7:38:08 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
HOPE ,
ELIZABETH
LEIGH |
|
| |
|
1954 HWY 51 SOUTH |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353260432 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER, GA 30547 |
|
| |
|
NE GA MED. CENTER GAINESVILLE, GA 30501 |
|
|
|
---- > |
5000 |
04/07/2008 |
6/21/2011 7:40:33 AM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
STEVENS,
ANN
MARIE |
|
| |
|
25 SCENIC DR. |
|
| |
|
HOSCHTON,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
04/07/1970
|
Female |
| |
|
123789200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
HWY 60 &HWY 124 BRASELTON, GA 30417 |
|
| |
|
ARMC ATHENS, GA 30606 |
|
|
|
---- > |
5000 |
07/28/2008 |
6/21/2011 7:43:00 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
GRAGG,
DOTTIE
P. |
|
| |
|
1625 BLUEBERRY LANE |
|
| |
|
ALTO,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12/06/1993
|
Female |
| |
|
247605863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER ST CLARKESVILLE, GA 30523 |
|
| |
|
NE GA MED. CTR. GAINESVILLE, GA 30501 |
|
|
|
---- > |
5000 |
04/29/1998 |
6/21/2011 7:45:29 AM |
| |
|
|
|
| |
|
04/17/1998 |
|
| |
|
WOMELSDORF,
BILL
N. |
|
| |
|
55 STATE ST. |
|
| |
|
COMMERCE,
GA
30529 |
|
| |
|
404-414-0781
|
256-770-1942 |
| |
|
404-192-2030
|
706-335-0129 |
| |
|
04/11/1967
|
Male |
| |
|
1239463377 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
946337 |
| |
|
|
194278A |
| |
|
14 |
|
| |
|
864 SILVER SHOALS RD. NORCROSS, GA 30113 |
|
| |
|
GWINNETT MEDICAL CENTER NORCROSS, GA 30442 |
|
|
|
---- > |
5000 |
04/21/2008 |
6/21/2011 7:47:31 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GRIFFITH,
KATRINKA
DENISE |
|
| |
|
3132 SAMPLE SCALES RD. |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
706-677-2758
|
|
| |
|
|
|
| |
|
10/08/1963
|
Female |
| |
|
253802859 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
XXA821483999 |
| |
|
|
|
| |
|
54 |
|
| |
|
2132 SAMPLE SCALES RD. HOMER, GA |
|
| |
|
NE GA MEDICAL CENTER GAINESVILLE, GA |
|
|
|
---- > |
5000 |
04/21/2008 |
6/21/2011 7:50:14 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
GARDINER,
HOLLY
MCDANIEL |
|
| |
|
1288 ERVIN CAHMBERS RD. |
|
| |
|
MAYSVILLE,
GA
30558 |
|
| |
|
706-677-3863
|
706-335-1419 |
| |
|
706-449-9442
|
706-336-8405 |
| |
|
04/23/1956
|
Female |
| |
|
249267942 |
|
| |
|
No |
|
| |
|
Blue Cross Blue Shield - BSBC
|
74946244793 |
| |
|
|
|
| |
|
8 |
|
| |
|
SAA |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
5000 |
05/01/2008 |
6/21/2011 7:52:39 AM |
| |
|
|
|
| |
|
05/01/2008 |
|
| |
|
WEST,
GINA
R |
|
| |
|
125 MILLSTONE DRIVE |
|
| |
|
COMMERCE,
GA
30530 |
|
| |
|
706-423-0000
|
706-335-0515 |
| |
|
706-224-9164
|
706-335-0519 |
| |
|
08/05/1942
|
Female |
| |
|
423258950 |
|
| |
|
Yes |
|
| |
|
Humana Gold
|
H0514693 |
| |
|
|
455266789 |
| |
|
25 |
|
| |
|
125 MILLSTONE DR COMMERCE GA 30530 |
|
| |
|
NEGMC GANIESVILLE GA 30501 |
|
|
|
---- > |
5000 |
04/21/2008 |
6/21/2011 7:55:01 AM |
| |
|
|
|
| |
|
04/21/2008 |
|
| |
|
RHOLETTER,
HOPE
ASHLEY |
|
| |
|
912 WESLEY CHAPEL RD |
|
| |
|
DANIELSVILLE ,
GA
30533 |
|
| |
|
706-789-3475
|
706-335-0123 |
| |
|
706-209-0100
|
706-335-0129 |
| |
|
03/03/1985
|
Female |
| |
|
369412837 |
|
| |
|
Yes |
|
| |
|
Blue Cross Blue Shield - BSBC
|
R50999969 |
| |
|
|
940458060 |
| |
|
21 |
|
| |
|
701 HWY 98 DANIELSVILLE GA 30533 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
5000 |
04/22/2008 |
6/21/2011 7:57:27 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS ,
CANELI
MARAN |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE ,
GA
30529 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
111876589711 |
| |
|
28 |
|
| |
|
78 STATE STREET CMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
5000 |
04/22/2008 |
7/15/2011 11:19:46 AM |
| |
|
|
|
| |
|
04/10/2008 |
|
| |
|
EVANS,
CAMELI
MARAN |
|
| |
|
55 STATE STREET |
|
| |
|
COMMERCE,
GA
30539 |
|
| |
|
706-335-5126
|
706-555-878 |
| |
|
706-888-876
|
706-666-547 |
| |
|
08/08/1982
|
Female |
| |
|
99999999 |
|
| |
|
Yes |
|
| |
|
Medicare - Mcare
|
654367881 |
| |
|
|
1187689111 |
| |
|
28 |
|
| |
|
78 STATE STREET COMMERCE GA 30529 |
|
| |
|
BJC COMMERCE GA 30529 |
|
|
|
---- > |
5000 |
04/21/2008 |
7/15/2011 11:23:22 AM |
| |
|
|
|
| |
|
04/03/2008 |
|
| |
|
HOPE,
ELIZABETH
LEIGH |
|
| |
|
1954 HWY 51 SOUTH |
|
| |
|
HOMER,
GA
30547 |
|
| |
|
708-870-6176
|
706-335-0123 |
| |
|
|
706-335-0129 |
| |
|
01/18/1920
|
Female |
| |
|
353260423 |
|
| |
|
Yes |
|
| |
|
Advantra Freedom
|
36429860 |
| |
|
|
1113427836424 |
| |
|
28 |
|
| |
|
1954 HWY 51 SOUTH HOMER GA 30547 |
|
| |
|
NE GA MED CENTER GAINESVILLE GA 30501 |
|
|
|
---- > |
5000 |
04/07/2008 |
7/15/2011 11:25:57 AM |
| |
|
|
|
| |
|
04/04/2008 |
|
| |
|
STEVENS ,
ANN
MARIE |
|
| |
|
25 SCENIC DR |
|
| |
|
HOSCHTON,
GA
30548 |
|
| |
|
706-555-1234
|
706-335-0123 |
| |
|
706-215-1234
|
706-335-0129 |
| |
|
07/07/1970
|
Female |
| |
|
123789200 |
|
| |
|
Yes |
|
| |
|
United Healthcare - UHC
|
123456789 |
| |
|
|
XLL456A7890 |
| |
|
40 |
|
| |
|
HEY 60 & HWY 124 BRASELTON GA 30417 |
|
| |
|
ARMC ATHENS GA 30606 |
|
|
|
---- > |
5000 |
07/28/2008 |
7/15/2011 11:28:44 AM |
| |
|
|
|
| |
|
06/25/2008 |
|
| |
|
GRAGG,
DOTTIE
P |
|
| |
|
1625 BLUEBERRY LANE |
|
| |
|
ALTO,
GA
30510 |
|
| |
|
706-423-9765
|
706-335-0123 |
| |
|
706-201-7666
|
706-335-0129 |
| |
|
12/06/1993
|
Female |
| |
|
247605863 |
|
| |
|
No |
|
| |
|
Cigna
|
867324962 |
| |
|
|
652709384 |
| |
|
28 |
|
| |
|
720 FLOWER ST CLARKESVILLE GA 30523 |
|
| |
|
NE GA MED CENTER GAINESVILLE GA 30501 |
|
|