9-Exhibit D Network Disruption - Medical Dental.xlsx

XLSX spreadsheet 2 MB Posted Aug 30, 2025

Attached to: HEALTHCARE BENEFITS
Solicitation number: 26RFP005
Issued by: Maricopa County, Arizona

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Written by GovTribe AI · Sep 1, 2025

I apologize, but the file "9-Exhibit D Network Disruption - Medical Dental.xlsx" was not actually included in the text for me to review. While the context provides information about a healthcare benefits contract opportunity for the City of Scottsdale in Arizona, without the specific exhibit file contents, I cannot summarize its details. The provided information indicates this is related to a healthcare benefits proposal seeking medical, pharmacy, dental, employee assistance program, stoploss, and flexible spending/health savings account administration services, but the specific exhibit file details are not present in the shared text.

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File	Type	Posted
10-Exhibit E RX Disruption.xlsx	XLSX spreadsheet	Aug 30, 2025
4-Attachment C Sample City Services Contract.pdf	PDF	Aug 30, 2025
11-Exhibit F Detailed RX Cost Analysis.xlsx	XLSX spreadsheet	Aug 30, 2025
2-Attachment A - Formal Instructions to Respondents.pdf	PDF	Aug 30, 2025
3-Attachment B - Formal Solicitation General Terms Conditions (1).pdf	PDF	Aug 30, 2025
6-Exhibit A Summary Plan Descriptions.pdf	PDF	Aug 30, 2025
7-Exhibit B Experience and Census.xlsx	XLSX spreadsheet	Aug 30, 2025
8-Exhibit C Medical Repricing.xlsx	XLSX spreadsheet	Aug 30, 2025
1-26RFP005 Solicitation.pdf	PDF	Aug 30, 2025
5-Attachment D Business Associate Agreement.pdf	PDF	Aug 30, 2025

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Medical

CITY OF SCOTTSDALE

Account Numbers: ('3337752')

TC 19 REPORT

DATE : Paid Date Between 04/01/2024 and 04/30/2025

Intended for Julie Hickey Only

CLIENT_ACCT_NUM	PROVIDER_TAX_ID	CPF_ID	PROV_NPI	PROV_NM	ADDR_LN_1	ADDR_LN_2	CITY_NM	ST_CD	POSTL_CD	NT_ID	PART_INDICATOR	PRODT_TY_CD	PROV_SPEC_CD	PROVIDER_SPECIALTY	PROVIDER_TYPE	CLAIM_PAID_NETWORK_IND	BEN_PLAN_NUM	CLAIMANTS	CLAIMS	VISIT_COUNT	SVC_UNIT_CNT	ELIGIBLE_BILLED_CHARGES
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	6	6	6	427	$137,550.40
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN3	1	1	1	6	$3,483.50
3337752	900054201	4334303	1851521785	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	258	$38,645.10
3337752	900220728	4340112		BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	386	$21,318.00
3337752	450233470	5500502		BANNER OCOTILLO MEDICAL CENTER	1405 S ALMA SCHOOL RD		CHANDLER	AZ	85286	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	2	2	148	$40,313.50
3337752	900054201	4334303		BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	380	$100,065.40
3337752	721561134	0991977		ST JOSEPHS HOSPITAL AND MEDICAL CENTER	350 W THOMAS RD		PHOENIX	AZ	85013	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	2	2	999	$460,213.00
3337752	262942698	5985761		ENCOMPASS HEALTH REHABILITATION HOSPITAL OF EAST VALLEY	5652 E BASELINE RD		MESA	AZ	85206	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	2	2	1620	$47,326.99
3337752	270036484	6024954	1972557650	BANNER THUNDERBIRD MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	12	$3,091.20
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	2	2	39	$22,350.50
3337752	900054201	4334303	1982191268	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	87	$21,070.20
3337752	621861138	0992523		ABRAZO SCOTTSDALE CAMPUS	3929 E BELL RD		PHOENIX	AZ	85032	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	111	$98,487.00
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	55	$14,352.21
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	1	1	0	$-116,836.06
3337752	270036484	6024954		BANNER THUNDERBIRD MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	0	$0.00
3337752	860830701	2317932		VALLEYWISE HEALTH	33 W TAMARISK ST		PHOENIX	AZ	85041	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	1	1	310	$35,974.77
3337752	621811285	0992376		ABRAZO ARROWHEAD CAMPUS	1643 NW 136TH AVE		SUNRISE	FL	33323	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	3	3	3	957	$245,863.77
3337752	270036484	6024954	1588026132	BANNER THUNDERBIRD MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	38	$11,261.90
3337752	621811285	0992376		ABRAZO ARROWHEAD CAMPUS	1643 NW 136TH AVE		SUNRISE	FL	33323	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	8	10	11	3108	$1,169,944.32
3337752	911858433	2752766		NEBRASKA MEDICAL CENTER	29150 FORD RD		GARDEN CITY	MI	48135	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	0	$37,363.66
3337752	860800150	1870517		MAYO CLINIC ARIZONA	13400 E SHEA BLVD		SCOTTSDALE	AZ	85259	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	2	2	150	$23,166.30
3337752	810771909	8838654		WILLOW MIDWIFE CENTER FOR BIRTH AND WELLNESS AZ LLC	2045 S VINEYARD 136		MESA	AZ	85210	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	1	1	0	$19,907.00
3337752	900389314	0993531		BANNER BOSWELL MEDICAL CENTER	10401 W THUNDERBIRD BLVD		SUN CITY	AZ	85351	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	125	$21,926.30
3337752	900054201	4334303		BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	5	5	78	$27,864.30
3337752	860871177	8897193	1427179753	PONGRATZ ORTHOTICS & PROSTHETICS INC	13020 W RANCHO SANTA FE BLVD 101		AVONDALE	AZ	85392	OA001	NONPAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$0.00
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	3	4	4	327	$83,883.30
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	27	27	27	4812	$1,245,869.49
3337752	251821705	0839942		SELECT SPECIALTY HOSPITAL	350 W THOMAS RD 3		PHOENIX	AZ	85013	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	3	3	697	$287,281.73
3337752	900054201	4334303	1750343240	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	427	$69,482.10
3337752	450233470	5500502		BANNER OCOTILLO MEDICAL CENTER	1405 S ALMA SCHOOL RD		CHANDLER	AZ	85286	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	60	$10,621.70
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	3	4	4	902	$80,712.80
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	6	5	6532	$851,107.00
3337752	463533638	8185813		ST JOSEPHS WESTGATE	7300 N 99TH AVE		GLENDALE	AZ	85307	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	195	$240,035.00
3337752	860871177	8897193	1164998696	PONGRATZ ORTHOTICS & PROSTHETICS INC	13020 W RANCHO SANTA FE BLVD 101		AVONDALE	AZ	85392	OA001	NONPAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	621861138	0992523		ABRAZO SCOTTSDALE CAMPUS	3929 E BELL RD		PHOENIX	AZ	85032	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	101	$30,789.00
3337752	900065118	6085777		BANNER ESTRELLA MEDICAL CENTER	9201 W THOMAS RD		PHOENIX	AZ	85037	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	2	2	2	78	$21,948.10
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	860871177	8897193	1033713060	PONGRATZ ORTHOTICS & PROSTHETICS INC	13020 W RANCHO SANTA FE BLVD 101		AVONDALE	AZ	85392	OA001	NONPAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$126.80
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	2	3	3	2186	$276,002.00
3337752	721561134	0991977		ST JOSEPHS HOSPITAL AND MEDICAL CENTER	350 W THOMAS RD		PHOENIX	AZ	85013	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	951644600	1036035		CEDARS SINAI MEDICAL CENTER	8700 BEVERLY BLVD		WEST HOLLYWOOD	CA	90048	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1185	$531,147.03
3337752	270036484	6024954	1972557650	BANNER THUNDERBIRD MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	5	$2,576.20
3337752	900220728	4340112	1700822947	BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	223	$26,906.40
3337752	860181654	4955754		JCL DV HOSPITAL	19829 N 27TH AVE		PHOENIX	AZ	85027	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	2	2	3315	$545,913.70
3337752	860338886	6439866		HOSPICE OF THE VALLEY	1510 E FLOWER ST		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	7	72	87	$21,155.00
3337752	900054201	4334303	1386961167	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	55	$12,006.80
3337752	621811285	0992376		ABRAZO ARROWHEAD CAMPUS	1643 NW 136TH AVE		SUNRISE	FL	33323	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	1	1	146	$40,171.00
3337752	900220728	4340112		BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	3	3	452	$45,044.10
3337752	900412842	1656860		BANNER IRONWOOD MEDICAL CENTER	37000 N GANTZEL RD		QUEEN CREEK	AZ	85140	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	170	$28,286.20
3337752	621809851	0991221		ABRAZO CENTRAL CAMPUS	2000 W BETHANY HOME RD		PHOENIX	AZ	85015	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	489	$228,652.60
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN3	1	1	1	134	$60,433.00
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP3	1	1	1	0	$0.00
3337752	900054201	4334303	1265775159	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	88	$38,336.60
3337752	860181654	4955754		JCL DV HOSPITAL	19829 N 27TH AVE		PHOENIX	AZ	85027	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	728	$79,973.30
3337752	473724879	2399247		DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL	1515 W CHANDLER BLVD		CHANDLER	AZ	85224	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	610	$111,061.53
3337752	260605527	3519421		NEWPORT ACADEMY-DARIEN	811 N RANCH WOOD TRL		ORANGE	CA	92869	OA001	NONPAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	6	16	12	$67,314.00
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	7	7	7	3330	$589,059.69
3337752	473724879	2399247		DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL	1515 W CHANDLER BLVD		CHANDLER	AZ	85224	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	1	1	268	$29,855.17
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	28	$23,520.00
3337752	900054201	4334303	1659720704	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	251	$17,977.60
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	2	1	70	$33,572.00
3337752	270036499	2599048		BANNER UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS	1111 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	2	2	15	$15,645.40
3337752	450233470	5500502		BANNER OCOTILLO MEDICAL CENTER	1405 S ALMA SCHOOL RD		CHANDLER	AZ	85286	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	956	$28,576.40
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	3	3	3	69	$23,047.00
3337752	811399621	5161703		HAVEN OF SCOTTSDALE LLC	3293 N DRINKWATER BLVD		SCOTTSDALE	AZ	85251	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	2	2	44	$9,508.34
3337752	860181654	1982484		SCOTTSDALE HEALTHCARE THOMPSON PEAK	7400 E THOMPSON PEAK PKWY		SCOTTSDALE	AZ	85255	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	6	7	2528	$298,580.85
3337752	883269656	8019639		MISSION PREP HEALTHCARE	2 OCEANAIRE DR		RANCHO PALOS VERDES	CA	90275	OA001	NONPAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	27	27	27	$127,575.00
3337752	852104820	0377179	1205509510	RAPID TEST LABORATORIES LLC	1245 E COLFAX AVE B102		DENVER	CO	80218	OA001	NONPAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	1	$116.67
3337752	860181654	6623119		SCOTTSDALE HEALTHCARE OSBORN	7400 E OSBORN RD		SCOTTSDALE	AZ	85251	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	900054201	4334303	1063899177	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	226	$18,809.40
3337752	860181654	6623119		SCOTTSDALE HEALTHCARE OSBORN	7400 E OSBORN RD		SCOTTSDALE	AZ	85251	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	2	2	1207	$125,558.00
3337752	900412842	1656860	1447213822	BANNER IRONWOOD MEDICAL CENTER	37000 N GANTZEL RD		QUEEN CREEK	AZ	85140	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	2	$5,701.70
3337752	621867232	1194449		ABRAZO WEST CAMPUS	13677 W MCDOWELL RD		GOODYEAR	AZ	85395	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	632	$45,711.00
3337752	270036499	2599048		BANNER UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS	1111 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	860181654	4955754		JCL DV HOSPITAL	19829 N 27TH AVE		PHOENIX	AZ	85027	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	485	$81,645.70
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN3	2	2	2	214	$44,814.40
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	3	3	3	123	$39,263.56
3337752	274160293	9385744		SCOTTSDALE HEALTH REHAB HOSPITAL	8850 E PIMA CENTER PKWY		SCOTTSDALE	AZ	85258	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	185	$79,805.34
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	44	$15,633.24
3337752	860800150	1870517		MAYO CLINIC ARIZONA	13400 E SHEA BLVD		SCOTTSDALE	AZ	85259	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	2	2	2843	$133,642.62
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404		PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	HDPF3	1	1	1	0	$0.00
3337752	474131755	0995337		CARONDELET ST JOSEPHS HOSPITAL	5620 W CORTARO FARMS RD		TUCSON	AZ	85742	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1678	$48,771.50
3337752	270036499	2599048		BANNER UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS	1111 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	176	$13,107.00
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	2	2	76	$20,911.00
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	3	3	2694	$221,260.05
3337752	900054201	4334303	1730592171	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	5345	$1,070,850.40
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	3	3	3	155	$52,313.62
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	232	$50,920.99
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	4	4	408	$112,334.00
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	4	4	1021	$115,115.00
3337752	273041167	6441548		BLOSSOM BIRTH AND WELLNESS CENTER	2928 N 18TH PL		PHOENIX	AZ	85016	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	4	2	1	$680.00
3337752	473724879	2399247		DIGNITY HEALTH EAST VALLEY REHABILITATION HOSPITAL	1515 W CHANDLER BLVD		CHANDLER	AZ	85224	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	2	$6,340.71
3337752	900220728	4340112		BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	305	$25,842.60
3337752	860181654	4955754		JCL DV HOSPITAL	19829 N 27TH AVE		PHOENIX	AZ	85027	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	184	$52,712.90
3337752	860800150	1870517		MAYO CLINIC ARIZONA	13400 E SHEA BLVD		SCOTTSDALE	AZ	85259	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	5	5	3410	$512,344.75
3337752	900412842	1656860		BANNER IRONWOOD MEDICAL CENTER	37000 N GANTZEL RD		QUEEN CREEK	AZ	85140	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	3	3	74	$32,378.50
3337752	861035549	9201085		BANNER HEART HOSPITAL	6750 E BAYWOOD AVE		MESA	AZ	85206	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	80	$18,458.50
3337752	860338886	6439866		HOSPICE OF THE VALLEY	1510 E FLOWER ST		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	2	22	22	$5,170.00
3337752	861035549	9201085	1770529240	BANNER HEART HOSPITAL	6750 E BAYWOOD AVE		MESA	AZ	85206	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	375	$86,574.50
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	3	3	283	$52,647.72
3337752	270036499	2599048	1295082790	BANNER UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS	1111 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	70	$17,069.60
3337752	860181654	6623119		SCOTTSDALE HEALTHCARE OSBORN	7400 E OSBORN RD		SCOTTSDALE	AZ	85251	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	6	9	9	3375	$484,406.47
3337752	450233470	0988575	1588195473	BANNER CASA GRANDE MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	164	$37,574.80
3337752	352263845	1797308		MERCY GILBERT MEDICAL CENTER	1 NATIONAL CHAMPIONSHIP DR N108		TUCSON	AZ	85721	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	5	5	5	1121	$398,673.00
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA010	PAR	OAPINR		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	2	2	2	46	$20,666.90
3337752	270036484	6024954		BANNER THUNDERBIRD MEDICAL CENTER	1441 N 12TH ST		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	4	4	1221	$148,730.60
3337752	900412842	1656860	1376750992	BANNER IRONWOOD MEDICAL CENTER	37000 N GANTZEL RD		QUEEN CREEK	AZ	85140	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	246	$21,309.40
3337752	900220728	4340112	1427018118	BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	2	$14,521.00
3337752	721561134	0991977		ST JOSEPHS HOSPITAL AND MEDICAL CENTER	350 W THOMAS RD		PHOENIX	AZ	85013	OA001	PAR	OAPIN		OTHER	FACILITY INPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	11	11	2139	$1,129,299.99
3337752	850903085	2937607	1720199276	AFC URGENT CARE	4004 N 132ND ST 101		OMAHA	NE	68164	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$385.85
3337752	860101019	1300812		GILBERT VA CLINIC	3285 S VAL VISTA DR		GILBERT	AZ	85297	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	3	3	6	$2,938.26
3337752	133757370	4017812	1437135886	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$630.00
3337752	911858433	2752766		NEBRASKA MEDICAL CENTER	29150 FORD RD		GARDEN CITY	MI	48135	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	4	4	9	$930.00
3337752	860110232	0988701		FLAGSTAFF MEDICAL CENTER INC	5200 E CORTLAND BLVD D6		FLAGSTAFF	AZ	86004	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	0	$0.00
3337752	992210303	3823266	1518713072	LABCORP GENETICS	PO BOX 8019		BURLINGTON	NC	27216	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	2	$3,500.00
3337752	260181185	7676996	1306137252	MEDSOLUTIONS INC	730 COOL SPRINGS BLVD 800		FRANKLIN	TN	37067	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	2	2	4	$510.76
3337752	461236453	8708417	1194733485	PCMG NWV URGENT CARE	20325 N 51ST AVE 116		GLENDALE	AZ	85308	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$481.00
3337752	200277709	7138287	1811559800	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	1	1	1	$255.65
3337752	860422559	0990696	1760480503	PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	NONPAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$1,856.00
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	2	2	2	0	$0.00
3337752	860800150	1870517		MAYO CLINIC ARIZONA	13400 E SHEA BLVD		SCOTTSDALE	AZ	85259	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI3	1	1	1	428	$13,259.62
3337752	330222508	1831909		CATALINA ISLAND MEDICAL CENTER	100 FALLS CANYON RD		AVALON	CA	90704	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	3	$5,226.57
3337752	871712552	1947235		BSC THREE LLC	7400 N DOBSON RD 301		SCOTTSDALE	AZ	85256	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	2	$39,100.00
3337752	461236453	8334340	1154985182	PCMG EVS URGENT CARE	5131 E SOUTHERN AVE		MESA	AZ	85206	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$481.00
3337752	860422559	0990696		PHOENIX CHILDRENS HOSPITAL	6524 W SACK DR		GLENDALE	AZ	85308	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	73	221	251	4102	$634,680.63
3337752	133757370	4017812	1750368700	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	1	1	2	$130.20
3337752	860181654	3540249		JCL N M HOSPITAL	9003 E SHEA BLVD		SCOTTSDALE	AZ	85260	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	9	12	16	1121	$33,944.60
3337752	271798256	3857444		EYE SURGERY CENTER AT THE BILTMORE	2222 E HIGHLAND AVE 101		PHOENIX	AZ	85016	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	3	3	3	3	$4,463.67
3337752	200277709	7138287	1598726051	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	4	2	4	$1,011.99
3337752	901183954	2546090		BANNER ESTRELLA SURGERY CENTER LLC	9301 W THOMAS RD		PHOENIX	AZ	85037	OA001	NONPAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	202684773	6965106		ORTHOPEDIC SURGERY CENTER OF ARIZONA	2262 E ROSE GARDEN LN		PHOENIX	AZ	85024	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	743238060	6868385	1346479169	MYRIAD WOMENS HEALTH	PO BOX 645693		CINCINNATI	OH	45264	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	2	3	2	4	$845.89
3337752	200277709	7138287	1528213840	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	2	$305.65
3337752	901133689	2823200	1891190062	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$546.00
3337752	866004791	8474992	1720420557	ARIZONA HEALTH CRE	PO BOX 678863		DALLAS	TX	75267	OA001	NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	0	$0.00
3337752	821186424	4300079	1922532944	DISPATCHHEALTH	1705 W UNIVERSITY DR 105		TEMPE	AZ	85281	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	3	3	3	$3,000.00
3337752	901133689	2823200	1619676996	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$339.00
3337752	061128081	2258015	1962480608	DIANON SYSTEMS INC	PO BOX 8005		BURLINGTON	NC	27216	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	1	$186.90
3337752	200277709	7138287	1730746959	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	2	$327.15
3337752	863569910	9731983	1851966105	DELTA LABORATORIES LLC	PO BOX 200620		DALLAS	TX	75320	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	0	$2,795.00
3337752	860101019	1318145		PHOENIX THREE VA CLINIC	400 N 32ND ST		PHOENIX	AZ	85008	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	4	4	9	$6,445.45
3337752	901133689	2823200	1972053072	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	7	7	7	7	$2,021.00
3337752	901133689	2823200	1700950425	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$278.00
3337752	200277709	7138287	1417639246	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	2	1	3	$460.15
3337752	320197974	2677193		WESTERN REGIONAL MEDICAL CENTER	6888 PAYSPHERE CIR		CHICAGO	IL	60674	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	HDPI1	1	1	1	0	$0.00
3337752	260708365	6999413	1356356067	HIGH DESERT CLINIC URGENT AND OCCUPATIONAL CARE	77 E FRY BLVD		SIERRA VISTA	AZ	85635	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	2	$208.00
3337752	200277709	7138287	1043776867	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	3	$355.65
3337752	743126687	4727295	1013973866	CARIS MPI INC	750 W JOHN CARPENTER FWY 800		IRVING	TX	75039	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	3	3	8	$45,582.25
3337752	205824138	9048040	1043371826	NEXTCARE URGENT CARE	20236 N JOHN WAYNE PKWY 100		MARICOPA	AZ	85139	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	6	6	6	8	$2,312.00
3337752	200277709	7138287	1437418621	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	1	1	1	$317.15
3337752	133757370	4017812	1538144910	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215		NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	-1	$0.00
3337752	860872873	1105910	1538105366	SONORA QUEST LABORATORIES LLC	1751 HWAY 95		BULLHEAD CITY	AZ	86442	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	252	573	475	3077	$249,425.13
3337752	200277709	7138287	1932150927	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	1	$317.15
3337752	222405059	0486402	1134277494	BIOREFERENCE HEALTH LLC	7710 N FRESNO ST 101		FRESNO	CA	93720	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	3	3	3	6	$617.90
3337752	999999999	9999999990001	1740262880	MISCELLANEOUS PROVIDER	1111 MARKET ST		CHATTANOOGA	TN	37402	OA001	NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	0	$125.85
3337752	860527381	2025201	1306996848	AETNA ARIZONA MERCY C	PO BOX 29216		NEW YORK	NY	10087	OA001		OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	34	34	0	$0.00
3337752	593209688	0780108	1609943174	ADVENTHEALTH CENTRA CARE	11001 W COLONIAL DR 110		OCOEE	FL	34761	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$326.00
3337752	901133689	2823200	1619423001	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	5	3	1	$243.00
3337752	200277709	7138287	1891031019	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$317.15
3337752	260181185	7676996	1720153075	MEDSOLUTIONS INC	730 COOL SPRINGS BLVD 800		FRANKLIN	TN	37067	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	1	1	2	$255.38
3337752	721561132	0988596		CHANDLER REGIONAL MEDICAL CENTER	150 N GILBERT RD		GILBERT	AZ	85234	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	3	3	3	448	$78,160.00
3337752	454611100	7637604	1902355530	GATEWAY URGENT CARE	920 E WILLIAMS FIELD RD 101		GILBERT	AZ	85295	OA001	NONPAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	2	$155.66
3337752	840611484	6117165	1073599478	LABORATORY CORPORATION OF AMERICA	3162 MOMENTUM PLACE		CHICAGO	IL	60689		NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	16	$0.00
3337752	200277709	7138287	1447653324	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	3	3	10	$953.15
3337752	133757370	4017812	1063556017	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN3	1	1	1	2	$100.80
3337752	270036499	2599048		BANNER UNIVERSITY MEDICAL CENTER PHOENIX CAMPUS	1111 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	2	2	2	0	$0.00
3337752	901133689	2823200	1972339315	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$451.50
3337752	900054201	4334303	1578548442	BANNER DESERT MEDICAL CENTER	1400 S DOBSON RD		MESA	AZ	85202	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN4	1	1	1	0	$0.00
3337752	471811550	6264105	1306238647	PM PEDIATRICS OF MARYLAND	5805 SILVER HILL RD		DISTRICT HEIGHTS	MD	20747	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	2	2	2	$760.00
3337752	901133689	2823200	1639234743	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	3	3	3	$785.00
3337752	900220728	4340112	1881198588	BANNER GATEWAY MEDICAL CENTER	1900 N HIGLEY RD		GILBERT	AZ	85234	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	7	$1,885.00
3337752	721561134	0991977		ST JOSEPHS HOSPITAL AND MEDICAL CENTER	350 W THOMAS RD		PHOENIX	AZ	85013	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	5	7	7	24	$31,940.00
3337752	260181185	7676996	1972091742	MEDSOLUTIONS INC	730 COOL SPRINGS BLVD 800		FRANKLIN	TN	37067	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	2	2	4	$510.76
3337752	860181654	3540249		JCL N M HOSPITAL	9003 E SHEA BLVD		SCOTTSDALE	AZ	85260	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI3	1	1	1	1	$323.00
3337752	901133689	2823200	1245870427	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	1	$355.00
3337752	901133689	2823200	1245854728	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	1	1	1	$271.00
3337752	901133689	2823200	1972053072	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$271.00
3337752	383990879	2712986		ARIZONA GENERAL HOSPITAL MESA	9130 E ELLIOT RD		MESA	AZ	85212	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	3	3	3	0	$0.00
3337752	870667809	9161498		EAST VALLEY ENDOSCOPY PLLC	6020 E ARBOR AVE 105		MESA	AZ	85206	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	9	9	9	14	$19,990.00
3337752	621867232	1194449		ABRAZO WEST CAMPUS	13677 W MCDOWELL RD		GOODYEAR	AZ	85395	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI3	1	1	1	6	$11,290.00
3337752	900389312	0994560		BANNER DEL WEBB MEDICAL CENTER	14502 W MEEKER BLVD		SUN CITY WEST	AZ	85375	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	2	3	27	$4,570.70
3337752	901133689	2823200	1548985815	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$355.00
3337752	132997301	0474558		MOUNT SINAI MORNINGSIDE AND WEST	1000 10TH AVE		NEW YORK	NY	10019	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	1	$0.00
3337752	251815559	7460919	1467436188	RABKIN DERMATOPATHOLOGY LAB P C	440 WILLIAM PITT WAY		PITTSBURGH	PA	15238	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$0.00
3337752	934895258	9048040	1114798071	NEXTCARE URGENT CARE	20236 N JOHN WAYNE PKWY 100		MARICOPA	AZ	85139	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	3	3	3	3	$1,095.00
3337752	621831495	3270639		TIMPANOGOS REGIONAL HOSPITAL	750 W 800 N		OREM	UT	84057	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	2	$182.33
3337752	200277709	7138287	1811375132	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI3	1	1	1	1	$0.00
3337752	264000683	0405295	1316173065	SIMONMED IMAGING	310 N WILMOT RD 302		TUCSON	AZ	85711	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	0	$0.00
3337752	461236453	8708417	1942789367	PCMG NWV URGENT CARE	20325 N 51ST AVE 116		GLENDALE	AZ	85308	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	2	2	6	$1,348.00
3337752	061128081	2258015	1962480608	DIANON SYSTEMS INC	PO BOX 8005		BURLINGTON	NC	27216	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	2	$373.80
3337752	471587223	1938262		ARIZONA GENERAL HOSPITAL LAVEEN	2977 E GERMANN RD		CHANDLER	AZ	85286	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$1,936.00
3337752	200277709	7138287	1811375132	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	2	2	5	$877.44
3337752	743238060	6868385	1346479169	MYRIAD WOMENS HEALTH	PO BOX 645693		CINCINNATI	OH	45264	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	1	1	0	$0.00
3337752	900735044	2906070	1295385094	BANNER URGENT CARE ARIZONA LLC	1676 E MCMURRAY BLVD 1		CASA GRANDE	AZ	85122	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$236.00
3337752	901133689	2823200	1255739488	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	1	$360.00
3337752	454307241	6297270		CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER LLC	600 S DOBSON RD BLDG A		CHANDLER	AZ	85224	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$5,342.00
3337752	860181654	4899439		SCOTTSDALE HEALTHCARE SHEA MEDICAL CENTER	2484 RIVER RD		EUGENE	OR	97404	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	HDPI1	1	1	1	0	$0.00
3337752	200277709	7138287	1073108593	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	2	2	2	$515.42
3337752	133757370	4017812	1750368700	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	3	3	3	4	$1,489.10
3337752	133757370	4017812	1538144910	LABCORP HOLDINGS	133 E DAVIS ST		GLEN RAVEN	NC	27215	OA010	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	4	$614.25
3337752	200277709	7138287	1447653324	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	2	2	2	$637.15
3337752	866004791	8474992	1467958611	ARIZONA HEALTH CRE	PO BOX 678863		DALLAS	TX	75267	OA001		OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN4	1	3	3	0	$0.00
3337752	721025017	0888321		BATON ROUGE GENERAL MEDICAL CENTER	8585 PICARDY AVE		BATON ROUGE	LA	70809	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$56.20
3337752	901133689	2823200	1811247026	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$374.00
3337752	871712552	1947235		BSC THREE LLC	7400 N DOBSON RD 301		SCOTTSDALE	AZ	85256	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$10,891.00
3337752	901133689	2823200	1356021901	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$271.00
3337752	900065118	6085777		BANNER ESTRELLA MEDICAL CENTER	9201 W THOMAS RD		PHOENIX	AZ	85037	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	2	2	15	$7,083.00
3337752	200277709	7138287	1841511714	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	2	1	4	$247.30
3337752	860181654	6623119		SCOTTSDALE HEALTHCARE OSBORN	7400 E OSBORN RD		SCOTTSDALE	AZ	85251	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	HDPI1	1	1	1	0	$0.00
3337752	901133689	2823200	1952087173	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	1	1	1	$265.00
3337752	860908400	0599475		ARIZONA ENDOSCOPY CENTER LLC	1410 E MCDOWELL RD		PHOENIX	AZ	85006	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$1,803.00
3337752	731553441	7527391		MOUNTAIN VIEW SURGERY CENTER OF SCOTTSDALE	8962 E DESERT COVE AVE 101		SCOTTSDALE	AZ	85260	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$12,387.00
3337752	200277709	7138287	1225001118	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$317.15
3337752	999999999	9999999990001		MISCELLANEOUS PROVIDER	1111 MARKET ST		CHATTANOOGA	TN	37402	OA001	NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAP1	1	1	1	0	$-1,205.00
3337752	860181654	1982484		SCOTTSDALE HEALTHCARE THOMPSON PEAK	7400 E THOMPSON PEAK PKWY		SCOTTSDALE	AZ	85255	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	9	10	10	176	$53,506.20
3337752	830552437	9949580	1851946875	EAST VALLEY OUTPATIENT SURGERY LLC	5620 E BROADWAY RD 102		MESA	AZ	85206	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	2	2	2	$12,000.00
3337752	840611484	6117165	1598747651	LABORATORY CORPORATION OF AMERICA	3162 MOMENTUM PLACE		CHICAGO	IL	60689	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	2	2	7	$514.34
3337752	200277709	7138287	1932789989	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	3	$359.77
3337752	901133689	2823200	1356021901	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	2	2	2	2	$677.00
3337752	934895258	9048040	1114798071	NEXTCARE URGENT CARE	20236 N JOHN WAYNE PKWY 100		MARICOPA	AZ	85139	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN3	1	1	1	1	$330.00
3337752	860181654	3540249		JCL N M HOSPITAL	9003 E SHEA BLVD		SCOTTSDALE	AZ	85260	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN4	1	1	1	0	$0.00
3337752	202684773	6965106		ORTHOPEDIC SURGERY CENTER OF ARIZONA	2262 E ROSE GARDEN LN		PHOENIX	AZ	85024	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	2	2	3	$50,826.00
3337752	203734391	9012150	1053584482	EMPIRE CITY LABORATORIES INC	229 49TH ST		BROOKLYN	NY	11220	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	2	10	4	181	$8,416.69
3337752	942916102	0990087		KINGMAN REGIONAL MEDICAL CENTER	3269 N STOCKTON HILL RD		KINGMAN	AZ	86409	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	3	4	4	77	$14,392.00
3337752	454611100	7637604	1992441836	GATEWAY URGENT CARE	920 E WILLIAMS FIELD RD 101		GILBERT	AZ	85295	OA001	NONPAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	840405257	7967460		EMERGENCY & URGENT CARE KEYSTONE	1252 COUNTY RD 8		KEYSTONE	CO	80435	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	6	$5,007.48
3337752	901133689	2823200	1386182541	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$236.00
3337752	860334392	7520538	1902918832	EVERNORTH CARE GROUP URGENT CARE	1840 S STAPLEY DR 101		MESA	AZ	85204	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	2	2	2	2	$538.46
3337752	010894487	1445079	1558672279	NATERA INC	PO BOX 889027		LOS ANGELES	CA	90088	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	2	3	2	7	$22,640.00
3337752	860101019	6212619		PHOENIX VAMC	650 E INDIAN SCHOOL RD		PHOENIX	AZ	85012	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$428.83
3337752	860181654	1982484		SCOTTSDALE HEALTHCARE THOMPSON PEAK	7400 E THOMPSON PEAK PKWY		SCOTTSDALE	AZ	85255	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	2	2	2	0	$0.00
3337752	860212139	9621024		PHOENIX IND MED CTR	4212 N 16TH ST		PHOENIX	AZ	85016	OA001	NONPAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	1	2	2	5	$418.28
3337752	200277709	7138287	1932789989	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$361.93
3337752	201808351	2745261		NORTH VALLEY SURGERY CENTER	8901 E RAINTREE DR 100		SCOTTSDALE	AZ	85260	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	9	9	9	13	$122,645.00
3337752	201808351	2745261		NORTH VALLEY SURGERY CENTER	8901 E RAINTREE DR 100		SCOTTSDALE	AZ	85260	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	2	2	2	5	$32,319.00
3337752	510426858	5166126		DESERT ENDOSCOPY CENTER	603 W BASELINE RD 101		MESA	AZ	85210	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	6	6	6	11	$13,088.00
3337752	271117058	0987774	1063734739	CLEVELAND HEARTLAB INC	6701 CARNEGIE AVE 500		CLEVELAND	OH	44103	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	41	$5,955.57
3337752	261565558	4250519	1497933162	MILLENNIUM HEALTH LLC	401 W MORGAN RD		ANN ARBOR	MI	48108	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	2	3	3	7	$1,214.97
3337752	901133689	2823200	1598426496	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$201.00
3337752	901133689	2823200	1164844387	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	1	1	1	1	$320.00
3337752	860181654	7256315		HONORHEALTH SONORAN CROSSING MEDICAL CENTER	33400 N 32ND AVE		PHOENIX	AZ	85085	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	2	5	5	201	$39,157.25
3337752	900735044	2906070	1508523929	BANNER URGENT CARE ARIZONA LLC	1676 E MCMURRAY BLVD 1		CASA GRANDE	AZ	85122	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	1	$368.00
3337752	721561134	0991977		ST JOSEPHS HOSPITAL AND MEDICAL CENTER	350 W THOMAS RD		PHOENIX	AZ	85013	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPI1	4	8	7	103	$28,697.71
3337752	200277709	7138287	1811559800	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	1	2	1	2	$359.95
3337752	901133689	2823200	1679651426	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$236.00
3337752	901133689	2823200	1245662063	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	4	4	4	3	$1,179.00
3337752	030400182	9793453		MERIT HEALTH MADISON	161 RIVER OAKS DR		CANTON	MS	39046	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	1	1	1	2	$3,307.91
3337752	264509307	8015877		DEER VALLEY SURGICAL AND ENDOSCOPY CENTER	19646 N 27TH AVE 101		PHOENIX	AZ	85027	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN1	5	5	5	7	$17,898.00
3337752	463095174	5716803	1629407069	EXACT SCIENCES LABORATORIES LLC	650 FORWARD DR		MADISON	WI	53711	OA010	PAR	OAPINR		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	LPIN1	2	2	2	2	$1,362.00
3337752	866004791	8474992	1225023179	ARIZONA HEALTH CRE	PO BOX 678863		DALLAS	TX	75267	OA001	NONPAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS OUT-OF-NETWORK	OAIN1	1	1	1	0	$0.00
3337752	200277709	7138287	1396159554	HONORHEALTH URGENT CARE	1515 E BETHANY HOME RD 120B		PHOENIX	AZ	85014	OA001	PAR	OAPIN		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAIN4	2	4	3	5	$938.79
3337752	900412842	1656860		BANNER IRONWOOD MEDICAL CENTER	37000 N GANTZEL RD		QUEEN CREEK	AZ	85140	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF3	1	1	1	3	$1,772.00
3337752	901133689	2823200	1407158090	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	1	$434.00
3337752	901133689	2823200	1154915197	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$236.00
3337752	860423068	0994392		SOUTHWESTERN EYE CENTER LTD	2005 INJO DR 102		LAKE HAVASU CITY	AZ	86403	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	HDPF1	1	1	1	2	$2,350.00
3337752	202684773	6965106		ORTHOPEDIC SURGERY CENTER OF ARIZONA	2262 E ROSE GARDEN LN		PHOENIX	AZ	85024	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP3	1	1	1	4	$46,912.50
3337752	901133689	2823200	1487433785	BANNER URGENT CARE SERVICES LLC	44572 W BOWLIN RD		MARICOPA	AZ	85138	OA001	PAR	OAP1		OTHER	FACILITY OUTPATIENT	CLAIMS PAID AS IN-NETWORK	OAP1	1	1	1	1	$278.00

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Sep 1, 2025.