Professional Documents
Culture Documents
Member Name
Prior
Authorization # Health Plan
1 Enrique Miller
120315017 Premier
2 Sachiko Kanda
120509088 Premier
3 Vicente Ascencio
120404020 Premier
4 Craig Guevarra
120509079 Premier
5 Nicanor Espinosa
120427083 Prmeier
6 Catherine Hansen
120509016 Prmeier
120406035 Fed Standard
120410013 Premier
7 Ava David
8 Gloria Restuvog
9
10
11
23-May-12
Wednesday
Outpatient ECU
Inpatient ECU
Initial Consult
Follow-up Consult
Outpatient
Procedure
Screening Colonoscopy
Shear wave
electroscopy /
Colonoscopy / cbc
crea bun liver fxn test
hbv dna anti hcv
PET CT
Inpatient
Procedure
for LAVH on
5/29/12
APPROVED
Dr. Ian Homer Cua
Dr. Danilo Kuizon
Others:
Inquiry:
Notes: