Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 9 165438 2/20/2017 URBAN WELLNESS GROUP LLC 4900 SE DIVISION ST PORTLAND OR 97206 $ 298.93 86060

2- Medical Claim 9 1001711 2/20/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3395 PORTLAND OR 97208 $ 278.40 $ 1,505.38 86068 2- Medical Claim 9 165473 2/20/2017 SALEM CLINIC PC PO BOX 8100 SALEM OR 97303 $ 64.75 86080 2- Medical Claim 9 165474 2/20/2017 BAY EYE CLINIC 3585 BROADWAY AVE NORTH BEND OR 97459 $ 123.08 86081 2- Medical Claim 9 165478 2/20/2017 GATEWAY WOMENS CLINIC 177 NE 102ND AVE PORTLAND OR 97220 $ 1,665.78 86086 2- Medical Claim 9 165480 2/20/2017 PACIFIC MEDICAL INC 1801 W OLYMPIC BLVD FILE 1616 PASADENA CA 91199 $ 215.00 $ 8.55 86090

2- Medical Claim 9 165513 2/20/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 MS 21 PORTLAND OR 97208 $ 8.32 86175 2- Medical Claim 9 165442 2/20/2017 PMG CLINICS PO BOX 3158 PORTLAND OR 97208 $ 223.95 $ 54.47 86192 2- Medical Claim 9 165450 2/20/2017 EAR NOSE AND THROAT ASSOCIATES LLC 900 SE OAK ST STE 201 HILLSBORO OR 97123 $ 1,172.70 $ 20.94 86203 2- Medical Claim 9 165466 2/20/2017 CALEB LANDRUM LLC 530 HUNTER ST ROCKMART GA 30153 $ 80.00 86243 2- Medical Claim 9 165439 2/20/2017 PEACEHEALTH PO BOX 24410 EUGENE OR 97402 $ 55.53 86056 2- Medical Claim 9 165440 2/20/2017 THERAPYWORKS NW 7927 SE ORIENT DR GRESHAM OR 97080 $ 5.85 86057 2- Medical Claim 9 1001713 2/20/2017 BYRAM HEALTHCARE CENTERS INC PO BOX 277596 ATLANTA GA 30384 $ 166.10 86059 2- Medical Claim 9 1001710 2/20/2017 HEART SPRING HEALTH 4804 SE LINCOLN ST PORTLAND OR 97215 $ 16.50 86063 2- Medical Claim 9 165469 2/20/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $ 4,652.93 86072 2- Medical Claim 9 165470 2/20/2017 TUALITY HEALTHCARE PO BOX 548 HILLSBORO OR 97123 $ 6,250.63 86073 2- Medical Claim 9 165471 2/20/2017 SALEM HOSPITAL PO BOX 2747 PORTLAND OR 97208 $ 6,206.12 86074 2- Medical Claim 9 165472 2/20/2017 CHILDRENS CLINIC PC PO BOX 2725 PORTLAND OR 97208 $ 2.00 86077

2- Medical Claim 9 165475 2/20/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $ 14.03 86083

2- Medical Claim 9 165476 2/20/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3060 PORTLAND OR 97208 $ 1,352.97 86084

2- Medical Claim 9 165479 2/20/2017 WALLOWA COUNTY HEALTH CARE DISTRICT 601 MEDICAL PKWY ENTERPRISE OR 97828 $ 29.39 86089 2- Medical Claim 9 165481 2/20/2017 SALEM PEDIATRIC CLINIC 2478 13TH ST SE SALEM OR 97302 $ 6.24 86093 2- Medical Claim 9 165482 2/20/2017 SALEM RADIOLOGY CONSULTANTS 2925 RYAN DR SE SALEM OR 97301 $ 18.20 86094 2- Medical Claim 9 165483 2/20/2017 CHIROPRACTIC PHYSICIANS PC 705 EWALD AVE SE SALEM OR 97302 $ 2.61 86096 2- Medical Claim 9 165484 2/20/2017 OREGON ANESTHESIOLOGY GROUP PO BOX 2040 PORTLAND OR 97208 $ 212.85 86098 2- Medical Claim 9 165485 2/20/2017 METRO WEST AMBULANCE INC 609 NW COAST ST NEWPORT OR 97365 $ 145.30 86099 2- Medical Claim 9 165486 2/20/2017 PEACEHEALTH SW MED CTR PO BOX 1588 VANCOUVER WA 98668 $ 7.58 86100 2- Medical Claim 9 165487 2/20/2017 GRH REGIONAL MEDICAL CLINIC PO BOX 3290 LA GRANDE OR 97850 $ 110.06 86101 2- Medical Claim 9 1001708 2/20/2017 ASANTE ASHLAND COMMUNITY 280 MAPLE ST ASHLAND OR 97520 $ 2,772.93 86102 2- Medical Claim 9 1001709 2/20/2017 HEART SPRING HEALTH LLC 819 SE MORRISON ST STE 115 PORTLAND OR 97214 $ 82.91 86110 2- Medical Claim 9 165488 2/20/2017 R COLUMBIA GORGE RADIOLOGY PC PO BOX 31 LANDISVILLE PA 17538 $ 6.56 86111 2- Medical Claim 9 165489 2/20/2017 PORTLAND SURGICAL SPECIALISTS 9200 SE 91ST AVE STE 320 HAPPY VALLEY OR 97086 $ 142.09 86116 2- Medical Claim 9 165490 2/20/2017 ASANTE PHYSICIAN PARTNERS PO BOX 748157 LOS ANGELES CA 90074 $ 23.40 86119 2- Medical Claim 9 165491 2/20/2017 SILVERTON HEALTH PO BOX 278 WOODBURN OR 97071 $ 242.64 86122 2- Medical Claim 9 165492 2/20/2017 LYNDON G JOHANSEN DPM 12658 SE STARK ST PORTLAND OR 97233 $ 28.04 86125

1 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 9 165493 2/20/2017 MERCY MEDICAL CENTER PO BOX 310011279 PASADENA CA 91110 $ 24.89 86126 2- Medical Claim 9 165494 2/20/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $ 203.84 86127 2- Medical Claim 9 165495 2/20/2017 CAL ORE LIFE FLIGHT PO BOX 930 WEST PLAINS MO 65775 $ 192.33 86128 2- Medical Claim 9 165496 2/20/2017 PNRSTUALATIN PO BOX 53034 PHOENIX AZ 85072 $ 6,552.83 86129 2- Medical Claim 9 165497 2/20/2017 BEND MEMORIAL CLINIC PC PO BOX 6048 BEND OR 97708 $ 0.98 86133 2- Medical Claim 9 165498 2/20/2017 PROVIDENCE NORTH COAST CLINICS PO BOX 3397 PORTLAND OR 97208 $ 5,009.10 86137 2- Medical Claim 9 165499 2/20/2017 PROVIDENCE HOOD RIVER CLINIC PO BOX 3390 PORTLAND OR 97208 $ 2,112.35 86139

2- Medical Claim 9 165500 2/20/2017 COLUMBIA PAIN AND SPINE INSTITUTE PC 831 NW COUNCIL DR STE 300 GRESHAM OR 97030 $ 166.44 86142

2- Medical Claim 9 165501 2/20/2017 SOUTHWEST WASHINGTON MEDICAL CENTER PO BOX 1588 VANCOUVER WA 98668 $ 16.20 86143

2- Medical Claim 9 165503 2/20/2017 CLACKAMAS PEDIATRIC CLINIC 9290 SE SUNNYBROOK BLVD STE 200 CLACKAMAS OR 97015 $ 11.03 86149 2- Medical Claim 9 165505 2/20/2017 PROVIDENCE MEDFORD MEDICA PO BOX 3308 PORTLAND OR 97208 $ 1,151.54 86154 2- Medical Claim 9 165506 2/20/2017 AMERICAN MEDICAL RESPONSE PO BOX 749667 LOS ANGELES CA 90074 $ 208.40 86155 2- Medical Claim 9 165507 2/20/2017 SPECTRA LABORATORIES INC PO BOX 360790 MILPITAS CA 95036 $ 6.40 86156 2- Medical Claim 9 165508 2/20/2017 OREGON HEALTH & SCIENCE UNIVERSITY PO BOX 5074 PORTLAND OR 97208 $ 20.66 86157 2- Medical Claim 9 165509 2/20/2017 DEPARTMENT OF HUMAN SERVICES PO BOX 14023 SALEM OR 97309 $ 339.78 86159 2- Medical Claim 9 165510 2/20/2017 ADVANCED CARE CHIROPRACTIC 837 E POWELL BLVD GRESHAM OR 97030 $ 12.05 86167 2- Medical Claim 9 165511 2/20/2017 CHILDRENS INTENSIVE THERAPY NW INC 12948 SE WINSTON RD DAMASCUS OR 97089 $ 46.81 86168 2- Medical Claim 9 165512 2/20/2017 NORMUND J AKOTS PHD PO BOX 96103 PORTLAND OR 97296 $ 58.00 86173 2- Medical Claim 9 165514 2/20/2017 NICOLA J CHERRY MD LLC 2580 DAGGETT AVE KLAMATH FALLS OR 97601 $ 14.20 86177 4252 SE INTERNATIONAL 2- Medical Claim 9 165515 2/20/2017 BELLEVUE HEALTHCARE II INC WAY STE G PORTLAND OR 97222 $ 0.96 86178 2- Medical Claim 9 165517 2/20/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $ 184.63 86184

2- Medical Claim 9 165519 2/20/2017 LEGACY EMANUEL HOSPITAL & HEALTH CENTER PO BOX 4037 PORTLAND OR 97208 $ 459.39 86189 2- Medical Claim 9 1001712 2/20/2017 AH MEDICAL GROUP PO BOX 92900 PORTLAND OR 97292 $ 88.07 86190 2- Medical Claim 9 165441 2/20/2017 LEGACY MERIDIAN PARK PROVIDERS PO BOX 6689 PORTLAND OR 97228 $ 2,860.94 86191 2- Medical Claim 9 165443 2/20/2017 CRC HEALTH OR AHS EAST 6601 NE 78TH CT PORTLAND OR 97218 $ 652.50 86193 2- Medical Claim 9 165444 2/20/2017 SYNERGY MEDICAL SYSTEMS LLC 28050 SW BOBERG RD WILSONVILLE OR 97070 $ 13.65 86195 2- Medical Claim 9 165445 2/20/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $ 16.29 86196 2- Medical Claim 9 165446 2/20/2017 SILVERTON HEALTH PO BOX 3417 PORTLAND OR 97208 $ 30.26 86199 2- Medical Claim 9 165447 2/20/2017 STEFAN JODKO MD PO BOX 1359 KLAMATH FALLS OR 97601 $ 14.34 86200 2- Medical Claim 9 165448 2/20/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $ 43.64 86201 2- Medical Claim 9 165449 2/20/2017 THE VITAL COMPASS 5412 N WILLIAMS AVE PORTLAND OR 97217 $ 5.40 86202 2- Medical Claim 9 165451 2/20/2017 CITY OF CORVALLIS AMBULANCE PO BOX 1083 CORVALLIS OR 97339 $ 111.48 86205 2- Medical Claim 9 165452 2/20/2017 DR KACY BORBA LLC 9989 SW NIMBUS AVE BEAVERTON OR 97008 $ 12.53 86207 2- Medical Claim 9 165453 2/20/2017 LIFE FLIGHT NETWORK LLC PO BOX 3881 MS 631031 SEATTLE WA 98124 $ 4,871.40 86208

2 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 9 165454 2/20/2017 ALICIA R PETERMAN 4203 SE HAWTHORNE BLVD PORTLAND OR 97215 $ 25.60 86210 2- Medical Claim 9 165455 2/20/2017 SILVERTON SPECIALISTS CENTER PO BOX 278 WOODBURN OR 97071 $ 88.10 86213 2- Medical Claim 9 165456 2/20/2017 SWEDISH EDMONDS LAB SERVICES PO BOX 3328 LYNNWOOD WA 98046 $ 83.35 86216 2- Medical Claim 9 165457 2/20/2017 NOEL SNODGRASS 1220 SW MORRISON ST STE 900 PORTLAND OR 97205 $ 5.50 86222 2- Medical Claim 9 165459 2/20/2017 21ST CENTURY WELLNESS INC 23792 ROCKFIELD BLVD LAKE FOREST CA 92630 $ 18.72 86226

2- Medical Claim 9 165460 2/20/2017 SALEM EMERGENCY PHYSICIANS SERVICE PC PO BOX 742547 LOS ANGELES CA 90074 $ 26.46 86229 2- Medical Claim 9 165461 2/20/2017 QUICKMED MEDICAL PC 2689 BROADWAY NEW YORK NY 10025 $ 6.37 86231 2- Medical Claim 9 165462 2/20/2017 ST JOSEPH EMERGENCY PHYSICIANS PLLC PO BOX 731644 DALLAS TX 75373 $ 102.41 86232 2- Medical Claim 9 165463 2/20/2017 EM SPECIALISTS PA PO BOX 8847 FORT WORTH TX 76124 $ 29.93 86234 2- Medical Claim 9 165465 2/20/2017 ARTHUR R MURRELL DC 200 NE 20TH AVE STE 20 PORTLAND OR 97232 $ 7.76 86238 2- Medical Claim 9 165467 2/20/2017 ELIXIA WELLNESS GROUP LLC 8113 SE 13TH AVE PORTLAND OR 97202 $ 4.00 86244 Member information 2- Member Loss 9 165468 2/20/2017 Member information redacted redacted Portland OR 97229 $ 10.50 86247 Batch Total $ 4,130.91 $ 50,064.81 2- Medical Claim/Void and Reissue 10 165524 2/23/2017 PEACEHEALTH MEDICAL GROUP 1115 SE 164th Ave Dept 364 VANCOUVER WA 98683 571.83 $ - 10108 2- Medical Claim/Void and Reissue 10 165520 2/23/2017 SAMARITAN PACIFIC HEALTH SERVICES INC PO Box 2847 CORVALLIS OR 97339-2847 $ 578.65 $ - 24687 2- Medical Claim/Void and Reissue 10 165521 2/23/2017 SENDERS KATHRYN J 1942 NW KEARNEY STE 22 PORTLAND OR 97209 $ 90.00 $ - 42616 2- Medical Claim/Void and Reissue 10 165522 2/23/2017 SENDERS KATHRYN J 1942 NW KEARNEY ST STE 22 PORTLAND OR 97209 $ 90.00 $ - 45192 2- Medical Claim/Void and Reissue 10 165523 2/23/2017 SENDERS KATHRYN J 1942 NW Kearney St STE 22 PORTLAND OR 97209 $ 90.00 $ - 46122 2- Medical Claim/Void and Reissue 10 165530 2/23/2017 MARTIN C FOSTER MD PO Box 21 LANDISVILLE PA 17538 $ 13.81 $ - 51486 2- Medical Claim/Void and Reissue 10 165533 2/23/2017 TCH ANESTHESIOLOGY DEPARTMENT DEPT LA 24105 PASADENA CA 91185 $ 879.42 51808 2- Medical Claim/Void and Reissue 10 165532 2/23/2017 TCH ANESTHESIOLOGY DEPARTMENT DEPT LA 24105 PASADENA CA 91185 $ 1,319.85 $ - 54148

3 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim/Void and Reissue 10 165528 2/23/2017 WHITE RIVER HEALTH DISTRICT PO BOX 219 MAUPIN OR 97037-0219 $ 475.07 $ - 55449 2- Medical Claim/Void and Reissue 10 165529 2/23/2017 SERENITY LANE PO Box 8549 EUGENE OR 97408 $ 935.00 $ - 56905 2- Medical Claim/Void and Reissue 10 165527 2/23/2017 DOCTORS EXPRESS PO Box 5943 VIRGINIA BEACH VA 23471 $ 123.80 $ - 57055 2- Medical Claim/Void and Reissue 10 165531 2/23/2017 TCH ANESTHESIOLOGY DEPARTMENT DEPT LA 24105 PASADENA CA 91185 $ 127.69 $ - 58548 2- Medical Claim/Void and Reissue 10 165525 2/23/2017 ROCHELLE MOLLEN 4504 SW CORBETT AVE STE 201 PORTLAND OR 97239 $ 240.00 $ - 58639 2- Medical Claim/Void and CLACKAMAS RADIATION ONCOLOGY CENTER Reissue 10 165526 2/23/2017 LLC PO BOX 3867 PORTLAND OR 97208 $ 10,357.39 $ - 69226 2- Medical Claim 10 165597 2/23/2017 URBAN WELLNESS GROUP LLC 4900 SE DIVISION ST PORTLAND OR 97206 $ 3.50 86249 2- Medical Claim 10 165598 2/23/2017 SELLWOOD FAMILY MEDICINE 1567 SE TACOMA ST PORTLAND OR 97202 $ 567.84 $ 28.22 86250 3181 SW SAM JACKSON 2- Medical Claim 10 165599 2/23/2017 UNIVERSITY PROFESSIONAL SERVICES PARK RD PORTLAND OR 97239 $ 16.50 86251 PROACTIVE ORTHOPEDIC AND SPORTS 2- Medical Claim 10 165600 2/23/2017 PHYSICAL THERAPY OF GRESHAM LLC PO BOX 52194 PHOENIX AZ 85072 $ 9.98 86259 2- Medical Claim 10 165601 2/23/2017 NORCO INC PO BOX 15299 BOISE ID 83715 $ 238.09 86262 2- Medical Claim 10 165602 2/23/2017 PEARL NATURAL HEALTH 511 SW 10TH AVE STE 801 PORTLAND OR 97205 $ 388.01 $ 11.36 86263 2- Medical Claim 10 165603 2/23/2017 COLUMBIA ANESTHESIA GROUP PS PO BOX 5157 VANCOUVER WA 98668 $ 38.70 86264 KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT 2- Medical Claim 10 165604 2/23/2017 2 PO BOX 99 WHITE SALMON WA 98672 $ 51.45 86265 2- Medical Claim 10 165605 2/23/2017 ALBANY GENERAL HOSPITAL PO BOX 1188 CORVALLIS OR 97339 $ 1,427.47 86266 2- Medical Claim 10 165534 2/23/2017 GOOD SAMARITAN HOSPITAL CORVALLIS PO BOX 1189 CORVALLIS OR 97339 $ 545.30 $ 28.70 86270 2- Medical Claim 10 1001715 2/23/2017 BAY CLINIC 1750 THOMPSON RD COOS BAY OR 97420 $ 124.71 86272 2- Medical Claim 10 165607 2/23/2017 ST CHARLES BEHAVIORAL HEALTH PO BOX 5579 BEND OR 97708 $ 135.00 $ 46.68 86276 CASCADE ORTHOPEDICS & SPORTS MEDICINE 2- Medical Claim 10 165608 2/23/2017 CENTER PC 1715 E 12TH ST THE DALLES OR 97058 $ 8.17 86278 1460 NE MEDICAL CENTER 2- Medical Claim 10 165609 2/23/2017 CENTRAL OREGON RADIOLOGY ASSOC PC DR BEND OR 97701 $ 210.93 86280

2- Medical Claim 10 165610 2/23/2017 VIRGINIA GARCIA MEMORIAL HEALTH CENTER PO BOX 568 CORNELIUS OR 97113 $ 151.60 $ 3.32 86281 2- Medical Claim 10 165611 2/23/2017 SALEM CLINIC PC PO BOX 8100 SALEM OR 97303 $ 89.60 86282

4 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 10 165611 2/23/2017 SALEM CLINIC PC PO BOX 8100 SALEM OR 97303 $ 2.55 86282 2- Medical Claim 10 165612 2/23/2017 PACIFIC MEDICAL GROUP PC 6 CENTERPOINTE DR STE 200 LAKE OSWEGO OR 97035 $ 120.52 86287 2- Medical Claim 10 165614 2/23/2017 NORTHWEST SURGICAL SPECIALISTS LLP 3355 RIVERBEND DR STE 300 SPRINGFIELD OR 97477 $ 50.58 86290

2- Medical Claim 10 165616 2/23/2017 SAMARITAN PACIFIC HEALTH SERVICES INC PO BOX 2847 CORVALLIS OR 97339 $ 80.87 86293 2- Medical Claim 10 165617 2/23/2017 ROGUE VALLEY SURGERY CENTER LLC 2925 SISKIYOU BLVD MEDFORD OR 97504 $ 50.48 86295 2- Medical Claim 10 165618 2/23/2017 SALEM PEDIATRIC CLINIC 2478 13TH ST SE SALEM OR 97302 $ 9.36 86296

2- Medical Claim 10 165619 2/23/2017 A BALANCED LIFE HEALTH CARE 2005 SE HAWTHORNE BLVD PORTLAND OR 97214 $ 18.50 86300 2- Medical Claim 10 165620 2/23/2017 WHITE RIVER FAMILY CARE LLC PO BOX 1268 BUCKLEY WA 98321 $ 13.14 86301 2- Medical Claim 10 165621 2/23/2017 NEIGHBORHOOD HEALTH CENTER PO BOX 4609 PORTLAND OR 97208 $ 153.93 86304 2- Medical Claim 10 165622 2/23/2017 QUEST DIAGNOSTIC FILE 50342 LOS ANGELES CA 90074 $ 21.46 86306 2- Medical Claim 10 165623 2/23/2017 PORTLAND PAIN CARE PO BOX 3714 SEATTLE WA 98124 $ 196.54 86308 2- Medical Claim 10 165624 2/23/2017 GRH REGIONAL MEDICAL CLINIC PO BOX 3290 LA GRANDE OR 97850 $ 41.85 86309 2- Medical Claim 10 165625 2/23/2017 ANESTHESIA ASSOCIATES PO BOX 1705 MEDFORD OR 97501 $ 199.90 86310 2- Medical Claim 10 165626 2/23/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $ 17.54 86311 2- Medical Claim 10 165627 2/23/2017 DALLAS OREGON EMERG PHYSICIANS PO BOX 98585 LAS VEGAS NV 89193 $ 57.00 86318 2- Medical Claim 10 165628 2/23/2017 SELLWOOD MEDICAL CLINIC PO BOX 8770 BELFAST ME 04915 $ 13.03 86319 2- Medical Claim 10 165629 2/23/2017 NORTHWEST ACUTE CARE SPECIALISTS PO BOX 4979 PORTLAND OR 97208 $ 166.60 86321 2- Medical Claim 10 165630 2/23/2017 ALL AND ONE ACUPUNCTURE 2906 NE GLISAN ST PORTLAND OR 97232 $ 453.34 $ 30.97 86323 2- Medical Claim 10 1001714 2/23/2017 HEART SPRING HEALTH LLC 819 SE MORRISON ST STE 115 PORTLAND OR 97214 $ 755.67 $ 37.97 86327 2- Medical Claim 10 165632 2/23/2017 LINCARE INC PO BOX 3187 SPOKANE WA 99220 $ 124.80 $ 68.28 86336 2- Medical Claim 10 165633 2/23/2017 ST CHARLES REDMOND PO BOX 6096 BEND OR 97708 $ 11.85 86339 2- Medical Claim 10 165634 2/23/2017 OREGON PULMONARY ASSOCIATES PC PO BOX 6958 PORTLAND OR 97228 $ 15.96 86340

2- Medical Claim 10 165635 2/23/2017 PEDIATRIX MEDICAL GROUP OF MISSOURI PC PO BOX 277279 ATLANTA GA 30384 $ 1,073.11 86341 2- Medical Claim 10 165636 2/23/2017 SE PORTLAND SURGICAL CLINIC 10000 SE MAIN ST STE 316 PORTLAND OR 97216 $ 1,031.74 86342 2- Medical Claim 10 165637 2/23/2017 MULTNOMAH COUNTY 421 SW OAK ST STE 210 PORTLAND OR 97204 $ 6.23 86343 2- Medical Claim 10 165638 2/23/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $ 1.57 86345 2- Medical Claim 10 165640 2/23/2017 PACIFIC CLEARVISION INSTITUTE PO BOX 10888 EUGENE OR 97440 $ 12.78 86348 2- Medical Claim 10 165641 2/23/2017 NORTHWEST CARDIOLOGISTS PC PO BOX 4049 PORTLAND OR 97208 $ 47.03 86350

2- Medical Claim 10 165643 2/23/2017 CRM PHYSICIANS LLC 12015 NW OLD QUARRY RD PORTLAND OR 97229 $ 46.44 86352 2- Medical Claim 10 165644 2/23/2017 SALUD MEDICAL CENTER PO BOX 190 TOPPENISH WA 98948 $ 10.77 86354 2- Medical Claim 10 165645 2/23/2017 PROVIDENCE NORTH COAST CLINICS PO BOX 3397 PORTLAND OR 97208 $ 278.54 86356 2- Medical Claim 10 165646 2/23/2017 PROVIDENCE HOOD RIVER CLINIC PO BOX 3390 PORTLAND OR 97208 $ 115.13 86359 ORTHOPEDIC & SPORTS MEDICINE CENTER OF 2- Medical Claim 10 165647 2/23/2017 OREGON 1515 NW 18TH AVE STE 300 PORTLAND OR 97209 $ 4.31 86362

2- Medical Claim 10 165648 2/23/2017 OREGON PEDIATRICS HAPPY VALLEY PC 9290 SE SUNNYBROOK BLVD STE 200 CLACKAMAS OR 97015 $ 32.51 $ 13.26 86365

5 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 10 165649 2/23/2017 HEARTFELT OBSTETRICS & GYNECOLOGY PO BOX 1359 KLAMATH FALLS OR 97601 $ 115.38 86367 2- Medical Claim 10 165650 2/23/2017 DOCTORS EXPRESS PO BOX 10660 PORTLAND OR 97296 $ 4.41 86369 2- Medical Claim 10 165651 2/23/2017 PORTLAND CLINIC 800 SW 13TH AVE PORTLAND OR 97205 $ 304.47 $ 25.62 86372 2- Medical Claim 10 165652 2/23/2017 RADIOLOGY CONSULTANTS INC PO BOX 3409 PORTLAND OR 97208 $ 40.19 86374 2- Medical Claim 10 165653 2/23/2017 MEDFORD RADIOLOGICAL GROUP PO BOX 3807 SEATTLE WA 98124 $ 9.89 86377

2- Medical Claim 10 165654 2/23/2017 WESTERN PSYCHOLOGICAL & COUNSELING PO BOX 82819 PORTLAND OR 97282 $ 15.55 86378

2- Medical Claim 10 165655 2/23/2017 CLACKAMAS PEDIATRIC CLINIC 9290 SE SUNNYBROOK BLVD STE 200 CLACKAMAS OR 97015 $ 376.20 $ 109.61 86381 2- Medical Claim 10 165656 2/23/2017 MID COLUMBIA FAMILY PHYSICIANS PO BOX 1519 WHITE SALMON WA 98672 $ 13.51 86387 2- Medical Claim 10 165657 2/23/2017 APRIA HEALTHCARE LLC PO BOX 31001 PASADENA CA 91110 $ 134.55 86388 2- Medical Claim 10 165658 2/23/2017 AMERICAN MEDICAL RESPONSE PO BOX 749667 LOS ANGELES CA 90074 $ 299.14 86394 2- Medical Claim 10 165659 2/23/2017 INHOUSE COUNSELING 10117 SE SUNNYSIDE RD STE F1217 CLACKAMAS OR 97015 $ 21.25 86400 2- Medical Claim 10 165660 2/23/2017 PACIFIC COAST IMAGING LLC PO BOX 3610 TUALATIN OR 97062 $ 18.63 86401 2- Medical Claim 10 165661 2/23/2017 WESTSIDE SLEEP CENTER LLC 7450 SW BEVELAND RD STE 120 PORTLAND OR 97223 $ 24.60 86402 2- Medical Claim 10 1001716 2/23/2017 UBH OF OREGON LLC 10300 SW EASTRIDGE ST PORTLAND OR 97225 $ 27.20 86403 2- Medical Claim 10 165584 2/23/2017 SILVER FALLS DERMATOLOGY PC 1793 13TH ST SE SALEM OR 97302 $ 122.76 86404 ADVANCED ORTHOPEDIC & SPORTS MEDICINE 2- Medical Claim 10 165585 2/23/2017 INSTITUTE L 620 NW 11TH ST STE 201 HERMISTON OR 97838 $ 1,498.64 86405 2- Medical Claim 10 165586 2/23/2017 REMOTE ALLERGY PROVIDERS PC 1050 W ELM AVE STE 150 HERMISTON OR 97838 $ 32.68 86410

2- Medical Claim 10 165587 2/23/2017 TOWER OCULOFACIAL PLASTIC SURGERY PC 1211 NW GLISAN ST STE 201 PORTLAND OR 97209 $ 28.90 86411

2- Medical Claim 10 165588 2/23/2017 HOLISTIC HEALTH CLINIC 4670 SW WASHINGTON AVE BEAVERTON OR 97005 $ 5.26 86412

2- Medical Claim 10 165589 2/23/2017 DESERT BONE AND JOINT SPECIALISTS LLC 1303 NE CUSHING DR STE 100 BEND OR 97701 $ 1.95 86416

2- Medical Claim 10 165590 2/23/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $ 10.96 86421 2- Medical Claim 10 165591 2/23/2017 THE OREGON CLINIC PC PO BOX 5087 MS 163 PORTLAND OR 97208 $ 16.38 86423 2- Medical Claim 10 165592 2/23/2017 OREGON PEDIATRIC CLINIC 5050 NE HOYT ST STE B55 PORTLAND OR 97213 $ 644.57 86424 2- Medical Claim 10 165592 2/23/2017 OREGON PEDIATRIC CLINIC 5050 NE HOYT ST STE B55 PORTLAND OR 97213 $ 140.62 86424 2- Medical Claim 10 165593 2/23/2017 COUNTY OF MULTNOMAH 421 SW OAK ST STE 210 PORTLAND OR 97204 $ 44.75 86428 2- Medical Claim 10 165594 2/23/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $ 655.52 86429 2- Medical Claim 10 165594 2/23/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $ 98.89 86429 2- Medical Claim 10 165595 2/23/2017 SAMARITAN MEDICAL SUPPLIES 946 NW CIRCLE BLVD CORVALLIS OR 97330 $ 303.81 86432

2- Medical Claim 10 165596 2/23/2017 LEGACY EMANUEL HOSPITAL & HEALTH CENTER PO BOX 4037 PORTLAND OR 97208 $ 4,219.58 86434 2- Medical Claim 10 1001717 2/23/2017 AH MEDICAL GROUP PO BOX 92900 PORTLAND OR 97292 $ 532.06 28.6 86435 2- Medical Claim 10 165535 2/23/2017 BRIDGETOWN MEDICAL GROUP 10000 SE MAIN ST STE 316 PORTLAND OR 97216 $ 32.91 86437 2- Medical Claim 10 165537 2/23/2017 PORTLAND ANESTHESIA SPECIALIST PO BOX 636856 CINCINNATI OH 45263 $ 1,260.00 86440

6 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 10 165538 2/23/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $ 27.58 86441 2- Medical Claim 10 165539 2/23/2017 THE OREGON CLINIC PC 847 NE 19TH AVE PORTLAND OR 97232 $ 6.89 86442 2- Medical Claim 10 165540 2/23/2017 POLK COUNTY FIRE DISTRICT NO 1 PO BOX 914 SPRINGFIELD OR 97477 $ 134.84 86443

2- Medical Claim 10 165541 2/23/2017 CONNECTED HOME HEALTH 7515 NE AMBASSADOR PL PORTLAND OR 97220 $ 121.92 86447 2- Medical Claim 10 165542 2/23/2017 SILVERTON HEALTH PO BOX 3417 PORTLAND OR 97208 $ 125.31 86448 2- Medical Claim 10 165543 2/23/2017 SKY LAKES MEDICAL CENTER INC PO BOX 2120 PORTLAND OR 97208 $ 7.22 86450 2- Medical Claim 10 165544 2/23/2017 THE ORGEON CLINIC 847 NE 19TH AVE PORTLAND OR 97232 $ 48.42 86451 2- Medical Claim 10 165545 2/23/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $ 185.26 86452 2- Medical Claim 10 165546 2/23/2017 THE VITAL COMPASS 5412 N WILLIAMS AVE PORTLAND OR 97217 $ 6.66 86454 2- Medical Claim 10 165547 2/23/2017 PACIFIC KIDNEY & HYPERTENSION PO BOX 16012 BELFAST ME 04915 $ 124.73 86456 2- Medical Claim 10 165548 2/23/2017 SHRINERS HOSPITALS FOR CHILDREN PO BOX 8500 PHILADELPHIA PA 19178 $ 50.90 86457 2- Medical Claim 10 165549 2/23/2017 SUMMIT FAMILY MEDICINE LLC 1021 JUNE ST STE 104 HOOD RIVER OR 97031 $ 11.20 86458 2- Medical Claim 10 165550 2/23/2017 SKY LAKES MEDICAL CENTER PO BOX 2120 PORTLAND OR 97208 $ 36.66 86463 2- Medical Claim 10 165551 2/23/2017 RISING TIDE MEDICINE 443 NE KNOTT ST PORTLAND OR 97212 $ 475.31 86466 2- Medical Claim 10 165552 2/23/2017 OREGON NATURAL MEDICINE LLC 1724 NE 42ND AVE PORTLAND OR 97213 $ 8.50 86468 PROVIDENCE HEALTH & SERVICES 2- Medical Claim 10 165553 2/23/2017 WASHINGTON PO BOX 32 LIBERTY LAKE WA 99019 $ 122.60 86469 2- Medical Claim 10 165554 2/23/2017 SUZANNE SCOPES ND PC 316 NE 28TH AVE PORTLAND OR 97232 $ 125.00 $ 164.35 86471 360 DEGREE SPORTS MEDICINE AND SPINE 2- Medical Claim 10 165555 2/23/2017 THERAPY 1215 SE 8TH AVE PORTLAND OR 97214 $ 25.80 86472 2- Medical Claim 10 165556 2/23/2017 NP2U LLC 25117 SW PARKWAY AVE WILSONVILLE OR 97070 $ 50.88 86473 2- Medical Claim 10 165557 2/23/2017 WILSHIRE SURGERY CENTER 9775 SW WILSHIRE ST STE 250 PORTLAND OR 97225 $ 1,588.50 86474 2- Medical Claim 10 165558 2/23/2017 CANBY AMBULANCE SERVICE 221 S PINE ST CANBY OR 97013 $ 101.20 86477 2- Medical Claim 10 165559 2/23/2017 FRED COLER M D PO BOX 13510 PORTLAND OR 97213 $ 18.87 86479

2- Medical Claim 10 165560 2/23/2017 PACIFIC BIPOLAR TREATMENT PROGRAM LLC 1675 SW MARLOW AVE STE 305 PORTLAND OR 97225 $ 26.50 86480 2- Medical Claim 10 165561 2/23/2017 TYLER KELIIHELEUA ND 14900 SW BARROWS RD STE 201 BEAVERTON OR 97007 $ 14.38 86482 2- Medical Claim 10 165562 2/23/2017 ICCO LLC 1292 HIGH ST # 224 EUGENE OR 97401 $ 39.88 86483 2- Medical Claim 10 165563 2/23/2017 ADVANCED LABORATORY SERVICES INC 501 ELMWOOD AVE SHARON HILL PA 19079 $ 17.09 86487 2- Medical Claim 10 165564 2/23/2017 SNAPDRAGON ACUPUNCTURE LLC 3025 SE 25TH AVE PORTLAND OR 97202 $ 9.60 86489 2- Medical Claim 10 165565 2/23/2017 ANDREA P FISK 1235 SE DIVISION ST STE 201 PORTLAND OR 97202 $ 21.20 86490 2- Medical Claim 10 165566 2/23/2017 DAVID NAIMON ND LAC PC 2700 SE 26TH AVE STE D PORTLAND OR 97202 $ 100.00 86491 2- Medical Claim 10 165567 2/23/2017 NATURAL PHYSICIANS 4555 LIBERTY RD S STE 360 SALEM OR 97302 $ 1,835.78 $ 139.85 86493 2- Medical Claim 10 165568 2/23/2017 WESTSIDE INTERNAL MEDICINE PO BOX 23200 PORTLAND OR 97281 $ 189.21 86496 2- Medical Claim 10 165569 2/23/2017 LINDA BIRD PO BOX 5485 SALEM OR 97304 $ 188.40 86499 2- Medical Claim 10 165570 2/23/2017 BEHALL ACUPUNCTURE LLC 5714 NE 17TH AVE PORTLAND OR 97211 $ 49.34 86500 2- Medical Claim 10 165571 2/23/2017 SARAH LARSON ND 1409 FRANKLIN ST STE 103 VANCOUVER WA 98660 $ 249.38 86501 2- Medical Claim 10 165572 2/23/2017 PROVIDENCE HEALTH & SERVICES PO BOX 3396 PORTLAND OR 97208 $ 171.40 86502 2- Medical Claim 10 165573 2/23/2017 SALEM REHABILITATION ASSOCIATES INC 3624 RIVER RD N KEIZER OR 97303 $ 88.60 86503

7 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 10 165574 2/23/2017 JEFFREY D LENOX MD LLC 528 COTTAGE ST NE STE 340 SALEM OR 97301 $ 22.75 86504 2- Medical Claim 10 165575 2/23/2017 PDX BODYWORKS PHYSICAL THERAPY 5020 SE TOLMAN ST PORTLAND OR 97206 $ 20.12 86505 2- Medical Claim 10 165576 2/23/2017 THE OREGON CLINIC PC PO BOX 5087 MAIL STOP 163 PORTLAND OR 97208 $ 20.17 86506 2- Medical Claim 10 165577 2/23/2017 HEALING LIFE SKILLS PC 3310 SE DIVISION ST PORTLAND OR 97202 $ 20.00 86508

2- Medical Claim 10 165578 2/23/2017 AMERICAN ANESTHESIOLOGY OF FLORIDA PO BOX 535470 ATLANTA GA 30353 $ 17.93 86510 29292 SW TOWN CENTER 2- Medical Claim 10 165579 2/23/2017 COMPLETE CARE CHIROPRACTIC PC LOOP E WILSONVILLE OR 97070 $ 190.48 86512 2- Medical Claim 10 165580 2/23/2017 ADJ CORPORATION 10200 PIONEER BLVD SANTA FE SPRINGS CA 90670 $ 10.39 86513 Member information 2- Member Loss 10 165581 2/23/2017 Member information redacted redacted PORTLAND OR 972042405 $ 4.60 86517 Member information 2- Member Loss 10 165583 2/23/2017 Member information redacted redacted Gladstone OR 97027 $ 6.25 86519 Batch Total $ 30,503.09 $ 13,141.60 2- Medical Claim 11 1001719 3/6/2017 BYRAM HEALTHCARE CENTERS INC PO BOX 277596 ATLANTA GA 30384 $165.16 $138.77 86529 2- Medical Claim 11 165788 3/6/2017 MUELLER MARCIA A 7380 SW GABLE PARK RD PORTLAND OR 97225 $36.62 86541 CENTER FOR DERMATOLOGY & LASER SURGERY 2- Medical Claim 11 165790 3/6/2017 PC PO BOX 2967 PORTLAND OR 97208 $1,199.93 86544 2- Medical Claim 11 165791 3/6/2017 NORCO INC PO BOX 15299 BOISE ID 83715 $341.76 $34.18 86545 2- Medical Claim 11 165794 3/6/2017 TUALITY HEALTHCARE PO BOX 548 HILLSBORO OR 97123 $1,047.38 $179.68 86556

2- Medical Claim 11 165798 3/6/2017 MEDICAL IMAGING GROUP OF HILLSBORO PO BOX 28130 PORTLAND OR 97228 $126.06 $4.11 86565 2- Medical Claim 11 165800 3/6/2017 PEACEHEALTH MEDICAL GROUP PO BOX 24410 EUGENE OR 97402 $312.61 $0.00 86573 PLANNED PARENTHOOD OF THE 2- Medical Claim 11 165805 3/6/2017 COLUMBIAWILLAMETTE INC 3727 NE M L KING BLVD PORTLAND OR 97212 $211.20 86583 2- Medical Claim 11 165812 3/6/2017 VICTOR B RICHENSTEIN MD PC 66 CLUB RD STE 210 EUGENE OR 97401 $44.07 86604 2- Medical Claim 11 165681 3/6/2017 NARTNUCHA U UNHANAND MD PC PO BOX 22 LANDISVILLE PA 17538 $88.80 86621 2- Medical Claim 11 165741 3/6/2017 CAL ORE LIFE FLIGHT PO BOX 930 WEST PLAINS MO 65775 $150.00 86649

2- Medical Claim 11 165752 3/6/2017 NORTHWEST CARDIOVASCULAR INSTITUTE LLP 1200 NW NAITO PKWY STE 200 PORTLAND OR 97209 $556.42 $21.82 86688 2- Medical Claim 11 165753 3/6/2017 OREGON UROLOGY CLINIC PC 2222 NW LOVEJOY ST STE 416 PORTLAND OR 97210 $96.91 $98.68 86692 2- Medical Claim 11 165757 3/6/2017 APRIA HEALTHCARE LLC PO BOX 31001 PASADENA CA 91110 $29.97 $17.69 86699 2- Medical Claim 11 165762 3/6/2017 INHOUSE COUNSELING 10117 SE SUNNYSIDE RD STE F1217 CLACKAMAS OR 97015 $146.06 $48.80 86716 2- Medical Claim 11 165765 3/6/2017 PAMELA SHARA FRASER 877 NE 25TH AVE HILLSBORO OR 97124 $59.77 86721 525 N COLUMBIA RIVER 2- Medical Claim 11 165769 3/6/2017 SAINT HELENS INTERNAL MEDICINE LLC HWY SAINT HELENS OR 97051 $64.14 $6.42 86729 2- Medical Claim 11 165777 3/6/2017 COUNTY OF MULTNOMAH 421 SW OAK ST STE 210 PORTLAND OR 97204 $141.83 $256.45 86755 2- Medical Claim 11 165783 3/6/2017 PACIFIC PAIN MANAGEMENT PC 6542 SE LAKE RD STE 101 PORTLAND OR 97222 $54.47 86772 2- Medical Claim 11 165693 3/6/2017 SHAWNTE YATES ND LAC LLC 1110 SE ALDER ST STE 201 PORTLAND OR 97214 $243.12 86797

8 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # GOOD SAMARITAN REGIONAL MEDICAL 2- Medical Claim 11 165698 3/6/2017 CENTER PO BOX 1189 CORVALLIS OR 97339 $183.18 $46.27 86806 2- Medical Claim 11 165709 3/6/2017 SNAPDRAGON ACUPUNCTURE LLC 3025 SE 25TH AVE PORTLAND OR 97202 $96.00 86827 2- Medical Claim 11 165711 3/6/2017 ELLEN SAUTER ND 2456 NW NORTHRUP ST STE 1A PORTLAND OR 97210 $86.93 $59.67 86831 2- Medical Claim 11 165714 3/6/2017 NATURAL PHYSICIANS 4555 LIBERTY RD S STE 360 SALEM OR 97302 $156.84 $41.17 86836

2- Medical Claim 11 165718 3/6/2017 LABORATORY CORPORATION OF AMERICA PO BOX 2270 BURLINGTON NC 27216 $107.43 $0.00 86844 2- Medical Claim 11 165725 3/6/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $336.50 86860 2- Medical Claim 11 165726 3/6/2017 TUALITY HEALTHCARE PO BOX 2950 HILLSBORO OR 97123 $113.02 86861 2- Medical Claim 11 165731 3/6/2017 EAST WEST ACUPUNTURE CLINIC 12050 SE HOLGATE BLVD PORTLAND OR 97266 $130.68 86867 Member information 2- Member Loss 11 165735 3/6/2017 Member information redacted redacted Portland OR 97211 $170.00 86873 2- Medical Claim/Void and Reissue 11 165662 3/6/2017 ANGELA CAIAZZA LMFT 123 E POWELL BLVD GRESHAM OR 97030 $187.70 54257 2- Medical Claim/Void and Reissue 11 165663 3/6/2017 ANGELA CAIAZZA LMFT 123 E POWELL BLVD GRESHAM OR 97030 $62.83 52311 2- Medical Claim/Void and Reissue 11 165664 3/6/2017 ANGELA CAIAZZA LMFT 123 E POWELL BLVD GRESHAM OR 97030 $62.50 55980 2- Medical Claim/Void and Reissue 11 165665 3/6/2017 ARMSTRONG TODD PO BOX 1192 GOLD BEACH OR 97444 $37.50 61641 2- Medical Claim/Void and Reissue 11 165666 3/6/2017 ARMSTRONG TODD PO BOX 1192 GOLD BEACH OR 97444 $37.50 60044 2- Medical Claim/Void and Reissue 11 165667 3/6/2017 ARMSTRONG TODD PO BOX 1192 GOLD BEACH OR 97444 $37.50 64344 2- Medical Claim/Void and 16144 SE HAPPY VALLEY Reissue 11 165668 3/6/2017 KATHERINE LOPEZ SANKEY TOWN CE HAPPY VALLEY OR 97086 $81.88 67628 2- Medical Claim/Void and 16144 SE HAPPY VALLEY Reissue 11 165669 3/6/2017 KATHERINE LOPEZ SANKEY TOWN CE HAPPY VALLEY OR 97086 $150.30 60402 2- Medical Claim/Void and ARIS RADIOLOGY PROFESSIONALS OF Reissue 11 165670 3/6/2017 MICHIGAN PC PO BOX 72078 CLEVELAND OH 44192 $63.87 64658

9 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim/Void and Reissue 11 165671 3/6/2017 BARNHART PROSTHETIC AND ORTHOT 1881 2nd Street Suite 101 SPRINGFIELD OR 97477 $59.85 56300 2- Medical Claim/Void and Reissue 11 165672 3/6/2017 CHILDRENS NATUROPATHIC CENTRE 4444 SW CORBETT AVE PORTLAND OR 97239 $75.45 64748 2- Medical Claim/Void and Reissue 11 165673 3/6/2017 DONALD E ROSEN 2250 NW FLANDERS ST PORTLAND OR 97210 $115.78 52934 2- Medical Claim/Void and Reissue 11 165674 3/6/2017 ERROLL E STEPHENS 10365 SE SUNNYSIDE RD CLACKAMAS OR 97015 $188.68 68853 2- Medical Claim/Void and Reissue 11 165675 3/6/2017 FREEH ASSOCIATES 51831 LANCASTER DR Suite 13 SALEM OR 97301 $25.00 61841 2- Medical Claim/Void and Reissue 11 165676 3/6/2017 JEFFREY D RICE 2250 NW FLANDERS ST PORTLAND OR 97210 $184.30 63638 2- Medical Claim 11 165682 3/6/2017 GENEVA HEALTH CENTER 3838 PACIFIC AVE FOREST GROVE OR 97116 $9.13 86523 2- Medical Claim 11 165683 3/6/2017 ARMSTRONG TODD PO BOX 1192 GOLD BEACH OR 97444 $3.75 86524 2- Medical Claim 11 165684 3/6/2017 TCH ANESTHESIOLOGY DEPARTMENT 335 SE 8TH AVE HILLSBORO OR 97123 $42.70 86525 2- Medical Claim 11 165685 3/6/2017 UMPQUA ORTHOPEDICS 277 NW MEDICAL LOOP ROSEBURG OR 97471 $112.36 86528 2- Medical Claim 11 165786 3/6/2017 ROSE CITY PEDIATRICS LLC 3507 SE 36TH AVE PORTLAND OR 97202 $15.38 86535 2- Medical Claim 11 165787 3/6/2017 SANTIAM MEDICAL GROUP LLC PO BOX 47 MILL CITY OR 97360 $11.95 86539 2- Medical Claim 11 165789 3/6/2017 MCKENZIE SURGERY CENTER LP 940 COUNTRY CLUB RD EUGENE OR 97401 $393.02 86542 2- Medical Claim 11 165792 3/6/2017 WILLAMETTE VALLEY RADIOLOGY PO BOX 522 SALEM OR 97308 $7.52 86546 2- Medical Claim 11 165795 3/6/2017 SALEM HOSPITAL PO BOX 2747 PORTLAND OR 97208 $307.58 86557 2- Medical Claim 11 165796 3/6/2017 CHILDRENS CLINIC PC PO BOX 2725 PORTLAND OR 97208 $55.56 86560

2- Medical Claim 11 165797 3/6/2017 VIRGINIA GARCIA MEMORIAL HEALTH CENTER PO BOX 568 CORNELIUS OR 97113 $32.06 86562 2- Medical Claim 11 165799 3/6/2017 EYE HEALTH NORTHWEST PC PO BOX 22009 PORTLAND OR 97269 $22.24 86566 2- Medical Claim 11 165801 3/6/2017 SANTA CLARA MEDICAL CLINIC PC 217 DIVISION AVE EUGENE OR 97404 $13.18 86575 2- Medical Claim 11 165802 3/6/2017 NORTHWEST SURGICAL SPECIALISTS LLP 3355 RIVERBEND DR STE 300 SPRINGFIELD OR 97477 $317.90 86576 2- Medical Claim 11 165803 3/6/2017 CORVALLIS CLINIC PC 444 NW ELKS DR CORVALLIS OR 97330 $176.16 86578 2- Medical Claim 11 165804 3/6/2017 LEGACY CLINICS LLC PO BOX 3777 PORTLAND OR 97208 $10.76 86580 2- Medical Claim 11 165806 3/6/2017 WALLA WALLA GENERAL HOSPITAL 1111 S 2ND AVE WALLA WALLA WA 99362 $22.43 86585 2- Medical Claim 11 165807 3/6/2017 BETH DOYLE LPC 1300 BOONE RD SE SALEM OR 97306 $2.06 86591 2- Medical Claim 11 165808 3/6/2017 ROBERT JONES PHD 1307 COMMERCIAL ST SE SALEM OR 97302 $4.68 86593 2- Medical Claim 11 165809 3/6/2017 JACKSON COUNTY PHYSICAL THERAPY 36 HAWTHORNE ST MEDFORD OR 97504 $11.96 86595

10 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 11 165810 3/6/2017 A BALANCED LIFE HEALTH CARE 2005 SE HAWTHORNE BLVD PORTLAND OR 97214 $3.50 86596 2- Medical Claim 11 165813 3/6/2017 ANESTHESIA ASSOCIATES PO BOX 1705 MEDFORD OR 97501 $43.02 86606 2- Medical Claim 11 165814 3/6/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $10.36 86607 2- Medical Claim 11 165815 3/6/2017 RETINA NORTHWEST PC 2525 NW LOVEJOY ST STE 100 PORTLAND OR 97210 $68.32 86608 2- Medical Claim 11 165817 3/6/2017 BENTON COUNTY HEALTH DEPT PO BOX 579 CORVALLIS OR 97339 $8.29 86612 GRAPEVINE WOMENS HEALTH AND 2- Medical Claim 11 1001723 3/6/2017 GYNECOLOGY LLC 5880 NE CORNELL RD STE C HILLSBORO OR 97124 $17.99 86613 2- Medical Claim 11 165678 3/6/2017 DALLAS OREGON EMERG PHYSICIANS PO BOX 98585 LAS VEGAS NV 89193 $36.64 86618 2- Medical Claim 11 165679 3/6/2017 SELLWOOD MEDICAL CLINIC PO BOX 8770 BELFAST ME 04915 $70.02 86619 2- Medical Claim 11 165680 3/6/2017 KEIZER HEALTH CENTER PO BOX 278 WOODBURN OR 97071 $6.00 86620 2- Medical Claim 11 1001724 3/6/2017 TUALITY PHYSICIANS PC 730 SE OAK ST STE D HILLSBORO OR 97123 $14.10 86626 2- Medical Claim 11 165677 3/6/2017 BOSTON HEART DIAGNOSTICS PO BOX 842856 BOSTON MA 02284 $29.47 86627 2- Medical Claim 11 1001720 3/6/2017 CENTER FOR CHIROPRACTIC PAIN 3241 NE BROADWAY ST PORTLAND OR 97232 $16.80 86629 2- Medical Claim 11 1001721 3/6/2017 HEART SPRING HEALTH LLC 819 SE MORRISON ST STE 115 PORTLAND OR 97214 $0.68 86631 2- Medical Claim 11 165736 3/6/2017 ALBANY EMER PHYS SVCS PC PO BOX 748087 LOS ANGELES CA 90074 $24.37 86634 2- Medical Claim 11 165737 3/6/2017 ANESTHESIA ASSOC NW LLC DEPT LA # 24105 PASADENA CA 91185 $44.00 86636 2- Medical Claim 11 165738 3/6/2017 BRIDGE TO HEALTH CHIROPRACTIC 5920 NE RAY CIR STE 140 HILLSBORO OR 97124 $8.50 86640 2- Medical Claim 11 165739 3/6/2017 OREGON PULMONARY ASSOCIATES PC PO BOX 6958 PORTLAND OR 97228 $16.90 86643 2- Medical Claim 11 165740 3/6/2017 MARYS PEAK EMERGENCY PHYSICIANS PO BOX 96353 OKLAHOMA CITY OK 73143 $64.33 86646 2- Medical Claim 11 165742 3/6/2017 GOOD SHEPHERD MEDICAL GROUP 600 NW 11TH ST STE E37 HERMISTON OR 97838 $302.66 86653 2- Medical Claim 11 165743 3/6/2017 COLUMBIA RIVER SURGERY CENTER LLC 9820 NE CASCADES PKWY PORTLAND OR 97220 $26.52 86654 2- Medical Claim 11 165744 3/6/2017 BEND MEMORIAL CLINIC PC PO BOX 6048 BEND OR 97708 $29.79 86656 2- Medical Claim 11 165745 3/6/2017 LEGACY HEALTH SYSTEM PO BOX 4037 PORTLAND OR 97208 $10.35 86660 2- Medical Claim 11 165747 3/6/2017 HILLSBORO PEDIATRIC CLINIC 445 E MAIN ST STE 100 HILLSBORO OR 97123 $1.77 86667 ORTHOPEDIC & SPORTS MEDICINE CENTER OF 2- Medical Claim 11 165748 3/6/2017 OREGON 1515 NW 18TH AVE STE 300 PORTLAND OR 97209 $237.25 86672

2- Medical Claim 11 165749 3/6/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 PORTLAND OR 97208 $2.58 86679 2- Medical Claim 11 165751 3/6/2017 MEDFORD RADIOLOGICAL GROUP PO BOX 3807 SEATTLE WA 98124 $30.93 86686 2- Medical Claim 11 165755 3/6/2017 SYNERGY MEDICAL SYSTEMS LLC 1710 WILLOW CREEK CIR # CIRCLE1 EUGENE OR 97402 $1.50 86695 2- Medical Claim 11 165756 3/6/2017 MID COLUMBIA FAMILY PHYSICIANS PO BOX 1519 WHITE SALMON WA 98672 $11.60 86698 2- Medical Claim 11 165758 3/6/2017 EVERGREEN HEALTH MEDICAL PO BOX 34738 SEATTLE WA 98124 $43.58 86705 2- Medical Claim 11 165759 3/6/2017 AMERICAN MEDICAL RESPONSE PO BOX 749667 LOS ANGELES CA 90074 $321.07 86708 2- Medical Claim 11 165761 3/6/2017 ROSEBURG HCS PO BOX 97814 LAS VEGAS NV 89193 $26.40 86713 2- Medical Claim 11 165763 3/6/2017 SYNERGY MEDICAL SYSTEMS LLC 55 COBURG RD STE 106 EUGENE OR 97401 $5.02 86718 2- Medical Claim 11 165764 3/6/2017 KRISTY R BAKER PSYD 22344 SW MAIN ST SHERWOOD OR 97140 $1.65 86720 ASSOCIATES FOR PSYCHIATRIC AND MENTAL 2- Medical Claim 11 165767 3/6/2017 HEALTH LL 14508 NE 20TH AVE STE 305 VANCOUVER WA 98686 $9.96 86724

11 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 4252 SE INTERNATIONAL 2- Medical Claim 11 165772 3/6/2017 BELLEVUE HEALTHCARE II INC WAY STE G PORTLAND OR 97222 $86.98 86739 2- Medical Claim 11 165773 3/6/2017 SERENITY LANE 1050 PRICE RD SE ALBANY OR 97322 $120.00 86743 2- Medical Claim 11 165775 3/6/2017 THE OREGON CLINIC PC PO BOX 5087 MS 163 PORTLAND OR 97208 $8.26 86748 2- Medical Claim 11 165776 3/6/2017 TERRANCE A FINSTAD PO BOX 14 LANDISVILLE PA 17538 $11.82 86751 2- Medical Claim 11 165778 3/6/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $226.07 86756 2- Medical Claim 11 165780 3/6/2017 MT TABOR FAMILY MEDICAL GROUP 5919 SE BELMONT ST PORTLAND OR 97215 $6.09 86769 2- Medical Claim 11 165781 3/6/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $2.71 86770 2- Medical Claim 11 165784 3/6/2017 BRYNNA L SIBILLA LCSW 1934 NE BROADWAY ST PORTLAND OR 97232 $6.50 86779 2- Medical Claim 11 165686 3/6/2017 THE VITAL COMPASS 5412 N WILLIAMS AVE PORTLAND OR 97217 $12.58 86782 2- Medical Claim 11 165687 3/6/2017 GURUKA K KHALSA 695 COMMERCIAL ST SE STE 114 SALEM OR 97301 $2.35 86785 2- Medical Claim 11 165689 3/6/2017 NORTHWEST WOMENS CLINIC PO BOX 5804 BELFAST ME 04915 $93.58 86791 2- Medical Claim 11 165691 3/6/2017 PAUL EBENSTEINER 4111 NE TILLAMOOK ST PORTLAND OR 97212 $4.00 86793 2- Medical Claim 11 165692 3/6/2017 BRIGHT MEDICINE CLINIC 1020 SE 7TH AVE UNIT 14100 PORTLAND OR 97293 $8.82 86795 2- Medical Claim 11 165694 3/6/2017 CITY OF ASHLAND PO BOX 914 SPRINGFIELD OR 97477 $24.57 86799 2- Medical Claim 11 165695 3/6/2017 SOULE HEALTHCARE 3526 SW CORBETT AVE PORTLAND OR 97239 $16.05 86801 2- Medical Claim 11 165696 3/6/2017 DR RYAN HOSLEY PSYD LLC 19824 SW 72ND AVE TUALATIN OR 97062 $6.45 86804 2- Medical Claim 11 165697 3/6/2017 SILVERTON SPECIALISTS CENTER PO BOX 278 WOODBURN OR 97071 $8.66 86805

2- Medical Claim 11 165699 3/6/2017 SAMARITAN PACIFIC COMMUNITIES HOSPITAL PO BOX 2847 CORVALLIS OR 97339 $26.00 86807

2- Medical Claim 11 165700 3/6/2017 EDWARD W SPARROW HOSPITAL ASSOCIATION 8175 RELIABLE PKWY CHICAGO IL 60686 $588.98 86808

2- Medical Claim 11 165701 3/6/2017 INTEGRATIVE TRAUMA TREATMENT CENTER 811 NW 19TH AVE STE 102 PORTLAND OR 97209 $9.50 86809 2- Medical Claim 11 165702 3/6/2017 WEST COAST MENS LLC 516 S THE STRAND OCEANSIDE CA 92054 $219.00 86811 9266 SW BEAVERTON 2- Medical Claim 11 165703 3/6/2017 DISCOVER CHIROPRACTIC HILLSDALE HWY BEAVERTON OR 97005 $56.62 86815 2- Medical Claim 11 165704 3/6/2017 NORTH COAST HOME CARE 2230 EXCHANGE ST ASTORIA OR 97103 $14.01 86819 2- Medical Claim 11 165705 3/6/2017 SUMMIT IMAGING INC PO BOX 847 CORVALLIS OR 97339 $1.69 86820 2- Medical Claim 11 165706 3/6/2017 STANFORD HOSPITAL CLINICS PO BOX 742188 LOS ANGELES CA 90074 $267.84 86821 2- Medical Claim 11 165707 3/6/2017 PACIFIC EDGE DIAGNOSTICS USA LTD PO BOX 782222 PHILADELPHIA PA 19178 $179.70 86825 2- Medical Claim 11 165710 3/6/2017 LAB EXPRESS PORTLAND INC 10445 SW CANYON RD BEAVERTON OR 97005 $1.64 86830 2- Medical Claim 11 165712 3/6/2017 21ST CENTURY WELLNESS INC 23792 ROCKFIELD BLVD LAKE FOREST CA 92630 $56.15 86832 2- Medical Claim 11 165713 3/6/2017 SUSAN F BARNES MD INC PO BOX 1359 KLAMATH FALLS OR 97601 $39.44 86835 2- Medical Claim 11 165715 3/6/2017 LAURA MAYO 503 PROSPECT AVE HOOD RIVER OR 97031 $11.23 86839 2- Medical Claim 11 165716 3/6/2017 AUGUSTINJE COLEBROOK 2000 WESTERLUND DR MEDFORD OR 97504 $160.62 86840 COUNTY OF CLACKAMAS OFFICE OF COUNTY 2- Medical Claim 11 165719 3/6/2017 AUDITOR 2051 KAEN RD OREGON CITY OR 97045 $2.68 86846

2- Medical Claim 11 165721 3/6/2017 PARKDALE RURAL FIRE PROTECTION DISTRICT PO BOX 914 SPRINGFIELD OR 97477 $249.80 86850

12 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 11 165722 3/6/2017 SERENITY LANE PO BOX 8549 EUGENE OR 97408 $3.50 86855

2- Medical Claim 11 165723 3/6/2017 ST JOHNS EMERGENCY PHYSICIANS INC PS PO BOX 101519 PASADENA CA 91189 $31.03 86858 2- Medical Claim 11 165724 3/6/2017 THE OREGON CLINIC PC PO BOX 5087 MAIL STOP 163 PORTLAND OR 97208 $97.48 86859 2- Medical Claim 11 165727 3/6/2017 INPATIENT MEDICINE SERVICES LLC PO BOX 25490 HONOLULU HI 96825 $9.75 86862

2- Medical Claim 11 165729 3/6/2017 LISA TONGEL 4031 SE HAWTHORNE BLVD PORTLAND OR 97214 $3.62 86864 2- Medical Claim 11 165730 3/6/2017 SANATAN GOLDEN 905 SE ANKENY ST PORTLAND OR 97214 $8.76 86865 2- Medical Claim 11 165732 3/6/2017 VIBRA PHYSICIANS LLC 8081 ROYAL RIDGE PKWY IRVING TX 75063 $6.09 86868 2- Medical Claim 11 165733 3/6/2017 OREGON PULMONARY ASSOCIATES PC 1585 SW MARLOW AVE STE 101 PORTLAND OR 97225 $57.23 86869 Member information 2- Member Loss 11 165734 3/6/2017 Member information redacted redacted PORTLAND OR 97202 $9.89 86871 2- Medical Claim 11 165717 3/6/2017 RACHEL EPPINGA 3821 NE M L KING BLVD PORTLAND OR 97212 $12.02 86843 2- Medical Claim 11 165720 3/6/2017 CHANDLER RADIOLOGY ASSOCIATES LLP PO BOX 15638 SCOTTSDALE AZ 85267 $22.48 86847 VITALIZE ACUPUNCTURE AND HERBAL 2- Medical Claim 11 165728 3/6/2017 MEDICINE LLC 511 SW 10TH AVE PORTLAND OR 97205 $5.03 86863 Batch Total $7,867.50 $6,869.28 2- Medical Claim/Void and PLANNED PARENTHOOD OF THE COLUMBIA Reissue 12 165822 3/14/2017 WILLAMETTE PO BOX 2927 PORTLAND OR 97208 $171.28 75686 2- Medical Claim 12 165876 3/14/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $18.00 86908 2- Medical Claim 12 165877 3/14/2017 LINCARE INC PO BOX 3187 SPOKANE WA 99220 $18.20 86917 2- Medical Claim 12 165880 3/14/2017 SALUD MEDICAL CENTER PO BOX 190 TOPPENISH WA 98948 $804.00 86923 2- Medical Claim 12 165883 3/14/2017 OSWEGO PROGRESSIVE MEDICINE 14535 WESTLAKE DR STE B LAKE OSWEGO OR 97035 $85.00 86927 525 N COLUMBIA RIVER 2- Medical Claim 12 165826 3/14/2017 SAINT HELENS INTERNAL MEDICINE LLC HWY SAINT HELENS OR 97051 $42.61 86951 2- Medical Claim 12 165833 3/14/2017 FABIANA WALLIS PHD 2014 NE SANDY BLVD STE 203 PORTLAND OR 97232 $146.00 34.8 86958 2- Medical Claim 12 165852 3/14/2017 DEANNA K OLSON 3250 SE LLEWELLYN ST PORTLAND OR 97222 $1,385.00 86994 2- Medical Claim 12 165857 3/14/2017 CUTTING EDGE HISTOLOGY SERVICES LLC 10300 NE HANCOCK ST PORTLAND OR 97220 $91.49 87001 2- Medical Claim 12 165864 3/14/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $392.40 87011 2- Medical Claim/Void and Reissue 12 165820 3/14/2017 KOTILA PHYSICAL THERAPY LLC 5265 NE ELAM YOUNG PKWY HILLSBORO OR 97124 $144.03 $0.00 53220 2- Medical Claim/Void and Reissue 12 165818 3/14/2017 ST CHARLES HEALTH SYSTEM INC PO BOX 7287 BEND OR 97708 $380.31 $0.00 56634 2- Medical Claim/Void and Reissue 12 165821 3/14/2017 KOTILA PHYSICAL THERAPY LLC 5265 NE ELAM YOUNG PKWY HILLSBORO OR 97124 $104.55 $0.00 58147

13 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim/Void and Reissue 12 165819 3/14/2017 LYMPHEDEMA SOLUTIONS NW 1975 NW 167th PL STE 100-23 BEAVERTON OR 97003 $2,009.85 $0.00 67746 PATHOLOGY ASSOCIATES MEDICAL 2- Medical Claim 12 165867 3/14/2017 LABORATORIES LLC PO BOX 2720 SPOKANE WA 99220 $86.80 86879 2- Medical Claim 12 165869 3/14/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $721.16 86886 2- Medical Claim 12 165870 3/14/2017 CHILDRENS CLINIC PC PO BOX 2725 PORTLAND OR 97208 $26.81 86889 2- Medical Claim 12 165872 3/14/2017 OREGON IMAGING CENTER PO BOX 25 EUGENE OR 97440 $42.09 86892 2- Medical Claim 12 165878 3/14/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $52.42 86920 2- Medical Claim 12 165879 3/14/2017 AETHENA GYNECOLOGY ASSOCIATES PO BOX 5170 BELFAST ME 04915 $33.41 86921

2- Medical Claim 12 165884 3/14/2017 SOUTHWEST WASHINGTON MEDICAL CENTER PO BOX 1588 VANCOUVER WA 98668 $8,809.09 86930 2- Medical Claim 12 165885 3/14/2017 MCMINNVILLE IMAGING LLP PO BOX 516 CORVALLIS OR 97339 $4.62 86935 17777 LOWER BOONES 2- Medical Claim 12 165886 3/14/2017 CASCADIA EYE CARE FERRY RD LAKE OSWEGO OR 97035 $4.54 86936 2- Medical Claim 12 165887 3/14/2017 PACIFIC WOMENS CENTER 10 COBURG RD STE 100 EUGENE OR 97401 $34.92 86937

2- Medical Claim 12 165888 3/14/2017 CHILDRENS MEDICAL CLINIC OF NEWBERG 506 VILLA RD NEWBERG OR 97132 $19.70 86938 2- Medical Claim 12 165891 3/14/2017 SAINT MARYS URGENT CARE LLC 1801 W OLYMPIC BLVD PASADENA CA 91199 $12.29 86942 2- Medical Claim 12 1001725 3/14/2017 CANYON MEDICAL CENTER 2100 SW CAMELOT CT PORTLAND OR 97225 $0.30 86946

2- Medical Claim 12 165823 3/14/2017 BRIDGEPORT MRI LLC 15755 SW SEQUOIA PKWY STE 100 PORTLAND OR 97224 $60.74 86948 2- Medical Claim 12 165824 3/14/2017 SILVER FALLS DERMATOLOGY PC 1793 13TH ST SE SALEM OR 97302 $12.89 86949

2- Medical Claim 12 165825 3/14/2017 JAY PAUL DOUGLASS MD LLC 16463 BOONES FERRY RD STE 300 LAKE OSWEGO OR 97035 $5.16 86950 FIBROMYALGIA AND NEUROMUSCULAR PAIN 2- Medical Claim 12 165827 3/14/2017 CENTER OF OREG 700 BELLEVUE ST SE STE 225 SALEM OR 97301 $15.30 86952

2- Medical Claim 12 165828 3/14/2017 MICHAEL MCMAHON 4203 SE HAWTHORNE BLVD STE A PORTLAND OR 97215 $27.03 86953 2- Medical Claim 12 165829 3/14/2017 DESCHUTES ORTHOPEDICS LLC 1693 SW CHANDLER AVE BEND OR 97702 $32.09 86954 2- Medical Claim 12 165831 3/14/2017 CENTER FOR SPECIALTY SURGERY PO BOX 4008 PORTLAND OR 97208 $133.65 86956 2- Medical Claim 12 165832 3/14/2017 GEOFF HOUGHTON ND 153 CLEAR CREEK DR STE 101 ASHLAND OR 97520 $9.00 86957

2- Medical Claim 12 165834 3/14/2017 SLEEP TECHNOLOGIES LTD 8440 SE SUNNYBROOK BLVD STE 208 CLACKAMAS OR 97015 $125.88 86959 2- Medical Claim 12 165836 3/14/2017 COUNTY OF MULTNOMAH 421 SW OAK ST STE 210 PORTLAND OR 97204 $2.92 86965 2- Medical Claim 12 165839 3/14/2017 PMG CLINICS PO BOX 3158 PORTLAND OR 97208 $19.28 86972

2- Medical Claim 12 165840 3/14/2017 ADVANCE SPORTS AND SPINE THEAPY LLC PO BOX 592 WEST LINN OR 97068 $2.50 86973 2- Medical Claim 12 165841 3/14/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $32.46 86975 2- Medical Claim 12 165842 3/14/2017 THE VITAL COMPASS 5412 N WILLIAMS AVE PORTLAND OR 97217 $12.94 86976

14 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 12 165844 3/14/2017 PEDIATRIC ASSOCIATES OF THE NW 2701 NW VAUGHN ST STE 360 PORTLAND OR 97210 $16.41 86979 2- Medical Claim 12 165845 3/14/2017 INTEGRATED TRAUMA TREAMENT CEN 811 NW 19TH AVE PORTLAND OR 97209 $3.80 86981 2- Medical Claim 12 165847 3/14/2017 SILVERTON SPECIALISTS CENTER PO BOX 278 WOODBURN OR 97071 $12.66 86985

2- Medical Claim 12 165849 3/14/2017 PACIFIC BIPOLAR TREATMENT PROGRAM LLC 1675 SW MARLOW AVE STE 305 PORTLAND OR 97225 $29.00 86988 9266 SW BEAVERTON 2- Medical Claim 12 165850 3/14/2017 DISCOVER CHIROPRACTIC HILLSDALE HWY BEAVERTON OR 97005 $18.26 86989 2- Medical Claim 12 165851 3/14/2017 TOD TOLAN MD LLC 8905 SW NIMBUS AVE BEAVERTON OR 97008 $41.40 86990 2- Medical Claim 12 165853 3/14/2017 DAVID NAIMON ND LAC PC 2700 SE 26TH AVE STE D PORTLAND OR 97202 $7.70 86996 2- Medical Claim 12 165854 3/14/2017 21ST CENTURY WELLNESS INC 23792 ROCKFIELD BLVD LAKE FOREST CA 92630 $150.70 86997 2- Medical Claim 12 165855 3/14/2017 NATURAL PHYSICIANS 4555 LIBERTY RD S STE 360 SALEM OR 97302 $69.30 86999 2- Medical Claim 12 165856 3/14/2017 KUAKINI MEDICAL CENTER PO BOX 31000 HONOLULU HI 96849 $1,608.98 87000 2- Medical Claim 12 165858 3/14/2017 WESTSIDE INTERNAL MEDICINE PO BOX 23200 PORTLAND OR 97281 $19.00 87002 2- Medical Claim 12 165859 3/14/2017 MONTANA ALLERGY PLLC 2900 12TH AVE N BILLINGS MT 59101 $39.53 87004

2- Medical Claim 12 165860 3/14/2017 ALICIA PETERMAN ND 4203 SE HAWTHORNE BLVD STE A PORTLAND OR 97215 $71.70 87006 2- Medical Claim 12 165861 3/14/2017 HEAD & NECK SURGICAL ASSOCIATES PC PO BOX 742628 LOS ANGELES CA 90074 $8.73 87007 2- Medical Claim 12 165862 3/14/2017 SHAWHEART VASCULAR 2801 NW MERCY DR STE 300 ROSEBURG OR 97471 $4.61 87008 2- Medical Claim 12 165863 3/14/2017 RETINA NORTHWEST PC PO BOX 6526 PORTLAND OR 97228 $13.14 87009 2- Medical Claim 12 165864 3/14/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $18.63 87011 2- Medical Claim 12 165865 3/14/2017 MEND HEALTH INC 9601 S SEPULVEDA BLVD LOS ANGELES CA 90045 $5.53 87013 2- Medical Claim 12 165866 3/14/2017 KITSAP EYE PHYSICIANS PS 2655 WHEATON WAY BREMERTON WA 98310 $11.80 87014 $5,792.72 $12,525.67 2- Medical Claim 13 165962 3/21/2017 LEGACY LABORATORY SERVICES LLC PO BOX 5337 PORTLAND OR 97228 $110.91 $12.55 87025 2- Medical Claim 13 165969 3/21/2017 NORCO INC PO BOX 15299 BOISE ID 83715 $100.18 $39.59 87036

2- Medical Claim 13 165973 3/21/2017 NATIONAL COLLEGE OF NATURAL MEDICINE 049 SW PORTER ST PORTLAND OR 97201 $185.42 $0.00 87044 2- Medical Claim 13 165981 3/21/2017 LEGACY CLINICS LLC PO BOX 3777 PORTLAND OR 97208 $24.60 $74.91 87066 2- Medical Claim 13 165988 3/21/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $8.85 $24.38 87090 2- Medical Claim 13 165989 3/21/2017 METROPOLITAN PEDIATRICS LLC PO BOX 3096 PORTLAND OR 97208 $235.26 87091 2- Medical Claim 13 165945 3/21/2017 JANETTE L GREEN MD PC 10200 SW EASTRIDGE ST STE 105 PORTLAND OR 97225 $160.20 87124 2- Medical Claim 13 165956 3/21/2017 PACIFIC WOMENS CENTER 10 COBURG RD STE 100 EUGENE OR 97401 $1,635.71 87177

2- Medical Claim 13 165932 3/21/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $111.60 87228

2- Medical Claim 13 165937 3/21/2017 PARKWAY MONILLITY AND MEDICAL SUPPLY 2475 NW STEWART PKWY ROSEBURG OR 97471 $198.00 87237 Member information 2- Medical Loss 13 165901 3/21/2017 Member information redacted redacted PORTLAND OR 97212 $50.00 $5.00 87276 2- Medical Claim 13 165906 3/21/2017 LINCARE INC PO BOX 3406 SPOKANE WA 99220 $177.36 $96.52 87300 2- Medical Claim 13 165908 3/21/2017 DAVID NAIMON ND LAC PC 2700 SE 26TH AVE STE D PORTLAND OR 97202 $77.00 87308

15 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 13 165915 3/21/2017 ANALYTICAL EDGE LABORATORIES LLC 865 RESEARCH PKWY OKLAHOMA CITY OK 73104 $516.60 87345 Member information 2- Medical Loss 13 165919 3/21/2017 Member information redacted redacted PORTLAND OR 97203 $29.48 $8.84 87355 2- Medical Claim/Void and Reissue 13 165892 3/21/2017 HEAD & NECK SURGICAL ASSOCIATES PO BOX 60000 LOS ANGELES CA 90060 $780.20 51244 2- Medical Claim 13 165893 3/21/2017 GURUKA K KHALSA 695 COMMERCIAL ST SE STE 114 SALEM OR 97301 $4.38 54669 2- Medical Claim 13 165961 3/21/2017 SELLWOOD FAMILY MEDICINE 1567 SE TACOMA ST PORTLAND OR 97202 $22.91 87023 2- Medical Claim 13 165963 3/21/2017 PORTLAND PREVENTIVE CARDIOLOGY LLC 8855 SW CANYON LN PORTLAND OR 97225 $16.93 87027

2- Medical Claim 13 165966 3/21/2017 FONTENOT LINDSAY M 125 NE KILLINGSWORTH ST STE 101 PORTLAND OR 97211 $25.12 87031

2- Medical Claim 13 165967 3/21/2017 PROVIDENCE HEALTH & SERVICESOREGON PO BOX 3456 PORTLAND OR 97208 $6.36 87033 SAINT ALPHONSUS REGIONAL MEDICAL CENTER 2- Medical Claim 13 165968 3/21/2017 INC 3340 E GOLDSTONE WAY MERIDIAN ID 83642 $2.02 87035 KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT 2- Medical Claim 13 165970 3/21/2017 2 PO BOX 99 WHITE SALMON WA 98672 $26.21 87039 2- Medical Claim 13 165972 3/21/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $1,139.60 87042 2- Medical Claim 13 165974 3/21/2017 SALEM HOSPITAL PO BOX 2747 PORTLAND OR 97208 $1,163.35 87046 2- Medical Claim 13 165975 3/21/2017 MEDICAL EYE CENTER INC 1333 E BARNETT RD MEDFORD OR 97504 $17.01 87048

2- Medical Claim 13 165977 3/21/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3060 PORTLAND OR 97208 $17.87 87058 2- Medical Claim 13 165979 3/21/2017 CORVALLIS CLINIC PC 444 NW ELKS DR CORVALLIS OR 97330 $163.20 87062 2- Medical Claim 13 165980 3/21/2017 GATEWAY WOMENS CLINIC 177 NE 102ND AVE PORTLAND OR 97220 $147.64 87063 2- Medical Claim 13 165982 3/21/2017 ROGUE VALLEY UROLOGY PC 1698 E MCANDREWS RD MEDFORD OR 97504 $65.51 87067 2- Medical Claim 13 165983 3/21/2017 MIDVALLEY COUNSELING CENTER INC 2250 D ST NE SALEM OR 97301 $8.30 87080 2- Medical Claim 13 165984 3/21/2017 ROGUE VALLEY UROLOGY 1698 E MCANDREWS RD STE 280 MEDFORD OR 97504 $202.87 87083

2- Medical Claim 13 165985 3/21/2017 A BALANCED LIFE HEALTH CARE 2005 SE HAWTHORNE BLVD PORTLAND OR 97214 $5.00 87084 2- Medical Claim 13 165986 3/21/2017 OREGON ANESTHESIOLOGY GROUP PO BOX 2040 PORTLAND OR 97208 $45.15 87085 2- Medical Claim 13 165987 3/21/2017 ANESTHESIA ASSOCIATES PO BOX 1705 MEDFORD OR 97501 $52.55 87089 2- Medical Claim 13 165990 3/21/2017 COLUMBIA MEMORIAL HOSPITAL 2111 EXCHANGE ST ASTORIA OR 97103 $11.97 87093 2- Medical Claim 13 165991 3/21/2017 SELLWOOD MEDICAL CLINIC PO BOX 8770 BELFAST ME 04915 $4.79 87094 2- Medical Claim 13 165992 3/21/2017 BOSTON HEART DIAGNOSTICS PO BOX 842856 BOSTON MA 02284 $51.38 87101 2- Medical Claim 13 1001726 3/21/2017 HEART SPRING HEALTH LLC 819 SE MORRISON ST STE 115 PORTLAND OR 97214 $29.28 87103 2- Medical Claim 13 165946 3/21/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $250.43 87127 2- Medical Claim 13 165947 3/21/2017 SAMARITAN NORTH LINCOLN HOSPITAL PO BOX 1194 CORVALLIS OR 97339 $25.13 87131 2- Medical Claim 13 165948 3/21/2017 PROVIDENCE HOOD RIVER CLINIC PO BOX 3390 PORTLAND OR 97208 $75.00 87139 2- Medical Claim 13 165949 3/21/2017 GREENFIELD HEALTH SYSTEM 9450 SW BARNES RD STE 100 PORTLAND OR 97225 $6.68 87145 2- Medical Claim 13 165950 3/21/2017 MAXWELL C FURR MD LLC 2222 NW LOVEJOY ST STE 607 PORTLAND OR 97210 $7.60 87156

16 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 13 165951 3/21/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 PORTLAND OR 97208 $7.89 87158 2- Medical Claim 13 165953 3/21/2017 TILLAMOOK REGIONAL MEDICAL CENTER PO BOX 458 TILLAMOOK OR 97141 $78.66 87168

2- Medical Claim 13 165955 3/21/2017 NORTHWEST CARDIOVASCULAR INSTITUTE LLP 1200 NW NAITO PKWY STE 200 PORTLAND OR 97209 $4.28 87175

2- Medical Claim 13 165958 3/21/2017 LAKE OSWEGO VISION 15480 BOONES FERRY RD LAKE OSWEGO OR 97035 $0.10 87180 2- Medical Claim 13 165959 3/21/2017 UW MEDICAL CENTER PO BOX 24366 SEATTLE WA 98124 $17.30 87183 2- Medical Claim 13 165960 3/21/2017 APRIA HEALTHCARE LLC PO BOX 31001 PASADENA CA 91110 $6.58 87187 OREGON SLEEP & PULMONARY LLC DBA 2- Medical Claim 13 165923 3/21/2017 OREGON SLEEP ASS 2228 NW PETTYGROVE ST STE 150 PORTLAND OR 97210 $7.00 87196

2- Medical Claim 13 165924 3/21/2017 OREGON OUTPATIENT SURGERY CENTER LLC 7300 SW CHILDS RD STE A PORTLAND OR 97224 $1,601.40 87200 SAINT ALPHONSUS MEDICAL CENTER BAKER 2- Medical Claim 13 165925 3/21/2017 CITY INC 3325 POCAHONTAS RD BAKER CITY OR 97814 $232.77 87202 ASSOCIATES FOR PSYCHIATRIC AND MENTAL 2- Medical Claim 13 165926 3/21/2017 HEALTH LL 14508 NE 20TH AVE STE 305 VANCOUVER WA 98686 $26.10 87206 2- Medical Claim 13 165927 3/21/2017 BRIGMAN SHANNON S 506 VILLA RD NEWBERG OR 97132 $9.98 87207 2- Medical Claim 13 165928 3/21/2017 OSTEOPATHIC PDX PC 4039 N MISSISSIPPI AVE STE 203 PORTLAND OR 97227 $15.00 87210

2- Medical Claim 13 165929 3/21/2017 MICHAEL MCMAHON 4203 SE HAWTHORNE BLVD STE A PORTLAND OR 97215 $12.54 87216

2- Medical Claim 13 165930 3/21/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 MS 21 PORTLAND OR 97208 $12.92 87218 2- Medical Claim 13 165933 3/21/2017 FAMILY MEDICAL GROUP NORTHEAST PC 2647 NE 33RD AVE PORTLAND OR 97212 $2.75 87229 EASTMORELAND EAR NOSE & THROAT CLINIC 2- Medical Claim 13 165935 3/21/2017 LLP DBA M PO BOX 848573 BOSTON MA 02284 $19.15 87232 2- Medical Claim 13 165936 3/21/2017 COUNTY OF MULTNOMAH 421 SW OAK ST STE 210 PORTLAND OR 97204 $121.21 87235 2- Medical Claim 13 165938 3/21/2017 SAMARITAN MEDICAL SUPPLIES 946 NW CIRCLE BLVD CORVALLIS OR 97330 $27.18 87238 2- Medical Claim 13 165939 3/21/2017 REBECCA L BERZOW 1020 SE 7TH AVE UNIT 14100 PORTLAND OR 97293 $15.38 87240 2- Medical Claim 13 165942 3/21/2017 LEGACY EMANUEL PROVIDERS PO BOX 4399 PORTLAND OR 97208 $17.54 87243 2- Medical Claim 13 165895 3/21/2017 PMG CLINICS PO BOX 3158 PORTLAND OR 97208 $116.35 87246 2- Medical Claim 13 165896 3/21/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $9.94 87249 2- Medical Claim 13 165897 3/21/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $64.16 87258 2- Medical Claim 13 1001731 3/21/2017 OREGON REPRODUCTIVE MEDICINE PO BOX 2867 PORTLAND OR 97208 $0.23 87259 2- Medical Claim 13 165894 3/21/2017 THE VITAL COMPASS 5412 N WILLIAMS AVE PORTLAND OR 97217 $18.03 87260

2- Medical Claim 13 1001729 3/21/2017 KINE FISCHLER ACUPUNCTURE & HERBS PC 2714 NE DUNCKLEY ST PORTLAND OR 97212 $26.33 87268 2- Medical Claim 13 165898 3/21/2017 MEDCOMP SCIENCES LLC 20203 MCHOST RD ZACHARY LA 70791 $25.27 87270 2- Medical Claim 13 165899 3/21/2017 MADELINE SCHAEFER 5909 N CURTIS AVE PORTLAND OR 97217 $12.53 87271 2- Medical Claim 13 165900 3/21/2017 RESTORATIVE HEALTH CLINIC 6464 SW BORLAND RD STE B2 TUALATIN OR 97062 $21.55 87275

17 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # GOOD SAMARITAN REGIONAL MEDICAL 2- Medical Claim 13 165902 3/21/2017 CENTER PO BOX 1189 CORVALLIS OR 97339 $10.59 87279

2- Medical Claim 13 165903 3/21/2017 DR STEFANA PECHER LLC 391 NORWICH WESTERLY RD NORTH STONINGTON CT 06359 $1.11 87280 2- Medical Claim 13 165904 3/21/2017 BOSTON HEART DIAGNOSTICS CORP PO BOX 842856 BOSTON MA 02284 $145.04 87282 9266 SW BEAVERTON 2- Medical Claim 13 165905 3/21/2017 DISCOVER CHIROPRACTIC HILLSDALE HWY BEAVERTON OR 97005 $4.28 87295 2- Medical Claim 13 1001728 3/21/2017 JOEL A AMUNDSON MD PC 2121 NE HALSEY ST PORTLAND OR 97232 $18.14 87303

2- Medical Claim 13 165907 3/21/2017 ASANTE THREE RIVERS MEDICAL CENTER LLC 731 BLACK OAK DR STE 101 MEDFORD OR 97504 $36.92 87307 2- Medical Claim 13 165909 3/21/2017 PEACEHEALTH PO BOX 569 EUGENE OR 97440 $69.30 87314 2- Medical Claim 13 165910 3/21/2017 SABRINA M FROLOV PO BOX 520 MOLALLA OR 97038 $3.00 87318

2- Medical Claim 13 165911 3/21/2017 SALEM EMERGENCY PHYSICIANS SERVICE PC PO BOX 742547 LOS ANGELES CA 90074 $40.59 87323 2- Medical Claim 13 165912 3/21/2017 WESTSIDE INTERNAL MEDICINE PO BOX 23200 PORTLAND OR 97281 $55.89 87325 2- Medical Claim 13 165913 3/21/2017 TUALITY HEALTH ALLIANCE DEPT LA 24105 PASADENA CA 91185 $88.20 87334 2- Medical Claim 13 165914 3/21/2017 JEFFERY W BAKER DC PC 4630 RIVER RD N STE A KEIZER OR 97303 $0.70 87336 1731 E HALLANDALE BEACH 2- Medical Claim 13 165916 3/21/2017 C & C COMPLETE MEDICAL CARE GROUP PA BLVD HALLANDALE BEACH FL 33009 $7.69 87348 2- Medical Claim 13 165917 3/21/2017 SKINPATH SOLUTIONS INC PO BOX 3429 AUGUSTA GA 30914 $42.63 87349 2- Medical Claim 13 165918 3/21/2017 OREGON PULMONARY ASSOCIATES PC 1585 SW MARLOW AVE STE 101 PORTLAND OR 97225 $54.95 87353 Member information 2- Member Loss 13 165920 3/21/2017 Member information redacted redacted PORTLAND OR 97201 $7.75 87357 Member information 2- Member Loss 13 165921 3/21/2017 Member information redacted redacted PORTLAND OR 97239 $24.40 87359 Batch Total $4,401.37 $6,997.33 2- Medical Claim 14 165996 3/24/2017 PATRICIA L NORRIS MD PC 2222 NW LOVEJOY ST STE 422 PORTLAND OR 97210 $188.20 87526 2- Medical Claim 14 166004 3/24/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $1,670.80 $250.85 87560 ARIS RADIOLOGY PROFESSIONALS OF 2- Medical Claim 14 166018 3/24/2017 MICHIGAN PC PO BOX 72078 CLEVELAND OH 44192 $30.60 87582 2- Medical Claim 14 166019 3/24/2017 WELLNESS DOCTOR INC 1693 SW CHANDLER AVE BEND OR 97702 $172.80 87583 2- Medical Claim 14 166028 3/24/2017 NORTH COAST HOME CARE 210 IVY AVE TILLAMOOK OR 97141 $78.35 $23.51 87596 2- Medical Claim 14 166037 3/24/2017 CENTRAL CITY CONCERN 232 NW 6TH AVE PORTLAND OR 97209 $28.74 87616 2- Medical Claim 14 166041 3/24/2017 SOUTHERN OREGON SLEEP CENTER INC 16289 HIGHWAY 101 S BROOKINGS OR 97415 $995.26 87622 2- Medical Claim 14 166042 3/24/2017 CALLOWAY CREEK SURGERY CENTER LP PO BOX 100679 ATLANTA GA 30384 $4,029.17 87623 2- Medical Claim 14 166047 3/24/2017 CHAN KIM 14350 WHITTIER BLVD WHITTIER CA 90605 $468.81 87636 2- Medical Claim 14 166058 3/24/2017 PORTLAND ANESTHESIA SPECIALISTS PO BOX 636856 CINCINNATI OH 45263 $1,260.00 87449 2- Medical Claim 14 166059 3/24/2017 DUNCAN SOULE 3526 SW CORBETT AVE PORTLAND OR 97239 $94.53 87450 2- Medical Claim 14 166061 3/24/2017 LINCARE INC PO BOX 3187 SPOKANE WA 99220 $363.50 87458 2- Medical Claim 14 166072 3/24/2017 VALERIE LYNN VOGEL 8283 SW BARBUR BLVD PORTLAND OR 97219 $48.16 87478

18 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 14 166074 3/24/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $16,498.00 87480 2- Medical Claim 14 166080 3/24/2017 MEDFORD RADIOLOGICAL GROUP PO BOX 3807 SEATTLE WA 98124 $210.41 87495 2- Medical Claim 14 166086 3/24/2017 GENOVA DIAGNOSTICS 63 ZILLICOA ST ASHEVILLE NC 28801 $288.07 87507 QUEST DIAGNOSTICS CLINICAL LABORATORIES 2- Medical Claim 14 166092 3/24/2017 INC PO BOX 822550 PHILADELPHIA PA 19182 $150.20 87368 2- Medical Claim 14 166093 3/24/2017 GERALD B RICH MD PC 11790 SW BARNES RD PORTLAND OR 97225 $1,308.40 87372 2- Medical Claim 14 166098 3/24/2017 MERCY FLIGHTS INCORPORATED 2020 MILLIGAN WAY MEDFORD OR 97504 $1,161.80 87382 2- Medical Claim 14 166101 3/24/2017 DRS CASSELL & BOREN PC 132 E BROADWAY STE 830 EUGENE OR 97401 $208.00 87389 2- Medical Claim 14 166106 3/24/2017 KLAMATH HEALTH PARTNERSHIP INC 2074 S 6TH ST KLAMATH FALLS OR 97601 $169.31 87406 2- Medical Claim 14 166108 3/24/2017 LEGACY CLINICS LLC PO BOX 3777 PORTLAND OR 97208 $86.49 87410 2- Medical Claim 14 166109 3/24/2017 JOHN MILNES LCSW 1645 LIBERTY ST SE SALEM OR 97302 $101.91 87422 2- Medical Claim 14 1001734 3/24/2017 CANYON MEDICAL CENTER 2100 SW CAMELOT CT PORTLAND OR 97225 $205.09 87514 2- Medical Claim 14 165993 3/24/2017 LINCARE INC 155 N SCHONEMAN AVE COOS BAY OR 97420 $120.00 87516 2- Medical Claim 14 165994 3/24/2017 PEARL WOMENS CENTER 140 NW 14TH AVE PORTLAND OR 97209 $366.35 87519 2- Medical Claim 14 165995 3/24/2017 ADVANCED CARE CHIROPRACTIC 837 E POWELL BLVD GRESHAM OR 97030 $15.64 87522

2- Medical Claim 14 165997 3/24/2017 PHYSICAL THERAPY ASSOCIATES OF ESTACADA 11203 SE SUNNYSIDE RD CLACKAMAS OR 97015 $13.48 87534

2- Medical Claim 14 165998 3/24/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $27.62 87536 2- Medical Claim 14 165999 3/24/2017 TERRANCE A FINSTAD PO BOX 14 LANDISVILLE PA 17538 $1.50 87540 2- Medical Claim 14 166003 3/24/2017 AFFILIATED PATHOLOGISTS MED GR PO BOX 749202 LOS ANGELES CA 90074 $15.94 87559 2- Medical Claim 14 166005 3/24/2017 SOUTHERN COOS HOSP 900 11TH ST SE BANDON OR 97411 $22.08 87561 2- Medical Claim 14 166006 3/24/2017 AMBRY GENETICS CORPORATION PO BOX 51458 ONTARIO CA 91761 $80.00 87563 2- Medical Claim 14 166007 3/24/2017 SKY LAKES MEDICAL CENTER INC PO BOX 2120 PORTLAND OR 97208 $7.02 87566 2- Medical Claim 14 166008 3/24/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $0.72 87568 2- Medical Claim 14 166009 3/24/2017 MULTICARE HEALTH SYSTEM PO BOX 34697 SEATTLE WA 98124 $0.71 87571 2- Medical Claim 14 166010 3/24/2017 SALEM SLEEP MEDICINE PC 1395 COMMERCIAL ST SE SALEM OR 97302 $6.37 87573 2- Medical Claim 14 166011 3/24/2017 CITY OF BEND AMBULANCE PO BOX 1024 BEND OR 97709 $61.30 87575 2- Medical Claim 14 166012 3/24/2017 RANDALL S LEWIS MD PO BOX 51270 EUGENE OR 97405 $78.42 87576 2- Medical Claim 14 166013 3/24/2017 MCV ASSOCIATED PHYSICIANS PO BOX 91734 RICHMOND VA 23291 $17.95 87577 2- Medical Claim 14 166014 3/24/2017 THE EVERETT CLINIC PO BOX 5127 EVERETT WA 98206 $18.69 87578

2- Medical Claim 14 166015 3/24/2017 SUNDSTROM CLINICAL SERVICES LLC 8440 SE SUNNYBROOK BLVD STE 120 CLACKAMAS OR 97015 $12.56 87579 2- Medical Claim 14 166016 3/24/2017 LIFE FLIGHT NETWORK LLC PO BOX 3881 MS 631031 SEATTLE WA 98124 $2,693.40 87580 SAINT ALPHONSUS MEDICAL CENTER BAKER 2- Medical Claim 14 166017 3/24/2017 CITY INC 3340 E GOLDSTONE WAY MERIDIAN ID 83642 $12.08 87581 2- Medical Claim 14 166020 3/24/2017 THE POLYCLINIC 1145 BROADWAY SEATTLE WA 98122 $14.43 87584 2- Medical Claim 14 166021 3/24/2017 BLAIR FAMILY & SPORTS CHIROPRACTIC 1185 ARTHUR ST EUGENE OR 97402 $21.93 87585 2- Medical Claim 14 166022 3/24/2017 LOUISE TOLZMANN 4039 N MISSISSIPPI AVE PORTLAND OR 97227 $6.27 87586

19 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # GOOD SAMARITAN REGIONAL MEDICAL 2- Medical Claim 14 166023 3/24/2017 CENTER PO BOX 1189 CORVALLIS OR 97339 $21.14 87587 2- Medical Claim 14 166024 3/24/2017 LEE RAYMOND LIGHT MD PA 850 CENTRAL AVE NAPLES FL 34102 $64.97 87589 2- Medical Claim 14 166025 3/24/2017 BAREFOOT AND BALANCED 2037 SE HARRISON ST MILWAUKIE OR 97222 $7.00 87590 2- Medical Claim 14 166026 3/24/2017 DR PEPEL FAMILY PRACTICE LLC 8855 SW HOLLY LN STE 100 WILSONVILLE OR 97070 $14.88 87593 2- Medical Claim 14 166027 3/24/2017 SCRIPPS HEALTH PO BOX 51066 LOS ANGELES CA 90051 $11.73 87595 2- Medical Claim 14 166029 3/24/2017 NORTH COAST HOME CARE 2230 EXCHANGE ST ASTORIA OR 97103 $4.67 87597 2- Medical Claim 14 166030 3/24/2017 CHARLES E HOLTON JR DC INC 289 E ELLENDALE AVE STE 102 DALLAS OR 97338 $3.10 87602 2- Medical Claim 14 166031 3/24/2017 OREGON COAST PODIATRY LLC PO BOX 12194 BELFAST ME 04915 $2.52 87604 2- Medical Claim 14 166032 3/24/2017 CUSTOM PHYSICAL THERAPY 4150 PACIFIC AVE STE 100 FOREST GROVE OR 97116 $13.67 87607 2- Medical Claim 14 166033 3/24/2017 LAB EXPRESS PORTLAND INC 10445 SW CANYON RD BEAVERTON OR 97005 $0.66 87609 2- Medical Claim 14 166034 3/24/2017 21ST CENTURY WELLNESS INC 23792 ROCKFIELD BLVD LAKE FOREST CA 92630 $975.55 87610 2- Medical Claim 14 166035 3/24/2017 CORAM ALTERNATE SITE SERVICES INC PO BOX 74798 CHICAGO IL 60694 $686.65 87612 2- Medical Claim 14 166036 3/24/2017 KINETIC ORTHOPEDICS 302 E PACIFIC AVE SPOKANE WA 99202 $417.49 87615 2- Medical Claim 14 166038 3/24/2017 SWIFT 4246 SE BELMONT ST PORTLAND OR 97215 $6.53 87618 2- Medical Claim 14 166039 3/24/2017 MDXHEALTH INC 15279 ALTON PKWY IRVINE CA 92618 $198.00 87619 2- Medical Claim 14 166040 3/24/2017 FLOYD HEALTHCARE MANAGEMENT INC PO BOX 233 ROME GA 30162 $17.61 87620 2- Medical Claim 14 166043 3/24/2017 SALEM REHABILITATION ASSOCIATES INC 3624 RIVER RD N KEIZER OR 97303 $77.27 87628 2- Medical Claim 14 166044 3/24/2017 AN KANG NATURAL HEALTH CENTER 5201 SW WESTGATE DR STE 116 PORTLAND OR 97221 $14.94 87630 2- Medical Claim 14 166045 3/24/2017 THE OREGON CLINIC PC PO BOX 5087 MAIL STOP 163 PORTLAND OR 97208 $13.63 87632 INDIANA UNIVERSITY HEALTH CARE 2- Medical Claim 14 166046 3/24/2017 ASSOCIATES INC 5208 RELIABLE PKWY CHICAGO IL 60686 $28.80 87634 2- Medical Claim 14 166048 3/24/2017 MICHELLE ROBERTS FNP PMHNP PO BOX 96103 PORTLAND OR 97296 $55.09 87637 COMPREHENSIVE OPTIONS FOR DRUG 2- Medical Claim 14 166049 3/24/2017 ABUSERS INC 1027 E BURNSIDE ST PORTLAND OR 97214 $7.79 87638 2- Medical Claim 14 166050 3/24/2017 SHARTWELL CHIROPRACTIC AND WEL 170 NW 2ND AVE CANBY OR 97013 $19.44 87639 HEALING SPIRIT INTEGRATIVE HEALTH CENTER 2- Medical Claim 14 166051 3/24/2017 INC 1355 OAK ST EUGENE OR 97401 $8.29 87641 2- Medical Claim 14 166052 3/24/2017 KATHLEEN MAY 201 TAHOMA BLVD UNIT 102 YELM WA 98597 $6.14 87643 2- Medical Claim 14 166053 3/24/2017 THERAPYWORKS NW 7927 SE ORIENT DR GRESHAM OR 97080 $50.60 87645 Member information 2- Medical Loss 14 166054 3/24/2017 Member information redacted redacted PORTLAND OR 97223 $9.67 87646 Member information 2- Member Loss 14 166055 3/24/2017 Member information redacted redacted PORTLAND OR 97202 $11.03 87647 Member information 2- Medical Loss 14 166056 3/24/2017 Member information redacted redacted MAPLETON OR 97453 $14.84 87648 Member information 2- Medical Loss 14 166057 3/24/2017 Member information redacted redacted WOODBURN OR 970715158 $33.00 87649 2- Medical Claim 14 166060 3/24/2017 ANESTHESIA ASSOC NW LLC DEPT LA # 24105 PASADENA CA 91185 $14.59 87454 2- Medical Claim 14 166062 3/24/2017 OREGON PULMONARY ASSOCIATES PC PO BOX 6958 PORTLAND OR 97228 $18.36 87462

20 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 14 166063 3/24/2017 EYE CENTER LLP 1550 OAK ST STE 3 EUGENE OR 97401 $5.60 87463 2- Medical Claim 14 166065 3/24/2017 GOOD SHEPHERD MEDICAL GROUP 600 NW 11TH ST STE E37 HERMISTON OR 97838 $12.64 87466 2- Medical Claim 14 166068 3/24/2017 COQUILLE VALLEY HOSPITAL 940 E 5TH ST COQUILLE OR 97423 $12.42 87470 2- Medical Claim 14 166069 3/24/2017 PROVIDENCE NORTH COAST CLINICS PO BOX 3397 PORTLAND OR 97208 $89.86 87471 2- Medical Claim 14 166070 3/24/2017 OREGON ANESTHESIOLOGY GROUP PC PO BOX 2040 PORTLAND OR 97208 $243.66 87472 2- Medical Claim 14 166071 3/24/2017 PROVIDENCE HOOD RIVER CLINIC PO BOX 3390 PORTLAND OR 97208 $8.66 87475

2- Medical Claim 14 166073 3/24/2017 ROSEBURG ANESTHESIOLOGY SPECIALISTS PC PO BOX 94383 SEATTLE WA 98124 $57.60 87479

2- Medical Claim 14 166075 3/24/2017 COLUMBIA GORGE MEDICAL IMAGING LLC 810 12TH ST HOOD RIVER OR 97031 $3.90 87483 2- Medical Claim 14 166076 3/24/2017 BRUNE DERMATOLOGY LLC 1740 NW 9TH ST CORVALLIS OR 97330 $15.19 87484

2- Medical Claim 14 166077 3/24/2017 COLUMBIA PAIN AND SPINE INSTITUTE PC 831 NW COUNCIL DR STE 300 GRESHAM OR 97030 $120.84 87486 2- Medical Claim 14 166078 3/24/2017 WILLAMETTE PAIN AND SPINE CENTER PC 2020 8TH AVE STE 200 WEST LINN OR 97068 $26.83 87487

2- Medical Claim 14 166079 3/24/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 PORTLAND OR 97208 $10.83 87489 2- Medical Claim 14 166081 3/24/2017 SUBLIMITY EYECARE PO BOX 237 SUBLIMITY OR 97385 $1.50 87496 2- Medical Claim 14 166082 3/24/2017 MCMINNVILLE IMAGING LLP PO BOX 516 CORVALLIS OR 97339 $3.13 87497 2- Medical Claim 14 166083 3/24/2017 CASCADE CYTOLOGY REFERENCE LAB INC PO BOX 4207 PORTLAND OR 97208 $3.64 87499 ADVANTAGE ORTHOPEDIC & SPORTS MEDICINE 2- Medical Claim 14 166085 3/24/2017 CLINIC 24076 SE STARK ST STE 110 GRESHAM OR 97030 $479.18 87502 2- Medical Claim 14 166087 3/24/2017 APRIA HEALTHCARE LLC PO BOX 31001 PASADENA CA 91110 $74.13 87508 2- Medical Claim 14 166088 3/24/2017 GENEVA HEALTH CENTER 3838 PACIFIC AVE FOREST GROVE OR 97116 $24.51 87360 2- Medical Claim 14 166089 3/24/2017 THREE RIVERS ANESTHESIA PC PO BOX 4008 PORTLAND OR 97208 $185.60 87362 2- Medical Claim 14 166090 3/24/2017 SELLWOOD FAMILY MEDICINE 1567 SE TACOMA ST PORTLAND OR 97202 $22.91 87363 2- Medical Claim 14 166091 3/24/2017 GRAIN INTEGRATIVE HEALTH LLC 4246 SE BELMONT ST STE 5 PORTLAND OR 97215 $18.54 87367 KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT 2- Medical Claim 14 166094 3/24/2017 2 PO BOX 99 WHITE SALMON WA 98672 $79.79 87375 LEGACY EMANUEL HOSPITAL AND HEALTH 2- Medical Claim 14 166095 3/24/2017 CENTER PO BOX 4399 PORTLAND OR 97208 $24.70 87377 2- Medical Claim 14 166096 3/24/2017 MIDCOLUMBIA MEDICAL CENTER PO BOX 1520 THE DALLES OR 97058 $2.00 87379 2- Medical Claim 14 166097 3/24/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $142.56 87380 CASCADE ORTHOPEDICS & SPORTS MEDICINE 2- Medical Claim 14 166100 3/24/2017 CENTER PC 1715 E 12TH ST THE DALLES OR 97058 $1.00 87388 2- Medical Claim 14 166102 3/24/2017 SALEM CLINIC PC PO BOX 8100 SALEM OR 97303 $20.67 87390

2- Medical Claim 14 166103 3/24/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3397 PORTLAND OR 97208 $17.90 87393 2- Medical Claim 14 166104 3/24/2017 PEACEHEALTH MEDICAL GROUP PO BOX 24410 EUGENE OR 97402 $652.32 87404 2- Medical Claim 14 166107 3/24/2017 TREASURE VALLEY ANESTHESIA PC PO BOX 2936 IDAHO FALLS ID 83403 $49.68 87407 2- Medical Claim 14 166110 3/24/2017 MICHAEL BEAVER LCSW 2367 STATE ST STE 100 SALEM OR 97301 $9.50 87423

21 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 14 166112 3/24/2017 NORTHWESTERN MEDICAL FACULTY F 38205 EAGLE WAY CHICAGO IL 60678 $77.69 87426 2- Medical Claim 14 166113 3/24/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $16.24 87429 2- Medical Claim 14 166114 3/24/2017 BENTON COUNTY HEALTH DEPT PO BOX 579 CORVALLIS OR 97339 $6.00 87433 2- Medical Claim 14 166115 3/24/2017 HEALTHY LIVING FAMILY MEDICINE LLC 3605 SE 26TH AVE PORTLAND OR 97202 $39.58 87435 2- Medical Claim 14 1001732 3/24/2017 TUALITY PHYSICIANS PC 730 SE OAK ST STE D HILLSBORO OR 97123 $26.73 87444 2- Medical Claim 14 1001733 3/24/2017 AH MEDICAL GROUP PO BOX 92900 PORTLAND OR 97292 $38.51 87550 2- Medical Claim 14 166117 3/24/2017 SPECTRACELL LABORATORIES INC 10401 TOWN PARK DR HOUSTON TX 77072 $31.73 87441 2- Medical Claim 14 166118 3/24/2017 ALL AND ONE ACUPUNCTURE 2906 NE GLISAN ST PORTLAND OR 97232 $70.65 87443 Batch Total $29,816.60 $9,446.89 2- Medical Claim 15 166134 3/28/2017 RADIOLOGY ASSOCIATES P C PO BOX 53 EUGENE OR 97440 $236.40 $11.82 87686 2- Medical Claim 15 166135 3/28/2017 PIONEER MEMORIAL HOSPITAL PO BOX 7287 BEND OR 97708 $491.29 87692 2- Medical Claim 15 166137 3/28/2017 SAMARITAN NORTH LINCOLN HOSPITAL PO BOX 1194 CORVALLIS OR 97339 $100.53 87700 2- Medical Claim 15 166146 3/28/2017 OREGON WEIGHT LOSS SURGERY LLC 1040 NW 22ND AVE PORTLAND OR 97210 $350.00 87724 2- Medical Claim 15 166156 3/28/2017 WEST VALLEY MEDICAL CENTER PO BOX 403025 ATLANTA GA 30384 $8.58 87756 2- Medical Claim 15 166165 3/28/2017 DAVID A RYAN LCSW 3939 NE HANCOCK ST STE 305 PORTLAND OR 97212 $230.00 87779 2- Medical Claim 15 166168 3/28/2017 THERAPYWORKS NW 7927 SE ORIENT DR GRESHAM OR 97080 $156.93 $47.08 87783 QUEST DIAGNOSTICS CLINICAL LABORATORIES 2- Medical Claim 15 166120 3/28/2017 INC PO BOX 822550 PHILADELPHIA PA 19182 $17.63 87655 2- Medical Claim 15 166121 3/28/2017 HANGER PROSTHETICS & ORTHOTICS INC PO BOX 650846 DALLAS TX 75265 $9,195.00 87656 GRESHAM TROUTDALE FAMILY MEDICAL 2- Medical Claim 15 166122 3/28/2017 CENTER PC PO BOX 730 TROUTDALE OR 97060 $30.43 87658 KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT 2- Medical Claim 15 166123 3/28/2017 2 PO BOX 99 WHITE SALMON WA 98672 $16.85 87659 2- Medical Claim 15 166124 3/28/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $31.99 87662 2- Medical Claim 15 166128 3/28/2017 SALEM WOMENS CLINIC INC 1395 LIBERTY ST SE SALEM OR 97302 $219.75 87670 2- Medical Claim 15 166130 3/28/2017 NORTHWEST SURGICAL SPECIALISTS LLP 3355 RIVERBEND DR STE 300 SPRINGFIELD OR 97477 $161.42 87673

2- Medical Claim 15 166141 3/28/2017 SOUTHWEST WASHINGTON MEDICAL CENTER PO BOX 1588 VANCOUVER WA 98668 $41.29 87709 2- Medical Claim 15 166142 3/28/2017 PORTLAND DERMATOLOGY CLINIC LLP PO BOX 5005 PORTLAND OR 97208 $79.70 87713 2- Medical Claim 15 166143 3/28/2017 OREGON UROLOGY CLINIC PC 2222 NW LOVEJOY ST STE 416 PORTLAND OR 97210 $38.79 87716 2- Medical Claim 15 166144 3/28/2017 PROLIANCE SURGEONS INC PS 7315 212TH ST SW EDMONDS WA 98026 $601.56 87717 2- Medical Claim 15 166147 3/28/2017 KADLEC REGIONAL MEDICAL CENTER PO BOX 34007 SEATTLE WA 98124 $9.65 87725 2- Medical Claim 15 166148 3/28/2017 PROVIDENCE MEDFORD MEDICA PO BOX 3308 PORTLAND OR 97208 $4.18 87726 2- Medical Claim 15 166149 3/28/2017 SPINCARE CHIROPRACTIC PC 230 NE 2ND AVE STE 1 HILLSBORO OR 97124 $8.00 87732

2- Medical Claim 15 166151 3/28/2017 WILLAMETTE VALLEY MEDICAL CENTER LLC PO BOX 742008 ATLANTA GA 30374 $372.06 87735

2- Medical Claim 15 166152 3/28/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $70.33 87738 2- Medical Claim 15 166157 3/28/2017 SKY LAKES MEDICAL CENTER PO BOX 2120 PORTLAND OR 97208 $10.40 87757 2- Medical Claim 15 166158 3/28/2017 NW NEURO NERVE MONITORING 1410 OAK ST EUGENE OR 97401 $13.49 87758

22 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 15 166159 3/28/2017 INTEGRATED TRAUMA TREAMENT CEN 811 NW 19TH AVE PORTLAND OR 97209 $3.80 87759 2- Medical Claim 15 166160 3/28/2017 MADELINE SCHAEFER 5909 N CURTIS AVE PORTLAND OR 97217 $24.55 87760 2- Medical Claim 15 166161 3/28/2017 THE OREGON CLINIC PC PO BOX 5087 LB 163 PORTLAND OR 97208 $67.26 87767 2- Medical Claim 15 166162 3/28/2017 LAURA MAYO 503 PROSPECT AVE HOOD RIVER OR 97031 $5.90 87769 2- Medical Claim 15 166164 3/28/2017 ARTHUR R MURRELL DC 200 NE 20TH AVE STE 20 PORTLAND OR 97232 $5.78 87778 OKANOGAN COUNTY PUBLIC HOSPITAL 2- Medical Claim 15 166166 3/28/2017 DISTRICT NO 3 PO BOX 793 OMAK WA 98841 $164.43 87781 2- Medical Claim 15 166167 3/28/2017 CORVALLIS CHILDRENS CLINIC 1835 NW KINGS BLVD CORVALLIS OR 97330 $5.10 87782 Batch Total $1,573.73 $11,258.24 2- Medical Claim 16 166180 4/7/2017 MARC E LEWIS MD LLC 356 SE 9TH AVE HILLSBORO OR 97123 $233.98 87784 QUEST DIAGNOSTICS CLINICAL LABORATORIES 2- Medical Claim 16 166184 4/7/2017 INC PO BOX 822550 PHILADELPHIA PA 19182 $117.33 87799 2- Medical Claim 16 166186 4/7/2017 SPECTRACELL LABORATORIES INC 10401 TOWN PARK DR HOUSTON TX 77072 $808.16 87854 2- Medical Claim 16 166188 4/7/2017 NW HEADACHE AND WELLNESS CT 11782 SW BARNES RD BLDG C PORTLAND OR 97225 $115.51 87857 525 N COLUMBIA RIVER 2- Medical Claim 16 166209 4/7/2017 SAINT HELENS INTERNAL MEDICINE LLC HWY SAINT HELENS OR 97051 $122.29 $52.29 87934

2- Medical Claim 16 166212 4/7/2017 WILLAMETTE VALLEY MEDICAL CENTER LLC PO BOX 742008 ATLANTA GA 30374 $174.76 $26.53 87943 2- Medical Claim 16 166213 4/7/2017 NORTHWEST BEHAVIORAL HEALTHCARE 18000 WEBSTER RD GLADSTONE OR 97027 $5,250.00 $750.00 87946

2- Medical Claim 16 166215 4/7/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $654.94 87953 2- Medical Claim 16 166218 4/7/2017 NORTHWEST FAMILY MEDICINE LLC 605 WELCH ST SILVERTON OR 97381 $10.56 87974 2- Medical Claim 16 166221 4/7/2017 NW MEDICAL INC PO BOX 2984 PORTLAND OR 97208 $75.65 87979

2- Medical Claim 16 166223 4/7/2017 PROVIDENCE HEALTH & SERVICES OREGON 4400 NE HALSEY ST STE 129 PORTLAND OR 97213 $1,829.92 $29.03 87990 2- Medical Claim 16 166224 4/7/2017 SALEM SLEEP MEDICINE PC 1395 COMMERCIAL ST SE SALEM OR 97302 $1,061.90 87992

2- Medical Claim 16 166234 4/7/2017 REGENTS OF THE UNIVERSITY OF CALIFORNIA FILE 2939 LOS ANGELES CA 90074 $4,403.00 88024 METHODIST HEALTHCARE SYSTEM OF SAN 2- Medical Claim 16 166235 4/7/2017 ANTONIO LTD LLP PO BOX 406180 ATLANTA GA 30384 $2,850.51 88030 2- Medical Claim 16 166239 4/7/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $74.65 88039 2- Medical Claim 16 166245 4/7/2017 MADRONA HILL URGENT CARE LLC PO BOX 17687 BELFAST ME 04915 $139.30 88056 2- Medical Claim 16 166246 4/7/2017 JANETTE L GREEN MD PC 10200 SW EASTRIDGE ST PORTLAND OR 97225 $214.42 88058 2- Medical Claim 16 166171 4/7/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $17,066.36 87810 2- Medical Claim 16 166200 4/7/2017 PORTLAND CLINIC 800 SW 13TH AVE PORTLAND OR 97205 $652.92 87899 2- Medical Claim/Void and Reissue 16 166169 4/7/2017 JULIE ROSENBERG MD 2250 NW FLANDERS ST 101 PORTLAND OR 97210 $89.57 55228 2- Medical Claim 16 166181 4/7/2017 HOSSEINION FAMILY MEDICINE LLC PO BOX 97115 LAKEWOOD WA 98497 $52.31 87786

23 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # PATHOLOGY ASSOCIATES MEDICAL 2- Medical Claim 16 166182 4/7/2017 LABORATORIES LLC PO BOX 2720 SPOKANE WA 99220 $9.66 87793 2- Medical Claim 16 1001736 4/7/2017 VANCOUVER CLINIC INC 700 NE 87TH AVE VANCOUVER WA 98664 $10.68 87806 2- Medical Claim 16 166170 4/7/2017 ALBANY GENERAL HOSPITAL PO BOX 1188 CORVALLIS OR 97339 $90.43 87808 2- Medical Claim 16 166172 4/7/2017 PACIFIC PATHOLOGY ASSOCIATES INC 5700 SOUTHWYCK BLVD TOLEDO OH 43614 $96.96 87819 2- Medical Claim 16 166174 4/7/2017 EYE HEALTH NORTHWEST PC PO BOX 22009 PORTLAND OR 97269 $18.17 87823 2- Medical Claim 16 166176 4/7/2017 CORVALLIS CLINIC PC 444 NW ELKS DR CORVALLIS OR 97330 $34.24 87831 2- Medical Claim 16 166177 4/7/2017 RICHARD E GELLMAN MD PC PO BOX 2726 PORTLAND OR 97208 $246.42 87837 2- Medical Claim 16 166178 4/7/2017 RETINA CONSULTANTS 2450 12TH ST SE SALEM OR 97302 $470.72 87842 2- Medical Claim 16 166179 4/7/2017 PORTLAND PAIN CARE PO BOX 3714 SEATTLE WA 98124 $10.72 87849 GRAPEVINE WOMENS HEALTH AND 2- Medical Claim 16 1001735 4/7/2017 GYNECOLOGY LLC 5880 NE CORNELL RD STE C HILLSBORO OR 97124 $57.46 87852 2- Medical Claim 16 166189 4/7/2017 MERCY REDDING PO BOX 742015 LOS ANGELES CA 90074 $945.10 87859 2- Medical Claim 16 166191 4/7/2017 MERCY MEDICAL CENTER PO BOX 310011279 PASADENA CA 91110 $7.11 87865 2- Medical Claim 16 166195 4/7/2017 VIBRA SPECIALTY PORTLAND 6730 N WEST AVE STE 109 FRESNO CA 93711 $6,649.71 87886 2- Medical Claim 16 166196 4/7/2017 J RAFE SALES MD PC 9155 SW BARNES RD STE 210 PORTLAND OR 97225 $22.90 87888

2- Medical Claim 16 166198 4/7/2017 NORTHWEST SURGICAL SPECIALISTS PC 200 NE MOTHER JOSEPH PL STE 210 VANCOUVER WA 98664 $483.10 87896

2- Medical Claim 16 166199 4/7/2017 SOUTHWEST WASHINGTON MEDICAL CENTER PO BOX 1588 VANCOUVER WA 98668 $973.99 87897 2- Medical Claim 16 166201 4/7/2017 CASCADE HEALTH SOLUTIONS PO BOX 4280 PORTLAND OR 97208 $430.05 87900 2- Medical Claim 16 166202 4/7/2017 PORTLAND DERMATOLOGY CLINIC LLP PO BOX 5005 PORTLAND OR 97208 $90.03 87902

2- Medical Claim 16 166203 4/7/2017 OREGON ORTHOPEDIC & SPORTS MEDICINE 1508 DIVISION ST STE 105 OREGON CITY OR 97045 $48.94 87905 2- Medical Claim 16 166204 4/7/2017 JAMES H IMATANI JR MD PC 8205 SW CREEKSIDE PL STE 150 BEAVERTON OR 97008 $85.28 87910 2- Medical Claim 16 166206 4/7/2017 DEPARTMENT OF HUMAN SERVICES PO BOX 14023 SALEM OR 97309 $14.04 87917

2- Medical Claim 16 166208 4/7/2017 PROMOTION ADVANCED FUNCTIONAL REHAB 601 N 1ST AVE STAYTON OR 97383 $15.54 87924 2- Medical Claim 16 166210 4/7/2017 HORIZON SURGERY CLINIC LLC 6542 SE LAKE RD STE 101 PORTLAND OR 97222 $13.54 87940 2- Medical Claim 16 166211 4/7/2017 GEOFF HOUGHTON ND 153 CLEAR CREEK DR STE 101 ASHLAND OR 97520 $8.00 87942 2- Medical Claim 16 166214 4/7/2017 BAY AREA HOSPITAL 1775 THOMPSON RD COOS BAY OR 97420 $3,008.02 87949 LEGACY GOOD SAMARITAN HOSPITAL & 2- Medical Claim 16 166217 4/7/2017 MEDICAL CENTER PO BOX 4037 PORTLAND OR 97208 $49.07 87970 2- Medical Claim 16 166220 4/7/2017 MEDIX AMBULANCE SERVICE INC 609 NW COAST ST NEWPORT OR 97365 $39.30 87978 2- Medical Claim 16 166226 4/7/2017 SKY LAKES MEDICAL CENTER PO BOX 2120 PORTLAND OR 97208 $3,043.95 87997 2- Medical Claim 16 166227 4/7/2017 REBECCA HIGGINSON 333 NE RUSSELL ST STE 200 PORTLAND OR 97212 $10.50 87999 2- Medical Claim 16 166228 4/7/2017 KATHERINE ZIEMAN 22400 SE STARK ST GRESHAM OR 97030 $5.15 88006 2- Medical Claim 16 166229 4/7/2017 GRAY WOLF RANCH PO BOX 102 PORT TOWNSEND WA 98368 $155.25 88010

2- Medical Claim 16 166230 4/7/2017 ROSEMARY MEDICINE 3942 SE HAWTHORNE BLVD PORTLAND OR 97214 $10.50 88015

24 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 16 166231 4/7/2017 ASANTE THREE RIVERS MEDICAL CENTER LLC 731 BLACK OAK DR STE 101 MEDFORD OR 97504 $39.30 88016

2- Medical Claim 16 166232 4/7/2017 GUNDERSEN LUTHERAN MEDICAL CENTER INC PO BOX 4444 LA CROSSE WI 54602 $40.57 88018 2- Medical Claim 16 166233 4/7/2017 PLAINVIEW HOSPITAL PO BOX 415976 BOSTON MA 02241 $0.01 88019 2- Medical Claim 16 166236 4/7/2017 OPTION CARE 4259 PAYSPHERE CIR CHICAGO IL 60674 $15.00 88032 2- Medical Claim 16 166238 4/7/2017 UKIAH ADVENTIST HOSPITAL 275 HOSPITAL DR UKIAH CA 95482 $299.92 88037 2- Medical Claim 16 166240 4/7/2017 CHICLARKIN VENTURES LLC 760 WARNER DR GOLDEN CO 80401 $39.74 88041 COMPREHENSIVE OPTIONS FOR DRUG 2- Medical Claim 16 166241 4/7/2017 ABUSERS INC 1027 E BURNSIDE ST PORTLAND OR 97214 $4.87 88043 OKANOGAN COUNTY PUBLIC HOSPITAL 2- Medical Claim 16 166242 4/7/2017 DISTRICT NO 3 PO BOX 793 OMAK WA 98841 $4.93 88049

2- Medical Claim 16 166243 4/7/2017 COLUMBIA PAIN AND SPINE INSTITUTE PC 689 NW BURNSIDE RD GRESHAM OR 97030 $70.87 88050 2- Medical Claim 16 166244 4/7/2017 THERAPYWORKS NW 7927 SE ORIENT DR GRESHAM OR 97080 $34.91 88052 2- Medical Claim 16 166247 4/7/2017 RADIOLOGY ASSOCIATES PC PO BOX 53 EUGENE OR 97440 $11.50 88059 2- Medical Claim 16 166171 4/7/2017 PORTLAND ADVENTIST MEDICAL CENTER PO BOX 16800 PORTLAND OR 97292 $419.62 87810 Batch Total $35,945.73 $19,045.93 2- Medical Claim 17 166331 4/18/2017 NORCO INC PO BOX 15299 BOISE ID 83715 $221.84 $17.60 88086 2- Medical Claim 17 166281 4/18/2017 PORTLAND CLINIC 800 SW 13TH AVE PORTLAND OR 97205 $103.04 88203 2- Medical Claim 17 166283 4/18/2017 ROB DRAMOV ND PC 9735 SW SHADY LN STE 104 PORTLAND OR 97223 $115.00 88218

2- Medical Claim 17 166293 4/18/2017 BEHAVIORAL HEALTHCARE NORTHWEST PC 10000 SE MAIN ST STE 148 PORTLAND OR 97216 $110.74 88251 2- Medical Claim 17 166304 4/18/2017 HAZELDEN SPRINGBROOK PO BOX 860188 MINNEAPOLIS MN 55486 $145.00 $2.70 88290 2- Medical Claim 17 166321 4/18/2017 SOUTHERNCROSS AMBULANCE INC PO BOX 311295 NEW BRAUNFELS TX 78131 $980.00 88340

2- Medical Claim 17 166324 4/18/2017 PUBLIC HOSPITAL DISTRICT 1 OF KING COUNTY PO BOX 34551 SEATTLE WA 98124 $78.07 88346 2- Medical Claim 17 166326 4/18/2017 GEORGE LIAKEAS 139 E 57TH ST NEW YORK NY 10022 $130.97 88351 2- Medical Claim/Void and Reissue 17 166248 4/18/2017 LESLIE WILLIAMS PO BOX 5785 PORTLAND OR 97228 $312.50 $0.00 62721 2- Medical Claim/Void and Reissue 17 166249 4/18/2017 NANI WADDOUPS 819 SE MORRISON ST PORTLAND OR 97214 $30.00 $0.00 59287 2- Medical Claim/Void and Reissue 17 166250 4/18/2017 FAMILY TIES COUNSELING CENTER 2304 E BURNSIDE ST PORTLAND OR 97214 $47.17 $0.00 63550 2- Medical Claim/Void and Reissue 17 166251 4/18/2017 RANDI A GALLI MD INC PO BOX 39000 DEPT 34412 SAN FRANCISCO CA 94139 $1,758.26 $0.00 58314

25 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim/Void and Reissue 17 166252 4/18/2017 RANDI A GALLI MD INC PO BOX 39000 DEPT 34412 SAN FRANCISCO CA 94139 $195.28 $0.00 56807 2- Medical Claim/Void and Reissue 17 166253 4/18/2017 RENEE M GARDNER 5319 SW WESTGATE DR PORTLAND OR 97221 $120.00 $0.00 61871 2- Medical Claim/Void and Reissue 17 166254 4/18/2017 RICK TANGEMAN MSW 4000 KRUSE WAY PL LAKE OSWEGO OR 97035 $64.54 $0.00 60473 2- Medical Claim/Void and Reissue 17 166255 4/18/2017 ROCKWOOD ORTHSPORTS PT 12151 NE HALSEY ST STE 280A PORTLAND OR 97220 $227.00 $0.00 60859 2- Medical Claim/Void and Reissue 17 166256 4/18/2017 SALEM PAIN AND SPINE SPECIALIS 700 BELLEVUE ST SE SALEM OR 97301 $112.78 $0.00 64177 2- Medical Claim/Void and Reissue 17 166257 4/18/2017 TERESA KEHRLI 320 N MAIN AVE GRESHAM OR 97030 $22.50 $0.00 50868 2- Medical Claim/Void and Reissue 17 166258 4/18/2017 VIRGINIA TERHAAR LPC 1830 NW RIVERSCAPE ST APT 608 PORTLAND OR 97209 $850.00 $0.00 62306 2- Medical Claim/Void and Reissue 17 166259 4/18/2017 MARTIN C FOSTER MD PO Box 21 LANDISVILLE PA 17538 $114.20 $0.00 65485 2- Medical Claim/Void and Reissue 17 166260 4/18/2017 ROGUE VALLEY PHYSICIANS 3524 HEATHROW WAY MEDFORD OR 97504 $18.37 $0.00 62340 2- Medical Claim/Void and Reissue 17 166261 4/18/2017 PACIFIC VASCULAR SPECIALISTS PC 3439 NE SANDY BLVD # 375 PORTLAND OR 97232 $422.93 $0.00 49579 2- Medical Claim/Void and Reissue 17 166262 4/18/2017 THOMAS E MATHESON PO BOX 749738 LOS ANGELES CA 90074 $73.44 $0.00 67183 2- Medical Claim/Void and Reissue 17 166263 4/18/2017 THOMAS E MATHESON PO BOX 749738 LOS ANGELES CA 90074 $6.00 $0.00 68861 2- Medical Claim/Void and Reissue 17 166264 4/18/2017 EDMUND PH MYERS 2408 SE 16TH AVE PORTLAND OR 97214 $155.33 $0.00 71424

26 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim/Void and Reissue 17 166265 4/18/2017 CHILDRENS NATUROPATHIC CENTRE 4444 SW CORBETT AVE PORTLAND OR 97239 $150.02 $0.00 54657 2- Medical Claim/Void and Reissue 17 166266 4/18/2017 ERROLL E STEPHENS 10365 SE SUNNYSIDE RD CLACKAMAS OR 97015 $425.31 $0.00 53743 2- Medical Claim/Void and ARIS RADIOLOGY PROFESSIONALS OF Reissue 17 166267 4/18/2017 MICHIGAN PC PO BOX 72078 CLEVELAND OH 44192 $198.51 $0.00 54231 2- Medical Claim/Void and Reissue 17 166268 4/18/2017 CHILDRENS NATUROPATHIC CENTRE 4444 SW CORBETT AVE PORTLAND OR 97239 $75.00 $0.00 56058 2- Medical Claim/Void and ARIS RADIOLOGY PROFESSIONALS OF Reissue 17 166269 4/18/2017 MICHIGAN PC PO BOX 72078 CLEVELAND OH 44192 $63.87 $0.00 55971 2- Medical Claim/Void and Reissue 17 166270 4/18/2017 ERROLL E STEPHENS 10365 SE SUNNYSIDE RD CLACKAMAS OR 97015 $47.17 $0.00 55496 2- Medical Claim/Void and Reissue 17 166271 4/18/2017 ERROLL E STEPHENS 10365 SE SUNNYSIDE RD CLACKAMAS OR 97015 $94.64 $0.00 56960 2- Medical Claim/Void and Reissue 17 166272 4/18/2017 HLTHCARE MIDCOLUMBIA REG PO BOX 4800 UNIT 17 PORTLAND OR 97208 $177.00 $0.00 56219 2- Medical Claim/Void and Reissue 17 166273 4/18/2017 CHILDRENS NATUROPATHIC CENTRE 4444 SW CORBETT AVE PORTLAND OR 97239 $75.00 $0.00 59044 2- Medical Claim 17 166276 4/18/2017 JOHN R.TONGUE MD PC 6485 SW BORLAND RD STE A TUALATIN OR 97062 $23.81 88171

2- Medical Claim 17 166279 4/18/2017 UMPQUA COMMUNITY HEALTH CENTER 150 NE KENNETH FORD DR ROSEBURG OR 97470 $0.56 88187 2- Medical Claim 17 166280 4/18/2017 KATHERINE ZIEMAN 22400 SE STARK ST # 105 GRESHAM OR 97030 $6.80 88191 2- Medical Claim 17 166282 4/18/2017 ST CHARLES HEALTH SYSTEM PO BOX 6095 BEND OR 97708 $583.80 88205 2- Medical Claim 17 166284 4/18/2017 LEBANON FIRE DISTRICT 1050 W OAK ST LEBANON OR 97355 $84.15 88220 3871 FAIRVIEW INDUSTRIAL 2- Medical Claim 17 166285 4/18/2017 WILLAMETTE VALLEY TX CENTER DR SE SALEM OR 97302 $69.60 88222 2- Medical Claim 17 166286 4/18/2017 AMERICAN MEDICAL RESPONSE PO BOX 749667 LOS ANGELES CA 90074 $1,456.55 88225 2- Medical Claim 17 166287 4/18/2017 PORTLAND VAMC PO BOX 98034 LAS VEGAS NV 89193 $11.94 88229 2- Medical Claim 17 166288 4/18/2017 MEDTRANS CORPORATION 2500 NE NEFF RD BEND OR 97701 $107.69 88238 2- Medical Claim 17 166289 4/18/2017 TOUCHSTONE 2925 SISKIYOU BLVD MEDFORD OR 97504 $11.09 88240

27 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 17 166292 4/18/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $110.48 88249 3181 SW SAM JACKSON 2- Medical Claim 17 166294 4/18/2017 UNIVERSITY PROFESSIONAL SVCS PARK RD PORTLAND OR 97239 $18.95 88268 2- Medical Claim 17 166296 4/18/2017 JAMES W BAKER MD LLC 9495 SW LOCUST ST STE A PORTLAND OR 97223 $1.91 88273 2- Medical Claim 17 166297 4/18/2017 KLICKITAT COUNTY HOSPITAL DISTRICT 2 PO BOX 99 WHITE SALMON WA 98672 $138.21 88275 2- Medical Claim 17 166298 4/18/2017 FALCK NORTHWEST CORP PO BOX 31001 PASADENA CA 91110 $137.72 88279 2- Medical Claim 17 166299 4/18/2017 NATIONAL LABS 3948 TRUST WAY HAYWARD CA 94545 $11.71 88280 2- Medical Claim 17 166300 4/18/2017 BAY CITIES AMBULANCE INC 609 NW COAST ST NEWPORT OR 97365 $176.83 88282 2- Medical Claim 17 166301 4/18/2017 PACIFIC KIDNEY & HYPERTENSION PO BOX 16012 BELFAST ME 04915 $12.76 88283 2- Medical Claim 17 166302 4/18/2017 KLAMARTH HEART CLINIC PO BOX 5109 KLAMATH FALLS OR 97601 $151.90 88287 2- Medical Claim 17 166303 4/18/2017 SUMMIT FAMILY MEDICINE LLC 1021 JUNE ST STE 104 HOOD RIVER OR 97031 $9.84 88288 2- Medical Claim 17 166305 4/18/2017 CITY OF BEND AMBULANCE PO BOX 1024 BEND OR 97709 $34.68 88291 2- Medical Claim 17 166306 4/18/2017 CITY OF CORVALLIS AMBULANCE PO BOX 1083 CORVALLIS OR 97339 $15.00 88292 2- Medical Claim 17 166307 4/18/2017 CITY OF ASHLAND PO BOX 914 SPRINGFIELD OR 97477 $124.58 88296 2- Medical Claim 17 166308 4/18/2017 CITY OF HOOD RIVER PO BOX 914 SPRINGFIELD OR 97477 $15.00 88297 2- Medical Claim 17 166309 4/18/2017 REDMOND FIRE & RESCUE 341 NW DOGWOOD AVE REDMOND OR 97756 $28.99 88303 2- Medical Claim 17 166311 4/18/2017 COWLITZ 2 FIRE & RESCUE PO BOX 2029 GIG HARBOR WA 98335 $47.93 88308 2- Medical Claim 17 166312 4/18/2017 CROOK COUNTY FIRE AND RESCUE 500 NE BELKNAP ST PRINEVILLE OR 97754 $30.76 88309 2- Medical Claim 17 166313 4/18/2017 AMERICAN MEDICAL RESPONSE PO BOX 31001 PASADENA CA 91110 $114.15 88311 2- Medical Claim 17 166314 4/18/2017 CITY OF EUGENE PO BOX 914 SPRINGFIELD OR 97477 $57.70 88312 2- Medical Claim 17 166315 4/18/2017 TUALATIN VALLEY FIRE & RESCUE 11945 SW 70TH AVE PORTLAND OR 97223 $60.03 88313 WINSTONDILLARD RURAL FIRE PROTECTION 2- Medical Claim 17 166317 4/18/2017 DISTRICT PO BOX 1779 WINSTON OR 97496 $124.71 88319 2- Medical Claim 17 166318 4/18/2017 BLUE SKY ACUPUNCTURE 119 NE 3RD ST MCMINNVILLE OR 97128 $6.05 88321 2- Medical Claim 17 166320 4/18/2017 BEHALL ACUPUNCTURE LLC 5714 NE 17TH AVE PORTLAND OR 97211 $11.61 88336 2- Medical Claim 17 166322 4/18/2017 AN KANG NATURAL HEALTH CENTER 5201 SW WESTGATE DR STE 116 PORTLAND OR 97221 $14.94 88341 COMPREHENSIVE OPTIONS FOR DRUG 2- Medical Claim 17 166323 4/18/2017 ABUSERS INC 1027 E BURNSIDE ST PORTLAND OR 97214 $0.97 88344 2- Medical Claim 17 166325 4/18/2017 VITAE DIAGNOSTICS INCORPORATED 3848 DEL AMO BLVD TORRANCE CA 90503 $17.60 88349 Member information 2- Member Loss 17 166327 4/18/2017 Member information redacted redacted PORTLAND OR 97201 $7.75 88355 2- Medical Claim 17 166328 4/18/2017 ARMSTRONG TODD PO BOX 1192 GOLD BEACH OR 97444 $3.75 88064 2- Medical Claim 17 166329 4/18/2017 THREE RIVERS ANESTHESIA PC PO BOX 4008 PORTLAND OR 97208 $76.80 88067 2- Medical Claim 17 166332 4/18/2017 MIDCOLUMBIA MEDICAL CENTER PO BOX 1520 THE DALLES OR 97058 $85.91 88090 2- Medical Claim 17 166334 4/18/2017 MERCY FLIGHTS INCORPORATED 2020 MILLIGAN WAY MEDFORD OR 97504 $68.22 88096 2- Medical Claim 17 166335 4/18/2017 SALEM HOSPITAL PO BOX 2747 PORTLAND OR 97208 $602.45 88098 2- Medical Claim 17 166336 4/18/2017 LEGACY CLINICS LLC PO BOX 3777 PORTLAND OR 97208 $21.04 88114 2- Medical Claim 17 166337 4/18/2017 ROGUE VALLEY PHYSICIANS 2900 DOCTORS PARK DR STE 250 MEDFORD OR 97504 $19.38 88115

28 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP #

2- Medical Claim 17 166339 4/18/2017 ASANTE ROGUE REGIONAL MEDICAL CENTER 2825 E BARNETT RD MEDFORD OR 97504 $2,521.52 88127 2- Medical Claim 17 166340 4/18/2017 MEDFORD WOMENS CLINIC 3170 STATE ST MEDFORD OR 97504 $57.63 88132 2- Medical Claim 17 166341 4/18/2017 ASHLAND ANESTHESIA ASSOCIATES 638 N MAIN ST ASHLAND OR 97520 $41.91 88133 2- Medical Claim 17 166342 4/18/2017 METRO WEST AMBULANCE INC 609 NW COAST ST NEWPORT OR 97365 $830.46 88139 2- Medical Claim 17 166343 4/18/2017 WOMENS HEALTHCARE ASSOC PO BOX 2885 PORTLAND OR 97208 $0.46 88143

2- Medical Claim 17 166344 4/18/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $7.80 88146 ALLERGY ASTHMA & DERMATOLOGY 2- Medical Claim 17 166345 4/18/2017 ASSOCIATES PC 2415 NE 134TH ST STE 301 VANCOUVER WA 98686 $9.80 88153 Batch Total $7,721.48 $8,206.18

2- Medical Claim 18 166348 4/21/2017 LABORATORY CORPORATION OF AMERICA PO BOX 2270 BURLINGTON NC 27216 $97.33 88476

2- Medical Claim 18 166351 4/21/2017 RADIOLOGY SPECIALISTS OF THE NORTHWEST PO BOX 4000 MS 21 PORTLAND OR 97208 $246.19 88505 2- Medical Claim 18 166354 4/21/2017 SALEM SLEEP MEDICINE PC 1395 COMMERCIAL ST SE SALEM OR 97302 $133.70 88613 SAINT ALPHONSUS MEDICAL CENTER BAKER 2- Medical Claim 18 166357 4/21/2017 CITY INC 3340 E GOLDSTONE WAY MERIDIAN ID 83642 $583.61 88786 NORTHWEST DERMATOLOGY AND RESEARCH 2- Medical Claim 18 166359 4/21/2017 CENTER LLC PO BOX 23200 PORTLAND OR 97281 $78.40 88861 2- Medical Claim 18 166363 4/21/2017 LEGACY EMANUEL PROVIDERS PO BOX 4399 PORTLAND OR 97208 $212.39 89234 2- Medical Claim 18 166370 4/21/2017 PACIFIC MEDICAL SYSTEMS INC 1407 132ND AVE NE BELLEVUE WA 98005 $248.54 88958 2- Medical Claim 18 166378 4/21/2017 SALEM PSYCHIATRIC ASSOCIATION PC 821 SAGINAW ST S SALEM OR 97302 $82.32 89674 2- Medical Claim 18 166346 4/21/2017 WENATCHEE VALLEY HOSPITAL PO BOX 361 WENATCHEE WA 98807 $12.35 88451 SAINT ALPHONSUS REGIONAL MEDICAL CENTER 2- Medical Claim 18 166347 4/21/2017 INC 3340 E GOLDSTONE WAY MERIDIAN ID 83642 $11.21 88462 2- Medical Claim 18 166358 4/21/2017 EYE HEALTH NORTHWEST PC PO BOX 22009 PORTLAND OR 97269 $7.58 88820 2- Medical Claim 18 166360 4/21/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $73.93 89114

2- Medical Claim 18 166362 4/21/2017 KIDNEY HYPERTENSION CENTER PC 2410 NW EDENBOWER BLVD STE 176 ROSEBURG OR 97471 $25.96 89216

2- Medical Claim 18 166364 4/21/2017 VIRTUAL RADIOLOGIC PROFESSIONALS LLC PO BOX 4246 CAROL STREAM IL 60197 $1.06 89250 PROVIDENCE MEDICAL GROUP GATEWAY 2- Medical Claim 18 166365 4/21/2017 IMMEDIATE CARE 1321 NE 99TH AVE STE 100 PORTLAND OR 97220 $0.17 89396 2- Medical Claim 18 166366 4/21/2017 MARQUIS COMPANIES I INC 725 SE 202ND AVE PORTLAND OR 97233 $1,000.03 89811 2- Medical Claim 18 166368 4/21/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $7.56 89899 ASSOCIATION OF CHRMC AND UNIVERSITY 2- Medical Claim 18 166371 4/21/2017 PHYSICIANS PO BOX 94390 SEATTLE WA 98124 $94.62 88989 2- Medical Claim 18 166372 4/21/2017 VAIL CLINIC INC PO BOX 1150 VAIL CO 81658 $24.03 89051 2- Medical Claim 18 166374 4/21/2017 GEOFF HOUGHTON ND 153 CLEAR CREEK DR STE 101 ASHLAND OR 97520 $6.19 89513

29 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 18 166375 4/21/2017 PACIFIC REGENCY CARE LLC 405 NE 5TH ST GRESHAM OR 97030 $1,597.10 89587 2- Medical Claim 18 166376 4/21/2017 JOHN R TONGUE MD PC 6485 SW BORLAND RD STE A TUALATIN OR 97062 $17.96 89622 2- Medical Claim 18 166377 4/21/2017 MCMINNVILLE EYE CLINIC 235 SE NORTON LN MCMINNVILLE OR 97128 $9.61 89644 2- Medical Claim 18 166381 4/21/2017 VIRTUAL RADIOLOGIC PROF LLC PO BOX 4246 CAROL STREAM IL 60197 $4.25 89711 2- Medical Claim 18 166382 4/21/2017 SPECTRACELL LABORATORIES INC 10401 TOWN PARK DR HOUSTON TX 77072 $55.77 89072 13101 COLLECTION CENTER 2- Medical Claim 18 166383 4/21/2017 MINIMED DISTRIBUTION CORP DR CHICAGO IL 60693 $37.72 89079 Batch Total $1,682.48 $2,987.10 2- Medical Claim 19 166388 4/25/2017 PACIFIC WEST AMBULANCE INC 609 NW COAST ST NEWPORT OR 97365 $842.00 89936 2- Medical Claim 19 166389 4/25/2017 FAMILY MEDICAL GROUP NORTHEAST PO BOX 28190 PORTLAND OR 97228 $235.15 89939 2- Medical Claim 19 166395 4/25/2017 PROV HOME MEDICAL EQUIPMENT PO BOX 5936A PORTLAND OR 97228 $1,529.00 89979

2- Medical Claim 19 166396 4/25/2017 ADVANCE SPORTS AND SPINE THEAPY LLC PO BOX 592 WEST LINN OR 97068 $158.27 $49.81 89981 2- Medical Claim 19 166398 4/25/2017 TYLER KELIIHELEUA ND 14900 SW BARROWS RD STE 201 BEAVERTON OR 97007 $148.80 $24.62 89998 2- Medical Claim 19 166402 4/25/2017 PEDAL PT LLC PO BOX 7228 BEND OR 97708 $830.00 $132.80 90015 2- Medical Claim 19 166403 4/25/2017 UCSF MEDICAL CENTER PO BOX 39000 DEPT 75631 SAN FRANCISCO CA 94139 $82.85 90019

2- Medical Claim 19 166385 4/25/2017 KIDNEY HYPERTENSION CENTER PC 2410 NW EDENBOWER BLVD STE 176 ROSEBURG OR 97471 $63.88 89911 2- Medical Claim 19 166390 4/25/2017 BEND ANESTHESIOLOGY GROUP PC PO BOX 3330 SALT LAKE CITY UT 84110 $52.42 89945 2- Medical Claim 19 166391 4/25/2017 SOUTHERN OREGON HOSPITALISTS PC 2640 E BARNETT RD STE E333 MEDFORD OR 97504 $64.35 89952 2- Medical Claim 19 166394 4/25/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $18.45 89971 2- Medical Claim 19 166397 4/25/2017 ALBANY FIRE DEPT 333 BROADALBIN ST SW ALBANY OR 97321 $57.61 89982

2- Medical Claim 19 166399 4/25/2017 VIRTUAL RADIOLOGIC PROFESSIONALS LLC PO BOX 4246 CAROL STREAM IL 60197 $19.01 90005 COMPREHENSIVE OPTIONS FOR DRUG 2- Medical Claim 19 166401 4/25/2017 ABUSERS INC 1027 E BURNSIDE ST PORTLAND OR 97214 $1.05 90010 Member information 2- Member Loss 19 166404 4/25/2017 Member information redacted redacted Eugene OR 97405 $4,752.25 90020 Batch Total $3,826.07 $5,236.25 2- Medical Claim 20 166408 5/9/2017 LEGACY CLINICS LLC PO BOX 3777 PORTLAND OR 97208 $289.28 90060

2- Medical Claim 20 166409 5/9/2017 HANGER PROSTHETICS & ORTHOTICS WEST INC PO BOX 650846 DALLAS TX 75265 $409.60 90067 2- Medical Claim 20 166415 5/9/2017 LYNDON G JOHANSEN DPM 12658 SE STARK ST PORTLAND OR 97233 $775.22 90097 Member information 2- Member Loss 20 166418 5/9/2017 Member information redacted redacted SHERWOOD FOREST MD 21405-2007 $2,193.90 90110 2- Medical Claim 20 166421 5/9/2017 PORTLAND CLINIC 800 SW 13TH AVE PORTLAND OR 97205 $88.04 90122 ORTHOPEDIC & SPORTS MEDICINE CENTER OF 2- Medical Claim 20 166425 5/9/2017 OREGON 1515 NW 18TH AVE PORTLAND OR 97209 $66.95 90147

2- Medical Claim 20 166428 5/9/2017 PROVIDENCE HEALTH & SERVICES OREGON PO BOX 3158 PORTLAND OR 97208 $239.20 90159

30 Oregon's Health CO-OP - May 16, 2017

Pre Post Receivership Receivership Claim Type Batch # Check # Check Register Provider Address Address 2 City State Zip 100% 10% EOP # 2- Medical Claim 20 166441 5/9/2017 OVERLAKE MEDICAL CLINICS LLC PO BOX 3947 SEATTLE WA 98124 $295.47 90220 Member information 2- Member Loss 20 166447 5/9/2017 Member information redacted redacted SHERWOOD FOREST MD 21405-2007 $4,241.19 90248 2- Medical Claim 20 166406 5/9/2017 DIAGNOSTIC RADIOLOGISTS PC PO BOX 2097 PORTLAND OR 97208 $2.90 90046

2- Medical Claim 20 166407 5/9/2017 SOUTH COAST ORTHOPAEDIC ASSOCIATES PC 2699 N 17TH ST COOS BAY OR 97420 $13.52 90049 2- Medical Claim 20 166412 5/9/2017 PORTLAND ANESTHESIA SPECIALISTS PO BOX 636856 CINCINNATI OH 45263 $23.71 90089 2- Medical Claim 20 166422 5/9/2017 SYNERGY MEDICAL SYSTEMS LLC 1710 WILLOW CREEK CIR # CIRCLE1 EUGENE OR 97402 $49.12 90132 2- Medical Claim 20 166424 5/9/2017 COAST COMMUNITY HEALTH CENTER 1010 1ST ST SE BANDON OR 97411 $1.81 90143 2- Medical Claim 20 166426 5/9/2017 ADVANCED ACUPUNCTURE INC II 315 2ND ST LAKE OSWEGO OR 97034 $0.51 90150 2- Medical Claim 20 166429 5/9/2017 ADVENTIST HEALTH PO BOX 619120 ROSEVILLE CA 95661 $18.45 90166 2- Medical Claim 20 166435 5/9/2017 MADELINE SCHAEFER 5909 N CURTIS AVE PORTLAND OR 97217 $49.61 90196 2- Medical Claim 20 166438 5/9/2017 HUMBOLDT GENERAL HOSPITAL 118 E HASKELL ST WINNEMUCCA NV 89445 $66.55 90209

2- Medical Claim 20 166440 5/9/2017 LABORATORY CORPORATION OF AMERICA PO BOX 2270 BURLINGTON NC 27216 $15.81 90216 2- Medical Claim 20 166442 5/9/2017 BOSTON PUBLIC HEALTH COMMISSION PO BOX 415936 BOSTON MA 02241 $25.00 90223 2- Medical Claim 20 166444 5/9/2017 AMON CHIROPRACTIC LLC 85458 HIGHWAY 11 MILTON FREEWATER OR 97862 $32.34 90233 2- Medical Claim 20 166445 5/9/2017 ZIEMAN KATHERINE A 22400 SE STARK ST GRESHAM OR 97030 $17.80 90238 2- Medical Claim 20 166446 5/9/2017 PEDAL PT LLC PO BOX 7228 BEND OR 97708 $12.69 90242 2- Medical Claim 20 1001738 5/9/2017 VANCOUVER CLINIC INC 700 NE 87TH AVE VANCOUVER WA 98664 $0.34 90037 Batch Total $8,598.85 $330.16 To be Member information 2- Return Premium assigned 5/15/2017 Member information redacted redacted PORTLAND OR 97203 $56.40 NA To be Member information 2- Return Premium assigned 5/15/2017 Member information redacted redacted Newberg OR 97132 $172.20 NA To be Member information 2- Member Loss assigned 5/15/2017 Member information redacted redacted Astoria OR 97103 5,876.18 NA $6,104.78

31