204-15 Clark County AB 225 07/01/2014 - 09/30/2014 as of 10/04/2014

ALL UNINSURED Data Data To Facility Name Accounts Charges To Facility Name Acounts Charges Sunrise Medical Center - 37 $ 38,373.89 Sunrise Medical Center - Las Vegas 16 $ 16,424.58 University Medical Center 16 $ 17,853.37 University Medical Center 12 $ 13,556.84 Western Arizona Regional Medical Center 15 $ 16,731.49 University Med Center 5 $ 5,827.42 Desert Springs 9 $ 9,163.29 Desert Springs Hospital 5 $ 5,212.30 Western Arizona Regional Medical University Med Center 8 $ 9,034.15 Center 4 $ 4,422.90 University Medical Center - Las Vegas 6 $ 6,257.76 Medical Center 2 $ 2,224.74 Spring Valley Hospital Medical Center 3 $ 3,297.24 Valley Hospital 2 $ 2,038.68 3 $ 3,164.34 Summerlin Hospital 2 $ 2,065.26 Valley Hospital 3 $ 3,084.60 (blank) 1 $ 1,055.20 Saint Rose Dominican Hospital Siena St. Rose San Martin Hospital 2 $ 2,628.01 Campus 1 $ 1,028.62 Saint Rose Dominican Hospital Siena Campus 2 $ 2,021.38 Centennial Hills Hospital 1 $ 1,311.72 Southern Hills Hospital 2 $ 2,018.63 Grand Total 51 $ 55,168.26 Centennial Hills Hospital 1 $ 1,311.72 (blank) 1 $ 1,055.20 Grand Total 108 $ 115,995.07

UMC 16 $ 17,853.37 14 $ 9,034.15 $ 6,257.76

30 $ 33,145.28 Total Current Account Number Charges Primary Name 20396624 1045.92 Medicaid - NV 20396625 1188.1 Amerigroup NV Claims 20405078 919.55 Medicare - NV 20405079 972.71 CCMSI 20443308 1045.92 20443309 1105.61 Medicare - NV 20443310 1019.34 Blue Cross Blue Shield of NV 20443311 1205.4 Health Plan of 20443312 1045.92 Sierra Health & Life Ins Co 20443313 1019.34 VA Southern NV Healthcare Sys 20454529 1152.24 Medicaid/Health Plan of NV 20454530 1205.4 Medicaid - NV 20454531 966.18 20454533 1125.66 20467392 966.18 20467393 1178.82 VISN 16 Consolidated Fee Unit 20509138 1019.34 VA Southern NV Healthcare Sys 20509139 1134.94 20509140 1072.5 Medicare - NV 20509141 1152.24 Aetna 20509142 1099.08 Medicaid - NV 20520507 1019.34 IEHP Health ACCESS Mcare 20520508 1079.03 20520509 1134.94 Medicare - NV 20532097 1079.03 Amerigroup NV Claims 20578309 1025.87 Teachers Health Trust 20578310 1025.87 Teachers Health Trust 20578311 1231.98 20578312 1019.34 20625920 1079.03 Progressive Insurance 20625921 939.6 Medicare - NV 20652161 1019.34 20652163 1072.5 Humana Regional Service Center 20666299 966.18 20666300 1099.08 20666301 946.13 Cigna Health Care 20701846 966.18 20728919 1152.24 20728920 1178.82 20728923 1079.03 Sierra Health & Life Ins Co 20728924 992.76 Medicare - NV 20728925 1099.08 20728926 1019.34 20739518 1079.03 Security Health Plan Mcare 20753807 1045.92 20762873 992.76 Cigna Health Care 20762874 946.13 Culinary Health Fund/ABPA 20762875 1045.92 Medicare - NV 20798739 1019.34 20822415 966.18 20822416 1072.5 20833874 966.18 Aetna 20833875 1028.62 Aetna 20847511 1052.45 20856307 999.29 20885265 1105.61 Medicare - NV 20885266 1211.93 20885267 1211.93 20885268 1152.24 20885269 1125.66 Medicare - NV 20908082 1045.92 20908083 1152.24 Kaiser Permanente 20948527 1045.92 20948528 966.18 Medicaid - NV 20971472 1072.5 United Medical Resources 20971475 966.18 Amerigroup 20971476 1099.08 Medicare - NV 20994282 1205.4 Humana Medicare Replacement Pl 20994283 919.55 21030154 1099.08 21030156 1055.2 21030157 1045.92 21040315 1311.72 21054627 919.55 Humana Regional Service Center 21054629 1045.92 Medi-Cal 21054630 1231.98 21066464 1241.26 21066465 1258.56 21105622 1105.61 Medicare - NV 21105623 1125.66 21105624 1134.94 21117382 892.97 Culinary Health Fund/ABPA 21117383 939.6 21117384 1072.5 21117386 1099.08 21117387 972.71 21117388 992.76 Medicaid/Health Plan of NV 21117389 992.76 21128900 1125.66 Medicare - NV 21138889 1079.03 CareMore Health Plan Mcare 21165465 992.76 Medicare - NV 21165466 1045.92 21165467 939.6 21165468 1152.24 Medicare - NV 21165469 1108.36 Triwest United Health 21180956 1125.66 21216529 1125.66 Health Choice of AZ 21216530 1045.92 21216532 1318.25 21216533 1019.34 21255705 1045.92 Blue Cross Blue Shield of NV 21270113 1152.24 Tricare - West 21289372 1422.61 Medicare - NV 21316154 992.76 Senior Dimensions 21316155 1028.62 21316156 1125.66 Medicare - NV 21326721 1125.66 21337972 1125.66 To Facility Name Desert Springs Hospital Sunrise Medical Center - Las Vegas Sunrise Medical Center - Las Vegas University Medical Center Sunrise Medical Center - Las Vegas Western Arizona Regional Medical Center Sunrise Medical Center - Las Vegas University Medical Center Sunrise Medical Center - 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