Adjustment List Report

S.No File # DOR Fas_Per Amt Mode Payor Practice CHK/EFT# Reason Identifier Type C/D Bill_NPI
HEALTH NET COMMUNITY ROBERTO SALAZAR
1 1090766783 06/02/2023 12/31/2023 -11558.41 NON 23153A8766 Forwarding Balance 3016639366 H C 1932722519
SOLUTIONS DENTAL CORPORA
HEALTH NET COMMUNITY Bad Debt
2 1090766461 06/02/2023 12/31/2023 -371.74 NON L P MEDICAL GROUP INC. 23153C7283 2836675440 H C 1710077961
SOLUTIONS Adjustment
HEALTH NET COMMUNITY JEON, D.D.S., DENTAL CORP Bad Debt
3 1090766458 06/02/2023 12/31/2023 -371.74 NON 23153C7249 2826244272 H C 1013590025
SOLUTIONS S BOM Adjustment
LAWRENCE A. WOLFF, DDS, Overpayment
4 1090443540 06/06/2023 12/31/2023 777.98 ACH MEDICARE SERVICE CENTER 800905745 558423132351002 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
5 1090143915 06/05/2023 12/31/2023 652.74 ACH MEDICARE SERVICE CENTER 800898900 558423111700944 I D 1912395369
INC. Recovery
AMERIDENT HEALTH PRO
6 1089517472 06/02/2023 12/31/2023 -51.88 ACH MEDICARE SERVICE CENTER 800889518 Authorized Return 7223151000004 I C 1467818401
INC
ARTUR ARKELAKYAN DDS
7 1089018969 06/01/2023 12/31/2023 -237.39 NON MEDICARE SERVICE CENTER 379446712 Forwarding Balance 8423139351086 H C 1295234607
INC
HEALTH NET COMMUNITY Bad Debt
8 1088356488 05/26/2023 12/31/2023 -371.74 NON HUI, D.D.S., CORP T WALLY 23146D9934 2809149217 H C 1922308915
SOLUTIONS Adjustment
9 1086685740 05/24/2023 12/31/2023 -1.86 ACH NOVITAS SOLUTIONS, INC. DR LEI WANG P C 887636599 Interest Owed L6 I C 1225633407
NOEMI TAGUINOD DENTAL Overpayment
10 1086708336 05/25/2023 12/31/2023 131.96 NON MEDICARE SERVICE CENTER 379432041 554721305901095 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
11 1086708336 05/25/2023 12/31/2023 1239.92 NON MEDICARE SERVICE CENTER 379432041 554721305901044 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
12 1086708336 05/25/2023 12/31/2023 131.96 NON MEDICARE SERVICE CENTER 379432041 554721305901030 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
13 1086708336 05/25/2023 12/31/2023 17.32 NON MEDICARE SERVICE CENTER 379432041 554721305901027 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
14 1086708336 05/25/2023 12/31/2023 131.96 NON MEDICARE SERVICE CENTER 379432041 554721305901024 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
15 1086708336 05/25/2023 12/31/2023 114.64 NON MEDICARE SERVICE CENTER 379432040 554721305901027 H D 1952707705
CORPOR Recovery
TSIBEL DENTAL 08608-
16 1086708492 05/24/2023 12/31/2023 -17.12 CHK AETNA Interest Owed L6 I C 1851589329
CORPORATION 058363194
17 1085526086 05/22/2023 12/31/2023 -4.81 ACH NOVITAS SOLUTIONS, INC. DR LEI WANG P C 887632087 Interest Owed L6 I C 1225633407

18 1085444479 05/23/2023 12/31/2023 -0.02 ACH PALMETTO GBA DR LI QIAN DDS PLLC 897163846 Interest Owed L6 I C 1295196418

19 1085023088 05/22/2023 12/31/2023 -777.98 NON MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 379417407 Forwarding Balance 8423132351260 H C 1225587876
LAWRENCE A. WOLFF, DDS,
20 1085023087 05/22/2023 12/31/2023 -777.98 NON MEDICARE SERVICE CENTER 379418623 Forwarding Balance 8423132351002 H C 1912395369
INC.
21 1085018388 05/22/2023 12/31/2023 -3529.25 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379420019 Forwarding Balance 4723121900108 H C 1780030304

22 1085018388 05/22/2023 12/31/2023 -895.41 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379420019 Forwarding Balance 4723121900107 H C 1780030304
LAWRENCE A. WOLFF, DDS,
23 1084627149 05/19/2023 12/31/2023 -652.74 ACH MEDICARE SERVICE CENTER 800831339 Forwarding Balance 8423111700944 I C 1912395369
INC.
Overpayment
24 1084626579 05/19/2023 12/31/2023 164.35 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 379415846 554721305900536 H D 1356713069
Recovery
HEALTH NET COMMUNITY
25 1056328450 03/04/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23063E4687 Authorized Return 2355106771 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
26 1056328450 03/04/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23063E4687 2355106771 H D 1780030304
SOLUTIONS Recovery
 HEALTH NET COMMUNITY
27 1056328450 03/04/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23063E4687 Authorized Return 2341873422 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
28 1056328450 03/04/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23063E4687 2341873422 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
29 1056328450 03/04/2023 12/31/2023 -152.36 NON JEON, D.D.S., INC S BOM 23063E4687 Authorized Return 2498929219 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
30 1056328450 03/04/2023 12/31/2023 152.36 NON JEON, D.D.S., INC S BOM 23063E4687 2498929219 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
31 1056328450 03/04/2023 12/31/2023 -79.61 NON JEON, D.D.S., INC S BOM 23063E4687 Authorized Return 2423702068 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
32 1056328450 03/04/2023 12/31/2023 79.61 NON JEON, D.D.S., INC S BOM 23063E4687 2423702068 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
33 1056323928 03/03/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23062B5416 Authorized Return 2411630167 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
34 1056323928 03/03/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23062B5416 2411630167 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
35 1056323928 03/03/2023 12/31/2023 -159.22 NON JEON, D.D.S., INC S BOM 23062B5416 Authorized Return 2400431975 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
36 1056323928 03/03/2023 12/31/2023 159.22 NON JEON, D.D.S., INC S BOM 23062B5416 2400431975 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
37 1056323928 03/03/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23062B5416 Authorized Return 2308199168 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
38 1056323928 03/03/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23062B5416 2308199168 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
39 1083062081 05/12/2023 12/31/2023 -371.74 NON L P MEDICAL GROUP INC. 23132B6964 Forwarding Balance 2836675440 H C 1710077961
SOLUTIONS
HEALTH NET COMMUNITY JEON, D.D.S., DENTAL CORP
40 1083059531 05/12/2023 12/31/2023 -371.74 NON 23132B1364 Forwarding Balance 2826244272 H C 1013590025
SOLUTIONS S BOM
LAWRENCE A. WOLFF, DDS,
41 1082325005 05/15/2023 12/31/2023 -7.85 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900281 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
42 1082325005 05/15/2023 12/31/2023 -7.33 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900279 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
43 1082325005 05/15/2023 12/31/2023 -17.44 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900278 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
44 1082325005 05/15/2023 12/31/2023 -10.72 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900276 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
45 1082325005 05/15/2023 12/31/2023 -8.20 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900275 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
46 1082325005 05/15/2023 12/31/2023 -25.70 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900274 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
47 1082325005 05/15/2023 12/31/2023 -24.69 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900273 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
48 1082325005 05/15/2023 12/31/2023 -25.03 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900272 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
49 1082325005 05/15/2023 12/31/2023 -11.52 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900271 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
50 1082325005 05/15/2023 12/31/2023 -6.94 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900270 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
51 1082325005 05/15/2023 12/31/2023 -11.09 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900269 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
52 1082325005 05/15/2023 12/31/2023 -20.76 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900268 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
53 1082325005 05/15/2023 12/31/2023 -8.47 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900267 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
54 1082325005 05/15/2023 12/31/2023 -9.02 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900266 I C 1912395369
INC.
 LAWRENCE A. WOLFF, DDS,
55 1082325005 05/15/2023 12/31/2023 -25.34 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900265 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
56 1082325005 05/15/2023 12/31/2023 -10.72 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900264 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
57 1082325005 05/15/2023 12/31/2023 -11.07 ACH MEDICARE SERVICE CENTER 800806127 Interest Owed 4619029900263 I C 1912395369
INC.
MARIA T ALARCON DDS
58 1081852445 05/12/2023 12/31/2023 -8819.75 NON MEDICARE SERVICE CENTER 467136303 Forwarding Balance 9723101900145 H C 1467955369
DENTAL
AMERIDENT HEALTH PRO Overpayment
59 1079559730 05/05/2023 12/31/2023 52.00 ACH MEDICARE SERVICE CENTER 800768171 554722192900094 I D 1467818401
INC Recovery
AMERIDENT HEALTH PRO Unspecified
60 1079559730 05/05/2023 12/31/2023 51.88 ACH MEDICARE SERVICE CENTER 800768171 800-304-3107 I D 1467818401
INC Recovery
ARTUR ARKELAKYAN DDS
61 1078122798 05/03/2023 12/31/2023 -429.67 NON MEDICARE SERVICE CENTER 379367769 Forwarding Balance 8423111351130 H C 1295234607
INC
THE CLIFTON CENTER FOR
62 1077386424 05/01/2023 12/31/2023 -4.46 ACH NOVITAS SOLUTIONS, INC. 896729018 Interest Owed L6 I D 1427281351
ORAL
THE CLIFTON CENTER FOR Overpayment
63 1077386424 05/01/2023 12/31/2023 5024.55 ACH NOVITAS SOLUTIONS, INC. 896729018 869722229050010 I D 1427281351
ORAL Recovery
ANNABELLA B CHU DMD Overpayment
64 1077377786 05/02/2023 12/31/2023 2735.63 NON MEDICARE SERVICE CENTER 379361651 554721347900569 H D 1164656187
INC Recovery
COHEN GOELA PROF
65 1074346883 04/24/2023 12/31/2023 -4819.17 NON MEDICARE SERVICE CENTER 379337837 Forwarding Balance 4723080900096 H C 1558973388
DENTAL CO
BLUE CROSS AND BLUE
66 1073856030 04/24/2023 12/31/2023 -1.50 ACH NEW DENTAL28 PLLC 736639270 Interest Owed L6 I C 1871034314
SHIELD OF MASS
THE CLIFTON CENTER FOR Overpayment
67 1070818645 04/13/2023 12/31/2023 147.25 NON NOVITAS SOLUTIONS, INC. 367199644 869722229050010 H D 1427281351
ORAL Recovery
68 1070278915 04/13/2023 12/31/2023 -248.91 ACH MEDICARE SERVICE CENTER YOONHO CHANG DDS INC 899193153 Bonus 9520230331706 I C 1750588646
HARRY HART DENTAL
69 1070278915 04/13/2023 12/31/2023 -44668.25 ACH MEDICARE SERVICE CENTER 899193151 Bonus 9520230331632 I C 1104492891
CORPORATIO
BLUE CROSS OF LAWRENCE A. WOLFF DDS
70 1065792198 03/27/2023 12/31/2023 992.13 CHK 6613072583 Forwarding Balance 6613072583 I D 1912395369
CALIFORNIA (CA) INC
TSIBEL DENTAL 08608-
71 1065466067 03/30/2023 12/31/2023 -4.17 CHK AETNA Interest Owed L6 I C 1851589329
CORPORATION 058064939
TSIBEL DENTAL 08608-
72 1064470121 03/28/2023 12/31/2023 -0.67 CHK AETNA Interest Owed L6 I C 1851589329
CORPORATION 058047012
LAWRENCE A. WOLFF DDS 9925645216-
73 1064167648 03/24/2023 12/31/2023 1094.70 NON CA MEDI-CAL 9015411019 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
74 1064167648 03/24/2023 12/31/2023 -1071.70 NON CA MEDI-CAL 9015411019 Forwarding Balance 9015411019 H C 1912395369
INC
BLUE CROSS OF LAWRENCE A. WOLFF DDS
75 1064167648 03/24/2023 12/31/2023 -992.13 NON 9015391444 Forwarding Balance 9015391444 H C 1912395369
CALIFORNIA (CA) INC
TSIBEL DENTAL 08608-
76 1063343775 03/24/2023 12/31/2023 -7.66 CHK AETNA Interest Owed L6 I C 1851589329
CORPORATION 058032797
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC
77 1062969358 03/21/2023 12/31/2023 -458.64 NON 23080B9932 Authorized Return 2866850032 H D 1295234607
SOLUTIONS ARTUR
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC Overpayment
78 1062969358 03/21/2023 12/31/2023 458.64 NON 23080B9932 2866850032 H D 1295234607
SOLUTIONS ARTUR Recovery
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC
79 1062969358 03/21/2023 12/31/2023 -6148.87 NON 23080B9932 Authorized Return 2888637462 H D 1295234607
SOLUTIONS ARTUR
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC Overpayment
80 1062969358 03/21/2023 12/31/2023 6148.87 NON 23080B9932 2888637462 H D 1295234607
SOLUTIONS ARTUR Recovery
TSIBEL DENTAL 08608-
81 1061323994 03/20/2023 12/31/2023 -2.03 CHK AETNA Interest Owed L6 I C 1851589329
CORPORATION 058001552
Overpayment
82 1059683437 03/16/2023 12/31/2023 1.60 ACH MEDICARE SERVICE CENTER JIN Y KIM DDS INC 800547324 554721300900570 I D 1063687937
Recovery
 Overpayment
83 1059683437 03/16/2023 12/31/2023 13.84 ACH MEDICARE SERVICE CENTER JIN Y KIM DDS INC 800547324 554721300900504 I D 1063687937
Recovery
Overpayment
84 1059683437 03/16/2023 12/31/2023 13.88 ACH MEDICARE SERVICE CENTER JIN Y KIM DDS INC 800547324 554721300900503 I D 1063687937
Recovery
UNITED HEALTHCARE
85 1056969561 03/09/2023 12/31/2023 0.25 ACH SUNSET DENTAL GROUP 9880693209 Forwarding Balance 9866601725 I D 1548445463
INSURANCE COMPANY
DR ROGER D SOHN PROF Overpayment
86 1055793267 03/07/2023 12/31/2023 -229.67 ACH MEDICARE SERVICE CENTER 899051263 951218 I C 1528442100
DENTAL Recovery
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC
87 1055562692 02/28/2023 12/31/2023 -2300.16 NON 23059A9476 Forwarding Balance 2866850031 H C 1295234607
SOLUTIONS ARTUR
BLUE CROSS AND BLUE
88 1053930425 02/21/2023 12/31/2023 -12.72 ACH NEW DENTAL28 PLLC 736168035 Interest Owed L6 I C 1871034314
SHIELD OF MASS
HEALTH NET COMMUNITY
89 1053494385 02/25/2023 12/31/2023 -33.75 NON L P MEDICAL GROUP INC. 23056D2347 Authorized Return 02005664 H D 1710077961
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
90 1053494385 02/25/2023 12/31/2023 33.75 NON L P MEDICAL GROUP INC. 23056D2347 02005664 H D 1710077961
SOLUTIONS Recovery
BLUE CROSS OF MARIA T ALARCON DDS Internal Revenue
91 1053356367 02/24/2023 12/31/2023 80.39 CHK 0304720588 STATE I D 1467955369
CALIFORNIA (CA) DENTAL CORPORAT Service Withholding
BLUE CROSS OF MARIA T ALARCON DDS Internal Revenue
92 1053356367 02/24/2023 12/31/2023 275.63 CHK 0304720588 FEDERAL I D 1467955369
CALIFORNIA (CA) DENTAL CORPORAT Service Withholding
BLUE CROSS OF
93 1053355060 02/24/2023 12/31/2023 82.76 CHK BOM SEOK JEON, DDS, INC 6612824119 Forwarding Balance 6612824119 I D 1780030304
CALIFORNIA (CA)
BLUE CROSS OF
94 1053355060 02/24/2023 12/31/2023 164.90 CHK BOM SEOK JEON, DDS, INC 6612824119 Forwarding Balance 6612824119 I D 1780030304
CALIFORNIA (CA)
DR ROGER D SOHN PROF Overpayment
95 1053123339 02/28/2023 12/31/2023 231.61 ACH MEDICARE SERVICE CENTER 899027946 549822364351004 I D 1528442100
DENTAL Recovery
THE CLIFTON CENTER FOR
96 1052105280 02/23/2023 12/31/2023 -5123.76 ACH NOVITAS SOLUTIONS, INC. 896531623 Forwarding Balance 9722229050010 I C 1427281351
ORAL
BLUE CROSS OF
97 1050730391 02/17/2023 12/31/2023 -82.76 NON BOM SEOK JEON, DDS, INC 9014136659 Forwarding Balance 9014136659 H C 1780030304
CALIFORNIA (CA)
BLUE CROSS OF
98 1050730391 02/17/2023 12/31/2023 124.27 NON BOM SEOK JEON, DDS, INC 9014136659 Forwarding Balance 9011375837 H D 1780030304
CALIFORNIA (CA)
JERRY L KRONQUIST
99 1050556836 02/22/2023 12/31/2023 -3.10 NON MEDICARE SERVICE CENTER 379149058 Forwarding Balance 4723045496660 H C 1548445463
SUNSET
Overpayment
100 1050556836 02/22/2023 12/31/2023 -777.98 ACH MEDICARE SERVICE CENTER J KIM DDS INC 800451731 3277 I C 1487237491
Recovery
NOEMI TAGUINOD DENTAL Overpayment
101 1050148648 02/21/2023 12/31/2023 3313.79 NON MEDICARE SERVICE CENTER 379144995 554721305901103 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
102 1050148648 02/21/2023 12/31/2023 197.94 NON MEDICARE SERVICE CENTER 379144995 554721305901095 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
103 1050148648 02/21/2023 12/31/2023 419.91 NON MEDICARE SERVICE CENTER 379144995 554721305901044 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
104 1050148648 02/21/2023 12/31/2023 461.86 NON MEDICARE SERVICE CENTER 379144995 554721305901030 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
105 1050148648 02/21/2023 12/31/2023 197.94 NON MEDICARE SERVICE CENTER 379144995 554721305901027 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
106 1050148648 02/21/2023 12/31/2023 461.86 NON MEDICARE SERVICE CENTER 379144995 554721305901024 H D 1952707705
CORPOR Recovery
BLUE CROSS AND BLUE
107 1049765099 02/21/2023 12/31/2023 -12.72 ACH NEW DENTAL28 PLLC 736168035 Interest Owed L6 I C 1871034314
SHIELD OF MASS
HEALTH NET COMMUNITY
108 1048286098 02/09/2023 12/31/2023 -153.75 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2430275002 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
109 1048286098 02/09/2023 12/31/2023 153.75 NON JEON, D.D.S., INC S BOM 23040B1700 2430275002 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
110 1048286098 02/09/2023 12/31/2023 -159.22 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2418238822 H D 1780030304
SOLUTIONS
 HEALTH NET COMMUNITY Overpayment
111 1048286098 02/09/2023 12/31/2023 159.22 NON JEON, D.D.S., INC S BOM 23040B1700 2418238822 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
112 1048286098 02/09/2023 12/31/2023 -79.61 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2397402109 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
113 1048286098 02/09/2023 12/31/2023 79.61 NON JEON, D.D.S., INC S BOM 23040B1700 2397402109 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
114 1048286098 02/09/2023 12/31/2023 -159.22 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2356044985 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
115 1048286098 02/09/2023 12/31/2023 159.22 NON JEON, D.D.S., INC S BOM 23040B1700 2356044985 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
116 1048286098 02/09/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2308199166 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
117 1048286098 02/09/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23040B1700 2308199166 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
118 1048286098 02/09/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2311475590 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
119 1048286098 02/09/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23040B1700 2311475590 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
120 1048286098 02/09/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2308199165 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
121 1048286098 02/09/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23040B1700 2308199165 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
122 1048286098 02/09/2023 12/31/2023 -203.44 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2341873410 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
123 1048286098 02/09/2023 12/31/2023 203.44 NON JEON, D.D.S., INC S BOM 23040B1700 2341873410 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
124 1048286098 02/09/2023 12/31/2023 -79.61 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2231802074 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
125 1048286098 02/09/2023 12/31/2023 79.61 NON JEON, D.D.S., INC S BOM 23040B1700 2231802074 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
126 1048286098 02/09/2023 12/31/2023 -159.22 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2239501510 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
127 1048286098 02/09/2023 12/31/2023 159.22 NON JEON, D.D.S., INC S BOM 23040B1700 2239501510 H D 1780030304
SOLUTIONS Recovery
HEALTH NET COMMUNITY
128 1048286098 02/09/2023 12/31/2023 -1248.82 NON JEON, D.D.S., INC S BOM 23040B1700 Authorized Return 2388294450 H D 1780030304
SOLUTIONS
HEALTH NET COMMUNITY Overpayment
129 1048286098 02/09/2023 12/31/2023 1248.82 NON JEON, D.D.S., INC S BOM 23040B1700 2388294450 H D 1780030304
SOLUTIONS Recovery
Overpayment
130 1047471313 02/13/2023 12/31/2023 1552.00 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900187 I D 1780030304
Recovery
Overpayment
131 1047471313 02/13/2023 12/31/2023 716.79 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900185 I D 1780030304
Recovery
Overpayment
132 1047471313 02/13/2023 12/31/2023 1641.18 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900131 I D 1780030304
Recovery
Overpayment
133 1047471313 02/13/2023 12/31/2023 2224.31 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900067 I D 1780030304
Recovery
Overpayment
134 1047471313 02/13/2023 12/31/2023 1700.33 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900066 I D 1780030304
Recovery
Overpayment
135 1047471313 02/13/2023 12/31/2023 643.67 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900261 I D 1780030304
Recovery
Overpayment
136 1047471313 02/13/2023 12/31/2023 1744.69 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900212 I D 1780030304
Recovery
Overpayment
137 1047471313 02/13/2023 12/31/2023 4517.27 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800414671 554721319900149 I D 1780030304
Recovery
Overpayment
138 1047471313 02/10/2023 12/31/2023 562.80 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379118745 554721319900351 H D 1780030304
Recovery
 Overpayment
139 1047471313 02/10/2023 12/31/2023 1294.12 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379118745 554721319900258 H D 1780030304
Recovery
Overpayment
140 1047471313 02/10/2023 12/31/2023 1638.11 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379118745 554721319900188 H D 1780030304
Recovery
Overpayment
141 1047471313 02/10/2023 12/31/2023 1818.83 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379118745 554721319900071 H D 1780030304
Recovery
Overpayment
142 1047471313 02/10/2023 12/31/2023 788.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379118745 554721319900066 H D 1780030304
Recovery
Overpayment
143 1046434115 02/09/2023 12/31/2023 1177.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379113918 554721319900258 H D 1780030304
Recovery
Overpayment
144 1046434115 02/09/2023 12/31/2023 2351.48 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379113918 554721319900141 H D 1780030304
Recovery
Overpayment
145 1046434115 02/09/2023 12/31/2023 2537.43 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379113918 554721319900129 H D 1780030304
Recovery
Overpayment
146 1045944584 02/08/2023 12/31/2023 4089.99 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900300 H D 1780030304
Recovery
Overpayment
147 1045944584 02/08/2023 12/31/2023 2972.69 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900296 H D 1780030304
Recovery
Overpayment
148 1045944584 02/08/2023 12/31/2023 621.20 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900141 H D 1780030304
Recovery
Overpayment
149 1045944584 02/08/2023 12/31/2023 2972.69 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900080 H D 1780030304
Recovery
Overpayment
150 1045944584 02/08/2023 12/31/2023 3788.04 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900070 H D 1780030304
Recovery
Overpayment
151 1045944584 02/08/2023 12/31/2023 2972.70 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900069 H D 1780030304
Recovery
Overpayment
152 1045944584 02/08/2023 12/31/2023 2972.69 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379109456 554721319900068 H D 1780030304
Recovery
WOLFF, D.D.S., INC A Bad Debt
153 1045537594 02/04/2023 12/31/2023 -4600.00 NON HEALTH NET, LLC 23035A9024 1056 H C 1912395369
LAWRENCE Adjustment
MARIA T RODRIGUEZ Internal Revenue
154 1045351328 02/03/2023 12/31/2023 5.95 CHK CA MEDI-CAL 0020331594 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
155 1045351328 02/03/2023 12/31/2023 20.40 CHK CA MEDI-CAL 0020331594 FEDERAL I D 1467955369
DENTAL Service Withholding
Overpayment
156 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900350 H D 1780030304
Recovery
Overpayment
157 1045155407 02/07/2023 12/31/2023 716.80 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900349 H D 1780030304
Recovery
Overpayment
158 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900348 H D 1780030304
Recovery
Overpayment
159 1045155407 02/07/2023 12/31/2023 281.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900347 H D 1780030304
Recovery
Overpayment
160 1045155407 02/07/2023 12/31/2023 380.62 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900346 H D 1780030304
Recovery
Overpayment
161 1045155407 02/07/2023 12/31/2023 346.24 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900345 H D 1780030304
Recovery
Overpayment
162 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900344 H D 1780030304
Recovery
Overpayment
163 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900339 H D 1780030304
Recovery
Overpayment
164 1045155407 02/07/2023 12/31/2023 576.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900337 H D 1780030304
Recovery
Overpayment
165 1045155407 02/07/2023 12/31/2023 553.98 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900332 H D 1780030304
Recovery
Overpayment
166 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900328 H D 1780030304
Recovery
 Overpayment
167 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900325 H D 1780030304
Recovery
Overpayment
168 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900321 H D 1780030304
Recovery
Overpayment
169 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900316 H D 1780030304
Recovery
Overpayment
170 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900311 H D 1780030304
Recovery
Overpayment
171 1045155407 02/07/2023 12/31/2023 2043.88 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900306 H D 1780030304
Recovery
Overpayment
172 1045155407 02/07/2023 12/31/2023 281.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900291 H D 1780030304
Recovery
Overpayment
173 1045155407 02/07/2023 12/31/2023 574.28 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900290 H D 1780030304
Recovery
Overpayment
174 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900288 H D 1780030304
Recovery
Overpayment
175 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900285 H D 1780030304
Recovery
Overpayment
176 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900284 H D 1780030304
Recovery
Overpayment
177 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900282 H D 1780030304
Recovery
Overpayment
178 1045155407 02/07/2023 12/31/2023 459.86 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900278 H D 1780030304
Recovery
Overpayment
179 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900271 H D 1780030304
Recovery
Overpayment
180 1045155407 02/07/2023 12/31/2023 574.28 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900270 H D 1780030304
Recovery
Overpayment
181 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900268 H D 1780030304
Recovery
Overpayment
182 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900264 H D 1780030304
Recovery
Overpayment
183 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900254 H D 1780030304
Recovery
Overpayment
184 1045155407 02/07/2023 12/31/2023 328.41 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900248 H D 1780030304
Recovery
Overpayment
185 1045155407 02/07/2023 12/31/2023 417.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900238 H D 1780030304
Recovery
Overpayment
186 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900234 H D 1780030304
Recovery
Overpayment
187 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900232 H D 1780030304
Recovery
Overpayment
188 1045155407 02/07/2023 12/31/2023 295.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900231 H D 1780030304
Recovery
Overpayment
189 1045155407 02/07/2023 12/31/2023 336.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900206 H D 1780030304
Recovery
Overpayment
190 1045155407 02/07/2023 12/31/2023 336.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900204 H D 1780030304
Recovery
Overpayment
191 1045155407 02/07/2023 12/31/2023 425.58 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900203 H D 1780030304
Recovery
Overpayment
192 1045155407 02/07/2023 12/31/2023 570.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900198 H D 1780030304
Recovery
Overpayment
193 1045155407 02/07/2023 12/31/2023 418.39 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900195 H D 1780030304
Recovery
Overpayment
194 1045155407 02/07/2023 12/31/2023 409.42 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900190 H D 1780030304
Recovery
 Overpayment
195 1045155407 02/07/2023 12/31/2023 287.14 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900189 H D 1780030304
Recovery
Overpayment
196 1045155407 02/07/2023 12/31/2023 336.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900182 H D 1780030304
Recovery
Overpayment
197 1045155407 02/07/2023 12/31/2023 570.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900178 H D 1780030304
Recovery
Overpayment
198 1045155407 02/07/2023 12/31/2023 295.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900168 H D 1780030304
Recovery
Overpayment
199 1045155407 02/07/2023 12/31/2023 281.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900167 H D 1780030304
Recovery
Overpayment
200 1045155407 02/07/2023 12/31/2023 316.39 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900166 H D 1780030304
Recovery
Overpayment
201 1045155407 02/07/2023 12/31/2023 316.39 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900165 H D 1780030304
Recovery
Overpayment
202 1045155407 02/07/2023 12/31/2023 409.42 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900163 H D 1780030304
Recovery
Overpayment
203 1045155407 02/07/2023 12/31/2023 222.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900162 H D 1780030304
Recovery
Overpayment
204 1045155407 02/07/2023 12/31/2023 334.58 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900160 H D 1780030304
Recovery
Overpayment
205 1045155407 02/07/2023 12/31/2023 3906.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900082 H D 1780030304
Recovery
Overpayment
206 1045155407 02/07/2023 12/31/2023 2087.57 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900071 H D 1780030304
Recovery
Overpayment
207 1045155407 02/07/2023 12/31/2023 118.36 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379104624 554721319900070 H D 1780030304
Recovery
208 1045155032 02/07/2023 12/31/2023 -4900.64 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800388687 Forwarding Balance 4723020900031 I C 1548540552

209 1045155032 02/07/2023 12/31/2023 -50.22 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800388687 Forwarding Balance 4723020900030 I C 1548540552

210 1045155032 02/07/2023 12/31/2023 -161.16 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800388687 Forwarding Balance 4723020900029 I C 1548540552
NOEMI TAGUINOD DENTAL Overpayment
211 1044735903 02/06/2023 12/31/2023 263.92 NON MEDICARE SERVICE CENTER 379100010 554721305901095 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
212 1044735903 02/06/2023 12/31/2023 41.95 NON MEDICARE SERVICE CENTER 379100010 554721305901044 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
213 1044735903 02/06/2023 12/31/2023 4334.28 NON MEDICARE SERVICE CENTER 379100010 554721305901037 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
214 1044735903 02/06/2023 12/31/2023 263.92 NON MEDICARE SERVICE CENTER 379100010 554721305901027 H D 1952707705
CORPOR Recovery
Overpayment
215 1044254090 02/03/2023 12/31/2023 627.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900343 H D 1780030304
Recovery
Overpayment
216 1044254090 02/03/2023 12/31/2023 627.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900341 H D 1780030304
Recovery
Overpayment
217 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900329 H D 1780030304
Recovery
Overpayment
218 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900327 H D 1780030304
Recovery
Overpayment
219 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900326 H D 1780030304
Recovery
Overpayment
220 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900324 H D 1780030304
Recovery
Overpayment
221 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900320 H D 1780030304
Recovery
Overpayment
222 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900319 H D 1780030304
Recovery
 Overpayment
223 1044254090 02/03/2023 12/31/2023 640.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900317 H D 1780030304
Recovery
Overpayment
224 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900315 H D 1780030304
Recovery
Overpayment
225 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900314 H D 1780030304
Recovery
Overpayment
226 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900310 H D 1780030304
Recovery
Overpayment
227 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900295 H D 1780030304
Recovery
Overpayment
228 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900294 H D 1780030304
Recovery
Overpayment
229 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900293 H D 1780030304
Recovery
Overpayment
230 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900292 H D 1780030304
Recovery
Overpayment
231 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900287 H D 1780030304
Recovery
Overpayment
232 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900286 H D 1780030304
Recovery
Overpayment
233 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900283 H D 1780030304
Recovery
Overpayment
234 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900281 H D 1780030304
Recovery
Overpayment
235 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900280 H D 1780030304
Recovery
Overpayment
236 1044254090 02/03/2023 12/31/2023 63.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900278 H D 1780030304
Recovery
Overpayment
237 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900277 H D 1780030304
Recovery
Overpayment
238 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900276 H D 1780030304
Recovery
Overpayment
239 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900275 H D 1780030304
Recovery
Overpayment
240 1044254090 02/03/2023 12/31/2023 640.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900274 H D 1780030304
Recovery
Overpayment
241 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900272 H D 1780030304
Recovery
Overpayment
242 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900269 H D 1780030304
Recovery
Overpayment
243 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900267 H D 1780030304
Recovery
Overpayment
244 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900266 H D 1780030304
Recovery
Overpayment
245 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900263 H D 1780030304
Recovery
Overpayment
246 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900262 H D 1780030304
Recovery
Overpayment
247 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900260 H D 1780030304
Recovery
Overpayment
248 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900257 H D 1780030304
Recovery
Overpayment
249 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900256 H D 1780030304
Recovery
Overpayment
250 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900255 H D 1780030304
Recovery
 Overpayment
251 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900253 H D 1780030304
Recovery
Overpayment
252 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900252 H D 1780030304
Recovery
Overpayment
253 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900251 H D 1780030304
Recovery
Overpayment
254 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900250 H D 1780030304
Recovery
Overpayment
255 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900249 H D 1780030304
Recovery
Overpayment
256 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900247 H D 1780030304
Recovery
Overpayment
257 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900246 H D 1780030304
Recovery
Overpayment
258 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900244 H D 1780030304
Recovery
Overpayment
259 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900242 H D 1780030304
Recovery
Overpayment
260 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900239 H D 1780030304
Recovery
Overpayment
261 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900237 H D 1780030304
Recovery
Overpayment
262 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900236 H D 1780030304
Recovery
Overpayment
263 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900235 H D 1780030304
Recovery
Overpayment
264 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900233 H D 1780030304
Recovery
Overpayment
265 1044254090 02/03/2023 12/31/2023 627.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900230 H D 1780030304
Recovery
Overpayment
266 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900226 H D 1780030304
Recovery
Overpayment
267 1044254090 02/03/2023 12/31/2023 627.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900225 H D 1780030304
Recovery
Overpayment
268 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900223 H D 1780030304
Recovery
Overpayment
269 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900222 H D 1780030304
Recovery
Overpayment
270 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900221 H D 1780030304
Recovery
Overpayment
271 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900220 H D 1780030304
Recovery
Overpayment
272 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900218 H D 1780030304
Recovery
Overpayment
273 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900217 H D 1780030304
Recovery
Overpayment
274 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900216 H D 1780030304
Recovery
Overpayment
275 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900214 H D 1780030304
Recovery
Overpayment
276 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900208 H D 1780030304
Recovery
Overpayment
277 1044254090 02/03/2023 12/31/2023 653.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900207 H D 1780030304
Recovery
Overpayment
278 1044254090 02/03/2023 12/31/2023 595.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900205 H D 1780030304
Recovery
 Overpayment
279 1044254090 02/03/2023 12/31/2023 597.79 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900202 H D 1780030304
Recovery
Overpayment
280 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900200 H D 1780030304
Recovery
Overpayment
281 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900197 H D 1780030304
Recovery
Overpayment
282 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900196 H D 1780030304
Recovery
Overpayment
283 1044254090 02/03/2023 12/31/2023 692.47 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900194 H D 1780030304
Recovery
Overpayment
284 1044254090 02/03/2023 12/31/2023 705.78 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900184 H D 1780030304
Recovery
Overpayment
285 1044254090 02/03/2023 12/31/2023 627.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900174 H D 1780030304
Recovery
Overpayment
286 1044254090 02/03/2023 12/31/2023 640.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900173 H D 1780030304
Recovery
Overpayment
287 1044254090 02/03/2023 12/31/2023 653.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900171 H D 1780030304
Recovery
Overpayment
288 1044254090 02/03/2023 12/31/2023 640.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900170 H D 1780030304
Recovery
Overpayment
289 1044254090 02/03/2023 12/31/2023 636.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379095177 554721319900318 H D 1780030304
Recovery
290 1044255452 02/03/2023 12/31/2023 -1071.87 NON MEDICARE SERVICE CENTER J KIM DDS INC 379093814 Forwarding Balance 4723017900142 H C 1487237491
UNITED HEALTHCARE
291 1044227391 02/03/2023 12/31/2023 -0.25 NON SUNSET DENTAL GROUP INC 9866601725 Forwarding Balance 9866601725 H D 1548445463
INSURANCE COMPANY
UNITED HEALTHCARE Overpayment
292 1044227391 02/03/2023 12/31/2023 0.25 NON SUNSET DENTAL GROUP INC 9866601725 20221019 H D 1548445463
INSURANCE COMPANY Recovery
Overpayment
293 1043748500 02/02/2023 12/31/2023 53.24 ACH MEDICARE SERVICE CENTER SUNG M AHN DDS INC 898940595 549722327493550 I D 1801093034
Recovery
Overpayment
294 1043748500 02/02/2023 12/31/2023 239.33 ACH MEDICARE SERVICE CENTER SUNG M AHN DDS INC 898940595 549722327493500 I D 1801093034
Recovery
Overpayment
295 1043731023 02/02/2023 12/31/2023 2066.04 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900342 H D 1780030304
Recovery
Overpayment
296 1043731023 02/02/2023 12/31/2023 2185.34 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900340 H D 1780030304
Recovery
Overpayment
297 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900338 H D 1780030304
Recovery
Overpayment
298 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900336 H D 1780030304
Recovery
Overpayment
299 1043731023 02/02/2023 12/31/2023 818.97 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900335 H D 1780030304
Recovery
Overpayment
300 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900334 H D 1780030304
Recovery
Overpayment
301 1043731023 02/02/2023 12/31/2023 1735.12 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900333 H D 1780030304
Recovery
Overpayment
302 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900329 H D 1780030304
Recovery
Overpayment
303 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900327 H D 1780030304
Recovery
Overpayment
304 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900326 H D 1780030304
Recovery
Overpayment
305 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900324 H D 1780030304
Recovery
Overpayment
306 1043731023 02/02/2023 12/31/2023 771.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900322 H D 1780030304
Recovery
 Overpayment
307 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900320 H D 1780030304
Recovery
Overpayment
308 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900319 H D 1780030304
Recovery
Overpayment
309 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900315 H D 1780030304
Recovery
Overpayment
310 1043731023 02/02/2023 12/31/2023 1573.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900313 H D 1780030304
Recovery
Overpayment
311 1043731023 02/02/2023 12/31/2023 784.07 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900312 H D 1780030304
Recovery
Overpayment
312 1043731023 02/02/2023 12/31/2023 717.13 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900308 H D 1780030304
Recovery
Overpayment
313 1043731023 02/02/2023 12/31/2023 1911.02 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900297 H D 1780030304
Recovery
Overpayment
314 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900295 H D 1780030304
Recovery
Overpayment
315 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900294 H D 1780030304
Recovery
Overpayment
316 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900293 H D 1780030304
Recovery
Overpayment
317 1043731023 02/02/2023 12/31/2023 771.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900289 H D 1780030304
Recovery
Overpayment
318 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900286 H D 1780030304
Recovery
Overpayment
319 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900283 H D 1780030304
Recovery
Overpayment
320 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900281 H D 1780030304
Recovery
Overpayment
321 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900280 H D 1780030304
Recovery
Overpayment
322 1043731023 02/02/2023 12/31/2023 183.09 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900278 H D 1780030304
Recovery
Overpayment
323 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900277 H D 1780030304
Recovery
Overpayment
324 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900276 H D 1780030304
Recovery
Overpayment
325 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900275 H D 1780030304
Recovery
Overpayment
326 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900269 H D 1780030304
Recovery
Overpayment
327 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900267 H D 1780030304
Recovery
Overpayment
328 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900266 H D 1780030304
Recovery
Overpayment
329 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900263 H D 1780030304
Recovery
Overpayment
330 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900262 H D 1780030304
Recovery
Overpayment
331 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900260 H D 1780030304
Recovery
Overpayment
332 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900257 H D 1780030304
Recovery
Overpayment
333 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900256 H D 1780030304
Recovery
Overpayment
334 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900255 H D 1780030304
Recovery
 Overpayment
335 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900253 H D 1780030304
Recovery
Overpayment
336 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900252 H D 1780030304
Recovery
Overpayment
337 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900251 H D 1780030304
Recovery
Overpayment
338 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900250 H D 1780030304
Recovery
Overpayment
339 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900249 H D 1780030304
Recovery
Overpayment
340 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900247 H D 1780030304
Recovery
Overpayment
341 1043731023 02/02/2023 12/31/2023 1638.11 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900245 H D 1780030304
Recovery
Overpayment
342 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900244 H D 1780030304
Recovery
Overpayment
343 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900242 H D 1780030304
Recovery
Overpayment
344 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900237 H D 1780030304
Recovery
Overpayment
345 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900236 H D 1780030304
Recovery
Overpayment
346 1043731023 02/02/2023 12/31/2023 1799.96 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900229 H D 1780030304
Recovery
Overpayment
347 1043731023 02/02/2023 12/31/2023 717.13 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900228 H D 1780030304
Recovery
Overpayment
348 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900226 H D 1780030304
Recovery
Overpayment
349 1043731023 02/02/2023 12/31/2023 1196.13 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900224 H D 1780030304
Recovery
Overpayment
350 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900221 H D 1780030304
Recovery
Overpayment
351 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900219 H D 1780030304
Recovery
Overpayment
352 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900216 H D 1780030304
Recovery
Overpayment
353 1043731023 02/02/2023 12/31/2023 1773.63 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900215 H D 1780030304
Recovery
Overpayment
354 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900214 H D 1780030304
Recovery
Overpayment
355 1043731023 02/02/2023 12/31/2023 1220.18 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900213 H D 1780030304
Recovery
Overpayment
356 1043731023 02/02/2023 12/31/2023 835.58 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900210 H D 1780030304
Recovery
Overpayment
357 1043731023 02/02/2023 12/31/2023 1925.25 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900209 H D 1780030304
Recovery
Overpayment
358 1043731023 02/02/2023 12/31/2023 727.33 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900201 H D 1780030304
Recovery
Overpayment
359 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900199 H D 1780030304
Recovery
Overpayment
360 1043731023 02/02/2023 12/31/2023 1707.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900193 H D 1780030304
Recovery
Overpayment
361 1043731023 02/02/2023 12/31/2023 1707.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900192 H D 1780030304
Recovery
Overpayment
362 1043731023 02/02/2023 12/31/2023 771.10 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900186 H D 1780030304
Recovery
 Overpayment
363 1043731023 02/02/2023 12/31/2023 1517.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900181 H D 1780030304
Recovery
Overpayment
364 1043731023 02/02/2023 12/31/2023 755.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900180 H D 1780030304
Recovery
Overpayment
365 1043731023 02/02/2023 12/31/2023 1919.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900179 H D 1780030304
Recovery
Overpayment
366 1043731023 02/02/2023 12/31/2023 784.07 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900177 H D 1780030304
Recovery
Overpayment
367 1043731023 02/02/2023 12/31/2023 835.58 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900176 H D 1780030304
Recovery
Overpayment
368 1043731023 02/02/2023 12/31/2023 1206.63 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900175 H D 1780030304
Recovery
Overpayment
369 1043731023 02/02/2023 12/31/2023 717.13 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900172 H D 1780030304
Recovery
Overpayment
370 1043731023 02/02/2023 12/31/2023 818.98 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900169 H D 1780030304
Recovery
Overpayment
371 1043731023 02/02/2023 12/31/2023 69.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 379090254 554721319900318 H D 1780030304
Recovery
HARRY HART DENTAL Overpayment
372 1038906989 01/20/2023 12/31/2023 3288.97 ACH MEDICARE SERVICE CENTER 898894630 548322315159000 I D 1104492891
CORPORATIO Recovery
MARIA T RODRIGUEZ Internal Revenue
373 1037355451 01/13/2023 12/31/2023 7.96 CHK CA MEDI-CAL 0020325016 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
374 1037355451 01/13/2023 12/31/2023 27.28 CHK CA MEDI-CAL 0020325016 FEDERAL I D 1467955369
DENTAL Service Withholding
TSIBEL DENTAL 08608-
375 1036853135 01/13/2023 12/31/2023 -0.52 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 057656679
376 1036326921 01/13/2023 12/31/2023 -738.49 ACH MEDICARE SERVICE CENTER YOONHO CHANG DDS INC 898873718 Bonus 9520221230225 I C 1750588646
HARRY HART DENTAL
377 1036326921 01/13/2023 12/31/2023 -5264.68 ACH MEDICARE SERVICE CENTER 898873715 Bonus 9520221230990 I C 1104492891
CORPORATIO
DR ROGER D SOHN PROF
378 1035830095 01/12/2023 12/31/2023 -229.67 ACH MEDICARE SERVICE CENTER 898868072 Forwarding Balance 9822364351004 I C 1528442100
DENTAL
BLUE CROSS OF MARIA T ALARCON DDS Internal Revenue
379 1034715330 01/06/2023 12/31/2023 0.38 CHK 0304617550 FEDERAL I D 1467955369
CALIFORNIA (CA) DENTAL CORPORAT Service Withholding
BLUE CROSS OF MARIA T ALARCON DDS Internal Revenue
380 1034715330 01/06/2023 12/31/2023 0.11 CHK 0304617550 STATE I D 1467955369
CALIFORNIA (CA) DENTAL CORPORAT Service Withholding
LAWRENCE A. WOLFF, DDS, Overpayment
381 1034613843 01/10/2023 12/31/2023 681.94 ACH MEDICARE SERVICE CENTER 800274933 558422350351158 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
382 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351154 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
383 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351153 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
384 1034613843 01/10/2023 12/31/2023 82.51 ACH MEDICARE SERVICE CENTER 800274933 558422350351152 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
385 1034613843 01/10/2023 12/31/2023 177.51 ACH MEDICARE SERVICE CENTER 800274933 558422350351151 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
386 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351150 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
387 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351149 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
388 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351148 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
389 1034613843 01/10/2023 12/31/2023 105.92 ACH MEDICARE SERVICE CENTER 800274933 558422350351147 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
390 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422350351146 I D 1912395369
INC. Recovery
 LAWRENCE A. WOLFF, DDS, Overpayment
391 1034613843 01/10/2023 12/31/2023 130.94 ACH MEDICARE SERVICE CENTER 800274933 558422350351145 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
392 1034613843 01/10/2023 12/31/2023 132.28 ACH MEDICARE SERVICE CENTER 800274933 558422350351142 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
393 1034613843 01/10/2023 12/31/2023 132.28 ACH MEDICARE SERVICE CENTER 800274933 558422350351140 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
394 1034613843 01/10/2023 12/31/2023 87.23 ACH MEDICARE SERVICE CENTER 800274933 558422343351012 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
395 1034613843 01/10/2023 12/31/2023 188.76 ACH MEDICARE SERVICE CENTER 800274933 558422343351011 I D 1912395369
INC. Recovery
ROBERTO SALAZAR Overpayment
396 1034309481 01/09/2023 12/31/2023 791.31 ACH MEDICARE SERVICE CENTER 800271456 558422215351071 I D 1932722519
DENTAL CORPO Recovery
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC
397 1033008379 12/30/2022 12/31/2022 -458.64 NON 22364A4485 Forwarding Balance 2866850032 H C 1295234607
SOLUTIONS ARTUR
398 1032145019 12/30/2022 12/31/2022 -620.81 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800238279 Authorized Return 7222362000002 I C 1922308915
HEALTH NET COMMUNITY ARKELAKYAN, D.D.S., INC
399 1032131545 12/27/2022 12/31/2022 -6148.87 NON 22361B0264 Forwarding Balance 2888637462 H C 1295234607
SOLUTIONS ARTUR
MARIA T RODRIGUEZ Internal Revenue
400 1030930738 12/23/2022 12/31/2022 2.40 CHK CA MEDI-CAL 0020318690 FEDERAL I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
401 1030930738 12/23/2022 12/31/2022 0.70 CHK CA MEDI-CAL 0020318690 STATE I D 1467955369
DENTAL Service Withholding
BLUE CROSS OF ALEX A PEZESHKIAN DMD
402 1030929689 12/23/2022 12/31/2022 1148.55 CHK 0304589831 Forwarding Balance 0304589831 I D 1346788981
CALIFORNIA (CA) MS INC
LAWRENCE A. WOLFF, DDS, Overpayment
403 1030858982 12/28/2022 12/31/2022 675.06 ACH MEDICARE SERVICE CENTER 800224753 558422334351034 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
404 1030858982 12/28/2022 12/31/2022 675.06 ACH MEDICARE SERVICE CENTER 800224753 558422334351025 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
405 1030858982 12/28/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800224753 558422334351018 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
406 1030858982 12/28/2022 12/31/2022 105.92 ACH MEDICARE SERVICE CENTER 800224753 558422334351013 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
407 1030858982 12/28/2022 12/31/2022 359.14 ACH MEDICARE SERVICE CENTER 800224753 558422334351011 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS,
408 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351154 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
409 1030501650 12/27/2022 12/31/2022 -681.94 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351158 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
410 1030501650 12/27/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351142 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
411 1030501650 12/27/2022 12/31/2022 -177.51 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351151 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
412 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351146 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
413 1030501650 12/27/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351140 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
414 1030501650 12/27/2022 12/31/2022 -82.51 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351152 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
415 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351149 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
416 1030501650 12/27/2022 12/31/2022 -130.94 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351145 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
417 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351150 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
418 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351148 H C 1912395369
INC.
 LAWRENCE A. WOLFF, DDS,
419 1030501650 12/27/2022 12/31/2022 -105.92 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351147 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
420 1030501650 12/27/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378977212 Forwarding Balance 8422350351153 H C 1912395369
INC.
421 1030500514 12/27/2022 12/31/2022 -439.71 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378977441 Forwarding Balance 8422350351167 H C 1922308915

422 1029552399 12/22/2022 12/31/2022 -123.04 ACH MEDICARE SERVICE CENTER UM DENTAL INC 800204096 Authorized Return 7222354000001 I C 1821757089
UNITED HEALTHCARE Overpayment
423 1029049737 12/21/2022 12/31/2022 -0.25 NON SUNSET DENTAL GROUP INC 9849262631 20221019 H C 1548445463
INSURANCE COMPANY Recovery
HARRY HART DENTAL Overpayment
424 1029147102 12/21/2022 12/31/2022 3194.54 ACH MEDICARE SERVICE CENTER 898792331 548322307900000 I D 1104492891
CORPORATIO Recovery
LAWRENCE A. WOLFF DDS 9925645216-
425 1028539256 12/16/2022 12/31/2022 1156.70 NON CA MEDI-CAL 9012048856 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
426 1028539256 12/16/2022 12/31/2022 -1094.70 NON CA MEDI-CAL 9012048856 Forwarding Balance 9012048856 H C 1912395369
INC
LAWRENCE A. WOLFF, DDS, Overpayment
427 1028375621 12/20/2022 12/31/2022 681.94 ACH MEDICARE SERVICE CENTER 800189481 558422327351052 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
428 1028375621 12/20/2022 12/31/2022 87.23 ACH MEDICARE SERVICE CENTER 800189481 558422327351036 I D 1912395369
INC. Recovery
429 1028375045 12/20/2022 12/31/2022 -6810.62 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800189822 Authorized Return 7222350000006 I C 1922308915

430 1028375045 12/20/2022 12/31/2022 -2431.18 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800189822 Authorized Return 7222350000005 I C 1922308915
LAWRENCE A. WOLFF, DDS,
431 1027967417 12/19/2022 12/31/2022 -87.23 NON MEDICARE SERVICE CENTER 378958082 Forwarding Balance 8422343351012 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
432 1027967417 12/19/2022 12/31/2022 -188.76 NON MEDICARE SERVICE CENTER 378958082 Forwarding Balance 8422343351011 H C 1912395369
INC.
NOEMI TAGUINOD DENTAL Overpayment
433 1026528034 12/14/2022 12/31/2022 1992.46 NON MEDICARE SERVICE CENTER 378948099 554721305901047 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
434 1026528034 12/14/2022 12/31/2022 4877.96 NON MEDICARE SERVICE CENTER 378948098 554721305901065 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
435 1026528034 12/14/2022 12/31/2022 3919.32 NON MEDICARE SERVICE CENTER 378948098 554721305901057 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
436 1026528034 12/14/2022 12/31/2022 4934.96 NON MEDICARE SERVICE CENTER 378948098 554721305901048 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
437 1026528034 12/14/2022 12/31/2022 4763.75 NON MEDICARE SERVICE CENTER 378948098 554721305901043 H D 1952707705
CORPOR Recovery
UNITED HEALTHCARE
438 1025350990 12/12/2022 12/31/2022 -0.10 ACH SUNSET DENTAL GROUP 9845468660 Interest Owed L6 I C 1548445463
INSURANCE COMPANY
Overpayment
439 1024928433 12/09/2022 12/31/2022 1376.16 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800146757 554721319900243 I D 1780030304
Recovery
Overpayment
440 1024928433 12/09/2022 12/31/2022 646.57 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800146757 554721319900241 I D 1780030304
Recovery
Overpayment
441 1024928433 12/09/2022 12/31/2022 1234.79 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800146757 554721319900227 I D 1780030304
Recovery
Overpayment
442 1024928433 12/09/2022 12/31/2022 3052.07 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800146757 551322139291000 I D 1780030304
Recovery
Unspecified
443 1024928433 12/09/2022 12/31/2022 13468.10 ACH MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 800146757 800-304-3107 I D 1780030304
Recovery
LAWRENCE A. WOLFF, DDS,
444 1024437464 12/08/2022 12/31/2022 -132.94 ACH MEDICARE SERVICE CENTER 800142007 Forwarding Balance 8422334351018 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
445 1024437464 12/08/2022 12/31/2022 -675.06 ACH MEDICARE SERVICE CENTER 800142007 Forwarding Balance 8422334351025 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
446 1024437464 12/08/2022 12/31/2022 -359.14 ACH MEDICARE SERVICE CENTER 800142007 Forwarding Balance 8422334351011 I C 1912395369
INC.
 LAWRENCE A. WOLFF, DDS,
447 1024437464 12/08/2022 12/31/2022 -675.06 ACH MEDICARE SERVICE CENTER 800142007 Forwarding Balance 8422334351034 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
448 1024437464 12/08/2022 12/31/2022 -105.92 ACH MEDICARE SERVICE CENTER 800142007 Forwarding Balance 8422334351013 I C 1912395369
INC.
Overpayment
449 1024436390 12/08/2022 12/31/2022 1397.08 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900323 H D 1780030304
Recovery
Overpayment
450 1024436390 12/08/2022 12/31/2022 1397.08 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900279 H D 1780030304
Recovery
Overpayment
451 1024436390 12/08/2022 12/31/2022 1397.08 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900259 H D 1780030304
Recovery
Overpayment
452 1024436390 12/08/2022 12/31/2022 20.92 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900243 H D 1780030304
Recovery
Overpayment
453 1024436390 12/08/2022 12/31/2022 1522.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900240 H D 1780030304
Recovery
Overpayment
454 1024436390 12/08/2022 12/31/2022 162.29 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900227 H D 1780030304
Recovery
Overpayment
455 1024436390 12/08/2022 12/31/2022 4289.58 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378933352 554721319900147 H D 1780030304
Recovery
MARIA T RODRIGUEZ Internal Revenue
456 1024319686 12/02/2022 12/31/2022 5.81 CHK CA MEDI-CAL 0020311336 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
457 1024319686 12/02/2022 12/31/2022 19.92 CHK CA MEDI-CAL 0020311336 FEDERAL I D 1467955369
DENTAL Service Withholding
LAWRENCE A. WOLFF, DDS,
458 1022788153 12/05/2022 12/31/2022 -681.94 ACH MEDICARE SERVICE CENTER 800123183 Forwarding Balance 8422327351052 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
459 1022788153 12/05/2022 12/31/2022 -87.23 ACH MEDICARE SERVICE CENTER 800123183 Forwarding Balance 8422327351036 I C 1912395369
INC.
Overpayment
460 1022787360 12/05/2022 12/31/2022 580.27 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 558422147351021 I D 1922308915
Recovery
Overpayment
461 1022787360 12/05/2022 12/31/2022 479.04 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 558422147351020 I D 1922308915
Recovery
Overpayment
462 1022787360 12/05/2022 12/31/2022 544.58 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 554721347900810 I D 1922308915
Recovery
Overpayment
463 1022787360 12/05/2022 12/31/2022 418.50 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 554721347900809 I D 1922308915
Recovery
Overpayment
464 1022787360 12/05/2022 12/31/2022 448.73 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 554721347900803 I D 1922308915
Recovery
Unspecified
465 1022787360 12/05/2022 12/31/2022 1060.52 ACH MEDICARE SERVICE CENTER WALLY HUI DDS CORP 800123544 800-304-3107 I D 1922308915
Recovery
466 1022304169 12/02/2022 12/31/2022 -52.79 NON MEDICARE SERVICE CENTER SUNG M AHN DDS INC 466721160 Forwarding Balance 9722327493550 H C 1801093034

467 1022304169 12/02/2022 12/31/2022 -237.33 NON MEDICARE SERVICE CENTER SUNG M AHN DDS INC 466721160 Forwarding Balance 9722327493500 H C 1801093034
Overpayment
468 1022304169 12/02/2022 12/31/2022 214.63 ACH MEDICARE SERVICE CENTER UM DENTAL INC 800117471 558422280351075 I D 1821757089
Recovery
Overpayment
469 1022304169 12/02/2022 12/31/2022 123.04 ACH MEDICARE SERVICE CENTER UM DENTAL INC 800117471 558422259351138 I D 1821757089
Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
470 1022303565 12/02/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800116257 558422301351059 I D 1912395369
INC. Recovery
Overpayment
471 1022300571 12/02/2022 12/31/2022 1508.94 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378917407 554721347900878 H D 1922308915
Recovery
Overpayment
472 1022300571 12/02/2022 12/31/2022 702.05 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378917407 554721347900822 H D 1922308915
Recovery
Overpayment
473 1022300571 12/02/2022 12/31/2022 176.04 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378917407 554721347900809 H D 1922308915
Recovery
Overpayment
474 1022300571 12/02/2022 12/31/2022 800.62 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378917407 554721347900770 H D 1922308915
Recovery
 MARIA T RODRIGUEZ Internal Revenue
475 1020886826 11/25/2022 12/31/2022 7.49 CHK CA MEDI-CAL 0020308973 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
476 1020886826 11/25/2022 12/31/2022 25.68 CHK CA MEDI-CAL 0020308973 FEDERAL I D 1467955369
DENTAL Service Withholding
BLUE CROSS OF 9926972897-
477 1020885473 11/25/2022 12/31/2022 159.22 NON BOM SEOK JEON, DDS, INC 9011375837 Forwarding Balance H D 1780030304
CALIFORNIA (CA) 2021120800072630
BLUE CROSS OF
478 1020885473 11/25/2022 12/31/2022 -124.27 NON BOM SEOK JEON, DDS, INC 9011375837 Forwarding Balance 9011375837 H C 1780030304
CALIFORNIA (CA)
479 1019994944 11/28/2022 12/31/2022 -3987.97 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800087777 Authorized Return 7222326000032 I C 1548540552
LAWRENCE A. WOLFF, DDS, Overpayment
480 1019426878 11/23/2022 12/31/2022 540.86 ACH MEDICARE SERVICE CENTER 800079237 558422304356316 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
481 1019426878 11/23/2022 12/31/2022 861.90 ACH MEDICARE SERVICE CENTER 800079237 558422304356315 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
482 1019426878 11/23/2022 12/31/2022 442.46 ACH MEDICARE SERVICE CENTER 800079237 558422304352175 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
483 1019426878 11/23/2022 12/31/2022 186.85 ACH MEDICARE SERVICE CENTER 800079237 558422304352151 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
484 1019426878 11/23/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800079237 558422304352147 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
485 1019426878 11/23/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800079237 558422304352146 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
486 1019426878 11/23/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800079237 558422304352145 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
487 1019426878 11/23/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800079237 558422304352144 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
488 1019426878 11/23/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800079237 558422304352143 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
489 1019426878 11/23/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800079237 558422304352136 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
490 1019426878 11/23/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800079237 558422304352135 I D 1912395369
INC. Recovery
AARP SUPPLEMENTAL
491 991952268 09/07/2022 12/31/2022 -0.17 CHK HEALTH PLANS FROM THE CLIFTON CTR FOR ORAL 1194436129 Interest Owed 2808318508 I C 1427281351
UNITEDHEALTHCARE
HARRY HART DENTAL
492 1019038843 11/17/2022 12/31/2022 -4.25 CHK HEALTH NET, LLC 0006173131 Interest Owed L6 I C 1104492891
CORPORATION
Overpayment
493 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900307 H D 1780030304
Recovery
Overpayment
494 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900303 H D 1780030304
Recovery
Overpayment
495 1018669653 11/22/2022 12/31/2022 2418.30 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900211 H D 1780030304
Recovery
Overpayment
496 1018669653 11/22/2022 12/31/2022 2285.63 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900191 H D 1780030304
Recovery
Overpayment
497 1018669653 11/22/2022 12/31/2022 332.46 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900159 H D 1780030304
Recovery
Overpayment
498 1018669653 11/22/2022 12/31/2022 2687.86 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900157 H D 1780030304
Recovery
Overpayment
499 1018669653 11/22/2022 12/31/2022 2687.86 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900156 H D 1780030304
Recovery
Overpayment
500 1018669653 11/22/2022 12/31/2022 2687.86 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900150 H D 1780030304
Recovery
Overpayment
501 1018669653 11/22/2022 12/31/2022 2220.39 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900148 H D 1780030304
Recovery
 Overpayment
502 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900144 H D 1780030304
Recovery
Overpayment
503 1018669653 11/22/2022 12/31/2022 2772.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900138 H D 1780030304
Recovery
Overpayment
504 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900137 H D 1780030304
Recovery
Overpayment
505 1018669653 11/22/2022 12/31/2022 2832.90 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900125 H D 1780030304
Recovery
Overpayment
506 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900124 H D 1780030304
Recovery
Overpayment
507 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900112 H D 1780030304
Recovery
Overpayment
508 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900110 H D 1780030304
Recovery
Overpayment
509 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900109 H D 1780030304
Recovery
Overpayment
510 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900105 H D 1780030304
Recovery
Overpayment
511 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900100 H D 1780030304
Recovery
Overpayment
512 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900098 H D 1780030304
Recovery
Overpayment
513 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900095 H D 1780030304
Recovery
Overpayment
514 1018669653 11/22/2022 12/31/2022 2432.54 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900094 H D 1780030304
Recovery
Overpayment
515 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900092 H D 1780030304
Recovery
Overpayment
516 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900091 H D 1780030304
Recovery
Overpayment
517 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900090 H D 1780030304
Recovery
Overpayment
518 1018669653 11/22/2022 12/31/2022 2432.65 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900087 H D 1780030304
Recovery
Overpayment
519 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900083 H D 1780030304
Recovery
Overpayment
520 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900076 H D 1780030304
Recovery
Overpayment
521 1018669653 11/22/2022 12/31/2022 2679.66 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900074 H D 1780030304
Recovery
Overpayment
522 1018669653 11/22/2022 12/31/2022 2432.54 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378895071 554721319900073 H D 1780030304
Recovery
Overpayment
523 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900331 H D 1780030304
Recovery
Overpayment
524 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900307 H D 1780030304
Recovery
Overpayment
525 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900303 H D 1780030304
Recovery
Overpayment
526 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900302 H D 1780030304
Recovery
Overpayment
527 1018245732 11/21/2022 12/31/2022 1042.64 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900297 H D 1780030304
Recovery
Overpayment
528 1018245732 11/21/2022 12/31/2022 3030.97 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900265 H D 1780030304
Recovery
Overpayment
529 1018245732 11/21/2022 12/31/2022 3005.78 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900183 H D 1780030304
Recovery
 Overpayment
530 1018245732 11/21/2022 12/31/2022 3005.78 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900153 H D 1780030304
Recovery
Overpayment
531 1018245732 11/21/2022 12/31/2022 2945.43 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900152 H D 1780030304
Recovery
Overpayment
532 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900144 H D 1780030304
Recovery
Overpayment
533 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900139 H D 1780030304
Recovery
Overpayment
534 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900137 H D 1780030304
Recovery
Overpayment
535 1018245732 11/21/2022 12/31/2022 3249.48 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900136 H D 1780030304
Recovery
Overpayment
536 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900132 H D 1780030304
Recovery
Overpayment
537 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900128 H D 1780030304
Recovery
Overpayment
538 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900124 H D 1780030304
Recovery
Overpayment
539 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900121 H D 1780030304
Recovery
Overpayment
540 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900120 H D 1780030304
Recovery
Overpayment
541 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900118 H D 1780030304
Recovery
Overpayment
542 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900117 H D 1780030304
Recovery
Overpayment
543 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900115 H D 1780030304
Recovery
Overpayment
544 1018245732 11/21/2022 12/31/2022 2909.89 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900114 H D 1780030304
Recovery
Overpayment
545 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900112 H D 1780030304
Recovery
Overpayment
546 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900110 H D 1780030304
Recovery
Overpayment
547 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900109 H D 1780030304
Recovery
Overpayment
548 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900105 H D 1780030304
Recovery
Overpayment
549 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900100 H D 1780030304
Recovery
Overpayment
550 1018245732 11/21/2022 12/31/2022 230.23 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900098 H D 1780030304
Recovery
Overpayment
551 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900095 H D 1780030304
Recovery
Overpayment
552 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900092 H D 1780030304
Recovery
Overpayment
553 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900091 H D 1780030304
Recovery
Overpayment
554 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900090 H D 1780030304
Recovery
Overpayment
555 1018245732 11/21/2022 12/31/2022 2700.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900085 H D 1780030304
Recovery
Overpayment
556 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900083 H D 1780030304
Recovery
Overpayment
557 1018245732 11/21/2022 12/31/2022 2700.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900081 H D 1780030304
Recovery
 Overpayment
558 1018245732 11/21/2022 12/31/2022 2819.11 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900079 H D 1780030304
Recovery
Overpayment
559 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900076 H D 1780030304
Recovery
Overpayment
560 1018245732 11/21/2022 12/31/2022 20.93 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378891210 554721319900074 H D 1780030304
Recovery
Overpayment
561 1018245732 11/18/2022 12/31/2022 130.34 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378886586 554721347900878 H D 1922308915
Recovery
Overpayment
562 1018245732 11/18/2022 12/31/2022 3697.05 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900304 H D 1780030304
Recovery
Overpayment
563 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900299 H D 1780030304
Recovery
Overpayment
564 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900298 H D 1780030304
Recovery
Overpayment
565 1018245732 11/18/2022 12/31/2022 1798.61 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900155 H D 1780030304
Recovery
Overpayment
566 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900123 H D 1780030304
Recovery
Overpayment
567 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900122 H D 1780030304
Recovery
Overpayment
568 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900113 H D 1780030304
Recovery
Overpayment
569 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900107 H D 1780030304
Recovery
Overpayment
570 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900106 H D 1780030304
Recovery
Overpayment
571 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900104 H D 1780030304
Recovery
Overpayment
572 1018245732 11/18/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900103 H D 1780030304
Recovery
Overpayment
573 1018245732 11/18/2022 12/31/2022 3661.45 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900102 H D 1780030304
Recovery
Overpayment
574 1018245732 11/18/2022 12/31/2022 4078.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900099 H D 1780030304
Recovery
Overpayment
575 1018245732 11/18/2022 12/31/2022 3431.05 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900093 H D 1780030304
Recovery
Overpayment
576 1018245732 11/18/2022 12/31/2022 3431.05 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900089 H D 1780030304
Recovery
Overpayment
577 1018245732 11/18/2022 12/31/2022 3431.05 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900075 H D 1780030304
Recovery
Overpayment
578 1018245732 11/18/2022 12/31/2022 3431.05 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378887706 554721319900072 H D 1780030304
Recovery
Overpayment
579 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900330 H D 1780030304
Recovery
Overpayment
580 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900309 H D 1780030304
Recovery
Overpayment
581 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900305 H D 1780030304
Recovery
Overpayment
582 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900142 H D 1780030304
Recovery
Overpayment
583 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900140 H D 1780030304
Recovery
Overpayment
584 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900130 H D 1780030304
Recovery
Overpayment
585 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900126 H D 1780030304
Recovery
 Overpayment
586 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900111 H D 1780030304
Recovery
Overpayment
587 1017251770 11/17/2022 12/31/2022 2823.40 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900108 H D 1780030304
Recovery
Overpayment
588 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900097 H D 1780030304
Recovery
Overpayment
589 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900086 H D 1780030304
Recovery
Overpayment
590 1017251770 11/17/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378883671 554721319900084 H D 1780030304
Recovery
Overpayment
591 1017166804 11/16/2022 12/31/2022 276.22 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378879225 554721347900876 H D 1922308915
Recovery
Overpayment
592 1017166804 11/16/2022 12/31/2022 544.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378879225 554721347900834 H D 1922308915
Recovery
Overpayment
593 1017166804 11/16/2022 12/31/2022 624.15 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378879225 554721347900804 H D 1922308915
Recovery
Overpayment
594 1017166804 11/16/2022 12/31/2022 396.28 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378879225 554721347900802 H D 1922308915
Recovery
Overpayment
595 1017166804 11/16/2022 12/31/2022 2093.12 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378879225 554721347900770 H D 1922308915
Recovery
Overpayment
596 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900301 H D 1780030304
Recovery
Overpayment
597 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900134 H D 1780030304
Recovery
Overpayment
598 1017166804 11/16/2022 12/31/2022 3965.57 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900133 H D 1780030304
Recovery
Overpayment
599 1017166804 11/16/2022 12/31/2022 3940.80 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900127 H D 1780030304
Recovery
Overpayment
600 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900116 H D 1780030304
Recovery
Overpayment
601 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900101 H D 1780030304
Recovery
Overpayment
602 1017166804 11/16/2022 12/31/2022 177.54 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900097 H D 1780030304
Recovery
Overpayment
603 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900096 H D 1780030304
Recovery
Overpayment
604 1017166804 11/16/2022 12/31/2022 1917.71 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900088 H D 1780030304
Recovery
Overpayment
605 1017166804 11/16/2022 12/31/2022 3788.03 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378880340 554721319900077 H D 1780030304
Recovery
BLUE CROSS OF LAWRENCE A. WOLFF DDS
606 1016149504 11/11/2022 12/31/2022 798.36 CHK 0304486503 Forwarding Balance 0304486503 I D 1912395369
CALIFORNIA (CA) INC
Overpayment
607 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900330 H D 1780030304
Recovery
Overpayment
608 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900309 H D 1780030304
Recovery
Overpayment
609 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900305 H D 1780030304
Recovery
Overpayment
610 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900301 H D 1780030304
Recovery
Overpayment
611 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900299 H D 1780030304
Recovery
Overpayment
612 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900298 H D 1780030304
Recovery
Overpayment
613 1015165153 11/14/2022 12/31/2022 4272.88 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900151 H D 1780030304
Recovery
 Overpayment
614 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900142 H D 1780030304
Recovery
Overpayment
615 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900140 H D 1780030304
Recovery
Overpayment
616 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900134 H D 1780030304
Recovery
Overpayment
617 1015165153 11/14/2022 12/31/2022 147.95 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900133 H D 1780030304
Recovery
Overpayment
618 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900130 H D 1780030304
Recovery
Overpayment
619 1015165153 11/14/2022 12/31/2022 172.72 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900127 H D 1780030304
Recovery
Overpayment
620 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900126 H D 1780030304
Recovery
Overpayment
621 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900123 H D 1780030304
Recovery
Overpayment
622 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900122 H D 1780030304
Recovery
Overpayment
623 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900116 H D 1780030304
Recovery
Overpayment
624 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900113 H D 1780030304
Recovery
Overpayment
625 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900111 H D 1780030304
Recovery
Overpayment
626 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900108 H D 1780030304
Recovery
Overpayment
627 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900107 H D 1780030304
Recovery
Overpayment
628 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900106 H D 1780030304
Recovery
Overpayment
629 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900104 H D 1780030304
Recovery
Overpayment
630 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900103 H D 1780030304
Recovery
Overpayment
631 1015165153 11/14/2022 12/31/2022 325.49 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900101 H D 1780030304
Recovery
Overpayment
632 1015165153 11/14/2022 12/31/2022 147.95 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900097 H D 1780030304
Recovery
Overpayment
633 1015165153 11/14/2022 12/31/2022 241.09 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900096 H D 1780030304
Recovery
Overpayment
634 1015165153 11/14/2022 12/31/2022 29.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900088 H D 1780030304
Recovery
Overpayment
635 1015165153 11/14/2022 12/31/2022 29.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900086 H D 1780030304
Recovery
Overpayment
636 1015165153 11/14/2022 12/31/2022 29.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900084 H D 1780030304
Recovery
Overpayment
637 1015165153 11/14/2022 12/31/2022 29.59 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378868863 554721319900077 H D 1780030304
Recovery
HARRY HART DENTAL
638 1014638662 11/10/2022 12/31/2022 -3167.81 ACH MEDICARE SERVICE CENTER 898645064 Forwarding Balance 8322307900000 I C 1104492891
CORPORATIO
HARRY HART DENTAL
639 1013736327 10/13/2022 12/31/2022 -41691.60 ACH MEDICARE SERVICE CENTER 898531663 Bonus 9520220930244 I C 1104492891
CORPORATIO
640 1018670320 11/22/2022 12/31/2022 -2101.19 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800071883 Authorized Return 7222322000012 I C 1548540552

641 1018670320 11/22/2022 12/31/2022 -104.98 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800071883 Authorized Return 7222322000011 I C 1548540552
642 1018670320 11/22/2022 12/31/2022 -1874.21 ACH MEDICARE SERVICE CENTER VALLEY ACE DENTAL 800071883 Authorized Return 7222322000010 I C 1548540552
LAWRENCE A. WOLFF, DDS, Overpayment
643 1018670200 11/22/2022 12/31/2022 421.05 ACH MEDICARE SERVICE CENTER 800072351 558422301351067 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
644 1018670200 11/22/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800072351 558422301351056 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
645 1018670200 11/22/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800072351 558422301351054 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
646 1018670200 11/22/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800072351 558422301351053 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
647 1018670200 11/22/2022 12/31/2022 292.48 ACH MEDICARE SERVICE CENTER 800072351 558422301351050 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
648 1018670200 11/22/2022 12/31/2022 292.48 ACH MEDICARE SERVICE CENTER 800072351 558422301351049 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
649 1018670200 11/22/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800072351 558422301351047 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
650 1018670200 11/22/2022 12/31/2022 119.36 ACH MEDICARE SERVICE CENTER 800072351 558422301351041 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
651 1018670200 11/22/2022 12/31/2022 132.28 ACH MEDICARE SERVICE CENTER 800072351 558422301351040 I D 1912395369
INC. Recovery
HARRY HART DENTAL
652 1018257743 11/18/2022 12/31/2022 -3261.45 NON MEDICARE SERVICE CENTER 466694806 Forwarding Balance 8322315159000 H C 1104492891
CORPORATIO
LAWRENCE A. WOLFF, DDS,
653 1017252468 11/17/2022 12/31/2022 -132.94 ACH MEDICARE SERVICE CENTER 800051655 Forwarding Balance 8422301351059 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS, Overpayment
654 1017170386 11/16/2022 12/31/2022 87.23 ACH MEDICARE SERVICE CENTER 800045136 558422287351056 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
655 1017170386 11/16/2022 12/31/2022 132.94 ACH MEDICARE SERVICE CENTER 800045136 558422287351041 I D 1912395369
INC. Recovery
656 1015638155 11/15/2022 12/31/2022 -0.40 ACH MEDICARE SERVICE CENTER CUONG NGUYEN DDS INC 800039891 Authorized Return 7222314000012 I C 1730413121

657 1015638155 11/15/2022 12/31/2022 -13.23 ACH MEDICARE SERVICE CENTER CUONG NGUYEN DDS INC 800039891 Authorized Return 7222314000011 I C 1730413121
MARIA T RODRIGUEZ Internal Revenue
658 1016164001 11/11/2022 12/31/2022 3.83 CHK CA MEDI-CAL 0020303954 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
659 1016164001 11/11/2022 12/31/2022 13.12 CHK CA MEDI-CAL 0020303954 FEDERAL I D 1467955369
DENTAL Service Withholding
Overpayment
660 1013454529 11/08/2022 12/31/2022 89.23 NON MEDICARE SERVICE CENTER UM DENTAL INC 378857044 558422259351138 H D 1821757089
Recovery
Overpayment
661 1013454529 11/08/2022 12/31/2022 214.63 NON MEDICARE SERVICE CENTER UM DENTAL INC 378857044 558422259351137 H D 1821757089
Recovery
LAWRENCE A. WOLFF, DDS,
662 1013454400 11/08/2022 12/31/2022 -132.94 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352145 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
663 1013454400 11/08/2022 12/31/2022 -442.46 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352175 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
664 1013454400 11/08/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352143 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
665 1013454400 11/08/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352135 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
666 1013454400 11/08/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352146 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
667 1013454400 11/08/2022 12/31/2022 -132.28 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352147 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
668 1013454400 11/08/2022 12/31/2022 -861.90 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304356315 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
669 1013454400 11/08/2022 12/31/2022 -132.94 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352136 H C 1912395369
INC.
 LAWRENCE A. WOLFF, DDS,
670 1013454400 11/08/2022 12/31/2022 -540.86 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304356316 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
671 1013454400 11/08/2022 12/31/2022 -186.85 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352151 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
672 1013454400 11/08/2022 12/31/2022 -132.94 NON MEDICARE SERVICE CENTER 378856221 Forwarding Balance 8422304352144 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
673 1013015117 11/07/2022 12/31/2022 -119.36 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351041 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
674 1013015117 11/07/2022 12/31/2022 -132.28 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351047 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
675 1013015117 11/07/2022 12/31/2022 -292.48 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351049 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
676 1013015117 11/07/2022 12/31/2022 -132.28 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351040 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
677 1013015117 11/07/2022 12/31/2022 -292.48 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351050 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
678 1013015117 11/07/2022 12/31/2022 -132.28 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351054 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
679 1013015117 11/07/2022 12/31/2022 -132.94 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351056 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
680 1013015117 11/07/2022 12/31/2022 -132.94 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351053 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
681 1013015117 11/07/2022 12/31/2022 -421.05 ACH MEDICARE SERVICE CENTER 800000772 Forwarding Balance 8422301351067 I C 1912395369
INC.
BLUE CROSS OF LAWRENCE A. WOLFF DDS
682 1012601313 11/01/2022 12/31/2022 -798.36 NON 9010595622 Forwarding Balance 9010595622 H C 1912395369
CALIFORNIA (CA) INC
NOEMI TAGUINOD DENTAL Overpayment
683 1012053683 11/03/2022 12/31/2022 4925.87 NON MEDICARE SERVICE CENTER 378846043 554721305901101 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
684 1012053683 11/03/2022 12/31/2022 5021.17 NON MEDICARE SERVICE CENTER 378846043 554721305901061 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
685 1012053683 11/03/2022 12/31/2022 690.86 NON MEDICARE SERVICE CENTER 378846043 554721305901037 H D 1972645851
CORPOR Recovery
Overpayment
686 1012049123 11/03/2022 12/31/2022 390.68 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900876 H D 1922308915
Recovery
Overpayment
687 1012049123 11/03/2022 12/31/2022 666.90 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900866 H D 1922308915
Recovery
Overpayment
688 1012049123 11/03/2022 12/31/2022 641.73 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900849 H D 1922308915
Recovery
Overpayment
689 1012049123 11/03/2022 12/31/2022 641.73 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900837 H D 1922308915
Recovery
Overpayment
690 1012049123 11/03/2022 12/31/2022 42.75 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900804 H D 1922308915
Recovery
Overpayment
691 1012049123 11/03/2022 12/31/2022 666.90 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378844990 554721347900784 H D 1922308915
Recovery
NOEMI TAGUINOD DENTAL Overpayment
692 1011773292 11/02/2022 12/31/2022 5344.16 NON MEDICARE SERVICE CENTER 378842224 554721305901042 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
693 1011773292 11/02/2022 12/31/2022 1195.21 NON MEDICARE SERVICE CENTER 378842224 554721305901040 H D 1972645851
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
694 1011773292 11/02/2022 12/31/2022 5483.17 NON MEDICARE SERVICE CENTER 378842223 554721305901098 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
695 1011773292 11/02/2022 12/31/2022 6383.22 NON MEDICARE SERVICE CENTER 378842223 554721305901091 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
696 1011773292 11/02/2022 12/31/2022 5471.04 NON MEDICARE SERVICE CENTER 378842223 554721305901023 H D 1952707705
CORPOR Recovery
NOEMI TAGUINOD DENTAL Overpayment
697 1011773292 11/02/2022 12/31/2022 3871.70 NON MEDICARE SERVICE CENTER 378842223 554721305901020 H D 1952707705
CORPOR Recovery
 NOEMI TAGUINOD DENTAL Overpayment
698 1011773292 11/02/2022 12/31/2022 6094.32 NON MEDICARE SERVICE CENTER 378842223 554721305901012 H D 1952707705
CORPOR Recovery
Overpayment
699 1010977642 11/01/2022 12/31/2022 27.71 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378836759 554721347900976 H D 1548540552
Recovery
Overpayment
700 1010977642 11/01/2022 12/31/2022 2230.99 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378836759 554721347900970 H D 1548540552
Recovery
MARIA T RODRIGUEZ Internal Revenue
701 1010968201 10/28/2022 12/31/2022 7.77 CHK CA MEDI-CAL 0020298769 STATE I D 1467955369
DENTAL Service Withholding
MARIA T RODRIGUEZ Internal Revenue
702 1010968201 10/28/2022 12/31/2022 26.64 CHK CA MEDI-CAL 0020298769 FEDERAL I D 1467955369
DENTAL Service Withholding
Overpayment
703 1010456757 10/31/2022 12/31/2022 724.78 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900863 H D 1922308915
Recovery
Overpayment
704 1010456757 10/31/2022 12/31/2022 989.19 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900851 H D 1922308915
Recovery
Overpayment
705 1010456757 10/31/2022 12/31/2022 38.72 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900849 H D 1922308915
Recovery
Overpayment
706 1010456757 10/31/2022 12/31/2022 675.61 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900838 H D 1922308915
Recovery
Overpayment
707 1010456757 10/31/2022 12/31/2022 38.72 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900837 H D 1922308915
Recovery
Overpayment
708 1010456757 10/31/2022 12/31/2022 675.61 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900835 H D 1922308915
Recovery
Overpayment
709 1010456757 10/31/2022 12/31/2022 135.29 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900834 H D 1922308915
Recovery
Overpayment
710 1010456757 10/31/2022 12/31/2022 1008.09 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900823 H D 1922308915
Recovery
Overpayment
711 1010456757 10/31/2022 12/31/2022 969.42 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900818 H D 1922308915
Recovery
Overpayment
712 1010456757 10/31/2022 12/31/2022 969.42 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900789 H D 1922308915
Recovery
Overpayment
713 1010456757 10/31/2022 12/31/2022 1757.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900788 H D 1922308915
Recovery
Overpayment
714 1010456757 10/31/2022 12/31/2022 1757.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900787 H D 1922308915
Recovery
Overpayment
715 1010456757 10/31/2022 12/31/2022 969.42 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900785 H D 1922308915
Recovery
Overpayment
716 1010456757 10/31/2022 12/31/2022 685.79 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378833430 554721347900776 H D 1922308915
Recovery
717 1009502262 10/27/2022 12/31/2022 -122.37 ACH MEDICARE SERVICE CENTER BOM JEON DENTAL CORP 899958353 Authorized Return 7222298000005 I C 1013590025
LAWRENCE A. WOLFF, DDS,
718 1007820495 10/24/2022 12/31/2022 -87.23 ACH MEDICARE SERVICE CENTER 899936058 Forwarding Balance 8422287351056 I C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
719 1007820495 10/24/2022 12/31/2022 -132.94 ACH MEDICARE SERVICE CENTER 899936058 Forwarding Balance 8422287351041 I C 1912395369
INC.
Overpayment
720 1007397607 10/21/2022 12/31/2022 4636.00 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378811681 554721319900273 H D 1780030304
Recovery
Overpayment
721 1007397607 10/21/2022 12/31/2022 4377.33 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378811681 554721319900164 H D 1780030304
Recovery
Overpayment
722 1007397607 10/21/2022 12/31/2022 885.30 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378811681 554721319900155 H D 1780030304
Recovery
723 1006255965 10/17/2022 12/31/2022 -213.08 NON MEDICARE SERVICE CENTER UM DENTAL INC 378795747 Forwarding Balance 8422280351075 H C 1821757089

724 1005022803 10/14/2022 12/31/2022 -0.03 ACH MEDICARE SERVICE CENTER TRUE VIEW DENTAL 886628925 Interest Owed L6 I C 1437738010

725 1004386271 10/13/2022 12/31/2022 -383.75 ACH MEDICARE SERVICE CENTER YOONHO CHANG DDS INC 898531666 Bonus 9520220930457 I C 1750588646
 HARRY HART DENTAL
726 1004386271 10/13/2022 12/31/2022 -41691.60 ACH MEDICARE SERVICE CENTER 898531663 Bonus 9520220930244 I C 1104492891
CORPORATIO
Overpayment
727 1002948463 10/07/2022 12/31/2022 580.34 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900870 H D 1922308915
Recovery
Overpayment
728 1002948463 10/07/2022 12/31/2022 622.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900859 H D 1922308915
Recovery
Overpayment
729 1002948463 10/07/2022 12/31/2022 134.01 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900857 H D 1922308915
Recovery
Overpayment
730 1002948463 10/07/2022 12/31/2022 651.38 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900846 H D 1922308915
Recovery
Overpayment
731 1002948463 10/07/2022 12/31/2022 609.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900839 H D 1922308915
Recovery
Overpayment
732 1002948463 10/07/2022 12/31/2022 596.73 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378771237 554721347900819 H D 1922308915
Recovery
Overpayment
733 1002831759 10/11/2022 12/31/2022 221.68 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378774804 554721347900976 H D 1548540552
Recovery
Overpayment
734 1002831759 10/11/2022 12/31/2022 1607.49 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378774804 554721347900974 H D 1548540552
Recovery
Overpayment
735 1002831759 10/11/2022 12/31/2022 221.68 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378774804 554721347900970 H D 1548540552
Recovery
Overpayment
736 1002831759 10/11/2022 12/31/2022 2342.47 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378774804 554721347900214 H D 1548540552
Recovery
Overpayment
737 1002831759 10/11/2022 12/31/2022 1625.01 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378774804 554721347900210 H D 1548540552
Recovery
Overpayment
738 1002830511 10/11/2022 12/31/2022 274.62 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900880 H D 1922308915
Recovery
Overpayment
739 1002830511 10/11/2022 12/31/2022 186.35 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900879 H D 1922308915
Recovery
Overpayment
740 1002830511 10/11/2022 12/31/2022 194.88 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900877 H D 1922308915
Recovery
Overpayment
741 1002830511 10/11/2022 12/31/2022 448.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900874 H D 1922308915
Recovery
Overpayment
742 1002830511 10/11/2022 12/31/2022 534.61 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900871 H D 1922308915
Recovery
Overpayment
743 1002830511 10/11/2022 12/31/2022 175.61 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900864 H D 1922308915
Recovery
Overpayment
744 1002830511 10/11/2022 12/31/2022 424.69 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900857 H D 1922308915
Recovery
Overpayment
745 1002830511 10/11/2022 12/31/2022 11.26 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900847 H D 1922308915
Recovery
Overpayment
746 1002830511 10/11/2022 12/31/2022 366.60 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900841 H D 1922308915
Recovery
Overpayment
747 1002830511 10/11/2022 12/31/2022 401.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900833 H D 1922308915
Recovery
Overpayment
748 1002830511 10/11/2022 12/31/2022 401.50 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900832 H D 1922308915
Recovery
Overpayment
749 1002830511 10/11/2022 12/31/2022 308.66 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900830 H D 1922308915
Recovery
Overpayment
750 1002830511 10/11/2022 12/31/2022 675.61 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900826 H D 1922308915
Recovery
Overpayment
751 1002830511 10/11/2022 12/31/2022 508.22 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900824 H D 1922308915
Recovery
Overpayment
752 1002830511 10/11/2022 12/31/2022 3274.79 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900823 H D 1922308915
Recovery
Overpayment
753 1002830511 10/11/2022 12/31/2022 33.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900815 H D 1922308915
Recovery
 Overpayment
754 1002830511 10/11/2022 12/31/2022 176.79 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900814 H D 1922308915
Recovery
Overpayment
755 1002830511 10/11/2022 12/31/2022 132.71 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900812 H D 1922308915
Recovery
Overpayment
756 1002830511 10/11/2022 12/31/2022 460.90 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900811 H D 1922308915
Recovery
Overpayment
757 1002830511 10/11/2022 12/31/2022 282.10 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900808 H D 1922308915
Recovery
Overpayment
758 1002830511 10/11/2022 12/31/2022 662.15 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900807 H D 1922308915
Recovery
Overpayment
759 1002830511 10/11/2022 12/31/2022 662.15 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900806 H D 1922308915
Recovery
Overpayment
760 1002830511 10/11/2022 12/31/2022 302.53 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900805 H D 1922308915
Recovery
Overpayment
761 1002830511 10/11/2022 12/31/2022 183.86 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900780 H D 1922308915
Recovery
Overpayment
762 1002830511 10/11/2022 12/31/2022 282.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900778 H D 1922308915
Recovery
Overpayment
763 1002830511 10/11/2022 12/31/2022 229.11 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900774 H D 1922308915
Recovery
Overpayment
764 1002830511 10/11/2022 12/31/2022 460.90 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900765 H D 1922308915
Recovery
Overpayment
765 1002830511 10/11/2022 12/31/2022 234.87 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900761 H D 1922308915
Recovery
Overpayment
766 1002830511 10/11/2022 12/31/2022 416.26 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900757 H D 1922308915
Recovery
Overpayment
767 1002830511 10/11/2022 12/31/2022 487.79 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378775297 554721347900751 H D 1922308915
Recovery
CHRISTOPHER DAI NGUYEN
768 953944769 05/17/2022 12/31/2022 -444.15 ACH MEDICARE SERVICE CENTER 899242636 Authorized Return 7222133000004 I C 1760644488
DDS A
Overpayment
769 1001882219 10/06/2022 12/31/2022 2390.37 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899857389 558422216700066 I D 1225587876
Recovery
Overpayment
770 1001882219 10/06/2022 12/31/2022 50.77 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899857389 558422214758851 I D 1225587876
Recovery
Overpayment
771 1001433581 10/05/2022 12/31/2022 1705.74 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378763123 554721361900730 H D 1891001566
Recovery
TSIBEL DENTAL 08608-
772 1000917415 10/03/2022 12/31/2022 -4.53 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 057120796
773 1000289567 10/03/2022 12/31/2022 -210.92 ACH MEDICARE SERVICE CENTER BOM JEON DENTAL CORP 899842506 Forwarding Balance 8422266351061 I C 1013590025

774 973638532 07/13/2022 12/31/2022 -757.22 ACH MEDICARE SERVICE CENTER YOONHO CHANG DDS INC 898193804 Bonus 9520220630711 I C 1750588646
HARRY HART DENTAL
775 973638532 07/13/2022 12/31/2022 -42157.54 ACH MEDICARE SERVICE CENTER 898193801 Bonus 9520220630577 I C 1104492891
CORPORATIO
776 953925254 05/17/2022 12/31/2022 -158.46 ACH MEDICARE SERVICE CENTER KWAN LEE DDS PLLC 892562159 Authorized Return 7222133000000 I C 1902439912

777 999813644 09/30/2022 12/31/2022 -132.72 NON MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 378752677 Forwarding Balance 8422259351127 H C 1225587876

778 999813644 09/30/2022 12/31/2022 -132.72 NON MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 378752677 Forwarding Balance 8422259351126 H C 1225587876
Overpayment
779 999342372 09/29/2022 12/31/2022 94.63 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378749398 554721361900730 H D 1891001566
Recovery
780 976175357 07/21/2022 12/31/2022 -2308.03 ACH MEDICARE SERVICE CENTER JASON S LEE DDS INC 898222107 Authorized Return 9522200000000 I C 1912052978
Overpayment
781 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900760 H D 1922308915
Recovery
Overpayment
782 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900759 H D 1922308915
Recovery
 Overpayment
783 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900758 H D 1922308915
Recovery
Overpayment
784 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900755 H D 1922308915
Recovery
Overpayment
785 976963055 07/25/2022 12/31/2022 4.02 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900754 H D 1922308915
Recovery
Overpayment
786 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900753 H D 1922308915
Recovery
Overpayment
787 976963055 07/25/2022 12/31/2022 26.00 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378555877 554721347900751 H D 1922308915
Recovery
AMERIDENT HEALTH PRO
788 976963055 07/25/2022 12/31/2022 -783.39 ACH MEDICARE SERVICE CENTER 899525486 Authorized Return 7222202000010 I C 1467818401
INC
Overpayment
789 976963055 07/25/2022 12/31/2022 16.22 NON MEDICARE SERVICE CENTER JUSTIN D HWANG DDS INC 378553487 554721355900204 H D 1215134226
Recovery
Overpayment
790 998879447 09/28/2022 12/31/2022 228.73 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378746034 554721347900214 H D 1548540552
Recovery
791 983520136 08/12/2022 12/31/2022 -158.46 ACH MEDICARE SERVICE CENTER KWAN LEE DDS PLLC 892797730 Authorized Return 7222222000006 I C 1902439912

792 997779178 09/26/2022 12/31/2022 -209.85 ACH MEDICARE SERVICE CENTER UM DENTAL INC 899809912 Forwarding Balance 8422259351138 I C 1821757089

793 997779178 09/26/2022 12/31/2022 -213.08 ACH MEDICARE SERVICE CENTER UM DENTAL INC 899809912 Forwarding Balance 8422259351137 I C 1821757089
Overpayment
794 997777715 09/26/2022 12/31/2022 112.89 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378738069 554721361900732 H D 1891001566
Recovery
Overpayment
795 996928197 09/22/2022 12/31/2022 1053.26 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378730644 554721347900214 H D 1548540552
Recovery
Overpayment
796 993871275 09/14/2022 12/31/2022 636.89 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378707815 554721347900855 H D 1922308915
Recovery
Overpayment
797 993871275 09/14/2022 12/31/2022 636.89 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378707815 554721347900831 H D 1922308915
Recovery
Overpayment
798 993871275 09/14/2022 12/31/2022 529.30 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378707815 554721347900812 H D 1922308915
Recovery
799 996352293 09/21/2022 12/31/2022 -6.63 ACH MEDICARE SERVICE CENTER L P MEDICAL GROUP 899788813 Interest Owed L6 I C 1710077961
Overpayment
800 995296170 09/19/2022 12/31/2022 65.17 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378719629 554721347900819 H D 1922308915
Recovery
Overpayment
801 993179982 09/13/2022 12/31/2022 181.79 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378703781 554721347900214 H D 1548540552
Recovery
LAWRENCE A. WOLFF DDS 9925645216-
802 993308156 09/09/2022 12/31/2022 1179.70 NON CA MEDI-CAL 9008912879 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
803 993308156 09/09/2022 12/31/2022 -1156.70 NON CA MEDI-CAL 9008912879 Forwarding Balance 9008912879 H C 1912395369
INC
LAWRENCE A. WOLFF, DDS, Overpayment
804 993179822 09/13/2022 12/31/2022 49.72 ACH MEDICARE SERVICE CENTER 899757673 558422224700699 I D 1912395369
INC. Recovery
LAWRENCE A. WOLFF, DDS, Overpayment
805 993179822 09/13/2022 12/31/2022 20.94 ACH MEDICARE SERVICE CENTER 899757673 558422224700698 I D 1912395369
INC. Recovery
MARIA T ALARCON DDS
806 992915066 09/12/2022 12/31/2022 -8.03 NON MEDICARE SERVICE CENTER 466538047 Forwarding Balance 9722244495220 H C 1467955369
DENTAL
TSIBEL DENTAL 08608-
807 991833286 09/07/2022 12/31/2022 -3.24 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 056988264
ROBERTO SALAZAR
808 990989908 09/07/2022 12/31/2022 -774.36 NON MEDICARE SERVICE CENTER 378689738 Forwarding Balance 8422215351071 H C 1932722519
DENTAL CORPO
Overpayment
809 990866629 09/06/2022 12/31/2022 20.94 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378684855 554721361900741 H D 1891001566
Recovery
Overpayment
810 988642521 08/30/2022 12/31/2022 31.97 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378670054 554721347900839 H D 1922308915
Recovery
 LAWRENCE A. WOLFF DDS 9925645216-
811 988638728 08/26/2022 12/31/2022 1358.70 NON CA MEDI-CAL 9008446060 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
812 988638728 08/26/2022 12/31/2022 -1179.70 NON CA MEDI-CAL 9008446060 Forwarding Balance 9008446060 H C 1912395369
INC
AILAN TRAN,D.D.S., A
8222380002026
813 988166545 08/31/2022 12/31/2022 -0.12 ACH AETNA PROFESSIONAL DENTAL Interest Owed L6 I C 1720106305
76
CORPORATI
LAWRENCE A. WOLFF, DDS, Overpayment
814 988150703 08/29/2022 12/31/2022 50.40 ACH MEDICARE SERVICE CENTER 899689829 558422210724091 I D 1912395369
INC. Recovery
Overpayment
815 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900861 H D 1922308915
Recovery
Overpayment
816 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900856 H D 1922308915
Recovery
Overpayment
817 988148781 08/29/2022 12/31/2022 33.88 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900855 H D 1922308915
Recovery
Overpayment
818 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900844 H D 1922308915
Recovery
Overpayment
819 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900843 H D 1922308915
Recovery
Overpayment
820 988148781 08/29/2022 12/31/2022 306.94 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900841 H D 1922308915
Recovery
Overpayment
821 988148781 08/29/2022 12/31/2022 33.88 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900839 H D 1922308915
Recovery
Overpayment
822 988148781 08/29/2022 12/31/2022 650.09 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900836 H D 1922308915
Recovery
Overpayment
823 988148781 08/29/2022 12/31/2022 33.88 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900831 H D 1922308915
Recovery
Overpayment
824 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900828 H D 1922308915
Recovery
Overpayment
825 988148781 08/29/2022 12/31/2022 641.73 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900827 H D 1922308915
Recovery
Overpayment
826 988148781 08/29/2022 12/31/2022 670.77 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378666091 554721347900821 H D 1922308915
Recovery
MARIA T ALARCON DDS Overpayment
827 987242359 08/25/2022 12/31/2022 937.80 ACH MEDICARE SERVICE CENTER 898358829 549822189351027 I D 1467955369
DENTAL Recovery
LAWRENCE A. WOLFF, DDS,
828 987719986 08/26/2022 12/31/2022 -49.72 NON MEDICARE SERVICE CENTER 378661750 Forwarding Balance 8422224700699 H C 1912395369
INC.
LAWRENCE A. WOLFF, DDS,
829 987719986 08/26/2022 12/31/2022 -20.94 NON MEDICARE SERVICE CENTER 378661750 Forwarding Balance 8422224700698 H C 1912395369
INC.
TSIBEL DENTAL 08608-
830 976589148 07/21/2022 12/31/2022 -0.53 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 056742517
MARIA T ALARCON DDS Overpayment
831 973639331 07/13/2022 12/31/2022 2687.95 ACH MEDICARE SERVICE CENTER 898196508 549822140351186 I D 1467955369
DENTAL Recovery
MARIA T ALARCON DDS Overpayment
832 985688122 08/18/2022 12/31/2022 999.48 ACH MEDICARE SERVICE CENTER 898332866 549822181351016 I D 1467955369
DENTAL Recovery
LAWRENCE A. WOLFF DDS 9925645216-
833 984190588 08/12/2022 12/31/2022 1368.70 NON CA MEDI-CAL 9008005354 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
834 984190588 08/12/2022 12/31/2022 -1358.70 NON CA MEDI-CAL 9008005354 Forwarding Balance 9008005354 H C 1912395369
INC
LAWRENCE A. WOLFF, DDS,
835 981732466 08/08/2022 12/31/2022 -50.40 NON MEDICARE SERVICE CENTER 378599422 Forwarding Balance 8422210724091 H C 1912395369
INC.
Overpayment
836 986845916 08/24/2022 12/31/2022 4033.29 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378653062 554721361900765 H D 1891001566
Recovery
Overpayment
837 986845916 08/24/2022 12/31/2022 167.08 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378653062 554721361900740 H D 1891001566
Recovery
838 986093850 08/22/2022 12/31/2022 -273.19 NON MEDICARE SERVICE CENTER L P MEDICAL GROUP 378643660 Forwarding Balance 8422224351210 H C 1710077961

839 985691145 08/18/2022 12/31/2022 -2373.07 NON MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 378636978 Forwarding Balance 8422216700066 H C 1225587876
Overpayment
840 984762184 08/17/2022 12/31/2022 668.68 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378633942 554721347900216 H D 1548540552
Recovery
Overpayment
841 984762184 08/17/2022 12/31/2022 1943.01 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378633942 554721347900215 H D 1548540552
Recovery
Overpayment
842 984762184 08/17/2022 12/31/2022 175.74 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378633942 554721347900214 H D 1548540552
Recovery
Overpayment
843 984762184 08/17/2022 12/31/2022 2324.59 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378633942 554721347900210 H D 1548540552
Recovery
Overpayment
844 985402113 08/18/2022 12/31/2022 184.02 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378637461 554721361900765 H D 1891001566
Recovery
Overpayment
845 985402113 08/18/2022 12/31/2022 184.02 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378637461 554721361900741 H D 1891001566
Recovery
Overpayment
846 985402113 08/18/2022 12/31/2022 184.02 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378637461 554721361900740 H D 1891001566
Recovery
Overpayment
847 985402113 08/18/2022 12/31/2022 1741.56 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378637461 554721361900739 H D 1891001566
Recovery
Overpayment
848 985402113 08/18/2022 12/31/2022 184.02 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378637461 554721361900732 H D 1891001566
Recovery
LAWRENCE A. WOLFF, DDS,
849 979733302 08/02/2022 12/31/2022 -7.19 ACH MEDICARE SERVICE CENTER 899567453 Interest Owed L6 I C 1912395369
INC.
Overpayment
850 984687248 08/17/2022 12/31/2022 2170.02 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378633573 554721361900738 H D 1891001566
Recovery
QUOC L. NGUYEN, D.D.S. A
851 984687248 08/17/2022 12/31/2022 -109.24 NON MEDICARE SERVICE CENTER 378635165 Forwarding Balance 4722172151250 H D 1093012494
PRO
QUOC L. NGUYEN, D.D.S. A
852 984687248 08/17/2022 12/31/2022 0.01 NON MEDICARE SERVICE CENTER 378635165 Interest Owed L6 H D 1093012494
PRO
Overpayment
853 983786919 08/15/2022 12/31/2022 20.68 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378626495 554721347900836 H D 1922308915
Recovery
Overpayment
854 983786919 08/15/2022 12/31/2022 29.04 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378626495 554721347900827 H D 1922308915
Recovery
Overpayment
855 983343262 08/11/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900860 H D 1922308915
Recovery
Overpayment
856 983343262 08/11/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900772 H D 1922308915
Recovery
Overpayment
857 983343262 08/11/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900771 H D 1922308915
Recovery
Overpayment
858 983343262 08/11/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900763 H D 1922308915
Recovery
Overpayment
859 983343262 08/11/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900762 H D 1922308915
Recovery
Overpayment
860 983343262 08/11/2022 12/31/2022 415.08 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378617515 554721347900761 H D 1922308915
Recovery
861 982660346 08/10/2022 12/31/2022 -50.40 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899606393 Forwarding Balance 8422214758851 I C 1225587876

862 982663050 08/10/2022 12/31/2022 -43.43 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378613719 Forwarding Balance 8422210719009 H C 1356713069
Overpayment
863 982033341 08/09/2022 12/31/2022 400.00 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378608578 554721305900743 H D 1356713069
Recovery
Overpayment
864 981730904 08/08/2022 12/31/2022 33.25 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378599848 554721347900859 H D 1922308915
Recovery
Overpayment
865 981730904 08/08/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378599848 554721347900783 H D 1922308915
Recovery
 Overpayment
866 981730904 08/08/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378599848 554721347900768 H D 1922308915
Recovery
Overpayment
867 981730904 08/08/2022 12/31/2022 646.43 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378599848 554721347900766 H D 1922308915
Recovery
868 981730904 08/08/2022 12/31/2022 -595.67 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378601733 Forwarding Balance 8422210737689 H C 1356713069
Overpayment
869 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900860 H D 1922308915
Recovery
Overpayment
870 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900859 H D 1922308915
Recovery
Overpayment
871 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900783 H D 1922308915
Recovery
Overpayment
872 980826718 08/04/2022 12/31/2022 675.95 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900775 H D 1922308915
Recovery
Overpayment
873 980826718 08/04/2022 12/31/2022 450.28 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900774 H D 1922308915
Recovery
Overpayment
874 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900772 H D 1922308915
Recovery
Overpayment
875 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900771 H D 1922308915
Recovery
Overpayment
876 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900768 H D 1922308915
Recovery
Overpayment
877 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900766 H D 1922308915
Recovery
Overpayment
878 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900763 H D 1922308915
Recovery
Overpayment
879 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900762 H D 1922308915
Recovery
Overpayment
880 980826718 08/04/2022 12/31/2022 29.52 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900761 H D 1922308915
Recovery
Overpayment
881 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900760 H D 1922308915
Recovery
Overpayment
882 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900759 H D 1922308915
Recovery
Overpayment
883 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900758 H D 1922308915
Recovery
Overpayment
884 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900755 H D 1922308915
Recovery
Overpayment
885 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900754 H D 1922308915
Recovery
Overpayment
886 980826718 08/04/2022 12/31/2022 683.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900753 H D 1922308915
Recovery
Overpayment
887 980826718 08/04/2022 12/31/2022 678.65 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378587677 554721347900752 H D 1922308915
Recovery
Overpayment
888 980381677 08/03/2022 12/31/2022 123.33 ACH MEDICARE SERVICE CENTER BOM JEON DENTAL CORP 899576597 554622111007110 I D 1013590025
Recovery
Overpayment
889 978919029 07/29/2022 12/31/2022 5.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900760 H D 1922308915
Recovery
Overpayment
890 978919029 07/29/2022 12/31/2022 5.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900759 H D 1922308915
Recovery
Overpayment
891 978919029 07/29/2022 12/31/2022 5.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900758 H D 1922308915
Recovery
Overpayment
892 978919029 07/29/2022 12/31/2022 5.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900755 H D 1922308915
Recovery
Overpayment
893 978919029 07/29/2022 12/31/2022 27.18 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900754 H D 1922308915
Recovery
 Overpayment
894 978919029 07/29/2022 12/31/2022 5.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900753 H D 1922308915
Recovery
Overpayment
895 978919029 07/29/2022 12/31/2022 207.89 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378571831 554721347900751 H D 1922308915
Recovery
TSIBEL DENTAL 08608-
896 976973682 07/22/2022 12/31/2022 -0.14 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 056748710
Overpayment
897 976620594 07/22/2022 12/31/2022 565.85 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378551849 554721347900814 H D 1922308915
Recovery
Overpayment
898 976620594 07/22/2022 12/31/2022 81.14 NON MEDICARE SERVICE CENTER VINIT JOSHI DDS INC 378552880 554721333900828 H D 1467846139
Recovery
AFFORDABLE DENTIST
899 976163353 07/20/2022 12/31/2022 -1.89 CHK NOVITAS SOLUTIONS, INC. 300081449 Interest Owed L6 I C 1770952814
NEAR ME
900 976147848 07/21/2022 12/31/2022 -0.35 ACH MEDICARE SERVICE CENTER TRUE VIEW DENTAL 886585781 Interest Owed L6 I C 1437738010
LAWRENCE A. WOLFF DDS 9925645216-
901 975293004 07/15/2022 12/31/2022 1369.70 NON CA MEDI-CAL 9007089280 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
902 975293004 07/15/2022 12/31/2022 -1368.70 NON CA MEDI-CAL 9007089280 Forwarding Balance 9007089280 H C 1912395369
INC
Overpayment
903 975814392 07/20/2022 12/31/2022 37.26 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378544014 554721347900814 H D 1922308915
Recovery
TSIBEL DENTAL 08608-
904 975824479 07/19/2022 12/31/2022 -0.15 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 056728327
MARIA T ALARCON DDS
905 974900103 07/18/2022 12/31/2022 -930.53 ACH MEDICARE SERVICE CENTER 898211944 Forwarding Balance 9822189351027 I C 1467955369
DENTAL
HARRY HART DENTAL
906 974900121 07/18/2022 12/31/2022 -5.50 ACH MEDICARE SERVICE CENTER 898209265 Interest Owed L6 I C 1104492891
CORPORATIO
907 974871609 07/18/2022 12/31/2022 -0.99 ACH MEDICARE SERVICE CENTER TRUE VIEW DENTAL 886583855 Interest Owed L6 I C 1437738010
Overpayment
908 974477327 07/15/2022 12/31/2022 1438.64 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378531102 554721347900216 H D 1548540552
Recovery
Overpayment
909 974477327 07/15/2022 12/31/2022 3535.65 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378531102 554721347900211 H D 1548540552
Recovery
NOEMI G TAGUINOD Overpayment
910 974009702 07/14/2022 12/31/2022 5865.79 NON MEDICARE SERVICE CENTER 378528313 554721305901031 H D 1952707705
DENTAL CORP Recovery
Overpayment
911 973636780 07/13/2022 12/31/2022 875.28 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378522051 554721361900734 H D 1891001566
Recovery
Overpayment
912 972923320 07/12/2022 12/31/2022 849.57 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378518720 554721347900854 H D 1922308915
Recovery
Overpayment
913 972923320 07/12/2022 12/31/2022 791.83 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378518720 554721347900852 H D 1922308915
Recovery
Overpayment
914 972923320 07/12/2022 12/31/2022 971.92 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378518720 554721347900825 H D 1922308915
Recovery
Overpayment
915 972923320 07/12/2022 12/31/2022 294.95 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378518720 554721347900824 H D 1922308915
Recovery
Overpayment
916 972923320 07/12/2022 12/31/2022 796.30 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378518720 554721347900813 H D 1922308915
Recovery
MARIA T ALARCON DDS
917 972533984 07/11/2022 12/31/2022 -991.73 NON MEDICARE SERVICE CENTER 466383314 Forwarding Balance 9822181351016 H C 1467955369
DENTAL
LAWRENCE A. WOLFF DDS 9925645216-
918 972146037 07/01/2022 12/31/2022 1540.87 NON CA MEDI-CAL 9006680115 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
919 972146037 07/01/2022 12/31/2022 -1369.70 NON CA MEDI-CAL 9006680115 Forwarding Balance 9006680115 H C 1912395369
INC
Overpayment
920 972085077 07/08/2022 12/31/2022 124.92 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378509886 554721347900854 H D 1922308915
Recovery
Overpayment
921 971620464 07/07/2022 12/31/2022 544.21 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900874 H D 1922308915
Recovery
 Overpayment
922 971620464 07/07/2022 12/31/2022 1121.79 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900867 H D 1922308915
Recovery
Overpayment
923 971620464 07/07/2022 12/31/2022 1224.38 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900853 H D 1922308915
Recovery
Overpayment
924 971620464 07/07/2022 12/31/2022 1195.90 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900845 H D 1922308915
Recovery
Overpayment
925 971620464 07/07/2022 12/31/2022 1029.57 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900817 H D 1922308915
Recovery
Overpayment
926 971620464 07/07/2022 12/31/2022 1030.66 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378506156 554721347900764 H D 1922308915
Recovery
Overpayment
927 971620464 07/07/2022 12/31/2022 81.14 NON MEDICARE SERVICE CENTER VINIT JOSHI DDS INC 378506804 554721333900828 H D 1467846139
Recovery
BLUE CROSS OF
928 970938907 07/01/2022 12/31/2022 -0.18 CHK WALLY HUI DDS CORP 0304168250 Interest Owed L6 I C 1922308915
CALIFORNIA (CA)
Overpayment
929 970851240 07/06/2022 12/31/2022 71.30 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378503496 554721347900853 H D 1922308915
Recovery
HARRY HART DENTAL
930 970851581 07/06/2022 12/31/2022 -0.99 ACH MEDICARE SERVICE CENTER 898168831 Interest Owed L6 I C 1104492891
CORPORATIO
Overpayment
931 970817338 07/05/2022 12/31/2022 250.64 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378499380 554721347900211 H D 1548540552
Recovery
Overpayment
932 970814299 07/05/2022 12/31/2022 1384.10 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378499879 554721347900847 H D 1922308915
Recovery
NOEMI G TAGUINOD Overpayment
933 970816591 07/05/2022 12/31/2022 604.70 NON MEDICARE SERVICE CENTER 378500930 554721305901031 H D 1972645851
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
934 970816591 07/05/2022 12/31/2022 6574.16 NON MEDICARE SERVICE CENTER 378500930 554721305901019 H D 1972645851
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
935 970816591 07/05/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378500929 554721305901031 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
936 970816591 07/05/2022 12/31/2022 1484.72 NON MEDICARE SERVICE CENTER 378500929 554721305901020 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
937 970816591 07/05/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378500929 554721305901019 H D 1952707705
DENTAL CORP Recovery
MARIA T ALARCON DDS
938 970851576 07/06/2022 12/31/2022 -1.69 ACH MEDICARE SERVICE CENTER 898170917 Interest Owed L6 I C 1467955369
DENTAL
939 970305836 06/16/2022 12/31/2022 -2937.32 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378452226 Forwarding Balance 1322139291000 H C 1780030304
Overpayment
940 970305836 05/16/2022 12/31/2022 2937.32 NON MEDICARE SERVICE CENTER BOM SEOK JEON, DDS, INC 378364618 554721319900154 H D 1780030304
Recovery
Overpayment
941 969038967 06/29/2022 12/31/2022 114.05 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378487024 554721361900734 H D 1891001566
Recovery
THE CLIFTON CENTER FOR
942 969055611 06/28/2022 12/31/2022 -0.06 ACH NOVITAS SOLUTIONS, INC. 895816994 Interest Owed L6 I C 1427281351
ORAL
Overpayment
943 969039897 06/29/2022 12/31/2022 2046.86 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378487434 554721347900215 H D 1548540552
Recovery
Overpayment
944 969039897 06/29/2022 12/31/2022 4141.14 NON MEDICARE SERVICE CENTER VALLEY ACE DENTAL 378487434 554721347900212 H D 1548540552
Recovery
LAWRENCE A. WOLFF DDS 9925645216-
945 968427655 06/24/2022 12/31/2022 1563.87 NON CA MEDI-CAL 9006462312 Forwarding Balance H D 1912395369
INC 2021012200136447
LAWRENCE A. WOLFF DDS
946 968427655 06/24/2022 12/31/2022 -1540.87 NON CA MEDI-CAL 9006462312 Forwarding Balance 9006462312 H C 1912395369
INC
THE CLIFTON CENTER FOR
947 968312928 06/27/2022 12/31/2022 -0.31 ACH NOVITAS SOLUTIONS, INC. 895811829 Interest Owed L6 I C 1427281351
ORAL
MARIA T ALARCON DDS
948 967992015 06/27/2022 12/31/2022 -0.25 ACH MEDICARE SERVICE CENTER 898139025 Interest Owed L6 I C 1467955369
DENTAL
949 967082119 06/23/2022 12/31/2022 -122.37 ACH MEDICARE SERVICE CENTER BOM JEON DENTAL CORP 899404337 Forwarding Balance 4622111007110 I C 1013590025
 DR ROGER D SOHN PROF
950 967144014 06/23/2022 12/31/2022 -0.05 ACH MEDICARE SERVICE CENTER 898125719 Interest Owed L6 I C 1528442100
DENTAL
LAWRENCE A. WOLFF, DDS, Overpayment
951 967082497 06/23/2022 12/31/2022 183.48 ACH MEDICARE SERVICE CENTER 899402061 558422147351776 I D 1912395369
INC. Recovery
MARIA T ALARCON DDS Overpayment
952 967143999 06/23/2022 12/31/2022 414.99 ACH MEDICARE SERVICE CENTER 898128069 549822126351003 I D 1467955369
DENTAL Recovery
MARIA T ALARCON DDS Overpayment
953 967143999 06/23/2022 12/31/2022 414.99 ACH MEDICARE SERVICE CENTER 898128069 549822126351002 I D 1467955369
DENTAL Recovery
MARIA T ALARCON DDS
954 965608643 06/21/2022 12/31/2022 -0.28 ACH MEDICARE SERVICE CENTER 898116500 Interest Owed L6 I C 1467955369
DENTAL
ROBERTO SALAZAR
955 965608461 06/21/2022 12/31/2022 -0.73 ACH MEDICARE SERVICE CENTER 899389041 Interest Owed L6 I C 1932722519
DENTAL CORPO
Overpayment
956 965607501 06/21/2022 12/31/2022 229.25 NON MEDICARE SERVICE CENTER NGOC LAN VO DDS INC 378458025 554721361900738 H D 1891001566
Recovery
AMERIDENT HEALTH PRO
957 965607501 06/21/2022 12/31/2022 -0.12 ACH MEDICARE SERVICE CENTER 899383745 Interest Owed L6 I C 1467818401
INC
Overpayment
958 965366141 06/17/2022 12/31/2022 803.63 ACH MEDICARE SERVICE CENTER HUYNH DDS INC 899381901 558422140351026 I D 1902579287
Recovery
TSIBEL DENTAL 08608-
959 964710268 06/15/2022 12/31/2022 -2.50 CHK AETNA Interest Owed L6 I C 1073611133
CORPORATION 056553319
960 964697783 06/16/2022 12/31/2022 -265.45 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378452241 Forwarding Balance 1322138292000 H C 1356713069
Overpayment
961 964197085 06/15/2022 12/31/2022 1384.10 NON MEDICARE SERVICE CENTER JIN Y KIM DDS INC 378447227 554721300900469 H D 1063687937
Recovery
962 959650670 06/02/2022 12/31/2022 -0.03 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899313551 Interest Owed L6 I C 1225587876

963 963561666 06/14/2022 12/31/2022 -461.04 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378443293 Forwarding Balance 8422147351020 H D 1922308915

964 963561666 06/14/2022 12/31/2022 -558.47 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378443293 Forwarding Balance 8422147351021 H D 1922308915

965 963561666 06/14/2022 12/31/2022 0.32 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378443293 Interest Owed L6 H D 1922308915
NOEMI G TAGUINOD
966 963562134 06/14/2022 12/31/2022 -0.06 NON MEDICARE SERVICE CENTER 378444364 Interest Owed L6 H D 1952707705
DENTAL CORP
NOEMI G TAGUINOD Overpayment
967 963562134 06/14/2022 12/31/2022 1297.14 NON MEDICARE SERVICE CENTER 378444364 554721305901098 H D 1952707705
DENTAL CORP Recovery
THE CLIFTON CENTER FOR
968 962689057 06/09/2022 12/31/2022 -0.25 ACH NOVITAS SOLUTIONS, INC. 895765371 Interest Owed L6 I C 1427281351
ORAL
Overpayment
969 962661510 06/10/2022 12/31/2022 225.63 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378435422 554721347900853 H D 1922308915
Recovery
LAWRENCE A. WOLFF, DDS,
970 961055604 06/07/2022 12/31/2022 -183.48 ACH MEDICARE SERVICE CENTER 899332718 Forwarding Balance 8422147351776 I C 1912395369
INC.
NOEMI G TAGUINOD Overpayment
971 960651519 06/06/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378420789 554721305901098 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
972 960651519 06/06/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378420789 554721305901031 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
973 960651519 06/06/2022 12/31/2022 1360.18 NON MEDICARE SERVICE CENTER 378420789 554721305901023 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
974 960651519 06/06/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378420789 554721305901020 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
975 960651519 06/06/2022 12/31/2022 51.36 NON MEDICARE SERVICE CENTER 378420789 554721305901019 H D 1952707705
DENTAL CORP Recovery
976 961714492 06/08/2022 12/31/2022 -49.12 NON MEDICARE SERVICE CENTER AILAN TRAN DDS APC 466309363 Forwarding Balance 9722136900051 H C 1790803310

977 961714492 06/08/2022 12/31/2022 -4508.10 NON MEDICARE SERVICE CENTER AILAN TRAN DDS APC 466309363 Forwarding Balance 9722136900050 H C 1790803310

978 961714492 06/08/2022 12/31/2022 -1982.71 NON MEDICARE SERVICE CENTER AILAN TRAN DDS APC 466309363 Forwarding Balance 9722136900049 H C 1790803310
979 961055884 06/07/2022 12/31/2022 -244.37 ACH MEDICARE SERVICE CENTER L P MEDICAL GROUP 899331368 Forwarding Balance 8422147351109 I C 1710077961
QUOC L. NGUYEN, D.D.S. A
980 960651114 06/06/2022 12/31/2022 -0.04 ACH MEDICARE SERVICE CENTER 899330109 Interest Owed L6 I C 1093012494
PRO
Overpayment
981 960127616 06/03/2022 12/31/2022 1572.31 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378415281 554721347900872 H D 1922308915
Recovery
Overpayment
982 960127616 06/03/2022 12/31/2022 1589.70 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378415281 554721347900868 H D 1922308915
Recovery
Overpayment
983 960127616 06/03/2022 12/31/2022 168.25 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378415281 554721347900847 H D 1922308915
Recovery
Overpayment
984 960127616 06/03/2022 12/31/2022 1595.78 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378415281 554721347900829 H D 1922308915
Recovery
Overpayment
985 960127616 06/03/2022 12/31/2022 1649.80 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378415281 554721347900816 H D 1922308915
Recovery
986 959650151 06/02/2022 12/31/2022 -803.63 NON MEDICARE SERVICE CENTER HUYNH DDS INC 378412519 Forwarding Balance 8422140351026 H C 1902579287
MARIA T ALARCON DDS Overpayment
987 959650286 06/02/2022 12/31/2022 101.37 ACH MEDICARE SERVICE CENTER 898054328 549622103660061 I D 1467955369
DENTAL Recovery
988 958865717 06/01/2022 12/31/2022 -0.03 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899307102 Interest Owed L6 I C 1225587876

989 958493592 05/31/2022 12/31/2022 -0.31 ACH MEDICARE SERVICE CENTER L P MEDICAL GROUP 899296506 Interest Owed L6 I C 1710077961

990 958493592 05/31/2022 12/31/2022 -0.02 ACH MEDICARE SERVICE CENTER SAM S. MARKZAR, INC. 899298450 Interest Owed L6 I C 1225587876
QUOC L. NGUYEN, D.D.S. A Overpayment
991 958493599 05/31/2022 12/31/2022 2245.95 ACH MEDICARE SERVICE CENTER 899303443 554622098900033 I D 1093012494
PRO Recovery
MARIA T ALARCON DDS
992 958493635 05/31/2022 12/31/2022 -2667.11 ACH MEDICARE SERVICE CENTER 898042885 Forwarding Balance 9822140351186 I C 1467955369
DENTAL
Overpayment
993 943166738 04/18/2022 12/31/2022 2702.20 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378279652 554721347900875 H D 1922308915
Recovery
Overpayment
994 943166738 04/18/2022 12/31/2022 2734.82 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378279652 554721347900862 H D 1922308915
Recovery
Overpayment
995 943166738 04/18/2022 12/31/2022 1401.02 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378279652 554721347900845 H D 1922308915
Recovery
Overpayment
996 943166738 04/18/2022 12/31/2022 2828.41 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378279652 554721347900842 H D 1922308915
Recovery
Overpayment
997 943166738 04/18/2022 12/31/2022 41.92 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378280792 554721305900743 H D 1356713069
Recovery
Overpayment
998 943166738 04/18/2022 12/31/2022 1185.79 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378280792 554721305900662 H D 1356713069
Recovery
Overpayment
999 943166738 04/18/2022 12/31/2022 1383.74 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378280792 554721305900645 H D 1356713069
Recovery
Overpayment
1000 943166738 04/18/2022 12/31/2022 41.92 NON MEDICARE SERVICE CENTER QUANG D HUYNH DDS INC 378280792 554721305900580 H D 1356713069
Recovery
QUOC L. NGUYEN, D.D.S. A
1001 943166738 04/18/2022 12/31/2022 -2278.84 ACH MEDICARE SERVICE CENTER 899107634 Forwarding Balance 4622098900033 I C 1093012494
PRO
THOMAS NGUYEN DENTAL
1002 943626754 04/19/2022 12/31/2022 -99.23 NON MEDICARE SERVICE CENTER 378282878 Forwarding Balance 8422098351138 H C 1487724456
CORP
Overpayment
1003 947110774 04/27/2022 12/31/2022 50.22 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378309615 554721347900850 H D 1922308915
Recovery
1004 948100269 04/29/2022 12/31/2022 -527.71 NON MEDICARE SERVICE CENTER BOM JEON DENTAL CORP 378319426 Forwarding Balance 4722097900186 H C 1013590025
Overpayment
1005 948582611 05/02/2022 12/31/2022 233.53 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378322479 554721347900870 H D 1922308915
Recovery
Overpayment
1006 953551359 05/16/2022 12/31/2022 1384.72 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378363436 554721347900870 H D 1922308915
Recovery
Overpayment
1007 953551359 05/16/2022 12/31/2022 2128.93 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378363436 554721347900850 H D 1922308915
Recovery
 Overpayment
1008 954610289 05/18/2022 12/31/2022 1731.69 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378371584 554721347900780 H D 1922308915
Recovery
Overpayment
1009 956404099 05/24/2022 12/31/2022 146.32 NON MEDICARE SERVICE CENTER JASON S LEE DDS INC 466272101 549721340900234 H D 1912052978
Recovery
Overpayment
1010 955540100 05/20/2022 12/31/2022 1851.63 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378379721 554721347900865 H D 1922308915
Recovery
Overpayment
1011 955540100 05/20/2022 12/31/2022 1276.97 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378379721 554721347900857 H D 1922308915
Recovery
Overpayment
1012 955540100 05/20/2022 12/31/2022 1855.24 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378379721 554721347900840 H D 1922308915
Recovery
QUOC L. NGUYEN, D.D.S. A Overpayment
1013 957593572 05/26/2022 12/31/2022 50.22 NON MEDICARE SERVICE CENTER 378396241 554622098900033 H D 1093012494
PRO Recovery
Overpayment
1014 957771184 05/25/2022 12/31/2022 100.95 NON MEDICARE SERVICE CENTER WALLY HUI DDS CORP 378391837 554721347900868 H D 1922308915
Recovery
HARRY HART DENTAL
1015 954611062 05/18/2022 12/31/2022 -0.34 ACH MEDICARE SERVICE CENTER 897994455 Interest Owed L6 I C 1104492891
CORPORATIO
HARRY HART DENTAL
1016 955090765 05/19/2022 12/31/2022 -1139.74 ACH MEDICARE SERVICE CENTER 897999667 Forwarding Balance 9722115900116 I C 1104492891
CORPORATIO
Overpayment
1017 956017979 05/23/2022 12/31/2022 53.63 NON MEDICARE SERVICE CENTER CUONG NGUYEN DDS INC 378384548 554721327900293 H D 1730413121
Recovery
Overpayment
1018 953524577 05/16/2022 12/31/2022 111.38 ACH MEDICARE SERVICE CENTER TRUE VIEW DENTAL 886553115 324722075900000 I D 1437738010
Recovery
NOEMI G TAGUINOD Overpayment
1019 953095978 05/13/2022 12/31/2022 1735.89 NON MEDICARE SERVICE CENTER 378360441 554721305901040 H D 1972645851
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1020 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901098 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1021 953095978 05/13/2022 12/31/2022 5885.27 NON MEDICARE SERVICE CENTER 378360440 554721305901041 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1022 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901040 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1023 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901031 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1024 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901023 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1025 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901020 H D 1952707705
DENTAL CORP Recovery
NOEMI G TAGUINOD Overpayment
1026 953095978 05/13/2022 12/31/2022 256.80 NON MEDICARE SERVICE CENTER 378360440 554721305901019 H D 1952707705
DENTAL CORP Recovery
MARIA T ALARCON DDS
1027 953551838 05/16/2022 12/31/2022 -411.77 ACH MEDICARE SERVICE CENTER 897985817 Forwarding Balance 9822126351003 I C 1467955369
DENTAL
MARIA T ALARCON DDS
1028 953551838 05/16/2022 12/31/2022 -411.77 ACH MEDICARE SERVICE CENTER 897985817 Forwarding Balance 9822126351002 I C 1467955369
DENTAL
Overpayment
1029 951480496 05/10/2022 12/31/2022 111.78 NON MEDICARE SERVICE CENTER CUONG NGUYEN DDS INC 378347856 554721327900293 H D 1730413121
Recovery

Total Row Count: 1029