Exhibit A, Medicare Claim Table — Case 7:17-cv-09424-CS-JCM (Document 13-1)
Summary
Exhibit A, filed June 2, 2021 as Document 13-1 in Case 7:17-cv-09424-CS-JCM. It is a table of Medicare claims for nine patients identified only as Patient A through Patient I. For each claim it lists the facility, Medicare claim number, service and through dates, RUG codes, rehab days and amount paid, for claims from 2012 through 2018. The exhibit is 6 pages.
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Cite this document
“13 1 Intervenor Complaint Against Issac Laufer Tami Whitney Parag.”
Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/13-1-intervenor-complaint-against-issac-laufer-tami-whitney-parag-fc05093a5e/
, SHA-256 9f3c6b22358d68baca467ca0048723179fc00dba41d015171a71ddbda050d30b.Full text
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 1 of 6
Exhibit A
Name Facility Medicare Claim Number Date of Thru Date RUG Code # Rehab Amount
Service on Billed Days Paid
Claim
Patient A LICC 21800800732907NYA 12/11/2017 12/31/2017 RUC10 14 $15,053.17
RUC20 7
Patient A LICC 21803604339207NYA 1/1/2018 1/31/2018 RUC20 9 $17,370.68
RUC30 22
Patient A LICC 21806802041307NYA 2/1/2018 2/28/2018 RUC30 8 $15,689.64
RUC40 20
Patient A LICC 21809602833507NYA 3/1/2018 3/20/2018 RUC40 10 $11,206.89
RUC50 10
Patient B Lynbrook 21300802423407NYA 12/27/2012 12/31/2012 RUC10 5 $3,370.40
Patient B Lynbrook 21303802779307NYA 1/1/2013 1/31/2013 RUC10 9 $18,528.48
RUC20 16
RUC30 6
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 2 of 6
Patient B Lynbrook 21306702423707NYA 2/1/2013 2/28/2013 RUC30 24 $14,730.24
RUC40 4
Patient B Lynbrook 21309902431707NYA 3/1/2013 3/31/2013 RUC40 26 $15,829.53
RVC50 5
Patient B Lynbrook 21312901671007NYA 4/1/2013 4/6/2013 RVC50 5 $2,108.42
Patient C Sutton Park 21619306368007NYA 6/28/2016 6/30/2016 RUB10 3 $4,808.55
Patient C Sutton Park 21622401850607NYA 7/1/2016 7/31/2016 RUB10 11 $47,479.39
RUC20 16
RUC30 4
Patient C Sutton Park 21625701683607NYA 8/1/2016 8/31/2016 RUC30 26 $44,797.13
RUC40 5
Patient C Sutton Park 21628502272707NYA 9/1/2016 9/30/2016 RUC40 25 $43,352.06
RUC50 5
2
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 3 of 6
Patient C Sutton Park 21631503380307NYA 10/1/2016 10/5/2016 RUC50 4 $5,901.99
Patient D North 21810101252307NYA 3/9/2018 3/31/2018 RUB10 14 $16,170.92
Westchester RUB20 9
Patient D North 21812901584407NYA 4/1/2018 4/30/2018 RUB20 7 $16,810.33
Westchester RUB30 23
Patient D North 21816203356007NYA 5/1/2018 5/31/2018 RUB30 7 $14,521.70
Westchester RUA40 24
Patient D North 21819301424107NYA 6/1/2018 6/15/2018 RUA40 6 $6,182.92
Westchester RUA50 8
Patient E Glen Cove 21504102434007NYA 1/20/2015 1/31/2015 RUB10 12 $8,197.54
Patient E Glen Cove 21507001444807NYA 2/1/2015 2/28/2015 RUB10 2 $16,040.60
RUB20 16
RUB30 10
3
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 4 of 6
Patient E Glen Cove 21509901759807NYA 3/1/2015 3/31/2015 RUB30 20 $16,392.14
RUB40 11
Patient E Glen Cove 21513103863707NYA 4/1/2015 4/30/2015 RUB40 19 $15,334.58
RUB50 10
Patient F Momentum 21804001458807NYA 1/17/2018 1/31/2018 RUB10 14 $10,846.98
RUB20 1
Patient F Momentum 21806801658507NYA 2/1/2018 2/28/2018 RUB20 15 16,472.25
RUB30 13
Patient F Momentum 21810103115507NYA 3/1/2018 3/31/2018 RUB30 17 $17,328.45
RUB40 14
Patient F Momentum 21812901887607NYA 4/1/2018 4/26/2018 RUB40 16 $13,974.55
RUB50 9
Patient G Oasis 21522302329607NYA 07/17/2015 07/31/2015 RUB10 14 $10,246.93
RUB20 1
4
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 5 of 6
Patient G Oasis 21525202315607NYA 08/01/2015 08/31/2015 RUB20 15 $17,163.89
RUB30 16
Patient G Oasis 21528202499207NYA 09/01/2015 09/30/2015 RUB30 14 $15,863.36
RUB40 16
Patient G Oasis 21531401997607NYA 10/01/2015 10/25/2015 RUB40 14 $11,365.45
RVB50 10
Patient H Excel 21516002249107NYA 5/11/2015 5/31/2015 RUB10 14 $11,104.35
RUB20 7
Patient H Excel 21519101434707NYA 6/1/2015 6/15/2015 RUB20 9 $7,402.90
RUB30 5
Patient I Marquis 21325401904207NYA 8/21/2013 8/31/2013 RUC10 11 $7,266.58
Patient I Marquis 21328302025307NYA 9/1/2013 9/30/2013 RUC10 3 $16,772.11
RUC20 16
RUC30 11
5
Case 7:17-cv-09424-CS-JCM Document 13-1 Filed 06/02/21 Page 6 of 6
Patient I Marquis 21331503779307NYA 10/1/2013 10/31/2013 RUC30 19 $16,385.76
RUB40 12
Patient I Marquis 21334403354107NYA 11/1/2013 11/28/2013 RUB40 18 $14,800.04
RUB50 10
6
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