Transaction Detail Previous Day 05 03 2021-02 56 31 PDF

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Download Transaction Detail Previous Day 05 03 2021-02 56 31 PDF

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Transaction Detail Report - PreviousDay Physicians Medical Center LLC - Q48069 Selected Criteria: Date: Accounts:

04/13/2021 00:00 to 04/13/2021 23:59 07023514917

Transaction Group:

ACH Credit, ACH Debit, Account Transfer Credit, Account Transfer Debit, CPS Device Credit, CPS Device Credit Adjustment, CPS Device Credit Reversal, CPS Device Debit, CPS Device Debit Adjustment, CPS Device Debit Reversal, Cash Letter Credit, Cash Recycle Debit Reversal, Cash Recycler Credit, Cash Recycler Credit Adjustment, Cash Recycler Credit Reversal, Cash Recycler Debit, Cash Recycler Debit Adjustment, Check, Deposit, Disbursing Credit, Disbursing Debit, Fee, International, Lockbox, Miscellaneous Credit, Miscellaneous Debit, Real Time Payment Credit, Real Time Payment Credit Adjustment, Real Time Payment Credits, Real Time Payment Debit, Real Time Payment Debit Adjustment, Real Time Payment Debits, Return, Wire Transfer Incoming, Wire Transfer Outgoing, Wire Transfer outgoing, ZBA Credit, ZBA Debit

Fifth Third Bank - 042000314 07023514917 - Checking - Physicians Medical Center - USD Date

Transaction Type

04/13/2021 Description:

Miscellaneous Debit 699000006990 COMMERCIAL LOAN PAYMENT 905582243-00026

04/13/2021

Check

600473219919

21375

04/13/2021

Lockbox

599472525821

36033000659

04/13/2021 Description:

Deposit 200501341562 99999041321 5-3 BANKCARD COMB. DEP. CHAIN 0U1675 COMB. DEP. PHYSICIANS MEDICAL CEN 041321

04/13/2021 Description:

ACH Credit 200109151152 Colonial Penn Li HCCLAIMPMT 041001036988358 PHYSICIANS MEDICAL CEN TRN*1*3511523*1231628836~ 041321

$1,737.30

04/13/2021 Description:

ACH Credit 200109144737 HNB - ECHO HCCLAIMPMT 205071967 PHYSICANS MEDICAL CENT TRN*1*993289354*1341858379 041321

$1,639.00

04/13/2021 Description:

ACH Credit 200108314481 HHP DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*011810018583718*1611013183 041321

04/13/2021 Description:

ACH Credit 200108309596 HHP LOU DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*005920001300256*1611013183 0413

04/13/2021 Description:

ACH Credit 200108148841 UnitedHealthcare HCCLAIMPMT 205071967 PHYSICIANS MEDICAL CEN TRN*1*1626858151*1411289245*000087726 0413

04/13/2021 Description:

ACH Credit 200108145726 UNITEDHEALTHCARE HCCLAIMPMT 205071967 PHYSICIANS MEDICAL CEN TRN*1*1TR81122520*1411289245*000087726 041

04/13/2021 Description:

ACH Credit 200108145604 UNITEDHEALTHCARE HCCLAIMPMT 205071967 PHYSICIANS MEDICAL CEN TRN*1*1TR81093132*1411289245*000087726 041

04/13/2021 Description:

ACH Credit 200108145558 UNITEDHEALTHCARE HCCLAIMPMT 205071967 PHYSICIANS MEDICAL CEN TRN*1*1TR81071427*1411289245*000087726 041

04/13/2021

ACH Credit

Mon May 03 14:56:31 EDT 2021

Bank Ref. #

Customer Ref. #

Debit Amount $180,000.00

Credit Amount

$20,000.00 $21,909.96 $678.00

$29,370.61

$1,320.82

$2,547.29

$44,978.24

$3,769.60

$1,636.51

$65.65

200108143135 Confidential

Page 1 of3

Deposit and credit products provided by Fifth Third Bank, National Association, Member FDIC. Equal Housing Lender. Fifth Third and Fifth Third Bank are registered service marks of Fifth Third Bancorp.

07023514917 - Checking - Physicians Medical Center - USD Date Description:

Transaction Type Bank Ref. # Customer Ref. # UMR HCCLAIMPMT 205071967 PHYSICIANS MEDICAL CEN TRN*1*626587259*1391995276*0000UMR01 041321

04/13/2021 Description:

ACH Credit 200107938364 WPS-TDEFIC CONTR HCCLAIMPMT 2220119545 PHYSICIANS MEDICAL CEN TRN*1*2220119545*1391268299*WPSTDEFIC 041

04/13/2021 Description:

ACH Credit 200107837515 ANTHEM BLUE IN5C EDI PAYMENT HCCLAIMPMT 3147905748 PHYSICIANS MEDICAL CEN TRN*1*3147905748*1350781558 0

04/13/2021 Description:

ACH Credit 200107836908 ANTHEM BLUE IN5F EDI PAYMENT HCCLAIMPMT 3147905747 PHYSICIANS MEDICAL CEN TRN*1*3147905747*1350781558 0

04/13/2021 Description:

ACH Credit 200103731557 CIGNA PROVIDER PAYMENT HCCLAIMPMT 202100553448129 PHYSICIANS MEDICAL CEN TRN*1*1123001MS2021041113007187

$873.72

04/13/2021 Description:

ACH Credit 200103729641 CIGNA PROVIDER PAYMENT HCCLAIMPMT 202100553448876 PHYSICIANS MEDICAL CEN TRN*1*1123001MS2021041106000566

$227.50

04/13/2021 Description:

ACH Credit 200103729633 CIGNA PROVIDER PAYMENT HCCLAIMPMT 202100553447700 PHYSICIANS MEDICAL CEN TRN*1*1123001MS2021041105002912

$266.31

04/13/2021 Description:

ACH Credit 200103728116 CIGNA PROVIDER PAYMENT HCCLAIMPMT 202100553448256 PHYSICIANS MEDICAL CEN TRN*1*1123001MS2021041109000309

$567.28

04/13/2021 Description:

ACH Credit 200102929541 HUMANA INS CO DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*019420056384999*1391263473

04/13/2021 Description:

ACH Credit 200102929457 HUMANA INS CO DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*001290056428703*1391263473

04/13/2021 Description:

ACH Credit 200102929213 HUMANA INS CO DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*001290056403772*1391263473

04/13/2021 Description:

ACH Credit 200102928949 HUMANA INS CO DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*001290056380119*1391263473

$8,499.22

04/13/2021 Description:

ACH Credit 200102920111 HUMANA FORDMOC DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*017300100065628*139126347

$2,590.34

04/13/2021 Description:

ACH Credit 200102900580 HUMANA AHP DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*014740102929803*1611013183 0

04/13/2021 Description:

ACH Credit 200102900550 HUMANA AHP DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*014740102925540*1611013183 0

04/13/2021

ACH Credit

Mon May 03 14:56:31 EDT 2021

Debit Amount

Credit Amount

$424.30

$10,952.29

$6,732.12

$2,720.05

$5,593.98

$3,353.83

$2,496.78

$310.09

$204.56

200102608903 Confidential

Page 2 of3

Deposit and credit products provided by Fifth Third Bank, National Association, Member FDIC. Equal Housing Lender. Fifth Third and Fifth Third Bank are registered service marks of Fifth Third Bancorp.

07023514917 - Checking - Physicians Medical Center - USD Date Description:

Transaction Type Bank Ref. # Customer Ref. # HUMANA GOVT BUSI HCCLAIMPMT 2212375989 PHYSICIANS MEDICAL CEN TRN*1*2212375989*1611241225*WPSEAST 0413

04/13/2021 Description:

ACH Credit 200102590257 HUMANA MATERIAL DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*045460099917642*13912634

$1,320.82

04/13/2021 Description:

ACH Credit 200102588951 HUMANA UAW FORD DISDATA-OPTIONAL HCCLAIMPMT 610208 PHYSICIANS MEDICAL CEN TRN*1*013190099974780*16110131

$3,379.95

04/13/2021 Description:

ACH Credit 200102160808 ANTHEM BCBS HCCLAIMPMT 730500421 22000000591309 TRN*1*730500421*1311440175 041321

04/13/2021 Description:

ACH Credit 200102160804 ANTHEM BCBS HCCLAIMPMT 730497770 22000000591309 TRN*1*730497770*1311440175 041321

04/13/2021 Description:

ACH Credit 200102122043 WISCONSIN PHYSIC 08101 HCCLAIMPMT 150172 PHYSICIANS MEDICAL CEN TRN*1*EFT2346430*1391268299*000008101~ 0

04/13/2021 Description:

ACH Debit 100101871734 OPTUM BANK DIR DEP 720000208 041321

04/13/2021 Check Totals (in USD): No. of Transactions:

Mon May 03 14:56:31 EDT 2021

086343830135

Debit Amount

Credit Amount

$18,931.83

$9,271.36

$24,930.61

$3,124.58

21390

$300.00 $203,424.58 4

Confidential

$213,299.92 31

Page 3 of3

Deposit and credit products provided by Fifth Third Bank, National Association, Member FDIC. Equal Housing Lender. Fifth Third and Fifth Third Bank are registered service marks of Fifth Third Bancorp....