Claim Number	Claim Status	Claim Type	Emp MI	Emp DOB	Emp City	Emp State	Emp Zip	Pat MI	Sex	Rel to Emp	Pat DOB	Student	Disabled	Unit	Location	Group Name	Plan	Option	Adjust Date	Pay to Provider	Diag1	CPT1	Provider Tax ID	Prov Suffix	BCode	Visits
2.0091E+11	DONE	DEN		10/25/1960	CENTERVILLE	UT	84014		F	DAU	7/27/1986	Y	N	SF105	SFGCC	"GREENE, INC."	GCCDN	GCDEX		363.2		D2392	870542081	X0002	82-N	-1111
2.0091E+11	DONE	HCFA	T	8/16/1967	LOGAN	UT	843415644	B	M	SON	9/22/1993	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	873.44	12051	364288180	S0002	33-N	-1111
2.01002E+11	DONE	DEN		9/27/1969	FARMINGTON	UT	84025		F	EMP	9/27/1969	N	N	SF105	SFGCC	"GREENE, INC."	GCCDN	GCDEX		108		D0120	201044157	X0002	81-N	-1111
2.01002E+11	DONE	HCFA	B	10/31/1979	SALT LAKE CITY	UT	84104	B	M	EMP	10/31/1979	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		246.96	591	74150	237268471	X0032	31-N	-1111
2.01002E+11	DONE	HCFA		3/9/1984	WEST VALLEY	UT	84120		M	EMP	3/9/1984	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	7847	99203	870284475	X0058	79-N	-1111
2.01002E+11	DONE	HCFA	K	5/20/1976	SLC	UT	84104		F	SPO	6/13/1975	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	78900	74160	870622942	X0012	79-N	-1111
2.01002E+11	DONE	HCFA	T	8/16/1967	LOGAN	UT	843415644	P	M	SON	11/15/2002	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	309.4	90806	841432018	S0002	54-O	1
2.01002E+11	DONE	OTHER		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		645.18			383693753	X0003	90-Z	-1111
2.01003E+11	DONE	OTHER		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		387.45			383693753	X0003	90-Z	-1111
2.01003E+11	DONE	HCFA		3/12/1965	ROY	UT	84067		F	SPO	5/23/1971	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		72.19	V72.3	99395	870643070	X0007	12AN	-1111
2.01003E+11	DONE	HCFA		12/31/1985	CENTERVILLE	UT	84014	M	M	SON	4/15/2009	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		37.74	382.9	99213	61506129	X0002	10-N	-1111
2.01003E+11	DONE	DEN	T	8/16/1967	LOGAN	UT	843415644	P	M	SON	11/15/2002	N	N	SF105	SFGCC	"GREENE, INC."	GCCDN	GCCDP		133.09		D0120	820470727	S0002	81-EO	1
2.01003E+11	DONE	DEN		9/27/1969	FARMINGTON	UT	84025		F	DAU	8/19/1997	N	N	SF105	SFGCC	"GREENE, INC."	GCCDN	GCDEX		102.5		D8670	870660909	X0002	84-O	-1111
2.01003E+11	DONE	HCFA		11/16/1977	KAYSVILLE	UT	84037		F	SPO	11/3/1979	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	V76.2	88175	870292280	X0002	79-N	-1111
2.01003E+11	DONE	HCFA	T	8/16/1967	LOGAN	UT	843234468	P	M	SON	11/15/2002	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	309.4	90806	841432018	S0002	54-O	1
2.01003E+11	DONE	HCFA		3/12/1965	ROY	UT	84067		M	SON	6/7/2006	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	486	99214	942854057	S0025	10-O	-1111
2.01003E+11	DONE	HCFA		3/12/1965	ROY	UT	84067		M	EMP	3/12/1965	N	N	SF105	SFGCC	"GREENE, INC."	GC90M	GC05C		0	465.9	99214	942854057	X0144	32-O	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		3375.88			760572393	X0002	95-Z	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		536.34			870672300	X0002	91-Z	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		120.06			870637617	X0002	93-Z	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		58			311368946	X0002	96-Z	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		24			870633290	X0002	99HZ	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		765.14			364291971	X0002	99BZ	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ	3/31/2010 12:54	78.3			470322111	X0003	98LZ	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		16			870544289	X0002	99JZ	-1111
2.01003E+11	DONE	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ		78.3			470322111	X0004	98LZ	-1111
A01003170551	ADJ	ADM		12/13/1960	SALT LAKE CITY	UT	84107		M	EMP	12/13/1960	N	N	SFGCX	GRNWC	"GREENE, INC."	GC90M	GCCZZ	3/31/2010 12:54	-78.3			470322111	X0003	98LZ	-1111