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2024-01-03 Final PacketNOTICE OF MEE (ING -- 1/3/2024 January 3, 2024 MEETING MINUTES OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING AT 10:00 A.M. IN THE COMMISSIONERS' COURTROOM IN THE COUNTY COURTHOUSE AT 211 S. ANN STREET SUITE 104 PORT LAVACA, CALHOUN COUNTY, TEXAS. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall County Judge Vern Lyssy Commissioner Pct 1 Joel Behrens Commissioner Pct 2 Gary Reese Commissioner Pct 3 (ABSENT) Anna Goodman Commissioner Pct 4 By: Kaddie Smith County Clerk Deputy Clerk The subject matter of such meeting is as follows: 1. Call meeting to order. Meeting was called to order at loam by Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Vern Lyssy 4. General Discussion of Public Matters and Public Participation. Happy New Year! Pagel of 3 ' NOTICE OF MFETING—1/3/2024 5. Consider and take necessary action to approve a resolution nominating a candidate to fulfill the unexpired term of Mr. W. H. "Bill" Bauer, Jr. (RHM) Commissioners voted to approve Mike Johnson as the new, board member. RESULT: APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner Pct 3 .. SECONDER: Gary Reese, Commissioner Pct 4, AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese ..• v w-w y v�uvi i w aNNi vvc a is au« i ui ivu iy of iu quu M icc a is uaw of which the stipends are to begin for the Sheriff's Department, Jail and District Attorney's office, (RHM) 7. Sheriff, Vickery explained the situation and the court approved and authorized the Treasurer to go ahead and Aisperse funds. RESULT:. APPROVED [UNAN%MOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall,; Commissioner Pct l AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Approve the minutes of the December 20, 2023 regular meeting. Consider and take necessary action on any necessary budget adjustments. (RHM) 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner' Hall, Lyssy, Behrens, Reese 2024 RESULT: APPROVED [UNANIMOUS.] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 2 of 3 NOTICF OF MEETING- 1./3/2024 9. Approval of bills and payroll. (RHM) MMC Bills RESULT: APPROVED, [UNANIMOUS] MOVER: David Hall, Commissioner Pct.l SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills 2023 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commssioner.Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:22am Page 3 of 3 AGENDA ?(. I ]f 1 1. I I ;,, i I I i•.. , II I. i Richard H. Meyer County judge David Hall, Commissioner, Precinct i Vern ]Lyssy, Commissioner, Precinct 2 Joel ]Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 NOTICE OF MEETING The Commissioners' Court of Calhoun County, Texas will meet on Wednesday, January 3, 2024 at 10:00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port Lavaca, Calhoun County, Texas. AGENDA The subject matter of such meeting is as follows: Az QI ElO o V'or l Call meeting to order, DEC 2 8 2.023 Invocation. i;Ot�tyi%c2st^Ci�ir�H�rc '3/. Pledges of Allegiance. eY i '°�l pE I General Discussion of Public Matters and Public Participation. 5. Consider and take necessary action to approve a resolution nominating a candidate to fulfill the unexpired term of Mr. W. H. "Bill" Bauer, Jr. (RHM) 461'�Consider and take necessary action to approve the S622 funding and authorize the date of which the stipends are to begin for the Sheriff's Department, Jail and District Attorney's office. (RHM) `,/Approve the minutes of the December 20, 2023 regular meeting. Consider and take necessary action on any necessary budget adjustments. (RHM) '?r Approval of bills and payroll. (RHM) Ric hard H. Meyer, County 36jk e Calhoun County, Texas Page I of 2 A copy of this Notice has been placed on the outside bulletin board of the Calhoun County Courthouse, 211 South Ann Street, Port Lavaca, Texas, which is readily accessible to the general public at all times. This Notice shall remain posted continuously for at least 72 hours preceding the scheduled meeting time. For your convenience, you may visit the county's website at www.Calh-off under "Commissioners' Court Agenda" for any official court postings. Page 2 of 2 # 04 # 05 NOTICE OF MEETING - 1/3/2024 5. Consider and take necessary action to approve a resolution nominating a candidate to fulfill the unexpired term of Mr. W. H. 'Bill" Bauer, Jr. (RHM) Commissioner's voted to approve Mike Johnson as the new board member. ... RESULT: I APPROVED [UNANIMOUS] MOVER: Joel Behrens, Commissioner,Pct 3 SECONDER:` Gary Reese, Commissioner`Pct 4 AYES:= Judge Meyer, Commissioner Hall, Lvssv, Behrens, Reese Page 2 of 6 A RESOLUTION OF THE COUNTY OF CALHOUN FOR THE NOMINATION OF A CANDIDATE TO FULFILL THE UNEXPIRED TERM OF W.H. "BILL" BAUER, JR. FOR THE BOARD OF DIRECTORS OF THE CALHOUN COUNTY APPRAISAL DISTRICT 2024-2025 REGULAR TERM WHEREAS, for the nomination of a candidate for the Board of Directors to fulfill the unexpired term due to the resignation of W. H."Bill" Bauer, Jr. from the Board of Directors; and WHEREAS, CALHOUN COUNTY is a taxing unit entitled to nominate a candidate for the Board of Directors of the Calhoun County Appraisal District, if so desired. NOW BE IT RESOLVED BY THE GOVERNING BODY OF CALHOUN COUNTY THAT THE FOLLOWING INDIVIDUAL IS NOMINATED AND SUBMITTED FOR ELECTION TO THE CALHOUN COUNTYAPPRAISAL DISTRICT BOARD OF DIRECTORS FOR THE TERMBEGINNING JANUARY 2024 AND ENDING DECEMBER 31, 2025: PASSED AND APPROVED THIS DAY OF 1-3 ,2024. Presiding Officer ATTEST* ignature and Title CALHOUN COUNTY APPRAISAL DISTRICT 426 West Main Street * P.O. Box 49 Port Lavaca, Texas 77979 Appraisal: (361)552.8808 Collections: (361)552-4560 Fax: (361)552-4787 Website: www.calliouncad.org December 27, 2023 Board of Directors mmi Cossioner Vern Lyssy, Chairman Kevin Hill, Vice Chairman Jessie Rodriguez, Secretary Benjamin Boone, Member ChiefAoararser Jesse W. Hubbell TO: THE PRESIDING OFFICERS AND GOVERNING BODIES OF THE COUNTY OF CALHOUN, THE CALHOUN COUNTY INDEPENDENT SCHOOL DISTRICT, THE CITY OF SEADRIFT, THE CITY OF POINT COMFORT AND THE CITY OF PORT LAVACA FROM: Jessie Rodriguez, Board Secretary, Calhoun County Appraisal District Greetings to All: Mr. W.H. " Bill" Bauer, Jr., longtime member of the Calhoun County Appraisal District Board of Directors, submitted his resignation to the board at our last board meeting of the year, held on Tuesday, December 19, 2023. Therefore; in accordance with Sec. 6.03(1) of the Texas Property Tax Code, the voting taxing units named above should nominate by resolution a candidate to fulfill the unexpired term of Mr. Bauer. Your nomination should be sent to the chief appraiser within 45 days of the date of this notification, however; as we are currently in the process ofhiring a new chiefappraiser it would he greatly appreciated ifyou would expedite your• nomination and have it sent to the district no later than Monday, January 15, 2024. The chief appraiser will then prepare a list appraisal of nominees and submit it to the board of directors within the next 5 days. The Calhoun County Appraisal District Board of Directors will then vote on the list of nominees submitted. The nominee receiving a majority of votes from the appraisal district board of directors will then be seated as the new member of the board, You may email your nomination to: jhubbell dcallyouncad on, or tnaria(it�ealhotuictui,ol`r Should you have any tl ucstions, please contact the chief appraiser. Respectfully, to Rodriguez Secretary, Board of Directors, Calhoun County Appraisal District # 06 NOTICE OF MFETING -- 1/3/2024 6. Consider and take necessary action to approve the SB22 funding and authorize the date of which the stipends are to begin for the Sheriff's Department, Jail and District Attorney's office. (RHM) authorized the Treasurer t RESULT: APPROV MOVER: Vern I vcs o ahead and disperse funds. [.UNANIMOUS] :ommissioner Pct 2 ommissioner Pct 1 Commissioner Hall, Lyssy, Behrens, Reese Page 3 of 6 Mae Belle Cassel From: rhonda.kokena@calhouncotx.org (rhonda kokena) <rhonda.kokena@calhouncotx.org> Sent: Thursday, December 28, 2023 9:16 AM To: MaeBelle.Cassel@calhouncotx.org Subject: AGENDA ITEM - 01/03/24 Good Morning - Please add the following to the next agenda: To Accept and Approve the SB22 funding and authorize date of which the stipends are to begin for the Sheriff's Department, Jail and District Attorney's office. Thank you, Rhonda S. Kokena Calhoun Co Treasurer 202 S. Ann Street, Suite A Port Lavaca, Texas 77979 361-553-4619 Calhoun County Texas # 07 NOTICE OF MEFTING — 1/3/2Q24 7. Approve the minutes of the December 20, 2023 regular meeting. RESULT: APPROVED [UNANIMOUS] MOVER: Vern Lyssy, Commissioner Pct 2 SECONDER: David Hall, Commissioner Pct 1 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 4 of 6 NOTICE OF MEETING—1.2/20/2023 December 20, 2023 MEETING MINUTES OF CALHOUN COUNTY COMMISSIONERS' COURT MET IN A REGULAR MEETING AT 10:00 A.M. IN THE COMMISSIONERS, COURTROOM IN THE COUNTY COURTHOUSE AT 211 S. ANN STREET SUITE 104 PORT LAVACA, CALHOUN COUNTY, TEXAS. THE FOLLOWING MEMBERS WERE PRESENT: Richard Meyer David Hall (ABSENT) Vern Lyssy Joel Behrens Gary Reese (ABSENT) Anna Goodman By: Kaddie Smith The subject matter of such meeting is as follows: 1. Call meeting to order County Judge Commissioner Pct 1 Commissioner Pct 2 Commissioner Pct 3 Commissioner Pct 4 County Clerk Deputy Clerk Meeting was called to order at loam by Judge Richard Meyer 2. Invocation. Commissioner David Hall 3. Pledges of Allegiance. US Flag: Commissioner Gary Reese Texas Flag: Commissioner Joel Behrens 4. General Discussion of Public Matters and Public Participation. Judge Meyer wishes everyone a Merry Christmas and happy birthday to Johnny Krause, Chief Deputy Sheriff 5. Hear report from Memorial Medical Center. Roshanda Thomas gave the report. Page 1 of 6 NOTICE OF MEETING — 12/20/2023 6. Public Hearing regarding a request to Vacate and Abandon all that certain tract or parcel containing 0.05 acre situated In the George H. Hall Survey, Abstract No. 235 of Calhoun County, Texas and being a part of the platted alley located within Block 6 of Mallory's First Addition to Alamo Beach recorded in volume Z, Page 351 of the Calhoun County Plat Records as described more fully in the application. Regular meetidg closed at 10:14Arn Anne Marre Odefey-explained the'vacate and abandonment ,gulag meethrS opened at 10.16am Rq 7. Consider and take necessary action to approve a request to Vacate and Abandon all that certain tract or parcel containing 0.05 acre situated in the George H. Hall Survey, Abstract No. 235 of Calhoun County, Texas and being a part of the platted alley located within Block 6 of Mallory's First Addition to Alamo Beach recorded in volume Z, Page 351 of the Calhoun County Plat Records as described more fully in the application. (DEH) RESU.LT., ` APPROVED ItUN 1 , MOVER David :Hall, Commissroner Pet � SECONDER: Joel Behrens, �omrreiss�Oner Pa 4 A1f�S Judge Meyer, Cgrnls�oner I Fell,hren,':fteese 8. Consider and take necessary action to authorize Commissioner Hall to contract with Kathy Smartt to make an emergency application for GLO CEPRA funds and send a letter of Waiver of Match to the GLO Land Commissioner to cover the County's 40% match for the Army Corps of Engineers CAP 206 project. (DEH) IES.ULT• APPROVED [i1Ni9NTM04]S] MOIi. Daviall, Corrimissioxler PGl 1 $EC. TID R. Joel Behrens, CorrrmisSionet?Lt 4 AYL Judge Meyer, CortJtttfBstonehHoll, Behrens, Reese t 9. Consider and take necessary action to approve the Interlocal Agreement for the Assessment and Collection of Property Taxes by the Appraisal District between Calhoun County and the Calhoun County Appraisal District. (RHM) RESULT APPROVED [UNANIMOU ] FAOVIEIRS Gary Freese, Commissioner 15Ct 4 CONDEa: Joel Behrens, Comm his' ioFieePct 3 AYES• . Judge Meyer, Commissiorier`Hall,' BehrenssReese .: Page 2 of 6 NOTICE OF MEETING--12/20/2023 10. Consider and take necessary action to approve a credit card with a limit of $5,000 for each precinct office manager: Angela Torres, Lesa Jurek, Lynette Adame and April Townsend. (VLL) 11 Consider and take necessary action on Amendment No. 1 to Matagorda Bay Mitigation Trust Contract 031 to fund the additional engineering services for the Green Lake Park Development Phase I. project, increase budget amount by $23,250 for a revised contract amount of $283,250 and authorize the County Judoe to sian tha rnntr=rf tr^_noA 12. Consider and take necessary action to install a stop sign on 47th Street at the intersection of 4th and Main Streets in Port O'Connor, Texas. (GDR) APPROVED [UNANIMOUs] 1 _ GaryReese, Comr>,�ssioner pct4 Joel BelSrens, Cprnnfssioner Rct3 Judge Meyer, CofYll liSSioner Halt_ Rahrmnd 13'n , 13. Consider and take necessary action to approve an increase of $2,000 for the Treasurer's Jury Cash. The Jury Cash Is currently held at $5,000, The increase is due to the Increase of individual jury pay starting at $20 for call out and $60 for each day served. This will bring the Treasurer's Jury Cash to $7,000. (RHM) Page 3 of 6 I NOTICE OF MEETING—12/20/2023 14. Consider and take necessary action to approve a lease agreement with Great American Financial Services for a Toshiba e-STUDI07518A copier and authorize the District Clerk to sign the agreement. (RHM) 15. Consider and take necessary action to accept Insurance proceeds received from State Farm for an accident involving Memorial Medical Center property in the amount of $1,600 and Issue a check to MMC. (RHM) 16. Consider and take necessary action to approve Addendum No. 1 to the Specifications and Invitation to Bid Packet, Bid Number 2023.09 for Inmate Telephone Services and Inmate Banking Software, Commissary Service and Fiduciary Management Services for the Calhoun County Adult Detention Center. (RHM) RESULT: APPROVED [UNANIMO.US] MQVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel�Behrens, Commisslorter Pct 3 _ AY0. ]ud�e Meyer, Commissioner; HaII,:Bet yens, Reese 17. Consider and take necessary action to approve the extension to the contract between Calhoun County and Janik Alligators LLC for the Green Lake Project Alligator Management and Nuisance Control for the contract year beginning January 1, 2024 and ending December 31, 2024 and authorize the County Judge to sign all necessary documents. (RHM) Page 4 of 6 NOTICE OF MEETING — 1.2/20/2023 18. Consider and take necessary action to award the Proposed Bid for Road Materials, Bid Number 2024,02, for the period January 1, 2024 through December 31, 2024. (RHM) RESULT. APPROVED CUNANIMOUS] MOVER: G-'ry Reese, Commissioner Pct 4' SEcd--- E[€ Joel Behrens, nmissi neriPct3 A1fES� Judge Meyer, Coinmiss[onel,'Mall, 8ehren8, Reese 19. Consider and take necessary action to approve the renewal to the Health Services Agreement between Calhoun County and Southern Health Partners, Inc., dba SHP Vista Health Management, Inc. for medical care of inmates in the Calhoun County Adult Detention Center and authorize the County Judge to sign all necessary documents. The renewal begins January 1, 2024 and ends December 31, 2024. (RHM) pass 20. Accept Monthly Reports from the following County Offices: i. Justice of the Peace, Precinct 3 — November 2023 ii. Justice of the Peace, Precinct 4 — July 2023, corrected Ill. Justice of the Peace, Precinct 4 — September 2023, corrected iv. Texas Agrilife Extension Service — November 2023 1. 4-H and Youth Development 2. Agriculture and Natural Resources 3. Family and Community Health 4. Coastal and Marine 21. Consider and take necessary action on any necessary budget adjustments. (RHM) RESULT ,.. APPROVED [UNANIMOUS] M01/ER. . Gary. Reese, Cornnlssioner Rct 4 SECONDER:' %Joel Behhfoirens, Cosinner Pct 3 '- AYES: Judge Meyer, Commisslonef 6' alij Behrens, Reese Page 5 of 6 NOTICE OF MFFTING — 1.2/2.0/2023 22. Approval of bills and Davroll. (RHM) Page 6 of 6 Richard H. Meyer County judge David Hall, Commissioner, Precinct 1 Vern ]Lyssy, Commissioner, Precinct 2 Joel Behrens, Commissioner, Precinct 3 Gary Reese, Commissioner, Precinct 4 The Commissioners' Court of Calhoun County, Texas met on Wednesday, December 20, 2023, at 10.00 a.m. in the Commissioners' Courtroom in the County Courthouse at 211 S. Ann Street, Suite 104, Port ]Lavaca, Calhoun County, Texas. Attached are the true and correct minutes of the above referenced meeting. t ichard H. Meyer, C ty Judge Calhoun County, Texas Anna Goodman, County Clerk r � :)eputy Clerk Date Date Page 1 of 1 rm 1: NO] ICE OF MEETING -- 1/3%2024 8. Consider and take necessary action on anv necessary budaet adiustments. (RHM) 2023 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4 SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall,,Lyssy, Behrens, Reese 2024 RESULT: APPROVED [UNANIMOUS] MOVER: Gary Reese, Commissioner Pct 4, SECONDER: Joel Behrens, Commissioner Pct 3 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Page 5 of 6 0: m: D � con=m O Or z m O Cani m N ti a a e rzz O O 2 z z m r a x= .i F9 H FA a 7�. T 0 fA o fA 49 T O o T T T 0 coo T T Of W W T O O O O V V m f9 T O O O O FFnn Bs � ill a a w 0-0 O O O O Z1141 2 W c 0 z D 1 m zz m m O D r m 0 r N m i a D 0 c O m z m Cl) m R < 0 N 3 m 9 (OD O �O z z a v: m: z z 9 N O m m z .0? a m m -Zi A m: m zS N �i z a 3€ <° m: m c)? p OE Ci Z. Z 1� < n A nE n C r? 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(RHM) MMC Bi11S RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES:.:, Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County Bills 2023 RESULT: APPROVED [UNANIMOUS]." MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese County" Bills 2024 RESULT: APPROVED [UNANIMOUS] MOVER: David Hall, Commissioner Pct 1 SECONDER: Vern Lyssy, Commissioner Pct 2 AYES: Judge Meyer, Commissioner Hall, Lyssy, Behrens, Reese Adjourned 10:22am Page 6 of 6 ) / 9 \ci \ j\ ( p � � \ ] } §§ J ) . « A { ; \\ HOmn�ba%H n ggHb"yl�JaKK Y7y0$ W h UO 'v H j W 61 (tqw c, H zzy c H nm c o c 00 n N 7 ? 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O O ° N N U ^ r) R o A O A` p S n O 0 c 9 e F m r= m e z n n 0 0 A J N P P O O u J N A O M c A n N O P P O 4 O J IJ F MEMORIAL MEDICAL CENTER COMMISSIONERS COURT APPROVAL LIST FOR ---January 03, 2024 PAYABLES AND PAYROLL 12/28/2023 Weekly Payables 146,690.96 12/28/2023 Patient Refunds 4,039.83 1/2/2024 Capital One -supplies 1,229.12 1/2/2024 McKesson-34011 Prescription Expense 1,032.72 1/2/2024 Amerisource Bergen-340B Prescription Expense 1,220.00 1/2/2024 Payroll Liabilities -Payroll Taxes 117,983,36 1/2/2024 Payroll 377,512.39 Prosperity Electronic Bank Payments 12/22-12/28123 Pay Plus -Patient Claims Processing Pee 139.72 12/22/2023 ExpertPay- child support 570.69 TOTAL PAYABLES, PAYROLL AND ELECTRONIC BANK PAYMENTS $ 650,468.79 TRANSFERS BETWEEN FUNDS-MMC 1/2/2024 Transfer from Money Market Account to MMC Operating -to cover parables and 500,000.00 payroll expenses TRANSFER BETWEEN FUNDS FROM MMCTO NURSING HOMES 22/2812023 MMC Operating to Ashford -NH portion of QIPP payment deposited into MMC 7,752.15 Operating 22/28/2023 MMCOperatingto Solera-NH portion of COPP paymentdeposited into MMC 2,318.40 Operating 12/28/2023 MMCOperatingto Fort bend -correction of NH insurance and QIPP payment 6,015.00 deposited into MMC Operating 12/28/2023 MMC Operating to Broadmoor-correction of NH QIPP payment deposited Into MMC 2,873.85 Operating 12/28/2023 MMC Operating to Crescent -correction of NH Insurance and QIPP payment deposited 12,789.35 into MMC Operating in error 12/2812025 MMC Operating to Golden Creek -correction of NH insurance and QIPP payment 50,091.07 deposited into MMC Operating in error 12/28/2023 MMC Operating to Tuscany Village -correction of NH insurance and QIPP payment 23,651AS deposited into MMC Operating in error 12/28/2023 MMC Operating to Bethany -correction of NH insurance and QIPP payment deposited 34,307.27 into MMC Operating In error TOTAL TRANSFERS. BETWEEN FUNDS $ . 639,798.57 NURSING HOME UPL EXPENSES 1/2/2024 Nursing Home UPL-Cantex Transfer 733,186.96 1/2/2024 Nursing Home UPL-Nexion Transfer 15,675.33 1/2/2024 Nursing Home UPL-Tuscany Transfer 60,774.89 1/2/2024 Nursing Home UPL-1,151-Transfer 144,578,61 TRANSFER BETWEEN FUNDS FROM NURSING HOMES TO MMC 1/2/2024 Broadmaor to MMC- MMC Insurance payment deposited Into Rroadmoor in error 105.71 TRANSFER OF FUNDS BETWEEN NURSING HOMES 1/2/2024 Crescent to Tuscany -Tuscany Insurance payment deposited into Crescent in error 35,100.00 TOTAL NURSING HOME UPI. EXPENSES $ 989,42150 TOTAL INTER -GOVERNMENT TRANSFERS GRAND TOTAL DISBURSEMENTS APPROVED January 03,2024 $ 21279,686.86 12/28123, 11:10AM imp_cw5report2818493882571029204.html EIVED BY THE MEMORIAL MEDICAL CENTER 1212W-f TYAUDITORQN 11:09 AP Open Invoice List ap_open_invoice.template 0 DEC 2 91&023 Due Dates Through: 01/1912024 Vendor# Vendor ame Class Pay Code / RI?ViouffbFiglffil§S , ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net / 163072912 ✓ 12127120212105120212130/202 63.61 0.00 0.00 53.61 ,yi FIRE MONITORING Vendor Totals: Number Name Gross Discount No -Pay .Net R1200 ADT COMMERCIAL (111 c;4I 2-3'1'y1511 23) 53.61 0.00 0.00 53.61 Vendor# Vendor Name Class Pay Code l A1680 AIRGAS USA, LLC -CENTRAL DIV✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Or Pay Gross Discount No -Pay Net 91451896130/ 12/271202 12/19/202 01/13/202 317.65 0.00 0.00 31T6.9 ✓� OXYGEN Vendor Totals: Number Name Gross Discount No -Pay Net A1680 AIRGAS USA, LLC - CENTRAL DIV 31T65 0.00 0.00 317.65 Ventlor# Vendor Name Class Pay Code / A2218 AQUA BEVERAGE COMPANY ✓ M Invoice# Comment Tran Dt Inv Ot Due Dt Check Dt Pay Grass Discount No -Pay Net YPW028• 12/27120211/30/20212/25/202 71.00 0.00 0.00 71.00 +� I Z9�kT WATER y( 36t<4�4294iL / ti3029A 12/27/20211/30/20212/25/202 41.00 0.00 0.00 41.006✓' WATER Vendor Totals: Number Name Gross Discount No -Pay Net A2218 AQUA BEVERAGE COMPANY 112.00 0.00 0.00 112.00 Vendor# Vendor Name Class Pay Code / 11766 AYA HEALTHCARE INC �` Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 3804024 / 12/27l20212/21/20201l101202 1,964,25 0.00 0.00 1,964.25 ✓ KARIANN DUNN 12/8.1219123 LAN Vendor Totals: Number .Name Gross Discount No -Pay Net 11756 AYA HEALTHCARE INC 1,964.25 0.00 0.00 1,964,25 Vendor# Vendor Name Class Pay Code 15176 .._ 1/ Invoice# Comment Tran Dt Inv Ol Due Dt Check Dt Pay Gross Discount No -Pay Net 203946 12/27/202 12/27/202 011011202 54.88 0.00 0.00 54.881- PT REFUND Vendor Totals: Number Name Gross Discount No -Pay Net 15176 54.80 0.00 0.00 54,88 Vendor# Vendor Name Class Pay Code B1150 BAXTER HEALTHCARE ✓ W Invoice# Comment Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 81103971/ 12/20/20211/20120212/15/202 50.00 0.00 0.00 50.00",l HP MANUAL 81213621✓ 12/26120212101120212/261202 3,071.40 0.00 0.00 3,071 AO ✓` / LEASE ✓ 81217364 12/26/20212/01/20212126/202 631.20 0.00 0.00 631.20 ✓"f SPECTRUM 81304496✓ 12126/202 12/061202 12131/202 669.68 0.00 0.00 669.66 ✓' �/ SUPPLIES 81314594✓ 12/26/20212/07/20201/01/202 113.96 0.00 0.00 113.96,i"� / SUPPLIES 81467508 ✓ 12/26/202 12/21120201/15/202 835.39 0.00 0.00 635.39 ✓ SUPPLIES file:/IIC:/Userslltrovino/opsi/memmed.cpsinet.com/u88l25/data 5/lmp_cw5report2818493862571029204.html 1/11 12128123. 11:10 AM tmp_cw5repert2818493882571029204.html Vendor Totals: Number Name Gross Discount No -Pay Net B11.50 BAXTER HEALTHCARE 5,171.63 0.00 0.00 5,171,63 Vendor# Vendor Name Class Pay Code M2485 BAYER HEALTHCARE ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay .Net 6010952343✓ 12/27/20212/12/202121271202 1,104.08 0.00 0.00 1,104.08 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net M2485 BAYER HEALTHCARE 1,104.08 0.00 0.00 1,104.08 Vendor# Vendor Name Class Pay Code B1220 BECKMAN COULTER INC ✓ M Invoice# Comment Tran Dt Inv D1 Due Dt Check Dt Pay Gross Discount No -Pay Net 111048691 r/ 12/261202 12/19/202 01/13/202 1,138.56 0.00 0.00 1,138.56 CONTRACT 5482549 ✓ 12/26/20212/21120201/151202 1,936.15 0.00 0.00 1,935.15 LEASE 4516380 12/26/202 12121/202 01/15/202 1,484.00 0.00 0.00 1,484.00 CONTRACT Vendor Totals: Number Name Gross Discount No -Pay Net 81220 BECKMAN COULTER INC 4,567.71 0.00 0.00 4.567.71 Vendor# Vendor Name ` Class Pay Code 14753 BIOMERIEUX, INC ✓ Invoice# 9mment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1213161320 12/26/20212/13/20201/13/202 20,726.75 0.00 0.00 / 20,726.75 e/ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net 14753 810MERIEUX, INC 20,726.75 0.00 0.00 20,726.75 Vendor# Vendor Name Class Pay Code 13892 BLUE CROSS BLUE SHIELD REFUND ✓ Invoice# Comment Tran Dt Inv Dt Due.Ot Check Dt Pay Gross Discount No,Pay Net 24,5507 12/27/20212/20/20201101/202 16.00 0.00 0.00 16,00 PT REFUND Vendor Totals: Number Name Grass Discount No -Pay Net 13892 BLUE CROSS BLUE SHIELD REFUND 16.00 0100 0.00 16,00 Vendor# Vendor Name Class Pay Code / 14120 CALHOUN COUNTY EMS r,/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2023-11 12/27/20212/05/20201/10/202 5,280.00 0.00 0.00 51280,(10.1� NOVTRANSFERS LIIj2.-1tjZSj Z3) Vendor Totals: Number Name Gross Discount No -Pay Net 14120 CALHOUN. COUNTY EMS 5,280.00 0.00 0.00 5,280.00 Vendor# Vendor Name class Pay Cade 01325 / CARDINAL HEALTH 414, INC. ✓ w Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 8002891246 ✓ 12/26/20206/30/20207/251202 319.24 0.00 0.00 319.24.-' SUPPLIES 8002938728 1 PJ26/202 08/201202 09/14/202 947.15 0.00 0.00. 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M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross NQ07472 f 12127/202 12/15/202 01114/202 1,501.54 SUPPLIES Vendor Totals: Number Name Gross C1992 CDW GOVERNMENT, INC. 1.501.64 Vendor# Vendor Name Class Pay Code 01730 CITY OF PORT LAVACA W Invoice# Comment Tran Dt Inv Dt Due Dt Check DI Pay Gross 121423 12/271202 12114/202 01/05/202 65.66 WATER 101 N.Vilit,16,111110-11-ItuJIS-) 121423A 121271202 12114/202 01/05/202 38.64 WATER rb 15 (J. ViPlylnaL t1110- I-L1161.01 121423B 12/27/20212/14120201/05``202 1,680." WATER $'IS N- VIniA4,ItiI1101^11-1to1�.3� 121424C 12127/20212/14/202011051202 135.53 WATER 14iG IV. t7i1' iltct_ I, 111fill- IZ11�lzs) Vendor Totals: Number Name Gross C1730 CITY OF PORT LAVACA 1,920.27 Vendor# Vendor Name Class Pay Code 11030 COMBINED INSURANCE ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 120123 1 PJ27/20212101/2021MI/202 643.66 PAYROLL DEDCUT Vendor Totals: Number Name Gross 11030 COMBINED INSURANCE 543.66 Vendor# Vendor Name Class Pay Code C1970 CONMED CORPORATION ✓/ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross ` 10421090r' 1 W2712021 PJ06/202 I PJ27/202 700,00 SUPPLIES Vendor Totals: Number Name Gross C1970 CONMED CORPORATION 700.00 Vendor# Vendor Name Class Pay Code 14608 COTIVITI Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 246138 12/28/20212/20/2D2 01/01/202 132.01 PTREFUND E Vendor Totals: Number Name Gross 14608 COTIVITI 132.01 Vendor# Vendor Name Class Pay Code 1036E DEWITT POTH & SON ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross file:///C:tUsers/ltrevinoicpst/memmed.cpsinst.com/U88125/data_5/(mp_cw5report28 i 8493882571029204.html Discount 0.00 Discount 0.00 Discount 0.00 Discount 0.00 0.00 0.00 0,00 Discount 0,00 Discount 0.00 Discount 0.00 Discount 0.00 Discount 0.00 0.00 0.00 0.00 0.00 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 0.00 0.00 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 291.00 270.61 739.70,-i 165.47 425.5df Net 5,424.47 Net 1,501.54 Net 1,501.54 Net 65.66 W/ 38.64 '✓ 1,680,44 1' 135.53 ✓� Net 1,920.27 Net 543,66 Net 543.66 Net 700.00 Net 700.00 Discount No -Pay Net 0.00 0.00 ,/ 132.01rr Discount No -Pay Net 0.00 0.00 132.01 Discount No -Pay Net 3111 12/28/23, 11:10AM tmp_cw$report2818493882571029204.htm1 739553.0 12/271202 12/121202 01/06/202 136.07 0.00 SUPPLIES f 739528-0✓ 12/27/202 12/13/202 01/07/202 640.72 0.00 SUPPLIES 739689-0 12/271202 12/141202 01/08/202 68,78 0.00 SUPPLIES 739689.1 12/27/202 12/191202 01/13/202 25.63 0.00 SUPPLIES 740368-0 ✓/ 12/271202 12/20/202 01/14/202 515.80 O.OD SUPPLIES 740308-1 ✓ 12/27/20212/20/20201/14/202 7.74 10D 740397.0� SUPPLIES 121271202 12120/202 01/14/202 69.12 0.OD SUPPLIES f 740368-2 ✓ 121271202 12/21/202 01/15/202 59.99 0.00 740397-1 SUPPLIES 12/271202 12/211202 01/151202 87,29 0.00 SUPPLIES Vendor Totals: Number Name Gross 10368 DEWITT POTH & SON 1.611,14 Vendor# Vendor Name Class Pay Code 11291 DOWELL PEST CONTROL v,, J Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay / Gross 24013 ✓ 12127/20212/26/20212/27/202 505.00 PEST CONTROL Vendor Totals: Number Name Gross 11291 DOWELL PEST CONTROL 505.00 Vendor# Vendor Name Class Pay Code C2510 EVIDENT / M Invoice# Co ment Tran Dt Inv Ot Due Dt Check Dt Pay Gross T2312111378 12/27/202 12/11/202 01 /05/202 10, 469.51 CODING T2312181378✓ 12/27/202 10181202 12/19/202 7,969.22 BUSINESS SERV Vendor Totals: Number Name Gross C2510 EVIDENT 18,438.73 Vendor# Vendor Name Class Pay Code 10003 / FILTER TECHNOLOGY CO, INC ✓ Invoice# / Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 118710 ✓ 12/27/20207/19/20208/19/202 2,507.25 SUPPLIES 118887✓ 12/27/20208117/20209117/202 2,681.34 SUPPLIES Vendor Totals: Number Name Gross 10003 FILTER TECHNOLOGY CO, INC 6,188.59 Vendor# Vendor Name Class Pay Code F1400 FISHER HEALTHCARE M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross 8171022 12/26/20212/O1 /2021 PJ26/202 110.12 / SUPPLIES 6203133 ✓ 1PJ26/20212/04/202 12/29/202 314.80 SUPPLIES 8203132e/ 1 PJ26/20212104/2021229/202 1,096.30 SUPPLIES / 8351798✓ 12/26/20212/08/20201/02/202 695.60 SUPPLIES tile:l//C:/Users/Itrevino/cpsilmemmed.cpsinet.eom/u88125/data 5/tmp_ew5report2818493882571029204.btml Discount 0.00 Discount 0.90 Discount 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 No -Pay 0.00 No -Pay 0.00 No -Pay 0.00 1,96.07 y 640.72 v� 68.78 e/ 25.83 ✓ 515.80 ✓A 7.74 ✓/ 69.12 ✓O 59.99 ",,,/ 87.29 Net 1,611 A41 Net 505.00 Net 505.00 Discount No -Pay Net 0.00 0.00 / 10,469.51 y 0.00 0.00 7,969.22 Discount No -Pay Net 0.00 0.00 18,438.73 Discount No -Pay Net 0.00 0.00 2,507.25 0:00 0.00 2.661.34 Discount No -Pay Not 0.00 0.00 5,188,59 Discount No -Pay Not 0.00 0.00 110,12./ 0.00 0.00 314.80 0:00 0.00 1,096.30 ✓ 0.00 0.00 695,60 4111 12128/23, 11:10 AM Imp_cw5report2818493882571029204,html 835179712/26/202 12/08/202 01/02/202 178.20 0.00 0.00 178.20 SUPPLIES 8351799 12126/20212/08/20201/02/202 534.60 0.00 0.00 534.60 ✓� / SUPPLIES f 8351800 12/26/20212/08/20201/02/202 36.02 0.00 0.00 36.02 SUPPLIES / 8391417 ✓ 12/26/20212/11/20201/05/202 1,248.36 0.00 0.00 1,248.36VI SUPPLIES 8391418 12/26/202 121111202 01/05/202 546.03 0.00 0.00 546.03 SUPPLIES 8431965 12/26/20212/12/20201/06/202 82.99 0.00 0.00 82.99 y� / SUPPLIES 8431965 y/ 12/261202 12/121202 01/061202 326.02 0.00 0100 326.02 SUPPLIES 8275352 ✓ 12/27120212106/20212/311202 170,70 0.00 0.00 170.70 .P SUPPLIES 8314300 J 12/27/202 12/07/202 01101/202 66.86 0.00 0.00 / 66.86✓ / SUPPLIES 8469076 ✓ 12127/20212/13120201107/202 1,194.90 0100 0.00 1,194.90 v� SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net F1400 FISHER HEALTHCARE 6.601.50 0.00 0.00 6,601.50 Vendor# Vendor Name - Class Pay Code / 11183 FRONTIER ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount ND -Pay Net 121923 12/27120212/19/20201/12/202 56.40 0.00 0.00 56.40 TELEPHONE Vendor Totals: Number Name Gross Discount No -Pay Net 11183 FRONTIER 56.40 0,00 0.00 56A0 Vendor# Vendor Name / Class Pay Code 12636 FUSION CLOUD SERVICES, LLC ✓ Invoice# C mmenI Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1029057096 I Pt27/20212/16/20201/15/202 857.11 0.00 0.00 857.11 TELEPHONE ( LA}6; PUvjVwwj `(.knIF0.64) Vendor Totals: Number Name Gross Discount No -Pay Net 12636 FUSION CLOUD SERVICES, LLC $57.11 0.00 0.00 857.11 Vendor# Vendor Name / Class Pay Code W1300 GRAINGER ✓ M Invoice# CCpmment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No•Pay Net 9937394089 ✓ 12/27120212/16120201/09/202 203.85 0.00 0.00 203.85� §UPPLIES 9937660695 ✓ 12127120212115/202011091202 282.34 0.00 0100 282.34 ✓ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net W1300 GRAINGER 486.19 0.00 0.00 486.19 Vendor# Vendor Name Class Pay Code G1210 GULF COAST PAPER COMPANY M Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2480109 12/27/2021211PJ20201/111202 932.48 0.00 0.00 932.48 / SUPPLIES 2482697 ✓ 12127/20212/19120201/181202 606.33 0.00 0.00 606,33 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net G1210 GULF COAST PAPER COMPANY 1,538.81 0.00 0.00 1.538.81 Vendor# Vendor Name Class Pay Code H0032 H + H SYSTEM, INC, ,/ 01e:11/C:/Users/Itrevinolcpsilmemmed.opsinet,cam/u88125/data_51tmp_cw$report2818493882571029204.html 5111 12/28123, 11 A0 AM tmp_cw5report2818493882571029204.html Invoice# Comment Tian Dt Inv Ot Due Dt Check Dt Pay Gross Discount No -Pay Net 042308 12114/20211/30120212/14/202 71.00 0.00 0.00 71.00 SUPPLIES Vendor Totals: Number Name Grass Discount No -Pay Net H0032 H + H SYSTEM, INC. 71,00 0.00 0.00 71.00 Vendor# Vendor Name Class Pay Code 13876 INQUISEEK, LLC Invoice# / Comment Tran Ot Inv Dt Due Dt Check Ot Pay Gross Discount No -Pay Net INV-0064✓ 1PJ27/202 12/20/202 12/21/202 1,800.00 0.00 0.00 1,800.00 G/ ANNUAL. SUBSCRIPTION Vendor Totals: Number Name Gross Discount No -Pay Net 13876 INQUISEEK, LLC 1,800.00 0.00 0.00 1,800.00 Vendor# Vendor Name Class Pay Code 15180 Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 250582 1 PJ27/202 12/27/202 01101/202 35.00 0.00 0.00 35.00 PT REFUND Vendor Totals: Number Name Gross Discount No -Pay Net 15180 35,00 0.00 0.00 35.00 Vendor# Vendor Name Class Pay Code J1350 / M.C. JOHNSON COMPANY INC ✓ M Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay .Gross Discount No -Pay Net / 00395046✓ I PJ26/2021PJ13/202 IPJ26/202 190.66 0.00 0.00 190.66✓ SUPPLIES Vendor Totals: Number Name - Gross Discount No -Pay Net J1350 M.C. JOHNSON COMPANY INC 190.66 0.00 0.00 190.66 Vendor# Vendor Name Class Pay Code 11141 / MEDICAL DATA SYSTEMS, INC.ir Invoice# / Comment Tran Ot Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 185386W 12J27120208/31/20209/25/202 39.08 0.00 0.00 / 39.08 ✓" COLLECTION FEES 186477✓ 12/27/20210/31/20211/25/202 1,080.29 0.00 0.00 ` 1,080.29 p✓ COLLECTION FEES 186478✓ 1 PJ27/20210/31/20211/25/202 3,651,24 0.00 0.00 3,651,24 COLLECTION FEES 187107/ 1 PJ27120210/31/20211/251202 198.94 0.00 0.00 190.94 COLLECTION FEES Vendor Totals: Number Name Gross Discount No -Pay Net 11141 MEDICAL DATA SYSTEMS, INC, 4,969.55 0.00 0.00 4,969.55 Vendor# Vendor Name Class Pay Code. M2470 MEDLINE INDUSTRIES INC/ M Invoice# CJgmmenI Tran Dt Inv Dt Due Ot Check Dt Pay Gross Discount No -Pay Net 2299172959J 12/26/20212119/20201/13/202 51,01 0.00 0100 51.01 S PPLIES 2299172954 y� 12/26/20212119120201/13/202 78.22 0.00 0.00 78.22 SUPPLIES 2299172951 12126/202 12/191202 01/131202 56.72 0.00 0.00 56.72� /SUPPLIES 22991729551/ 12/26/20212/19/20201/13/202 77.22 0.00 0.00 77.22� UPPLIES 2299172958 12/26/20212/19/20201113/202 51.01 0.00 0.00 61.01 ✓ yUPPLIES . 2299172953,/ 12/26/20212119120201/13/202 115.30 0100 0.00 115.30"- �UPPLIES 2299172957 12126120212/19/20201113/202 62.52 0.00 0.00 62,52 w-"' SUPPLIES file:///C:/Users/Itrevino/cpsi/memmed,cpsinat.coWu88l25/data_5/tmp_cw5report2818493882571029204.html 6/11 12128/23, 11:10 AM l imp_cw5report2818493882571029204.html 2299172952./ 12126/20212/19/20201/13/20Z y�UPPLIES 44.54 0.00 0100 44;54 2299172950✓ 12/26/20212/19/20201/13/202 SUPPLIES 209.17 0.00 0.00 2pg,17✓ 2299172956 �•/ I PJ26/202 IPJ19/20201/13/202 SUPPLIES 100.10 0.00 0.00 100.10✓ 229939934P / 12/26/20212/20/20201/14/202 SUPPLIES 57,00 0;00 0100 57.00v 22993993,99V I PJ261202 12/20/202 01/14/202 /SUPPLIES 332.22 0.00 0.00 332,22 ✓ 2299399350 ✓ 12/26/202 12/20/202 01/14/202 JgUPPLIES 750.81 0.00 0.00 750.61 "+ 2299399346 112/26/202 12/201202 01/14/202 1.413.,4Y3.60 0.00 0.00 1,413,60✓ 2299399340./ 12/26/202 12/20/20201/14/202 SUPPLIES 81.52 0.00 0.00 81.52 ✓ 2299399343 12/26/20212/20/20201/14/202 SUPPLIES 31,56 0.00 0:00 31.56 ✓ 2299399349✓ 12126/202 12/20/202 01/14/202 5,882,00 0.00 0.00 5;862.00 ri 2299344716�UPPLIES 12/26/20212/20/20201/14)20<. S PPLIES 422.76 0.00 0.00 / 422.76 ✓" 2299344715 I PJ26/202 12/20/202 01/14/202 ?SUPPLIES 7,421.08 0.00 0.00 7,421.08 ✓ 2299399344✓ I PJ26/202 I PJ20120201/141202 !SUPPLIES 101..1.E 0.00 0.00 101,18 ✓` 2299399338 12/26/20212/201202 01/14/202 142.7E 0.00 0.00 142.76✓ 2299399341�UPPLIES 12/26/202121201202 01/14/202 �yUPPLIES 30.20 0.00 0.00 30:20✓ 2299869984 V 12I26/20212/22/20201/16/202 SUPPLIES 3.63 0,00 0.00 3.63 y� Vendor Totals: Number Name M2470 MEDLINEINDUSTRIES INC Gross Discount No -Pay Net. Vendor# Vendor Name / class Pay Code M2621 MMC AUXILIARY GIFT 17,496.11 0.00 0.00 17,490.17 SHOP ✓ W Invoice# Comment Tran Dt Inv DI Due Dt Check Dt Pay Gross 122123 12/27/20212/211202 I PJ30IP02 Discount No• Pay Net PAYROLL DEDUCT 714.72 0.00 0,00 714.72 ,f Vendor Totals: Number Name M2621 MMC AUXILIARY GIFT SHOP Gross Discount No -Pay Net Vendor# Vendor Name Class Pay Code 714.72 0.00 0,00 714,72 10536 MORRIS.B DICKSON CO, LLD Invoice# / Comment Tran Dt Inv Dt Due Dt Check Dt Pay 1421104 ✓ Gross Discount 12126120212119/20212/29/202 No-PayNet / INVENTORY 1424205✓ 910.29 O.DO 0.0000 910,29s- 12/26/20212/19/202 I PJ291202 INVENTORY 1421103 882,53 0.00 0.00 882:53 ✓ 1 PJ26120212/19/20212129/202 INVENTORY 1424204 ✓ 1,043.11 0.00 0.00 1,043.11 12/26/20212119120212/29/202 INVENTORY 1421107 284.67 0.00 0.00 284.67 ✓'� 12/26/20212/19/20212/29/202 INVENTORY 96,11 0.00 0.00 96.17 1421105,/ 12/26120212/19/20212/29/202 INVENTORY 43,82 0:00 0.00 43.82 f file:!//C?Users/Itravinolcpsl/memmad.cpsineLcomN88125/date_51tmp_cw5report2818493882571029204.html 7/11 12/28123. 11:10 AM tmp_cw5repor12818493882571029204,html 1421108 12/26/20212/19/20212/29/202 27.08 0100 0,00 27.08 ✓ / INVENTORY 1430596 ✓ 12/27/202 12/201202 12/30/202 111.32 0.00 0.00 111.32 ✓ INVENTORY 1430595 12/27/20212/20/20212/30/202 180.38 0.00 0.00 180.38 rr INVENTORY 1432557✓ 12127/20212721/20212/31/202 126.45 0.00 0100 126.45 rig INVENTORY � 1432556 12127120212/21/202 12/31/202 304.07 0.00 0.00 304,07 a✓ INVENTORY / CM80789✓ 12/27/20212/21120212131/202 -160.93 0.00 0.00 -160,93 ✓ CREDIT V1 ✓ 1434797 12/27/20212/21/20212/31/202 499,58 0.00 0.00 499.58 / INVENTORY 143479OV 12127/20212/21120212/31/202 514.89 0100. 0.00 514.89✓ INVENTORY 1441792/ 12/27120212125/20201/041202 378.38 0,00 0.00 378.38 ✓ / INVENTORY 1441793 ✓ I PJ27/202 I PJ25/20201/04/202 492.39 0.00 0.00 492.39 1-' INVENTORY 1440358✓ 12/27/20212125/20201104/202 435.53 0.00 0.00 435.53 ✓ INVENTORY 1446937V/ 1 PJ271202 12/26/202 01/05/202 240.17 0.00 0.00 240.17 ✓ / INVENTORY 1446939✓ i 2/27120212/26120201105/202 820.51 0.00 0.00 820.51r / INVENTORY 1446938✓ 12/27/20212/26/20201/05/202 3.95 0.00 0.00 3.95�/ / INVENTORY ` 1446940✓ 12/27/20212/26120201/05/202 8.69 0.00 0.00 8,69 Ul INVENTORY Vendor Totals: Number Name Gross Discount No -Pay Net 10536 MORRIS & DICKSON CO, LLC 7,242.99 0.00 0.00 7,242.99 Vendor# Vendor Name Class Pay Code 10188 NATUS MEDICAL INC v//' Invoice# Cyomment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 1041529--- 12112120211/14/20212/091202 497,97 0.00 0.00 497,97 pr SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Not 10188 NATUS MEDICAL INC 497.97 0.00 0.00 497.97 Vendor# Vendor Name / Class Pay Code 01416 ORTHO CLINICAL DIAGNOSTICS ✓ Invoice# alnment Tran Dt Inv Ot Due Dt Check Dt Pay Gross Discount No+Pay Net 1853294347 12/26120212/11/20201/10/202 752.16 0.00 0.00 / 752.1661 SUPPLIES Vendor Totals: Number Name Grass Discount No -Pay Net 01416. ORTHO CLINICAL DIAGNOSTICS 752.16 0.00 0.00 752,16 Vendor# Vendor Name Class Pay Code / 10152. PARTSSOURCE,LLC d Invoice#, Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 05048757✓/12126120212/07/20201/06/202 141.54 0.00 0.00 141.541/! SUPPLIES 050491971/ 1 W6120212107/20201/061202 37.92 0.00 0.00 37.92 ✓ SUPPLIES Vendor Totals: Number Name Grass Discount No -Pay Net 10152 PARTSSOURCE, LLC 179.46 0.00 0.00 170.46 Vendor# Vendor Name Class Pay Code file:l//C:/Userslltrevino/cpsilmemmed.epsinet,cam/u88125/data 5/tmp_cw5report2818493882571029204.hunt 8/11 12128/23, 11:10 AM tmp_cw5report2818493882571029204.html P1800 PITNEY BOWES INC J/ W Invoice# Comment Tran DI Inv Dt Due Of Check Dt Pay Gross Discount No -Pay Net 1024409121w/ 12/27/202 12/101202 01/09/202 527.64 0.00 0.00 527,64 POSTAGE Vendor Totals: Number Name Gross Discount No -Pay Net P1800 PITNEY BOWES INC 527,04 0.00 0.00 527.64 Vendor# Vendor Name Class Pay Code S1405 SERVICE SUPPLY OF VICTORIA INC ✓ W Invoice# omment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 701207638'/C 12/26/20212119120201/101202 984.00 0.00 0.00 / 984.00 r/ SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net S1405 SERVICE SUPPLY OF VICTORIA INC 984.00 0.00 0.00 984.00 Vendar# Vendor Name Class Pay Code S2001 SIEMENS MEDICAL SOLUTIONS INC M Invoice# lComment Tran Of Inv Dt Due Of Check Dt Pay 116476320 / Grass Discount No -Pay Net 12/27/20212I6120201/101202 2,375.92 0.00 0.00 2,375.92 SYMBIA EVO CONTRACT Vendor Totals: Number Name Gross Discount Nc-Pay Net S2001 SIEMENS MEDICAL SOLUTIONS INC 2,375.92 0.00 0.00 2.375.92 Vendor# Vendor Name Class Pay Code 12472 SOMETHING MORE MEDIA, INC. Invoice# Comment Tran Dt Inv Dt Due Dt Check Ot Pay 2166 Gross Discount No -Pay Net 12/27P20212126/20201/10/202 2,5261.00 0.00 0.00 2,525.00 ADVERTISING Vendor Totals: Number Name Gross Discount No -Pay Net 12472 SOMETHING MORE MEDIA, INC. 2,525.00 0.00 0.00 2,525.00 Vendor# Vendor Name Class Pay Code C1010 ! SPARKLIGHT✓ W Invoice# Comment Tran Dt Inv Of Due Dt Check Of Pay Gross Discount No -Pay Net 121423 12/27/20212/14/20212/15/202 125.23 0.00 0.00 / 125,23 CABLE -PT "ft., $.0O 121623 1?l27/20212116/20212117/202 132.61 0.00 0100 132.61 CABLE -CLINIC La.}L fl0_ 10.00 Vendor Totals: Number Name Gross Discount No -Pay Net C1010 SPARKLIGHT 257.84 0.00 0.00 25T84 Vendor# Vendor Name Class Pay Code 10094 / ST DAVIDS HEALTHCARE ✓ Invoice# Comi�ant Tran Dt Inv Dt Due Dt. Check Dt Pay Gross Discount No -Pay Net MMCPL-2023.11✓ 12127120212121/20201110/202 745.00 0.00 0.00 745.00 ys NOV CONNECTIVITY VendorTatals: Number Name Gross Discount No -Pay Net 10094 ST DAVIDS HEALTHCARE 745.00 0.00 0.00 745,00 Vendor# Vendor Name Class Pay Code S2694 / STANFORD VACUUM SERVICE ✓ M Invoice# f Comment Tran Of Inv Dt Due Dt Check Of Pay 295677✓ Gross Discount No -Pay Net 12/27/202 12/14/202 12/31/202 550,00 0.00 0.00 550.00 V , GREASETRAP Vendor Totals: Number Name Gross Discount No -Pay Net S2694 STANFORD VACUUM SERVICE 550.00 0.00 0.00 550.00 Vendor# Vendor Name Class Pay Code S3940 STERIS CORPORATION V1 M Invoice# / Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross. Discount No -Pay Net 11881217 ✓ 12/27/20212/15/20201/09/202 192.85 0.00 0.00 192.86 SUPPLIES 11896618 12/27/20212/20/20201/14/202 140.96 0.00 0.00 140.96 file:///C,./Users/itrevinO/cpsl/memmed.cpsinet.comiuBB125/data_5/tmp_cwBreport2818493882571029204.html 9111 12/28/23, 11:10 AM imp_cw5report2818493882571029204.html SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net S3940 STERIS CORPORATION 333.81 0.00 0.00 333.81 Vendor# Vendor Name Class Pay Code T0420 TELEFLEX MEDICAL,. Invoice# Comment Tran Dt Inv Dt Due DI Check Dt Pay Gross Discount No -Pay Net 95D75805977 ✓/12/28/202 12/12/202 01/11/202 158.29 0.00 0.00 158.29 v1 SUPPLIES Vendor Totals: Number Name Gross Discount No -Pay Net T0420 TELEFLEX MEDICAL 158.29 0.00 0.00 158.29 Vendor# Vendor Name Class Pay Code 12704 / TEXAS BURNER& BOILER SERVICES ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net. / 23-3479 O 12/27/2D212/16/20201/16/202 2,469.00 0.00 0.00 2,469.00 BOILER QfoP (5 Vendor Totals: Number Name Gross Discount No -Pay Net 12704 TEXAS BURNER & BOILER SERVICES 2,469.00 0.00 0.00 2,469,00 Vendor# Vendor Name Class Pay Code 10758 TEXAS SELECT STAFFING, LLC v/ Invoke# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 0023322 1 PJ27/2021 PJ21/202 t 2/22/202 8,277.50 0.00 0.00 / 8,277.50✓ B BATES M MARTIN 12JI 6123 t W Vendor Totals: Number Name Gross Discount No -Pay Net 10758 TEXAS SELECT STAFFING,. LLC 8,277.50 0.00 0.00 8,277.60 Vendor# Vendor Name Class Pay Cade U1064 UNIFIRST HOLDINGS INC ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 2921020835 �/ 12/26120212/18/20201112/202 91.80 0.00 0.00 91.8o LAUNDRY 2921520830. v/ 12/26/20212/18/20201/12/202 2,568.39 0.00 0.00 2,568.39✓ LAUNDRY 29210211581/ 12126/20212118/20201/12/202 139.15 0.00 0.00 139.15� J AUNDRY 2921621157 "/ 12/26/20212/21/20201/1 $/202 266.35 0.00 0.00 250.35✓ LAUNDRY 2921021151 �f 12/26/20212/21/20201/15/202 137.01 0.00 0.00 137.01 LAUNDRY 2921621153 ,) 12120/202 12/21/202 01/151202 2,728.06 0100 0.00 2,728.06 y,,f LAUNDRY ✓' 2921021154 12/26/20212/21/20201I15/202 29:95 0.60 0.00 29;95 ,% LAUNDRY 2921021155 12126/202 12/21/202 01116/202 354.34 0.00 0.00 354.34 LAUNDRY ( 2921021152 ✓ 12/26120212/21120201/15/202 222.37 0.00 0.00 222,37 /LAUNDRY 2921021166d 12126/202 12/211202 01/151202 264.19 0.00 0.00 254.19 f LAUNDRY Vendor Totals: Number Name Gross Discount No -Pay Net U1064 UNIFIRST HOLDINGS INC 6,77&61 0.00 0A0 6,775.61 Vendor# Vendor Name Class Pay Code V1056 / VICTORIA AIR CONDITIONING LTD,/ w invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net / 208601✓ 12/271202 12/18/202 12/27/202 712,60 0.00 0.00 712.50 f LABOR Vendor Totals: Number Name Gross Discount No -Pay Net V1056 VICTORIA AIR CONDITIONING LTD 712.50 0.00 0.00 712.50 file:///C:Nsers/itrevino/cpsi/mammed.opsinst.com/u88l26tdata_5/tmp_cw5report2818493882571029204.html 10111 12/28/23, 11:10AM tmp_cw5report2818493882571029204.htm1 Vendor# Vendor Name / Class Pay Code 11110 WERFEN USA LLC ✓ Invoice# Qomment Tran Dt Inv Dt Due DI: Check Dt Pay Gross Discount No -Pay 91114323321 12/26/20212/21/20201/151202 1,185.25 0.00 0.00 SUPPLIES Vendor Totals: Number Name 11110 WERFEN USA LLC Grand Totals: Gross 146,690.96 APPROVED ON g DEC �N2 9 22p023 CALHOU%f COUNTY IT& Gross Discount No -Pay 1.185.25 0.00 0.00 iii}pOri � Uniitl2l'y Discount No -Pay Net 0.00 0.00 146,690.90 Net 1,185.25 Net 1,185.25 file:111C:/Userslltrevino/cpsitmemmed,cpslnet.com/u88l25/data_51tmp_cw5report2818493882571029204.html 11111 WON MWOIAL R PAGE I 09 05�R EDITRLIST1FOR PATIENT REFUNDS ARID4001 APCDEDIT jfoT' 2 8 2023 PAY PAT NBFIBBR PAYEE NA118 DATE AMOUNT CODE TYPE DESCRIPTION GL Of ----------- ------------- / ---.....------ 1522811 al ASSET PROTECTION UNIT, INC. / 1564947 122823 760.80 / ✓ 2 REFUND FOR v91.ALLIED BENEFIT SYSTEMS LLC 122823 1906:63 ✓/ 3 REFUND FOR - 122823 100.00 / 2 REFUND FOR I. 15f4963 ,4/1 THRIVENT 1575184 122823 578.40 ✓ 2 REFUND FOR ,.o THRIVENT 122823 594.60,% 2 REFUND FOR " 1576117 1 NEW ERA ---------------------------------- ...--------------------------------------- 122823 99.40 ✓ 2 .---------------- REFUND FOR .......................... ------- ARID4001 TOTAL -------------------..--------_-----------------------------------------------------.......---------I.........--------. 4039.83 TOTAL 4039.83 APPROVED ON DEC 2 8 2023 CALLHCMOAW,1 W 12129125PE (EIfi1,j8Y THE COUNTY UUN/NT, YAUDITOR ON imp_cw5repon2104661305626510939.html IIO 1Y�'29'/207Q3'2 2024 MEMORIAL MEDICAL CENTER 15'36 CALHOUN COUNTY, TEXAS AP Open Invoice List Vendor# Ventlor Name / Dates Through: 14064 CAPITAL ONE v' Class Pay Code Invoice# Comment 1652818689 Tran Dt Inv Dt Due Or Check Dt Pay Gross Discount 12/29/20212119/202 01/13/20e Vendor Totals: Number Name 14064 CAPITALONE Grand Totals: Gross 1,229.12 ''PROVED Ott, g JAN 02 2024 CA LHO��OURAi'�YOIT/ ERAS Discount 0.00 1.229.12 0.00 Gross Discount 1,229.12 0.00 No -Pay 0.00 0 ap_open_invoice.template No -Pay Net 0.00 1,229.12 ✓ No -Pay Net 0.00 1.229,12 Net 1,229.12 file:///C:/Users/Itrevino/cpsilmemmed.cpsinet.com/u88125/data_5/tmp_cw5report2104661305626510939.html ill MC&C,DVIY STATEMENT As at: 12/22/2023 Few: 002 To ensure proper Croak to yam e,xvuM, Mach e:M tMa aama++y: acao herniations stub with your herniations DC: 8/13 M9NOflML MEDICAL C9JT6i / Cunom INV Supp10: As al: 12/22/2023 An 002 Mail to: Camp 8000 AMT DUE REMITTED Tm VIA ACH OMIT Terdtary: : AP ✓ Statement for Intormellon only AMT DUE REMITTED VIA ACH OMIT a15 N VINDINIA STREET CaW. 332838 Statement for Information only POFr LAVACA TX 77979 gala:te: I2/23/2023 Cup: 632536 PtPASE CHECK ANY Date: 12/23/2023 ff3MS NOT PAID (�) M01:m Due fleeeivabl�etloml AcmuM yie Cash Amount P Arms P P=ebablo DMa Dale Number flalere:me Description Discumd (gmm) F (not) F Number W coiumm Island: P = AnM Due Ibm, F = FoWm Due Item, baser, = Cement Due Item TOTAL National Accl 632536 MEMORIAL MEDICAL CENTER Subtotafa: 1,104.82 USD Future Due: 0.00 Due N Anid On. Time: 11 Anb By 1212612023, USC 1,082.72 Pest Due: 0.00 Pay This Amount: 1,082.72 USD 01. bat 8 paid kb: last Payment 2,451.97 If RAW Attar 12I28/2023, Due If Paid Win 22.10 08/07/2017 Any this Amount: 1.104.82 USD USD 1,104.82 1+065•'<'7 4.16 5.87 + 7.42 + 1,.08.:2.72 u APPROVED ON JCAp�N02 22024 gy cA 0%' C'DUN71$.I %As For AR Inquiries please contact 800-867-0333 MWESSON STATEMENT Cameo" 8000 WALMART 1098/MEM MED PHS ACN D p pMT DUE RIMMED VIA MEDICAL CENTER Slekmem for informationA only VICKV KAUSEt 815 N VIRGINIA ST l POW LAVACA TX 77979 As of: 12/22/2023 Raga: 001 To amum Prow gpfK to yore eccour0, dai and mt" Shia Nub with your mmedenco DC: Cualony: er IN V SupplO: As 12/22/2023 Rage: 001 Malll 10: Territory: T001 Camp; 8000 AMT DUE HEdITTED VIA DEBIT Customer. 256342 Sietemenl for inlomatlen only Dale; 12/23/2023 Coal: 266342 PlEASE CHECK ANY Dale: 12/23/2023 RBAS NOT PAID (,) fkcalvahlranonal Amount /98 �yl Amount P A�llunt F Nece�eb(e Date Oa of Number Reference Deecdptlon Dhcaum (Bross) F CW=W Number 256342 WALMARr 1098/MEd MED PHS 12/18/2023 12/20/2023 7464630229 99350283 1151nv01ce 9.3T 468.50 12/1B/2023 1W26/2023 7464830230 99389585 1151nvotce 8.03 459.13 /� 7464830229 12/18/2023 12/26/2023 7465031068 99396031 1951nvcica 0.34 401.28 393.25 ✓ 7464830230 1W1812023 12/26/2023 7465031069 99315609 /951nvolce 0.01 16.92 16.58 146fi031058 12120/2023 12/2W2023 7465669011 99750315 1961nvoloe 0.01 0.32 0.32 0.31 746503t 069 12121/2023 12M6/2023 7465812900 998a8008 1151nvolm 1.00 50.24 0.31.E 49.24 7465:59011 12/21/2023 12/26/2029 7465955105 99901746 1151nve1Ce 0.55 27.45 ,/ 746512900 12/22/2023 12/26/2023 7466092419 100033127 1151nvoke 2.42 26.90./ ✓ 746fi96610 12/22/2023 12/26/2023 7466092420 100104322 1151nv01ce 120.84 118.42 ✓ 74660B2415 12122MO23 12/26/2023 7466092422 100104322 1151nvoice 0,01 0.20 0.20 ✓ Y466092420 IV22/2023 12/2012023 7466240073 100039097 1951wolce 0.63 0.62 ✓ 74B6092422 0.01 0.32 0.31 )468240013 PF column legend: P � Poal Doe Rem, F . Rau- Due Item, blank Current Due Nem TOTAL• Customer Number 256342 WALMART 1099IMM M® PHS SuNNelm 1.087.02 USO Fatum Due: 0.00 P4N. DW: 0.00 11 Paid By12 23, Pay TN. Amotent; uni: Dw It Add On Time: USD 1.066.27 1.065.2T USD OMo lent K paid late: Und Pa manl Y 3,OSfi.55 12I18/2029 It PoW After 12l26/2029, Dw If Pold late: 21.T5 Pay this Amourd: 1.081.02 USO USD 1.087.02 �A,Mdi��T 1..J.4l,�t../�•i1V�4�� APPROVED ON JAN 02 2M CANE OUARrY SAS For AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT As d: 12/22/2023 o^^'wm: exo Page: 00, To eluum proper emdp to your aopmed, detwir sed retum this DC: 8115 CVS PHCY f0358/MQ4 MC FHS dub with year mmhtaex ANT DUE flBA1TTED VIA pCH D®IT Cull mer INV SUPPID: MEMORIAL MEDICAL CE4TEA As d: 12/22/2D23 M.11 to: Page: 001 VICKY KALISEX Statement for Inloennion only Tenttory: 7001 Comp: 8000 Sib N VIflGINIA ST Cudomer. 835430 POINT LAVACA TX AMT DUE REMITTED VIA ACH DEBIT Statement for Infannaflon only 77979 Date; 12/23/2023 Cud: 835430 PLEASE CHECK ANY Delp Bill- Duo Ikxfaabl N-Hand A..M 9,31T6 Date Beim 12/23/2023 ITEMS NOT PAID (0) Number Hafemnce D dptbn 0leeounl Amount F A t P neceN Me Cud N be 89699a CVS PHCY 10958/MBa MC MS( I) F N be 12/20/2023 12/26/2023 7465510664 2912629 0.08 PF column 1 egeni P a Fad Due Item, F e Fdum Duo Sam, 9.24 4,18 ,/ ]465610559 L_J honk a Curmd pua Item s, De it. TOTAL Cudomx Number 835490 CVS PHCY 1035E/M@p MC PNS SuMotale; 4.24 USD Fdma pue: 0,00 Peat Due: 0.00 II Pald By 1212612023. Due If t4M On Time; Pay This Amount: 4.16 Lad Payment USD USD 4.16 Dix toe K field Ida: 12/18/2023 31055.55 11 NMI After f 2128/2029, 0.08 Ply this Amount: 4.24 LED Dtm If Paid late: U6D 4.24 APPROVED ON JAN 02p2�0�2T4pp CABLHORU COUNTY, TENAS �U'VLWL9.V.: 11.Jir �BJ[1t^i i I}+'W�11:)\ For AR Inquiries please contact 800-867-0333 MSKESSONSTATEMENT As of: 12/22/2023 Page: OD1 TO ensue proper medh to your account, aleMah aM alum this aama�WY� emao stub with your mmillana OC: 6115 CVS PBCY 8923IMEM MC PHS Customer,:. INV SOPPIO: As oF. 1 12/22/2023 Pep: 00 Nall lComp: 00 MEt40RIAL MEDICAL CENTER ANT DUE REMITTED VIA ACH DEBIT Tenhory: 7001 VICKY KAUSEK / Statement for inlormallon only ANT DUE REMITTED VIA ACH DEBIT 815 N VIRDINIA ST '/ Custamx, 835434 Statement for Information only PORT LAVACA TX 77979 Dale: 12/23/2023 Curl: 835434 PLEASE CHRCIK ANY Date: 12/23/2023 ITEMS NOT PAID (.r) Blllirm4 Due Reoalmbl Natimul Acccunl 6 . Date Date Number pt Cash Pefamnu Dasotl Ion Diwroum (grow) F A. nl F N ba Ne El Cumomm Number 835434 CVS PBCY 6923/M13,1 MC PBS 12/20/2023 12/26/2023 7466507111 2912761 1151nvoice 0.12 6.99 5.67 ,/ 7465507111 O PF means legend: P = Pert Can Item, F = Futon Due Item, blank = Current Dua Item AL Cuelomer Number 835434 CVS PNCY 8923/MEIB MC PHIS SuMraN: 5.99 USD Rates auto 0.00 Pest Due: If Paid By 12/26/2023, Due D Paid On Timm: USD 5.87/. 0.00 Pay This Amount: 5.87 USD Oise lost N paid latt. Led Payment 3,055.65 12/18/2023 It Paid After 12/26/2023, 0.12 Due If Paid late: Pay thin Amour: 5.99 LED USD 5.99 APPROVED oN JAN 02 2024 CALLHOUNU CON ForFor AR Inquiries please contact 800-867-0333 MSKESSON STATEMENT comp�,o: eoeo CVS PNCY 7475/MEIA MC MS MWOmAL MEDICAL CENTER VICKY KAUSIX ,% ANT DUE HIMITTED VIA ACH DEBIT Statement for Information only 815 N VIRGINIA ST PORT LAVACA TX ]18]9 AB of: 12/22I2023 Room 001 To ensue proper detlf to your —M. tl8Mch antl Blum Into fault Won your IB111111811ne DC: 8115 Cueremor INV SuMID: As M: 12/22/2023 MPe98: W1 Mall to: Comp: 8001 Territory: 7001 AMT DUE RE41TTED VIA ACH DEBIT Customer. 835438 Statement for inlormalion only Data: 12/23/2023 cum: 835438 PLEASE CHECK ANY Data: 12/23/2023 ITEMS NOT PAID (,) along pre RenwWabilllatimul Aomffl We Cash Amwp1 P Amount P Bxelvabla Date Date Number Mennu Oeeeriptlon Dimount (gmeal F (rqt) F Number Coolants, Number 835438 CVS PNCY ]4)5/MPM MC RNS 12/20/2023 12/26/2023 7465692519 2913599 1151nvoioe 0.15 7.57 7.42 ✓ 7465692519 O PF ma unn legenrt P e Real Om Item, F = Fulun Due Item, blank = Cmmnt Due Sam TOTAL Cufaomer Number 835488 CYb PHCV ]NfiIMEM MC ME; Subratals: 7.57 USD Future Duo: 0.00 Due If Pald On Time: Peet a.: It Paltl by 1212612023, USD 7.42 0.00 Pay Thle Amount: 7.42 USD Di. bet S peltl Nte: - teat l 91055.55 It Pelt After 12/26Ya023, Duo 11 Peltl Tate: 0.15 12I16/2023 /2023 Pay this Amount: ].5] USO USD ].5] APPROVED ON gg DCCNJAppN 02 2924 pp CAL UCOUNTY�ITEXAS For AR Inquiries please contact 800-867-0333 AmeoulY;eBe en` STATEMENT Statement Number. 66541708 Dal.. 19-99_9n93 1 of AMERISOURCEBERGEN DRUG CORP WALGREENS 412494 3400 12]2] W. AIRPORT BLVO. MEMORIAL MEDICAL CENTER 100135284 / 03]028188 - SUGARLANDT% 77478.6101 1302 N VIRGINIA ST PORT LAVACATX 7797 2509 DF-A: RA0289276 Sat -FM Due in 7 days 666-461-9656 AMERISOURCEBERGEN��PJ—"® PO Box 905223 CHARLOTTE NC 2829"223 Nat Vet Due: 9.00 Curtenl: 1,220.00 Paai Due: 0.00 Tolal Due: 1,220.00 Amount Balance: 1,220.00 Account Activity Document Due Reference Date Purchase Order Document Original Last Receipt Amount Received Balance Date Number Number Type Amount 12.16-2023 12-29.2023 3157825992 fumuf600o Irnaico 1WAS 0.00 190.18 12-18.2023 12-29-2023 315705903 7005082982 Invoice 156.29 12-18-2023 12-29.2023 3158033362 7005093387 Involve 70625 0.00 156.29 f2-1B-2023 12Q9-2023 31582224fi7 7005103962 Imolce 92.08 0.00 ]06.25 12-20-2023 12-29.2023 3158392565 7005113788 Irnoice 7.73 0.00 92.05 12-22-2023 12-29.2023 3158705838 7005129517 Involce 0.00 7.73 67A7 0.00 67.47 1.16 Days 16-30 Days 31.60 Days 61-90 Days 91.120 Deys Over 120 Days 1220.00�0.00�0.00 �Current 0.00 000 96D o0a 000 0000.09 900 Thank You for Your You for Your Payment Reminders Date Amount Due Date Amount 12-22-2023 (4374F) 12-284I023 1,220.00 Total Due: 1,220.00 v APPROVED ON JApN 02 g12024 T A& CALHOIIND�OUA TOLL FEE PHONE NUMBER: 1-800-555-3453 (EFTPS TUTORIAL SYSTEM: 1-800-572-8583) "ENTER 9-DIGIT TAXPAYER IDENTIFICATION NUMBER" F"ENTER YOUR 4-DIGIT PIN" "MAKE A PAYMENT, PRESS 1" "ENTER THE TAX TYPE NUMBER FOLLOWED BY THE # SIGN" F71F FEDERAL TAX DEPOSIT ENTER 1" ❑"ENTER 2-DIGIT TAX FILING YEAR" "ENTER 2-DIGIT TAX FILING ENDING MONTH" 1ST QTR - 03 (MARCH) - Jan, Feb, Mar 2ND QTR - 06 (JUNE) Apr, May, June 3RD QTR - 09 (SEPTEMBER) -July, Aug, Sept 4TH QTR -12 (DECEMBER) - Oct, Nov, Dec "ENTER AMOUNT OF TAX DEPOSIT- FOLLOWED BY # SIGN" "1 TO CONFIRM" "ENTER W/CENTS AMOUNT OF SOCIAL SECURITY" "ENTER W/CENTS AMOUNT OF MEDICARE" "ENTER W/CENTS AMOUNT OF FEDERAL WITHHOLDING" ❑11 6-DIGIT SETTLEMENT DATE" "1 TO CONFIRM" ACKNOWLEDGEMENT NUMBER CALLED IN BY: CALLED IN DATE: CALLED IN TIME: J:1AP-Payroll FileslPayrall Tue9120241#1 R1 MMC TAX OEPOSIT WORKSHEET 12.28.23.xis #### ENTER: ###=I 1 $ '117,983.36=; 1 $ 62,178.16 $ 14,541.64 $ 41,263.56 102024 941 RECITAX DEPOSIT FOR MMC PAYROLL PAYPERIOD: BEGIN 12/1512023 ^E v_q! PAY PERIOD: END 12/28/2023 PAY DATE: 1/6/2024 GROSS PAY: $ 546,037.79 DEDUCTIONS: AIR $ 217.91 ADVANC BOOTS MUTUAL CRITICAL ILLNESS $ 1,142.65 MUTUALACCIDENT $ 791,20 IRS TAX MUTUAL SHORT TERM DIS $ 2,957.88 MUTUAL VISION $ 923.00 CAFE.D $ 1,292.58 CAFE•H $ 31,144.24 S - CAFE-P CANCER CHILD $ 670.69 CLINIC $ 107.09 COMBIN § 271.83 CREDUN $ _ DENTAL $ DEP-LF MUTUAL TERM LIFE $ 1,408.62 MUTUAL HOSP INDEM $ 678.32. FED TAX S 41,263.66 FICA-M $ 7,270.82 FICA-0 S 31,089.08 FICA•M ADDITIONAL FIRST C FLEX S $ 5,244.97 FLX•FE $ GIFT S S 751.55 GRP4N GTL HOSP-1 LEGAL $ 1,172.36 OTHER NATIONAL FARM LIFE S 1,286,49 MED SURCHARGE $ 296.00 PR FIN $ RELAY REPAY STONEDF 5 1,015.86 STONE STONE STUDEN TSA-R S 37,459,90 UWIHOS $ TOTAL DEDUCTIONS: $ 167,$25.40 $ NET PAY: $ 377,612.55 $'n TOTAL CAFE 126 PLAN: S 43.602.28 Lax =Q&9MLATED•' From MMC RepoR MED (ER) ,es% $ 7,270.81 MED(EE) i,E S 7,270SI $ 7.270.82 S SOC SEC (ER) axe $ 31,088.00 SOC SEC (EE) an% $ 31,089.00 $ 31,089.08 S $ TAX DEPOSIT: 8�a117.983.18 S 117,903.36 FICA -MEDICARE xvx S 14.$41.62 $14,541.64 FICA -SOCIAL SECURITY 62,178.00 $62.178.16 PREPARED BY: FED WITHHOLDING $ 41.263.56 $41,263.56 PREPARED DATE: TOTAL TAX: $ 117,983.18 $117.983.36 $ (0.18) 41 R1 MLIC TAX DEPOSIT WORKSHEET 122e.23 Ac TAX DEPOSIT WORKSHEET 102024 I II REVISED S(IWO74 TOTALS $ 545,037.79 S 217.81 S - $ 5 1,142.56 $ 781.20 S - 5 2,057.88 $ 923.00 $ 1,292.55 S 31,144.24 570.69 187.09 271,83 1,408.52 678.32 41,263.56 7,270.82 31,089.08 3,244.97 751.55 1,1T2.36 1,286.49 295.00 1,016.86 37,g59.90 167,628.40 377,612.39 Exempt Am4 Employees over FICA•SS Cap: Roshanda Thomas Michael Gaines Paycode 8 • Employee Reimb.: TOTAL: 5 Andde Flores 11212024 Run Date: 01/02/24 MEMORIAL RSD3CAL CENTER Page 113 Time: 13:45 Payroll Register j Ri-weekly I P2REG Pay Period 12115/23 - 12/28/23 Run# 1 FLnfii SW.. ry •-- P a y C o d e 9 u m m a r y -------- ______________________________... '-_ D e d u c t i o n s S u n a a r y-_.__.....__:r PayCd Description Era JOTISEIN3IEOIC31 Gross I Code Amount *________ ---------------------------------------------------- _--------------------------------------------------- ......... ._____s 1 REGULAR, PAY -Si 9604,25 N N V 204900.84 A/R 217.911/92 A/H3 1 REGULAR PAY-81 1633,00 N N N N 80966.17 ADVANX AWARDS BCBSVI 1 REGULAR PAY-81 203,75 1 N Y 7851,72 BOOTS CAPE S CAFE-1 1 REGULAR PAY-81 244.50 Y N 11 7389.18 CAFE-2 CUM CAPS-4 2 REGULAR PAY.S2 2237.25 N H N 61510.78 CAFE-5 CAFE-C t'E-D 1292.58J 2 REGULAR PAY-S2 197.75 N N Y 8944.80 CAPB-F CAFE-R 31144.24 -I 2 REGULAR PAY-S2 142.00 Y N N 4848.06 CAFE-1. CAPE-P CANCER 3 REGULAR PAY-S3 1352.00 N N N 47039.81 CHILD 570,64LMIC 187.09AOMRHI 27I.B3 3 RE6l m PAY-S3 214,75 N N Y 10546.91 CREDUN DD ADV DENTAL 3 REGULAR PAY-S3 76.50 Y N N 3250.30 DEP-LF DIS-LF HAT 4 CALL BACK PAY 28.75 N 1 N N Y 110711, EATCSK FEDTAX 41263.S4ICA-M 7270.821/ 4 CALL BACK PAY 29.50 N 2 N N Y 1260.20 FICA-0 31069.04IRSTC FLEX S 4665.39,/ 4 CALL BACK PAY 2.09 N 3 N N Y 63,13 FIX PE FORT D FUTA 4 CALL BACK PAY .25 Y 1 N N Y 17.99 G17T S 751.55JRAET DAMN 4 CALL BACK PAY .75 Y 2 N N Y 49.32 GTL MOSP-I NSA 579.58 J C CALL FAY 2245.75 N 1 N N 4491.SO ID TPT IRSTAX LEAF D DOUBLE 7114B 8.00 N 1 N N 693.28 LEGAL 273.86 MASA 898,5D ILW D D DOUBLE TIME DOUBLE 71HE 10.00 N 1 4.00 R Y 21EM6 METVIS RISC YISC/ N 2 N N 362,64 MURK, MOOACC 781.2 00ILL 1142.55J D DOUBLE TIME 25.75 H 2 N Y 3348.04 MOOIND 676.7 OLIF 1408.5,`,4COSTD 2057.984 D 00061E TINE 15.50 N 3 N 7 2552.86 MGOVIS 923,0011ATM 1296.4AATHRR 5 EXTRA MORE N N O N -560.00 PHI PHIsi* PR PIN E EXTRA WAGES N I N N N 2194.50 RELAY REPAY SAM F FUNERAL LB.4VE 44.00 N I N N 817,44 SCRUBS 91GNDN ST-TX K FX18!A)ID-rrurSS-BAIN: 60.00 N 1I N N 2751,20 S ONOF 1015.86TOHE STONE2 K EXIMIDEC-ILINPSS-10 567,00 N 1 11 H 25983.20 SIWEN SUNACC SUNILL P PAID -TIME -OFF 333,55 N N N H 8438.03 SU4IIND .SUNUP $UN STD P PAID -TIME -OFF 2216.00 N 1 N 17 17676.61 SUIIVIS SURCRO 295.0OJTSA.1 P PAID-TIMR-OFF N I N N N 65.00 TSA-2 ;SA-C TSA-P X CALL PAY 2 160.00 N 1 N N 320.00 7SA-R 37459.9DOf ion UNIFOR E CAL PAY 3 96.00 N S N 13 282.00 UB/HOS p PAID TIME OFF - PROBATION 104.00 N 1 N N 2172.48 t PHONE & DATA 11 N N N 1355,00 '------------------- Grand Totals: 26884.55.....-• I Gross: $45037.79 Deductions: 167525.40✓ Net'- ''177512,394 Checks. Count:- FT 206 PT 13 Other 36 ?ereie 228 Hale 26 Credit DvarAmt 17 2eroNet Term ' Total: 2S4 <..................."......_.._...........................................................____........._.. ........ n L (7-Iz Run Date: DI/02/24 Time: 15:24 No. Name 02794 HEAT.4ER L F.UTCh7,ER $0262 IRA R SEAAP 65247 DIANA CAST[LI7! 00041 an LEE RING 00083 SYLVIA A VARGAS 00094 SYLVIA A M:72DOZA 00113 JACI)w CARESON 00132 S4NLPA A SHRUB 00192 S.4E1'OA ➢ RENA 00344 SANDRA LEE RUDDICK 00307 BILLIE F DJC.{WDRTH 00392 FONTCA. T C4.RR 00399 LIN'Dn J TIJERINA 00401 VE0% J PLEA 00417 SHERRy L RING 00423 GONt7 V STRLMGO 00482 PAN FIEAC 00581 CYtrjIA L RUSHING MEL RILLA SENSE WOOD 00652 DEBDRAH E RITTHDBERT 00697 FARIA C FARIAS 00707 KIMBEELY RESENUEZ 00055 E11LIE DIA:ME WILRBY 01015 SUSAN B S7TUa 01291 SRAEUg R SPARKS 01234 JENISE N SVEI7,IR 01241 Mmy RACE 01367 FARILyN A SANDERS 01451 JENNIFER L ZISSA 01791 RAUSHANAM J HUNUAV 02011 ERIN R CLEVENGER 02021 ERIKA OSORNIA-SANCRBZ 02022 APJMA J ➢RIGSS, OTR 0206E Am LAD77A GARCIA 02099 TRACI M SRgPCIK 02112 LESLIE THRNA,S 02132 JASMINE RUIZ 02135 t40RMA ALLISO➢ 02126 TAMMI ESQUIVEL 02154 JUSTAIS STRELCZI'R 02162 NIRTAH PALUEA 02168 JENSIr, KNIGHT 02193 TIRI VERGLAR 02202 SBNONI SANCHEZ 02271 DARN J EUBENIE 02301 NICOLAS TIJERINA 02302 MITERI,NG NA"EIS OSCILOS 02363 CONNIE N PADISEER 02315 NINA 14 GRERC 02331 JESSICA E BLFFLE 02346 JEhen L F,AL.vN 02416 JANfLLE SCOTT 02511 FAGDALFNA SEEULVEOA MEMORIAL MEDICAL CENTER BI-N'Z6KLY Check Register +••• Pay Penad 12/1-/23--12/28/23 Run: I 2yoe=NS". 10000001 OPEBATING - PROMRI72 Amount CHECK 0. DATE 2092,13 757,26 907.48 1190.85 906.43 3274.0E 1054.56 744.07 2250.03 3025.36 2317,29 1055.05 3518.82 1272.92 2481.07 3284.25 1572.85 1625.31 1956.09 191.18 1208,36 1637,44 698.05 3315.27 340.15 2204.64 2012.79 744.27 408.88 2153.83 3932.36 440.37 2549,64 3766.74 2000.83 2883.50 1871.11 1565.04 525.96 1071.26 1540,90 2A1.28 1733.23 707.25 2272.43 1979.30 616.42 2459.87 2435.14 1500.18 2654.59 1914.70 356.04 00063371 01/05/24 00063372 01/05/24 00063373 01/05/24 DD 02/05/24 DO 01/05/24 DO 01/05/24 DO 01/057Z4 DO OI/05/24 DD 02/05/24 DO 01/05/24 DO 01/05/24 DO 01/OS/24 DO 01/05/24 DO 01/05/24 DO 01/05/24 DD 01/05/24 DD 01/05/24 D➢ 01/05/24 DO 01/05/24 GO 01/05/24 GO 01/05/24 DD 01/05/24 DO 01/05/24 DO 01/OS/24 DO 0I/05/24 DO 01/OS/24 DO 01/05/24 DO 01/05/24 OD 01/05/24 GO 01/05/24 DD 01/05/24 DO 01/05/24 DO 01/05/24 DO 01/05/24 DD 01/05/24 DO 01/05/24 DO 01/05/24 DO 01/05/24 DO 01/05/24 DO OV05/24 DO 01/05/24 DD 01/05124 DO 01/05/24 DO 01/05/24 DD 01/05/24 DD 01/05/24 GO 01/05/24 DD 01/05/24 DO 01/05/24 DO O1/05/24 DO 01/6/24 DD 01/8124 DO 01/05/24 Page 2 P2DISTP Run Date: 91102/24 MEHORIAL MEDICAL CENTER BI-KEEELY Page 2 Time: li:24 +..+ Check Register '+•+ P2DISTP Pay Period 12/15,123--12/28/23 Run: 1 Type-10 10000001 OPERATING - PROSPERITY Hum. Name ATount CHECK 01 DATE 02552 VERONICA PAGOSIN 1840.53 DO D1/05/24 02622 JSSDSA MAP.IB BENAVIDES 751.16 DO 01105/24 0267B MELISSA VISI0NEY 1457.69 DO O1/05/24 02695 JULIANA TORRRB 243.BD DO O1/OS/24 027DI RONDA GOKLES 3639.DC DD 01/05/24 02719 DAeR H MCCL3LLAND 2121.75 DD 01/05/24 02120 ELDA M LUERA 2158.47 DO O1/05/24 02733 ROSIN N PLEDGER 2575.05 DD 01/05/24 02735 ZANDRA A GARCIA 3BB.83 DO 01/OS/24 02612 BRITTANY N RUDDICK 1959.90 DD O1/05124 02907 PARIA F LONGORIA 1243.74 DD 01/05/24 02927 MICHAEL 1 GAIN'S 2810.39 DD 01/05/24 02963 DOROMY J RENOCI4 1253.54 DD 31/05/24 02910 DIANNE 0 ATKINSON 2192.93 DO DS/D5/24 03864 JACOVELINE R HeRRERA 1194.37 OD O1/05/24 05003 CCU14NBB D THMXILS 2959.25 DO 01/C5/24 05005 REG311A A MARTINEZ 1975,51 OD 01j05/24 05122 MARiSSA RARGEL 410.48 DO O1105/24 05264 SAM WRITER 024.06 ➢D 011'OS/24 05345 ERICA NGUYEN 617.68 DO O1/O5124 05641 AlGiNVA R BY 2115.39 DD 01/05124 07123 CYKIHIA SM.. 2568,94 DO O1105124 07147 SRO A VORCE 2441.86 DO 01/05/24 VATS DIANA C SAUCE➢A 1166.42 DD 01105/24 11197 CATHENINE A SAM 1938.58 DD 01/05124 31412 COURTNEY L PARKOVS.RY B52.55 DD 01105124 12011 KIMMY J REM 475.00 DO 01105124 12115 LISA J EIHOJOSA 864.49 DO O1/DS124 12129 MICRA3L HERRES 1774,44 DO 01/05/24 12603 RAELIN R LUNJA 691.86 0O 01/05/24 15097 KYLE L ➢AN13L 4132.90 DO 01/05/24 ISM SAVANVAR ILA.RLRY 1487.71 DD 01/05/24 15139 KRIST_K NICOLE BALIARD 2591.96 DD 02/05124 1SIG3 KELSEY TIS140LD 4809.16 DD 01/05/24 ISM JESSICA MDR 1739.12 DD 01/05/24 ISM EESSENIA L CRAHADDS 882.06 DO 01/05/24 15206 DARK 14 MARBK 2088.62 DD O1/05/24 15555 STEPHANIE MARTIN 42636 DD O1/05124 15909 JULIE NGUYEN 3045.44 DO 01/05/24 15515 BRIMM J KEY 2053.65 DO 01105/24 20012 ALBKIS LOREDO 743.42 DO 01/05124 20112 YULNA PATRICA RODRIG➢?Z 729,57 DD O1/05124 20156 MR MGM RIM. 1721.21 DD 01/05/24 20166 JCSI.'0A PEPPERS 774.63 DD 01/05/24 20178 AM.Y GARCIA 3010,55 DD 01/05/24 20164 MELISSA ZAMORARO 790.91 DO 01/05/24 20206 IELLI R GOFF 1734.94 OD 01/05/24 20207 SHAW G HARTL, NLT 2467.02 DD 01/05/24 20243 MELANIO CORTEZ 2965.99 DO 01/05/24 20272 ANGELA TRADER 1991,73 DO 01/05124 20294 JESSICA D NALIVER 1030.47 OD 01/05124 2C324 PATRICIA STAMM 2251.00 DO 01105124 26343 SAVANNAH N SOCA.RRAS 1121.13 D➢ 01/05/24 20456 SA'YDI A S^ CLAIR 221.64 DO 01105/24 Run Oate: O1/02/24 WRIAL MEDICAL CUTER BI-WEEKLY Page 3 Tina: 15:24 +••• Check Register •••• P20ISTP Pay Period 12/15/23--12/28/23 Run: I Type=LET 30009001 OPERATINC - PROSPERITY NUR. Nave Amnunr CHECK HUM DATE 20494 ERIANU S PASSMORE 598.3E DD 01/05/24 20759 JAMIE SADLER 751.72 D0. 01/05/24 20788 JAYLIN RAMIREZ 362.10 OD 01/05/24 20797 BETFANN M DIRrS 2035.85 DD 01/05/21 20517 CHERYL L TFSCH 2192.45 DO 01/05/24. 20909 SAVANA LENTO 805.37 DD 01/03/24 21450 DIANA E LEAL 1567.a0 OD OWS/24 21629 JACOBY R CRANFORD 1753.36 DO 01/05/24 28120 JESSIC4 V SELVEPA $03.78 DO 01/05/24 2919E RELLY A SCROTT 1550.27 DO 01/05/24 31035 STACIE L EPLEY 1916.39 DO 01/05/24 31054 LORA L LAMBORN 933.22 DD 01/05/24 31099 ARACELY Z GARCIA 1104.52 DD O1/05/24 32219 LAUREL PHILLIPS 1480.50 DD 01/05/24 31241 MICA SALAZAR 413.72 DD 01/05/24 Y231 M`IHIA L BIAS 168i.79 DO 01/05/24 3i513 KATRSRIAE LYNN JIMENEZ 2264.58 DO 01/05/24 31319 STACY L FARMER 1795.91 DO 01/05/24 33463 EDNARD E FATDLA 2513.49 DO 01/05/24 31503 RAWL A HEFFNER 1983.07 DO 01/05/24 3'821 KAYLA M ALVAREZ 1157,91 OD 01/05/24 38118 KRYSI3LLA F !ISIAE 1036.9E DD C1/05/24 38183 MADELINE ANDERSON 1069,29 DD 01/05/24 38428 JULIAN EEYSQD:ERDO 1093.46 DD 01/05/24 41112 ANASTASIA L PEREZ 652.20 DD 01/05/24. 41171 TCdNI' M TR-sVINO 646.86 DD 01/05/24 41219 GUADWPE O=EZ 094.57 DD 01/05/24 41225 LESLIE A. CRAIGER 1099.22 DO 01/05/24 41216 PAMELA K VANNOY 1387.63 DO 01/05/24 43251 am YBARBO 673.B7 DO 01/05/24 41261 3BRNICE AGO Ml 874.87 DD 01/05/24 41269 BERENICE LUGO 742,20 DD C1/05/24 41274 KA.REI CAM 1073.40 D3 01/05/24 4'279 PAMELA R RAW 59.99 00 01/05/24 41347 ADRIANNA D STRAWS 419.41 DO 01/05/24 41418 A.NGEN M CASSEL 952.57 DD 01/05/24 4i426 TASPA NORMAN 3442.83 00 01/05/24 41506 JOSEFAT 1140 TORRES 864.52 DD OIJ05/24 41612 SONJA A OILAJARID 870.1E DO 01/05/24 41617 JACM1,71M M MARTINEZ BS?.63 DD 01/05/24 41105 KELSEY R TAY60R 1079.92 OC 01/05/24 41896 ?MAE MICHELLE EMERY 691.90 OD 01/05/24 41897 ROKANNA MIIR02 855.69 DO 01/05/24 41901 JOANTTA R NILLEP. 1075.13 SO 01/05124 41953 KAYLE04 TRIVINO B19.75 DO 01/05/24 42106 CHRISTY SIVIAS 911.95 00 01/05/24 421i2 SCCORRO C CORZALES 1017.92 DO O1/05/24 42122 LEI ANA CRAVANA 1719,12 DO 01/05/24 42125 MRRIA 7UCY C1d2MA 74232 DO OV05/24 42304 NI91T T HOOVER 2147.14 DD 01/05/24 4253E RARIAR A SOCARRAS 605.20 DO 01/05/24 42820 FA?IA 0 COAVEZ 821.45 00 01/05/24 42842 SFAANA S 0 DONNELL 3255.43 DO 31/05/24 50018 MICR.L3 LE 11 MORALES 1626.3E DO 01/05/24 Rua Date: 01/02/24 MEMORIAL -WICAl CENTER B1488KLY Page 4 Time: 15:24 •u+ Cheek Register iv-- 920I5"P Pay Period 12/15123--12/26/23 Run: 1 TypaMl 10000001 OPSWING - PROSPERITY Sum. Nara Amount CHECK NUM DATE 5014E PENNY GOULDEN 3373.24 DO 01/05/24 50161 BRIliM MICHELLE ZANORA 1505-52 D➢ 01/05124 50250 SUMMER 'e NICHOSON 637.77 DO 01/05/24 S0282 JACOB H WILTON, PT, OPT 2564.39 DO D1105/24 50310 JASMR33 GRIGSBY 761.87 OD 01/05/24 50546 Y.EL4N1E E SAMAYOA 2130.71 DO 01/05124 50573 DEMA R DAVIS 1677.48 OD D1/05/24 50556 BETIY S DAVIS 2232.82 DD 01105/24 50719 D5BRA K MUSTERED 240.64 DO 01/05/24 50920 ADINA GERDES 679.66 DD DI/05/24 53541 JACLYN E Ra4TL 1531.61 DO 01105/24 54024 MONICA A ESCALNTE 987.54 DO 01/05/24 55025 LEA, C RESENDEZ 1382.51 OD 01/05/24 55026 IREHE B PEREZ 732.65 DD 01/05/24 55227 APRIL N KUBALA 1915.62 DD 01/05/24 55371 BLANCA HERNALDEZ 393.09 DD OS/05/24 55382 SHAM JACIL➢D 194.05 DD 01/05/24 SS656 LCIUAN SILKS 8L6.54 DD 01/05/24 58115 NEW ME SEE 700.40 DD 01105/24 59510 RITA L POLENSKY 1039.37 DO 0105/24 60112 ROBERT A RODRIQUEZ 2028,13 DD 01/05/24 60131 NO.RA OVALU 500.34 OD 01105/24 60156 DANIELLE M KALISB8 10A3.91 DO O1%OS/24 60165 TBRESA A, ESNIT.EZ 172311 DO 01/05/24 60539 JASON J LOYA 1141.33 DO 01/05/24 60616 ➢OROTHY A LOKC-C•RIA $94.12 DO 01/05/24 62322 ALM MIGHT 1541.29 DO 01/05/24 63193 MICHAEL SOCAR.RAS 1080.98 DD 01/6/24 63458 VIRGINIA CBERNARDINO 911.2E DO 01/05/24 65100 FELICITA BONUZ 786.90 DO 01105/24 65125 MANTRA CUMPEAN 793.53 DD. 01/05/24 65127 VERONICA ORTIZ 737,94 ➢D 01/0$/24 45136 TINA KCRANEK 1043.81 DO 01/05/24 65148 MARTA M71GU82 1057.23 DO 01/05/24 65151 ELIA O ACHIA 1294.25 DD 01/05/24 65189 SLVIRA EANCBBZ 1061.85 OD 01/05/24 65205 JUADA SANTILLAN 1290.50 DD 01/05/24 65213 LEE SIBEHLY 1167.17 ➢D 01/05/24 65269 NATALIE BARSPIEM 96D,66 DD 01105/24 65315 ELVA RODRIGUEZ 576,97 DD 01/05/24 65393 LAN.ODA A PBREZ 1679.72 DO 01/05/24 65453 AMALIA L FLARBS 1410.81 DO 01/05/24 65463 WARM I VELAM MAT DD 01/05/24 65406 ROSA RODRIGUE2 746.27 DD 01/05/24 65313 MARIA MORALES 948.08 DO 01/05/24 6S705 DOMITILA HERREM 1013.92 DO 01/05124 65715 103IA R Com 951.93 DD 01/a5/24 65865 FROM F LEDEZHA 793.20 DO 01/05/24 68369 MUM GARCIA 477.92 DO 0710512, 68568 CHRISTOPHER BUTHERFOR➢ 856.5E DO 01/05/24 68792 NAZAP.IO DIAZ HERNANDEZ 1866.03 nD 01/05/24 70119 SW 9 3LMSOE 2385,65 DO 01105/24 73749 GLORIA N RRID 2254.52 DO WDS/24 74159 CAROL VILLARREAL 920.00 DO 01/05/24 Run Date: 01/02/24 MEMORIAL :MEDICAL CRITER BI-NEBNLY T.me: 4:24 **+• Check Register +"** Pay Parld 12/15/23--12/28/23 Run: 1 Type=NET 10000001 OPERATING - PROSPBRITi Rum. Rave Amount CHECK NUM. DATE 75190 RIBA KLTER 1954.21 DO 01/03/24 76603 INIA DELEON 630.05 DO 01/05/24 76115 JENNIFER R CARLOCR 686.56 DD 01/05/24 76120 RACHEL CANALBS 1239.72 DD 01/05/24 76138 %ABRN D GARCIA 724,21 DD 01/05/24 76210 209 VISLARREAL 575.12 OD 01/05/24 76100 AIDA JIMENEZ 1005A9 DD 01/05/24 16313 PAMELA L BARTON 790.18 DO C1/DS/24 76403 KATRINA A PORLOCA 1246.06 DD 01/05/24 76647 CHERYL A SEE 956.9E DD Cl/05/24 7670E GREGQRr B HORALBS 767.24 ➢O O1/OS/24 76854 NARY PATTERSON USX DD 01/05/24 769BS VANESSA TRIBTAN 244.31 DD 01/05/24 77646 FAREN A GOYZALH3 1029.66 OD 01/05/24 7BD20 6IETY R PASSMOAE 1598.49 DD 01/05/24 7805E 3YANN J PONSE 248.52 DO 01/05/24 78072 DONNA M RANLINGS 1890.21 DD 01/05/24 79129 XUA OOiN-1ASILLA 1041.16 DO 01/05/24 70297 MARISSA D ALMANZAR 2234.29 DO D1/05/24 78336 JESSICA L GLOVER 1310.40 DO 01/05/24 78556 Mi 18EA R GEE 557.36 DO 01/05/24 78764 ASLEY D HA.DLEY 2045,67 DD 01/05/24 78781 NRIST3N R D..CHICEX 3235.70 IS 01/05/24 73737 FARAR I JANAY. 2624.60 GO 01105/24 78897 DAYLS J R03INS011 658.86 DD 01/05/24 80008 ADPM D HERD) 2496.29 DD 01/05/24 80141 JEANNIE ORTA 1606.73 DD 01/05/24 8092B B.RYAN HOBGOOD 1041.67 DD 01/05/I4 82227 CAITLIN A CLEVENGER 942,74 IS 03/05/24 86462 REGAN M HARPER 001.54 DO 01/05/24 06576 SO HE.RRERA 752.11 DO 01/05/24 S8125 LISA M TREVINO 1156.98 DD 01/05/24 88148 M.ICHSLLE CGMHEG AMD 93.35 DO 01/05/24 86321 ANDREN IS LOS SAVTOS 2643,17 DO 01/05/24 88435 JOE GARCIA 1574.07 IS 01/05/24 90320 ROSHANGA S THOMA6 5876.0E DO 01/05/24 90529 STCT BROCE 4855.83 DD 01/05/24 93231 AMDRIE M FM2RE5 1075.42 DD 01/05/24 93241 SARIAH N RD8IO 1265.90 DD 01/05/24 9875E ADRUM M GP.LVAN 1617.77 DD 01/05/24 377522.39 Page 5 02DISTP MEMORIAL MEDICAL CENTER PROSPERITY BANK ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT--- Dec 22 - Dec 29, 2023 'r p� Date Bank Description 12/22/2023 PAY PLUS ACHTrans 0000000101904831010006930 MMC Notes CF 4.6 0 e A ount 12/22/2023 EXPERTPAY EXPERTPAY 746003411 91000015139543 - 3rd Party Payer Fee $ i - 8 ::46r401 168 U 12/22/2023 AMERISOURCE BERG PAYMENTS 0100007768 2100002 -Child Support Payment $ rawA • 6 5 + 12/22/2023 MEMORIAL MEDICAL PAYROLL 746003411113122650 - 340B Drug Program Expense $ 437.42,+ 67. 8'/ + 12/26/2023 PAY PLUS ACHTrans 0000000103178231010006940 Payroll $ 383,343.09 4�- �§r�� .. �tY;Z: 4: 12/26/2023 MCKESSON DRUG AUTO ACH ACH05801977910000158 12/26/2023 -3rd Party Payer Fee 340B Drug Program $ kA AD, �M VITVi-�Ay IRS USATAXPYMT 2703760137965946103601001538 Expense $ 1,082.7290k 12/27/2023 PAY PLUS ACHTrans 0000000104362361010006952 -Payroll Taxes $ 121,295.37 570 • 6 9 + 12/28/2023 PAY PLUS ACHTrans 0000000105063661010006964 - 3rd Party Payor Fee $ i8185 sr s',67,., - 3rd Party Payer Fee $ a67i-,"""x 80 139•'72 , 570 - 69 506,869.01 + 710.41 m y 506,869.1)1 + ANDREW DE LOS SANTOS December 29, 2023 4 3,/ A 7 Memorial Medical Center} RYp''a It'9A 2a 6L 5 8 3 + 3 4 3 • II Y — PROSPERITY BANK X 71- U3ll be aypwvt d -}I,µS lAO.ri' I I3IL9 1 + 0 8'Z • / - ELECTRONIC TRANSFERS FOR OPERATING ACCOUNT. - ESTIMATED ACHS 12 1 + 295 - Date Description 1 0• 4 1 �a MIMIC7 MC Notes Amount 710.4.1 . 710 41 - ANDREW DE LOS SANTOS December 29, 2023 Memorial Medical Center APPROVED ON JpAp'N1 00y2p12024 CAQHOII�\I tK,OIINTY'WT A,F Memorial Medic- l er Transfer Request 500;000.00 Account: MMC Prosperity Money Market•299S MMC ProsperityOR atin•4357 Date: 12/28/212/28/2�� APPROVED ON JAN 02 2024 GAROUNUG0UNT1', (TEXAS To transfer funds from Prosperity Money Market Account to Prosperity Operating account for Memorial Medical Center by: Caitlin Clevenrzu, Date; 12/28/2Di3 Date: ` ry , S J? Date: f Z z'{i 1N2.7 12/28123, 9:21 AM imp_cw5report6155956127852978512.htm1 RECEIVED BY THE Y AUDITOR ON 17COUN0 23 MEMORIAL MEDICAL CENTER 0 09:2BEC 2 8 2023 AP Open Invoice List ap_open_invoice.template Dates Through: VAMb1 (e. ra ftmOAS / Class Pay Code 11816 ASHFORD GARDENS ✓ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 122023 12/261202 12120/902 01120/202 7,752.15 0.00 0.00 / 7,752.15 t/ UHC OCT OIPP Vendor Totals: Number Name Gross Discount No -Pay Net 11816 ASHFORD GARDENS 7,752.16 0.00 0.00 7,752.15 Grand Totals: Gross Discount No -Pay Net 7,752.15 0.00 0.00 7,752.15 APPROM ON DEnCN2 8at2�0p23 R ('A',HOIGNU IOUN7V.lTqXA8 file://IC:/Usersiltrevino/cpaiimemmed.cpsinet.com/u88l25/data_5/tmp_cw5report6156950127852978612,html 111 12/28/23, 9:24 AM 1mp_cw5report886164793329673822.html RECEIVED BY THE 12&8gdR YAUDITOR ON MEMORIAL MEDICAL CENTER 09:24pEC 2 8 2023 AP Open Invoice List Oates Through: Vendor# Vendor Name Class Pay Code ih> ✓}dOU915CWTW&VJ14OUSTON Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount 122023 12/26/20212/20/20201/20/202 2,318.40 0.00 UHC OCT QIPP Vendor Totals: Number Name Gross Discount 11828 SOLERA WEST HOUSTON 2,318.40 0.00 Raped 9�dranr'xy Grand Totals: Gross Discount No -Pay 2,318.40 0.00 0.00 APPRpVI�p ON DEC'22 8 2023p CALBHOUN��OU4WJ` 1r A5 0 ap_open_involce, to mplate No -Pay Net 0.00 2,318,40 No -Pay Net 0.00 2,318.40 Net 2,318.40 file:IIIC:/Userslltrevino/cpsi/memmed.cpsinet.com/u88125/data_5/tmp_cw5report886164793329673822.html 1/1 12128123, 9:23 AM tmp_cw5reportl 157890079561178514.html RECEIVED BY THE GQQY/jb2WDITOR ON MEMORIAL MEDICAL CENTER $$pp, OfJGI. 29 2023 AP Open Invoice List Dates Through: Vendor# Vendor Name Class Pay Code Ctr0RT9EIffMHEALTHCARE CENTER / Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount 121923 12/26/202 12119/202 01/201202 3,600.00 0.00 TRANSFER tJR jYJWV1lW fy0 Jgem}ed AK Mild- orai-+ 122023 12/26/20212/20/20201/20/202 2,415.00 0!00 UHC OCT QIPP Vendor Totals: Number Name Gross Discount 11820 FORTBEND HEALTHCARE CENTER 6,015.00 0.00 n oi3aI`:'um,, IaTy Grand Totals: Gross Discount No -Pay 6,015.00 0.00 0.00 APPROVE® Ot4 g DCE�Cu�27 8 2Q23 OALHOl1N C�U�tXAS 0 ap_open_i nvoice.template No -Pay Net 0.00 3,600.00 L, 0.00 / 2,415.00 r/ No -Pay Net 0.00 6,016.00 Net 6,015.00 file:/!/C:Nserslitrevino/cpsi/memmed.cpsinet.comlu881251data_51tmp_cw5reportll57890079561178514.html 1/1 12128/23, 9:23 AM RECEIVED BY THE COUNTY AUDITOR ON c'' 09:�&1 8 2023 tm p_cw"eport4558920323486074338.html MEMORIAL MEDICAL CENTER AP Open Invoice List :VWd6VN VAdbRNaWFeXA$ Dates Through: 11832 BROADMOOR AT CREEKSIDE PARK Class Pay Code Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay 122023 12/26/2021 PJ201202 01/20/202 UHC OCT OIPP Vendor Totals: Number Name 11832 BROADMOOR AT CREEKSIDE PARK Grand Totals; H r'a,t Sdi,jmmciry Gross Discount 2,673.85 0.00 APPROVED ON DEC 2 8 2023 CABH0%UpO WlTOR V 0 ap_open_invoice.template Gross Discount No -Pay 2,873.85 0.00 0.00 Gross Discount No -Pay 2,873.86 0.00 0.00 No -Pay Net 0.00 2,873.85 Net 2,873.85 Net 2,873.85 rile:111C:/Userslltrevinolcpsflmemmed.cpsinet.comiu88125/data_5/tmp_cw5report4558920323486074338. html 12/28/23, 9:25 AM tmp_cw5report7598164576541504381.html HE .(R1BTY AUDITOR ON i�z/2�/2023 - MEMORIAL MEDICAL CENTER o9KC 2 8 2023 AP Open Invoice List Dates Through: Vendor# Venn F�I�t�7�/tC CRESCENT Class Pay Code 'fii8214tJid THE Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount 122023 1 PJ26/202 I PJ20/20201/20/202 2,149.35 0.00 UHC OCT QIPP 122123 12/27/20212/21/20201121/P02 10,640.00 0.00 TRANSFER TMjOkUMML dtfot;&w If lo, OkUL OV W-' Vendor Totals: Number Name Gross Discount 11824 THE CRESCENT 12,789.35 0.00 Grand Totals: ,4PPMOVED ON DccEppC 2 8 2��02T3�p CA�HOUNUGOUNT ,TEXAS 0 ap open invoice.template No -Pay Net 0.00 2,149.35 0.00 10,640.00 No -Pay Net 0.00 12,789.35 Gross Discount No -Pay Net 12,789.35 0,00 0.00 12,789.35 file:IIIC:/Userslitrevino/cpsllmemmed.cpsinst.com/u88125/data 5/tmp_cw5report7598164576541504381.html ill 12128/23, 9:23 AM tmp_cw5repart520282282368079799.htmI RECEIVED BYTHE IT 12/jeffiffYAUDITOR ON MEMORIAL MEDICAL CENTER 09:23DEC 2 8 2023 AP Open Invoice List ap invoice,template 0 Dates Through: open Vendor# Vendor Name Class Pay Code 1q t4B10Ut81Xd�ft ff $HEALTHCARE ✓/ Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Gross Discount No -Pay Net 121523 12/26120212/15/20201120/202 1,614.82 0.00 0.00 1,614.82 LL', TRANSFER t4" jlf USt,YU (18Kt de.pt7ol{Ed lirt-it K&.L uptri,, } Vj,L/� 121523A 12/261202 12/151202 01/20/202 4,470,30 U.00 0.00 4,470,30 TRANSFER It rI 121823A 12/26/20212/18/20201/20/202 320.59 0.00 0,00 320,59 ✓ TRANSFER itu 1218238 12/26/20212/18/20201/20/202 836.45 0.00 0.00 836.45 ✓ TRANSFER tt 121823 12126/202 12/18/202 01/20/202 621.81 0.00 0.00 / 621.81 W TRANSFER t' n 122023 12126/202 12/201202 01/20/202 3.821.98 0.00 0.00 3,821.981i UHC OCT OIPP 122123 12/26/202 12/21/202 01/21/202 237.19 0.00 0.00 237,19 ✓ TRANSFER tt 122023A 12/27/202 12120/202 01/20/202 1,000.00 0,00 0.00 1,000.00 TRANSFER rt .p 122123A 12/27/20212121/20201/21/202 3,555.00 0.00 0.00 31555.01) ,S TRANSFER N tl 122223A 12/27/20212/22/20201/22/202 20,805.37 0.00 0.00 20,805.37 TRANSFER it 11 122223 12127/20212/22/20201/22/202 12.807.56 0.00 0.00 12,807.56 ✓ Vendor Totals: Number Name Gross Discount No -Pay Net 11836 GOLDENCREEK HEALTHCARE 50,091.07 0.00 0.00 50,091.07 Repo:'. SwnoorV Grand Totals: Gross Discount No -Pay Net 50,091.07 0.00 0.00 50,091.07 APPROVED ON DEC 2 8 Z023 �] CALHOIIN ,�f�I AR'T?VAS file:///C:/Users/itrevino/cpsl/memmed.cpsinet.com/u88l25/data_5/tmp_cw5report520282282366079799.htm) 1/1 RECEIVED BYTHE 12128A2022SAUDITOR ON MEMORIAL MEDICAL CENTER 09: el UE AP Open Invoice List 0 ap_open_invoice.template C 2 8 2023 Dates Through: Vendor# Vendor Name Class Pay Code i7F100UN RS16t3AryltL�'AVIlAGE Invoice# Comment Tran Dt Inv Dt Due Dt Check Dt Pay Grass Discount No -Pay Net 121923A 12/26120212/19/20201/201202 2,573.98 0.00 0.00 2,573.98 TRANSFER f 0 ivtsurwnls P6VLJ- dtfaGittt jK-t tt . D?W+W 121923 12/26/20212/19/20201/20/202 3,400.00 0.00 0.00 3,400.00 / TRANSFER It tt 122023 12/261202 12120/202 01120/202 3,277.50 0.00 0.00 3,277.50 ✓ UHC OCT QIPP 122023A 12/27120212/20/20201/20/202 14,400.00 0.00 0.00 14,400.00 TRANSFER 0 u Vendor Totals: Number Name Gross Discount N,.Pay Net 13004 TUSCANY VILLAGE 23,651.48 0.00 0.00 23,651.48 Grand Totals: Gross Discount No -Pay Net 23,651.48 0.00 0.00 23,651.48 APPROVED ON DEC 2 8 2023 CALLHO%NUC ONTY,ITE E3 12128/23, 9:22 AM tmp_cw5repart7196356131140791389. himl RECEIVED RECBY THE 12MMY AUDITOR ON MEMORIAL MEDICAL CENTER 09:22DEC 2 8 2023 AP Open Invoice List 0 Dates Through: Vendor# Vendor Name ap_open_invoice.template q� 1SFNIOUPBWAI t ,SEFNIOR LIVING ✓ Class Pay Code Invoice# Comment Tran Dt Inv Ct Due Dt Check Dt Pay 122023 Gross Discount 12/26/20212/20/202 01/20/202 31693,59 No -Pay Net UHC OCT OIPP 0.00 0.00 3,693.59 122123 12127120212121/202 01/21/202 TRANSFER tjtj IYLNpa(L' F�l(kf d 1�06(�lr.� 11,374.29 0.00 0.00 11,374.29 �✓ 122223 II'1-{7 12/27/202121221202 01122f202 �Mkc. t}` �0,00 TRANSFER li 3,818.16�t,M 0.00 3.816.16 122223p 12/27/20212/22/20201/22/202 tl TRANSFER It 15,423.23 0.00 0.00 15,423.23 a® Vendar Totals: Number Name 12792 BETHANY SENIOR LIVING Gross Discount No -Pay Net 34,307.27 0.00 0.00 34.307.27 Grand Totals: Gross Discount 34,307.27 No -Pay Net 0.00 0.00 34,307.27 APPROVED ON DEC 2 S 2023 CAMOIM C&NTY,ITEXAB file:/!/C:/UsersAtrevino/cpsilmemmed.cpsinet.com1u88125/data_5/1mp_cw5report7196356131140791389.html i11 Memorial Medical4nter Nursing Home UPL Weedy6mu Trawler PmI9erHyAmeuntr IV29/2023 eewn InWp � ,q R'.!YAffiS ��i llSA{a.15 ySuAni M�114>M.l{ {/ SI ".44 eRe5Sf1�lIJl1e�J91JS 141,562.86 + 111,203.6-1 +gems 140e432,96 + 62,096•15 + 277e891m_�1 + 73.3, 186.96 u.\rxv. 5{S,W.n Ym YYYnw YPW emrtiPane.aw, p,(,nJwnl aYw,xSnwa / n! xY.mY.Ymw u5,u� / .eimaee.�..nnmr.ram. uurlm r/4/ �rana,a r.un,•a. 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IA,J9IJ3� b11.749U 966.392.67 >4.i9Ln MEMORIAL MEDICAL CENTER - OPERATING -4357 $1.585,668.01 it , 532e= 11,535.;lie nt 51,t4I,Si�3::1; MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014-4365 SUOA8 154048 1510e a 15J/i 1R MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING-4373 $435.11 1155.11 1!g411 $435;I MEMORIAL MEDICAL CENTER/NH ASHFORD-4381 ✓ $165.44436 VJ 5195.57_'36 S1fi5i_t 36 51960770A MEMORIAL MEDICAL CENTER NH BROADMOOR•440?�/ $120,377.40 /✓ •// SI_0.371d9 5110.377 J0 S206. E7676 MEMORIAL MEDICAL CENTER NH CRESCENT•4411, / $182.653.37 // V�✓/ SI E6.547 e3 118233337 >_S1T__ MEMORIAL MEDICAL CENTER SOLERA AT WEST HOUSTON •4438•/ $285,412.34 r/% $30 1.1 Y.CJ S?55:1235 535u.3J3,a_ MEMORIAL MEDICAL CENTER NH FORT BEND t4446 $69,697.21 S6?,537.31 5.4 MEMORIAL MEDICAL NH GOLDEN CREEK HEALTHCARE-4454 $16.092.43 517.95515 516.•75243 14,375P7 MMC -NH GULF POINTE PLAZA. PRIVATE PAY-5433 $3,200.76 S..zc076 e,'_0076 s3.22G.7,: MMCC-NH GULF POINTE PLAZA- MEOICARE/MEDICAID 15"1 $3,611.88 53,61185 SeslI 38 57141651 MMC-NH BETHANY SENIOR LIMING•5506 $145.056.30 1159.297;;< St45.C5630 $304, 5353A MMC -NH TUSCANY VILLAGE •3407 $75,431.85 1152.EZ2 63 173431 E5 D20I7.57: Memorial Medical Center Nursing Home UPL Weekly Nezion Transfer Prosperity Accounts 10/23/2023 P-w4u) Auaum tkllnnln) No"'fache Urexewrble66 willbe rm Jenedw Manuninahome. Nate£ Foob aawuntbw ebem baknttelStW MatMMCdeporindroanen owount. APPROVED ON JAN 02 2024 CALHOUNU COURVA9 TedeV')eealnnWX AmeunttA Be TmMerced re NUNC 16,0143 San v.n.r. 16,092)3 Vamnw Lteve lnentanw 166.0 OEabIl Mom, nano Novwberint..A 03.66 Adlurt BrlanuRranMrAmt_-=x6;6]593:�✓ Aoorwee: �.f`LL'1Ti Lc•Jli (\�� AxoAFwoFlos sneros tt/xsnoxa 1:\NH Weetlytomhn\HN UPLignrto )ummary\lb])\NNtIrLMnNv)ummrry 12)9.L3 1}/]yM33 WIPFdNMFIV4NX[µTXyp/{G440[NdE[MXl Ilp9/fi}3 XNB•[}NGNCgI�MIMTYE0M1INaYa}a}BH YRNma9 x4musauNwxxauMPM}Nxma3aowiN lL3)/IM} 44NIFNq![MFM)M[[CpflllffiX91NmW3 YR9f]p]] )fl9/}M1q)XKTFCC BIINMNN9R91119} ll/1C/30]9 xru)x xamxNsvcxgwmPMf})]MpN11bY] 1)AB/M]9 X[Mix XYMIXNCNgWMPMI ])I]WMi1301}3 i}gHAi) ]BI MMCP011tI0N qPP/Comps Tnnrtn-0u1 liinMrvin OIPP/fam9t qPP/fgm i qPP/Camp) 8Y q TI NX PDXN4N lIl.lN31 P/ snwm - zm.w y1N.n - ]snm - ]a9zaa - ]xn ],9N.w 9.i9a.N 3i.D ie.le9)} � 9d9D.69 �/ 19! 99 . 7;dl� i % ss � ti MEMORIAL MEDICAL CENTER - OPERATING '4357 $1,585,668.01 Jo 741,532v14 51,565,;G501 11,341.°^_,7 MEMORIAL MEDICAL CENTER• CLINIC SERIES 2014 IQ65 $540.48 5510 43 5540 = 134040 MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING*4373 1415.11 Se3i 11 543i 11 3435 11 MEMORIAL MEDICAL CENTER /NH ASHFORD-4381 S16SA44.36 II35,37`36 S',6 d44514 51 S60770F MEMORIAL MEDICAL CENTER/NH BROADMOOR-4403 $120,377.40 $1±0,37740 St±0.377.40 1208.37576 MEMORIAL MEDICAL CENTER /NH CRESCENT-"11 $182,653.37 515;:997(Is 118265337 MEMORIALMEDICAL CENTER/SOLERAATWEST HOUSTON'4438 f285Al2.34 5307,013 co S±83AI234 :>549453- MEMORIAL MEDICAL CENTER l NH FORT BEND'4446 $69.697.21 55?, 37.=1 S69,13372 MEMORIAL MEDICAL NH GOLDEN CREEK HEALTHCARE -44Siv/ f16,092.43J� 517,ry55.±i VV SI6.05243 Sue,374 n7 MMC• NH GULF POINTE PLAZA- PRIVATE PAY'5433 13,200,76 s3,2)7i; 53.24i 7C, 553>)7,g MMC-NH GULF POINTE PLAZA- MEDICARE/AIEDICAID'SMI 33.611.38 5361168 "AlI 5E S7. 44E. E,I MMC-N H BETHANY SENIOR LIVING-550fi $145.056.30 31i9.2i'._= 1145.05,:30 Ss04,1335% MMC-NH TUSCANY VILLAGE•1407 $75.431.05 SI[2.62-1u9 575,431.35 SE201'^37 Memorial Medical Center Nursing Home UPL Weekly HMG Transfer Prosperity Alxtiunts 12/29/2023.j Fm . anbuM .0-., NW Xeme Yr eNtte AnwWt NUM Nnme / NumHe ewe: skrM1lamWna/o[vsSaM t:ot, emn/rrrNw uenmNgh— Xbw2:Not .1.1 M1r]v!✓tteelWtt✓1SIMMot MMC✓e✓M✓N toyma¢nnr, APPROVED ON JAN 02 2024 CAWOU�UCOUN., ,MAU lunk0alanw Wrlana Leaveln Wanw INW PMMII✓er r W✓Mreaw ndidlurt&Iww/1'nntloGmt 1100.]6 •�� PmWMOB! vrmry TnMrm✓b C[ UXu & N Ealan[e X NaT1 / 3R14! mnk Bob.. ]bsue ,]✓�/ e�� vsXance �dIRF6N brveln BXanw LW,EO FdiuXBalmn/rnbM1tNM i.fllA{ TnTPL1MN5iER5 06n.et M- '�YO¢ - Y A �:.� fC��, J� • nay l�s� PNO0.EV/eEIMEWTOf C. IS/!!/IDI! snxxwwu;rn.mm�txxvnsonrcvsmnmtmsaawx u.Lmn✓nswnnxrv]:asn MMCPORTION OIPP/Come QIPP/Campo _ TMn[far•Oat TranR 5,26 gIPP/Cempf I OIPP/COmp3 6bpM OIPP iI NH PORTHIN 1y@ECH 28/33 HNB�OH[MIMPMT]a60Wa11 ad0009ED91E3 - {ISA6 - 2I5,36 UAW. HN5•CCHOHCMWPMT74W03411ap000010096I - 315.20 MAR MMC PORTION OIPP/Comp QIPP/CoMP6 TnnrNWut Tran r-In QIpP/C,Rpl 1 QIPP/ComP3 Wp. gIPPTI NN PORTION R/28OM WIRE OUT HMO Rnr0paO]NF, 7g894.63 - 12/2T/3023 HNB-F"ONCMIMPMT7461O34SIM 2029M - 1,670.91 - 1.670.91 1Z/2612023 NORIDMN93NHCMIMPMTW5892a200001MUM - 3a.0 / _ 33.94 12/22/2023 WMY tPTANT HCCWMpMT2901619M210M - 3B0].03 iBUMB ]0AM.63.r� 3A]lA8 , / 351f RR. / 70.M.63 3.9 Z.32 3."L32 MEMORIAL MEDICAL CENTER - OPERATING '4357 $1.585,668.01 i'74I:SS2 c_ 51.>5°,iE S1_:4150: 6-1 MEMORIAL MEDICAL CENTER- CLINIC SERIES 2014-4365 $540.48 55.04R 55.0.3 $5404P MEMORIAL MEDICAL CENTER- PRIVATE WAIVER CLEARING'4373 $05.11 S23511 !43511 Wi 11 MEMORIAL MEDICAL CENTER/NH ASHFORD-4381 i 5165,44436 1195.57255 SI6544456 $196,0770i MEMORIAL MEDICAL CENTER / NH BROADMOOR'4403 $120,377.40 51 0,377._0 51-10.377,40 52085,-'.% MEMORIAL MEDICAL CENTER/ NH CRESCENT'4411 5782,653.37 Sibb.9<7c5 !Ia265537 >__,__ MEMORIAL MEDICAL CENTER SOLERA AT WEST HOUSTON'4438 $205.412.34 5337.p 139J SISi 41234 535G.34]-- MEMORIAL MEDICAL CENTER/NH FORT BEND-4 16 $69,697.21 56 637._11 56269721 1112,Ia1.77 MEMORIAL MEDICAL NH GOLDEN CREEK HEALTHCARE'4454 $16,092.43 S179c5?5 S16,052..3 SI4„'/',5.fi] J MMC NH GULF POINTE PLAZA- PRIVATE PAY'5433 ,% �/% 53,200.76 / -=: +>,!- ..,1.,po r� S31i•.,' S3.2C^% MMC-NH GULF POINTE PLAZA- MEDICARE/MEOICAID'SUI $3,611.80 !'-ntt SS L,/J53,6116A MMC-NH BETHANY SENIOR LIVING'5506 5145,056.30 i159.1'_4 5145;)-E 30 Sd04.:?�Ad MMC•NH TUSCANY VILLAGE'3407 $75,431.85 1162 ^22',? 175431 E5 SE1017 el Memorial Medical Center Nursing Nome UPL Weekly Tuscany Transfer Prosperityaccounts 12/29/2023,, prMiWr Xox.nt aar,rdnp N.M rM - B.l.na �_ r lalllA3 RM.: Q*W.I.doe r,4tam.rtaerr..ymNmmenaomvn.me. .It 2 Fad ouarrnt"$ a&IttN wvj$1W that MMCdrMaedr, rym.tmnt. APPROVED ON JAN 0'2 2024 CALHOUN C �NiYITV M .-ttoF. Tr..NmN.. ^nr AAalA MTFABB ern461eve MAIA vN.nn rervUnallmv IDam MnRllrapp U.N., i71s I"%$, MIuR Wamllrunlbr NrR >. lr4L^ Roaraved: S\n�i\f 7r'rn aJ�A %Y�/��_. WO0.kW BFtO35Wr05 {_ IF/B/FOIi 12128/2023 MREOUTUNBARENTERPRISUALC 12/2a/2023 HNS-ECHOHCMIMPMTT46003411990000247634 12/27/2023 MOLINA HEALTHCAR MOUNMCH 0124523943000010 12/27/1023 NOWTA69OLUUON HCCIAIMPMT6T620142000015R IVZV2023 HNS- ECIO HCOAIMPMT 74WX14114400p0300971 12/22/2029 HNE-ECNOHCOAIMPMT746003411440000201669 12/22/2023 HNE-ECHO HCW MPMT)4600341141000U200961 MMC PORTION QIPP/Comp QIPP(tamp QIPP/Comp Transfer -Out T,.wfe,l. 3 QIPP(Cemp2 3 48,apse QIPPTI NHPORTION 9J30AT - 3,144.75 - 3,144.75 3,494.14 - 3,494.14 29,46IA3 - 29,462.43 3,935.69 - 1,936.68 12,343.93 - 12,343.93 14393.9E - 30,393.9E MEMORIAL MEDICAL CENTER OPERATING-4357 $1.585,668.01 51741.5',261 SLSi bou Ol <l,g.lt 0.'>d% MEMORIAL MEDICAL CENTER- CLINICSERIE62014-4365 $540.48 55403R 5540 -'.°. 15421R MEMORIAL MEOICALCENTER- PRIVATE WAIVER CLEARING-4373 $435.11 3_3511 1 435 11 513E 11 MEMORIAL MEDICAL CENTER/NH ASHFORD-4381 $165,44436 5195,i72i6 51u+11436 S1960770S MEMORIAL MEDICAL CENTER! NH BROADMOOR-4403 $120,377.40 S 12D, 577.2.1 S1_, �3774G 5203,3707? MEMORIAL MEDICAL CENTER/NH CRESCENT-4411 $182.653.37 S1 SS.0?J 65 St82 e53:7 S2Ei,-.%22 MEMORIAL MEDICAL CENTER SOLERAATWEST HOUSTON'd138 $285,412.34 53tl'^10 G0 [i55=12 j4 MEMORIAL MEDICAL CENTER TNH FORTSEND'4446 $69,697.21 569,c37.'I S*13DR .2; Su,i.:c-7- MEMORIAL MEDICAL/ NH GOLDEN CREEK HEALTHCARE'4454 $16,092.43 SI7 5;25 SIAD32A3 5142:07S. 17 MMC-NH GULF POINTE PLAZA- PRIVATE PAY'5433 61200.76 76 53-'X 78 53,+^;'7'3 MMC-NH GULF POINTE PLAZA-MEDICARE/MEDICAID'S44I $3,611.88 S&i:'S5 S5,c:15F .?a1251 MMC-NH BETHANY SENIOR LIVING-5506 $145,056.30 5159.2 14 Su51:563n Si0'.336 P.c. {/ MMC-NH TUSCANY VILLAGE-307 U/� $75.431.85 V✓ 5162.022.89 175,43165 noi01Z67 Memorial Medical Center Nursing Name UPL week1V HSLTransfer Prosperity Acw IS12/29/2023 .� vmww rawne NUN Name •' ' Nall: prlyWlunw[ Jaa A000-Y&honIf N. lFenurtMafwne. NMt1:faM IXb lk%a bnfW c..fPlan oommc nvrx.dl..a.n araunl. APPROVED ON JAN 02 2024 C41y4Ot1Rf CbI1Flt'/,�T�XA r.naq M.CL.n bnkbbnw W rbnw lore In bbnw INAM Nmaan.wb twnn.m.em e[[aMrinlfnN UL2V n.w W,r..nn IIS.b axlunbhaf/Irembrbn. tb ssss-'//zl NleafWNlPxfW a�� .1Ia9IMa. a::WM WaNinnxn\xxurltnpbsunm.ryVbaWx u60uWxsunn.rc laav]a WMERM NZ3 WIRE 0.M WW] Oenoyl I]ll(Ilm] 0moxt Wly]0]3 Mpopt W]y]pU pfmm W1)/SOU XOVRKfOlV110XNUWMPARBifMl.lml]I9e IL]f/30U NGIM MUALN3Y[XUWMIM[111IMU]UOUl W3U3pU Imi fy33/]xv xxe• fcxoxcWlxrMf alfmMv WYd]pY19] W3]/3033 MOVRK SOWIION H[CWMIMf6Y6N11IM[01]6 WU/]WI Iro1PIU 0f f0V9Np.ymeMf Nf 1UUU9mU3W I�319�6 7/ LMS Q, 3NSY6f MMCiORl10N 3e933 RagiftLCW T..EFRJp WP1/hmP1 aM/Comp3 m"/Q.p3 awww' wu aMTI NHPoIRIOX - 91s3r ns.er - 303UAS 30,x9)AB - ]AU.0 3AU.i1 33m.0 - 4,310.13 L30M - 3301.63 - LVI.1e - 1,971,19 itnx.w - M0s3 3Mex ".22"1 • i319U 99.3Ud1 MEMORIAL MEDICAL CENTER - OPERATING `4357 $1,585,660.01 5t?y 1.532^:- 11365455N 11.341, Si 367 MEMORIAL M EDICALCENTER- CLINIC SERIES 201 A-4369 $540.48 E54G 43 1540 R 15G14F. MEMORIAL MEDICALCENTER - PRIVATE WAIVER CLEARING-4373 5435AI 1-35 it 143511 !1>5.11 MEMORIAL MEDICAL CENTER NH ASHFORD•4381 S166A44.36 519557236 51654__36 $196077 n, MEMORIAL MEDICAL CENTER /NH BROADMOOR-4403 $120,377.40 5120, E774u 5120,377 t0 5208,37671 MEMORIAL MEDICAL CENTER/NH CRESCENT-4411 S1B2,653.37 5159,3765 118265337 S26?11722 MEMORIAL MEDICAL CENTER / SOLERAATWEST HOUSTON-4438 $285,412.34 S307.019 n0 52aSAQ.34 1350:i4i.3G MEMORIAL MEDICAL CENTER/NH FORT BEND'4 16 $69,697.21 599,6>721 W.i3721 MEMORIAL MEDICAL/ NH GOLDEN CRBEN MEALTHCARE-4454 516,092.473 51'.,PEE.25 51;:052=3 5;y2 7c'1v MMC-NH GULF POINTE PLAZA. PRIVATE PAY`5433 53,200,76 53,2O1.76 S:_'M 7e i",2COT> MMC-NH GULF POINTE PLAZA-MEDICARE/MEOICAID`5441 $3,611.83 3,51'. 63 13.3113E 1'+4.4y451 / MMC•NH BETHANY SENIOR LIVING•5506 �� 5145,056.3D J( 5159.?72S L/✓5162.622 $4 p5g in 131)y,5;35;' MMC-NHTUSCANYVILLAGE-3407 575,431.85 -i9 575.431.3 322,0I7>7 P A Y E E AMOUNT: MEMORIAL MEDICAL CENTER CHECK REQUEST- f3voadwwr Memorial Medical Center Date Requested: 12/29/2023 FOR ACCT USE ONLY APPROVED ON ❑ Imprest Cash ❑ A/P Check JAN 02 2024 CCpo N qU Ypp ❑Mail Check to Vendor CAIBJYIOUN� C�UN11�ITEH! S ❑ Return Check to Dept $ 105.71,E G/LNUMBER: 21400007 EXPLANATION: Claim payment transfer from BroadmoortoMMC REQUESTED BY: Caitlin Clevenger AUTHORIZED BY:(+, k U � tZ -2(1 () —) P Tuscany Village A Y MEMORIAL MEDICAL CENTER CHECK REQUEST - CvtsLm+ Date Requested: 12/29/2023 E E APPROVED ON JAN 02 2024 AMOUNT: EXPLANATION: FOR ACCT USE ONLY ❑ Imprest Cash ❑ A/P Check ❑ Mail Check to Vendor ❑ Return Check to Dept $ 35,100.00 G/LNUMBER: claim pymt transfer from Crescent to Tuscany,/ REQUESTED BY: Caitlin Clevenger AUTHORIZED BY:(l.,,, r " . -1, ) IJ_A 1