prvdr aaa comprehensive healthcare 1 7451 n …...prvdr current rev rate revenue provider owner...

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1396067500 AAA COMPREHENSIVE HEALTHCARE 01 001 10/1/2018 $158.18 0521 T1015 1 F 7451 N LANKERSHIM BLVD NORTH HOLLYWOOD CA 91605 FQ 035 19 1215383047 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 900 KING STREET ARBUCKLE CA 95912 RH 035 06 1316937121 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $201.19 0521 T1015 1 U 15230 LAKESHORE DR CLEARLAKE CA 95422 RH 035 17 1508212424 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 151 E WEBSTER COLUSA CA 95932 RH 035 06 1558737486 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $ 81.32 0521 T1015 1 U 18990 COYOTE VALLEY RD HIDDEN VALLEY CA 95467 RH 035 17 1609222512 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $160.00 0521 T1015 1 U 501 E STREET WILLIAMS CA 95987 RH 035 06 1841626587 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2017 $ 81.32 0521 T1015 1 U 9430 LAKE STREET LOWER LAKE CA 95457 RH 035 17 1962492876 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $150.94 0521 T1015 1 U 5290 STATE ST KELSEYVILLE CA 95451 RH 035 17 1972593788 ADVENTIST HEALTH CLEARLAKE 01 001 10/1/2018 $146.41 0521 T1015 1 U 21337 BUSH ST MIDDLETOWN CA 95461 RH 035 17 1275841629 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $278.89 0521 T1015 1 U 105 WEST E STREET TEHACHAPI CA 93561 RH 035 15 1508175431 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $237.83 0521 T1015 1 U 2041 BELSHAW STREET MOJAVE CA 93501 RH 035 15 1699084525 ADVENTIST HEALTH MEDICAL 02 001 10/1/2018 $237.83 0521 T1015 1 U 9350 NORTH LOOP BLVD CALIFORNIA CITY CA 93505 RH 035 15 1922490960 AGHABY COMPREHENSIVE 01 001 10/1/2018 $180.80 0521 T1015 1 F 349 W COMPTON BLVD COMPTON CA 90220 FQ 035 19 1881632867 ALAMEDA COUNTY HEALTH 01 001 10/1/2018 $229.01 0521 T1015 1 F 1900 FRUITVALE AVE OAKLAND CA 94601 FQ 035 01 1104959089 ALAMEDA COUNTY MED CTR 01 001 10/1/2018 $311.98 0521 T1015 1 F 6955 FOOTHILL BLVD OAKLAND CA 94605 FQ 035 01 1922131804 ALAMEDA COUNTY MED CTR 01 001 10/1/2018 $289.79 0521 T1015 1 F 6066 CIVIC TERRACE AVE NEWARK CA 94560 FQ 035 01 1548551997 ALAMEDA COUNTY MEDICAL 01 001 10/1/2018 $205.69 0521 T1015 1 F 1411 E 31ST STREET OAKLAND CA 94602 FQ 035 01 1033241633 ALAMEDA HEALTH SYSTEM 01 001 10/1/2018 $257.34 0521 T1015 1 F 664 SOUTHLAND MALL HAYWARD CA 94545 FQ 035 01 1306128822 ALL FOR HEALTH HEALTH 01 001 10/1/2018 $182.55 0521 T1015 1 F 437 S PACIFIC AVE GLENDALE CA 91204 FQ 035 19 1457633364 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $142.65 0521 T1015 1 F 520 EAST BROADWAY BLVD GLENDALE CA 91205 FQ 035 19 1568567220 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $119.91 0521 T1015 1 F 519 E BROADWAY GLENDALE CA 91205 FQ 035 19 1700131679 ALL FOR HEALTH, HEALTH 01 001 10/1/2018 $182.55 0521 T1015 1 F 401 S GLENOAKS BLVD BURBANK CA 91502 FQ 035 19 1073907689 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 800 S CENTRAL AVE GLENDALE CA 91204 FQ 035 19 1518398031 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 1030 SOUTH GLENDALE AVE GLENDALE CA 91205 FQ 035 19 1710318878 ALL FOR HEALTH HEALTH FOR 01 001 10/1/2018 $182.55 0521 T1015 1 F 8134 FOOTHILL BLVD SUNLAND CA 91040 FQ 035 19 1467971747 ALL FOR HEALTH, HEALTH FOR 01 001 5/1/2018 $166.60 0521 T1015 1 F 710 S CENTRAL AVE GLENDALE CA 91204 FQ 035 19 1760900922 ALL FOR HEALTH, HEALTH FOR 01 001 5/12/2018 $166.60 0521 T1015 1 F 2048 MONTROSE AVE MONTROSE CA 91020 FQ 035 19 1831617018 ALL FOR HEALTH, HEALTH FOR 01 001 5/12/2018 $166.60 0521 T1015 1 F 115 GIBSON ROAD TEMPLETON CA 93465 FQ 035 40 1902263015 ALL FOR HEALTH, HEALTH FOR 01 001 10/1/2018 $175.65 0521 T1015 1 F 5855 CAPISTRANO AVE ATASCADERO CA 93422 FQ 035 40 1710218409 ALLIANCE MEDICAL CENTER 01 001 10/1/2018 $186.64 0521 T1015 1 F 8465 OLD REDWOOD HWY WINDSOR CA 95492 FQ 035 49 1750399796 ALLIANCE MEDICAL CENTER 01 001 10/1/2018 $202.12 0521 T1015 1 F 1381 UNIVERSITY ST HEALDSBURG CA 95448 FQ 035 49 1518418862 ALLIANCE MEDICAL CENTER INC 01 001 10/1/2017 $196.97 0521 T1015 1 F 8499 OLD REDWOOD HIGHWAY WINDSOR CA 95492 FQ 035 49 1174996177 ALL-INCLUSIVE COMMUNITY 01 001 10/1/2018 $195.60 0521 T1015 1 F 3920 EAGLE ROCK BLVD LOS ANGELES CA 90065 FQ 035 19 1093019051 ALL INCLUSIVE COMMUNITY HLTH 01 001 10/1/2018 $147.91 0521 T1015 1 F 1311 N SAN FERNANDO BLVD BURBANK CA 91504 FQ 035 19 1528108610 ALTA FAMILY HEALTH CLIN 01 001 10/1/2018 $161.71 0521 T1015 1 F 888 N ALTA AVE DINUBA CA 93618 FQ 035 54 1982814745 ALTAMED COMM HEALTH CLIN 01 001 10/1/2018 $221.84 0521 T1015 1 F 10418 VALLEY BLVD EL MONTE CA 91731 FQ 035 19 1982814745 ALTAMED COMM HEALTH CLIN 01 002 10/1/2017 $177.95 0521 T1015 1 F 910 S SUNSET AVE WEST COVINA CA 91790 FQ 035 19 1346450103 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $157.87 0521 T1015 1 F 1701 ZONAL AVE LOS ANGELES CA 90033 FQ 035 19 1366834400 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $248.35 0521 T1015 1 F 1155 W CENTRAL AVE SANTA ANA CA 92707 FQ 035 30 1629283197 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $454.36 0521 T1015 1 F 4650 SUNSET BLVD LOS ANGELES CA 90027 FQ 035 19 1629283197 ALTAMED HEALTH SERVICES 01 002 10/1/2017 $431.03 0521 T1015 1 F 2100 W 3RD STREET LOS ANGELES CA 90057 FQ 035 19 1710191283 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $250.90 0521 T1015 1 F 9436 SLAUSON AVE PICO RIVERA CA 90660 FQ 035 19 1730481318 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $248.34 0521 T1015 1 F 1300 S SUNSET AVE WEST COVINA CA 91790 FQ 035 19 1760651814 ALTAMED HEALTH SERVICES 01 001 10/1/2018 $243.89 0521 T1015 1 F 2720 S BRISTOL STREET SANTA ANA CA 92704 FQ 035 30 1760651814 ALTAMED HEALTH SERVICES 01 002 10/1/2017 $228.15 0521 T1015 1 F 1515 S BROADWAY SANTA ANA CA 92707 FQ 035 30 1770006728 ALTAMED HEALTH SERVICES 01 001 4/16/2018 $216.51 0521 T1015 1 F 972 GOODRICH BLVD COMMERCE CA 90022 FQ 035 19 1790177582 ALTAMED HEALTH SERVICES 01 001 10/1/2017 $224.02 0521 T1015 1 F 1900 E SLAUSON AVE HUNTINGTON PARK CA 90255 FQ 035 19 1902267479 ALTAMED HEALTH SERVICES 01 002 4/26/2018 $236.42 0521 T1015 1 F 8627 ATLANTIC AVENUE SOUTH GATE CA 90280 FQ 035 19 1902267479 ALTAMED HEALTH SERVICES 01 001 10/15/2017 $236.42 0521 T1015 1 F 8627 ATLANTIC AVENUE SOUTH GATE CA 90280 FQ 035 19 1063659985 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $241.75 0521 T1015 1 F 1814 W LINCOLN AVE ANAHEIM CA 92801 FQ 035 30 1083851992 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 12751 HARBOR BLVD GARDEN GROVE CA 92840 FQ 035 30 1134492937 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $228.39 0521 T1015 1 F 2219 E 1ST STREET LOS ANGELES CA 90033 FQ 035 19 1235376047 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 1820 W LINCOLN AVENUE ANAHEIM CA 92801 FQ 035 30 1306015425 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $230.45 0521 T1015 1 F 8041 NEWMAN AVE HUNTINGTON BEACH CA 92647 FQ 035 30 1316116221 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $223.03 0521 T1015 1 F 4010 E CHAPMAN AVE ORANGE CA 92869 FQ 035 30 1356775878 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $245.51 0521 T1015 1 F 6336 PASSONS BLVD PICO RIVERA CA 90660 FQ 035 19 1437414190 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $249.85 0521 T1015 1 F 1300 N VERMONT AVE LOS ANGELES CA 90027 FQ 035 19 1538303516 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $164.43 0521 T1015 1 F 1814 W LINCOLN AVE ANAHEIM CA 92801 FQ 035 30 1740427657 ALTAMED HEALTH SERVICES CORP 01 001 10/1/2018 $243.89 0521 T1015 1 F 1400 N MAIN ST SANTA ANA CA 92701 FQ 035 30 1740427657 ALTAMED HEALTH SERVICES CORP 01 002 4/26/2018 $240.52 0521 T1015 1 F 1400 N MAIN STREET SANTA ANA CA 92701 FQ 035 30 1255542601 ALTAMED MEDICAL & DENTAL 01 001 10/1/2018 $228.97 0521 T1015 1 F 3945 WHITTIER BLVD LOS ANGELES CA 90023 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 002 10/1/2017 $214.20 0521 T1015 1 F 268 E BLOOM STREET LOS ANGELES CA 90012 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 003 10/1/2017 $214.20 0521 T1015 1 F 1305 S CONCORD STREET LOS ANGELES CA 90023 FQ 035 19 1255542601 ALTAMED MEDICAL & DENTAL 01 005 10/1/2017 $214.20 0521 T1015 1 F 1424 CRUSADO LANE LOS ANGELES CA 90033 FQ 035 19 1083800098 ALTAMED MEDICAL GROUP 01 001 10/1/2018 $215.60 0521 T1015 1 F 5425 POMONA BLVD LOS ANGELES CA 90022 FQ 035 19 1396959060 ALTAMED MEDICAL GROUP- 01 001 10/1/2018 $250.27 0521 T1015 1 F 5427 WHITTIER BLVD LOS ANGELES CA 90022 FQ 035 19 1023011632 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $135.67 0521 T1015 1 F 1101 N CHERRY ST TULARE CA 93274 FQ 035 54 1346486511 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $144.86 0521 T1015 1 F 737 W BARDSLEY AVE TULARE CA 93274 FQ 035 54 1568827210 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $165.20 0521 T1015 1 F 1500 W TULARE DRIVE TULARE CA 93274 FQ 035 54 1689011637 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $149.81 0521 T1015 1 F 3035 E BARDSLEY AVE TULARE CA 93274 FQ 035 54 1790105559 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $159.01 0521 T1015 1 F 600 N CHERRY ST TULARE CA 93274 FQ 035 54

PrvdrCurrent Rev Rate RevenueProvider Owner Service Current Revenue Special Zip Type CountyProvider Legal Name Rate Begin Procedure Status Physical Street Address City TypeNumber Num Location Rate Code Processing State Code Code CodeDate Code CodeType Code 1811174725 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $124.20 0521 T1015 1 F 1186 LELAND AVE TULARE CA 93274 FQ 035 54 1932529831 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $161.37 0521 T1015 1 F 16686 ROAD 168 WOODVILLE CA 93257 FQ 035 54 1942506605 ALTURA CENTERS FOR HEALTH 01 001 10/1/2018 $208.34 0521 T1015 1 F 1203 N CHERRY STREET TULARE CA 93274 FQ 035 54 1740222934 AMERICAN INDIAN HEALTH 01 001 10/1/2018 $249.17 0521 T1015 1 F 4141 STATE ST SANTA BARBARA CA 93110 FQ 035 42 1255350351 AMPLA HEALTH 01 001 10/1/2018 $120.57 0521 T1015 1 F 334 SAMUEL DR YUBA CITY CA 95991 FQ 035 51 1285667758 AMPLA HEALTH 01 001 10/1/2018 $146.18 0521 T1015 1 F 1211 CORTINA DR ORLAND CA 95963 FQ 035 11 1285667758 AMPLA HEALTH 01 002 10/1/2017 $107.30 0521 T1015 1 F 1187 EAST SOUTH STREET ORLAND CA 95963 FQ 035 11 1316963606 AMPLA HEALTH 01 001 10/1/2018 $119.54 0521 T1015 1 F 680 COHASSET RD CHICO CA 95926 FQ 035 04 1477586808 AMPLA HEALTH 01 001 10/1/2018 $171.05 0521 T1015 1 F 555 FREMONT ST COLUSA CA 95932 FQ 035 06 1497931828 AMPLA HEALTH 01 001 10/1/2018 $134.09 0521 T1015 1 F 89 PUTNAM WAY ARBUCKLE CA 95912 FQ 035 06 1639194004 AMPLA HEALTH 01 001 10/1/2018 $113.05 0521 T1015 1 F 520 KENTUCKY ST GRIDLEY CA 95948 FQ 035 04 1689699415 AMPLA HEALTH 01 001 10/1/2018 $123.60 0521 T1015 1 F 278 MAIN STREET HAMILTON CITY CA 95951 FQ 035 11 1801829296 AMPLA HEALTH 01 001 10/1/2018 $120.80 0521 T1015 1 F 4941 OLIVEHURST AVE OLIVEHURST CA 95961 FQ 035 58 1811329899 AMPLA HEALTH 01 001 10/1/2017 $138.47 0521 T1015 1 F 7981 HIGHWAY 99 E LOS MOLINOS CA 96055 FQ 035 52 1831115070 AMPLA HEALTH 01 001 10/1/2018 $133.08 0521 T1015 1 F 1000 SUTTER STREET YUBA CITY CA 95991 FQ 035 51 1952326811 AMPLA HEALTH 01 001 10/1/2018 $110.71 0521 T1015 1 F 931 MARKET ST YUBA CITY CA 95991 FQ 035 51 1952333635 AMPLA HEALTH 01 001 10/1/2018 $145.34 0521 T1015 1 F 2800 LINCOLN BLVD OROVILLE CA 95966 FQ 035 04 1346491651 AMU, JAVIER MD 01 001 10/1/2018 $107.34 0521 T1015 1 R 1093 11TH STREET REEDLEY CA 93654 RH 035 10 1427123496 ANAND NARAYAN MD INC 02 001 10/1/2018 $105.82 0521 T1015 1 R 468 VERMONT AVE DINUBA CA 93618 RH 035 54 1568449304 ANDERSON VALLEY HEALTH 01 001 10/1/2018 $190.08 0521 T1015 1 F 13500 AIRPORT RD BOONVILLE CA 95415 FQ 035 23 1346563673 ANTELOPE VALLEY COMM CLINIC 01 001 10/1/2018 $140.44 0521 T1015 1 F 2151 E PALMDALE BLVD PALMDALE CA 93550 FQ 035 19 1619290624 ANTELOPE VALLEY COMM CLINIC 01 001 10/1/2017 $125.72 0521 T1015 1 F 45104 10TH STREET WEST LANCASTER CA 93534 FQ 035 19 1710199674 ANTELOPE VALLEY COMM CLINIC 02 002 10/1/2018 $195.73 0521 T1015 1 F 45104 10TH ST W LANCASTER CA 93534 FQ 035 19 1730499872 ANTELOPE VALLEY COMM CLINIC 01 001 10/1/2018 $127.13 0521 T1015 1 F 45104 10TH STREET WEST LANCASTER CA 93534 FQ 035 19 1720537863 ANTELOPE VALLEY COMMUNITY 01 002 10/1/2018 $182.95 0521 T1015 1 F 37926 47TH STREET EAST PALMDALE CA 93552 FQ 035 19 1003230038 APLA HEALTH & WELLNESS 01 001 10/1/2018 $301.44 0521 T1015 1 F 611 S KINGSLEY DRIVE LOS ANGELES CA 90005 FQ 035 19 1639414139 APLA HEALTH & WELLNESS 01 002 10/1/2018 $285.23 0521 T1015 1 F 3743 S LABREA AVE LOS ANGELES CA 90016 FQ 035 19 1811367709 APLA HEALTH & WELLNESS 01 001 12/12/2017 $238.00 0521 T1015 1 F 1043 ELM AVENUE LONG BEACH CA 90813 FQ 035 19 1174665905 ARROYO VISTA FAMILY 01 001 10/1/2018 $163.66 0521 T1015 1 F 2411 N BROADWAY LOS ANGELES CA 90031 FQ 035 19 1316088479 ARROYO VISTA FAMILY 01 001 10/1/2018 $176.26 0521 T1015 1 F 4815 VALLEY BLVD LOS ANGELES CA 90032 FQ 035 19 1447353701 ARROYO VISTA FAMILY 01 001 10/1/2018 $137.88 0521 T1015 1 F 6000 N FIGUEROA ST LOS ANGELES CA 90042 FQ 035 19 1891837621 ARROYO VISTA FAMILY 01 001 10/1/2018 $ 85.44 0521 T1015 1 F 6000 N FIGUEROA ST LOS ANGELES CA 90042 FQ 035 19 1346200342 ARROYO VISTA FAMILY HEALTH 01 001 10/1/2018 $272.34 0521 T1015 1 F 303 S LOMA DR LOS ANGELES CA 90017 FQ 035 19 1821302027 ARROYO VISTA FAMILY HEALTH 01 001 10/1/2018 $159.15 0521 T1015 1 F 4837 HUNTINGTON DRIVE N LOS ANGELES CA 90032 FQ 035 19 1093898454 ASHMEAD ALI, MD 01 001 10/1/2018 $ 88.31 0521 T1015 1 R 9300 N LOOP BLVD CALIFORNIA CITY CA 93505 RH 035 15 1750490363 ASIAN AMERICANS FOR COMM 01 001 10/1/2018 $197.27 0521 T1015 1 F 2400 MOORPARK AVE SAN JOSE CA 95128 FQ 035 43 1225179641 ASIAN HEALTH SERVICE 01 001 10/1/2018 $280.48 0521 T1015 1 F 835 WEBSTER ST OAKLAND CA 94607 FQ 035 01 1003134545 ASIAN HEALTH SERVICES 01 001 10/1/2018 $324.17 0521 T1015 1 F 250 E 18TH ST OAKLAND CA 94606 FQ 035 01 1447391719 ASIAN HEALTH SERVICES INC 01 001 10/1/2018 $254.74 0521 T1015 1 F 818 WEBSTER ST OAKLAND CA 94607 FQ 035 01 1447391719 ASIAN HEALTH SERVICES INC 01 005 10/1/2017 $172.22 0521 T1015 1 F 900 FALLON ST OAKLAND CA 94607 FQ 035 01 1447391719 ASIAN HEALTH SERVICES INC 01 004 10/1/2017 $172.22 0521 T1015 1 F 817 HARRISON ST OAKLAND CA 94607 FQ 035 01 1336208255 ASIAN PACIFIC HEALTH 01 001 10/1/2018 $254.06 0521 T1015 1 F 1530 HILLHURST AVE LOS ANGELES CA 90027 FQ 035 19 1609147743 ASIAN PACIFIC HEALTH CARE 01 001 10/1/2018 $193.65 0521 T1015 1 F 9960 BALDWIN PLACE EL MONTE CA 91731 FQ 035 19 1811129091 ASIAN PACIFIC HEALTH CARE 01 002 10/1/2018 $240.15 0521 T1015 1 F 180 UNION PLACE LOS ANGELES CA 90026 FQ 035 19 1003951708 ASIAN PACIFIC HLTH CARE 01 001 10/1/2018 $226.95 0521 T1015 1 F 3939 TRACY ST LOS ANGELES CA 90027 FQ 035 19 1376798413 ASIAN & PACIFIC ISLANDER 01 001 10/1/2017 $160.60 0521 T1015 1 F 726 POLK STREET SAN FRANCISCO CA 94109 FQ 035 38 1922528694 ASIAN & PACIFIC ISLANDER 01 001 10/1/2017 $160.60 0521 T1015 1 F 1800 MARKET STREET SAN FRANCISCO CA 94102 FQ 035 38 1336201482 AURORA GRACE HWANG MD 01 001 10/1/2018 $ - 0521 T1015 1 R 835 N SEQUOIA AVE LINDSAY CA 93247 RH 035 54 1336201482 AURORA GRACE HWANG MD 01 001 10/1/2018 $107.54 0521 T1015 1 R 835 N SEQUOIA AVE LINDSAY CA 93247 RH 035 54 1346250347 AVALON MEDICAL DEV CORP 01 001 10/1/2018 $151.16 0521 T1015 1 U 100 FALLS CANYON ROAD AVALON CA 90704 RH 035 19 1073868527 AVENAL COMMUNITY HEALTH 01 001 10/1/2018 $163.72 0521 T1015 1 F 140 C STREET LEMOORE CA 93245 FQ 035 16 1225387616 AVENAL COMMUNITY HEALTH 01 001 10/1/2017 $126.36 0521 T1015 1 F 1000 SKYLINE BLVD AVENAL CA 93204 FQ 035 16 1275918674 AVENAL COMMUNITY HEALTH 01 001 10/1/2018 $168.34 0521 T1015 1 F 304 BECKY PEASE ST KETTLEMAN CITY CA 93239 FQ 035 16 1912312273 AVENAL COMMUNITY HEALTH 01 001 10/1/2018 $199.10 0521 T1015 1 F 148 E KINGS STREET AVENAL CA 93204 FQ 035 16 1912312273 AVENAL COMMUNITY HEALTH 01 002 10/1/2017 $194.02 0521 T1015 1 F 781 SEQUOIA AVENUE LINDSAY CA 93247 FQ 035 54 1932169240 AVENAL COMMUNITY HEALTH 01 001 10/1/2018 $134.26 0521 T1015 1 F 1000 SKYLINE BLVD AVENAL CA 93204 FQ 035 16 1992176267 AVENAL COMMUNITY HEALTH 01 001 10/1/2018 $185.80 0521 T1015 1 F 20326 MAIN STREET STRATFORD CA 93266 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 003 10/1/2017 $198.13 0521 T1015 1 F 781 SEQUOIA AVENUE LINDSAY CA 93247 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 005 10/1/2017 $198.13 0521 T1015 1 F 1320 BAILEY DR HANFORD CA 93230 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 014 5/21/2018 $200.51 0521 T1015 1 F 247 N L STREET DINUBA CA 93618 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 001 10/1/2018 $203.32 0521 T1015 1 F 3554 W MT WHITNEY AVE RIVERDALE CA 93656 FQ 035 10 1154736429 AVENAL COMMUNITY HEALTH CENT 01 004 10/1/2017 $198.13 0521 T1015 1 F 329 W 8TH STREET HANFORD CA 93230 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 006 10/1/2017 $198.13 0521 T1015 1 F 329 W 8TH STREET HANFORD CA 93230 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 007 10/1/2017 $198.13 0521 T1015 1 F 329 W 8TH STREET HANFORD CA 93230 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 008 10/1/2017 $198.13 0521 T1015 1 F 209 C ST LEMOORE CA 93245 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 009 10/1/2017 $198.13 0521 T1015 1 F 329 W 8TH STREET HANFORD CA 93230 FQ 035 16 1154736429 AVENAL COMMUNITY HEALTH CENT 01 010 2/20/2018 $200.51 0521 T1015 1 F 973 SEQUOIA AVE LINDSAY CA 93247 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 012 2/20/2018 $200.51 0521 T1015 1 F 575 W PUTNAM AVE PORTERVILLE CA 93257 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 013 5/22/2018 $200.51 0521 T1015 1 F 271 N L STREET DINUBA CA 93618 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 015 7/16/2018 $200.51 0521 T1015 1 F 229 W CHERRY AVE PORTERVILLE CA 93257 FQ 035 54 1154736429 AVENAL COMMUNITY HEALTH CENT 01 002 10/1/2017 $198.13 0521 T1015 1 F 755 SEQUOIA AVENUE LINDSAY CA 93247 FQ 035 54

PrvdrCurrent Rev Rate RevenueProvider Owner Service Current Revenue Special Zip Type CountyProvider Legal Name Rate Begin Procedure Status Physical Street Address City TypeNumber Num Location Rate Code Processing State Code Code CodeDate Code CodeType Code

1154736429 AVENAL COMMUNITY HEALTH CENT 01 011 2/20/2018 $200.51 0521 T1015 1 F 781 SEQUOIA AVE LINDSAY CA 93247 FQ 035 54 1235562224 AVENAL COMMUNITY HEALTH CTR 01 001 10/1/2018 $211.77 0521 T1015 1 F 1000 SKYLINE BLVD AVENAL CA 93204 FQ 035 16 1306877121 AXIS COMMUNITY HEALTH 01 001 10/1/2018 $206.67 0521 T1015 1 F 3311 PACIFIC AVE LIVERMORE CA 94550 FQ 035 01 1669403390 AXIS COMMUNITY HEALTH 01 001 10/1/2018 $206.67 0521 T1015 1 F 4361 RAILROAD AVE PLEASANTON CA 94566 FQ 035 01 1609249994 AXIS COMMUNITY HEALTH INC 01 001 10/1/2017 $160.60 0521 T1015 1 F 5925 W LAS POSITAS BLVD PLEASANTON CA 94588 FQ 035 01 1346480985 AXIS COMMUNITY HEALTH, INC. 01 001 10/1/2017 $158.85 0521 T1015 1 F 6666 OWENS DRIVE PLEASANTON CA 94588 FQ 035 01 1346353679 BANNING HEALTH CENTER 01 001 10/1/2018 $286.48 0521 T1015 1 F 3055 W RAMSEY ST BANNING CA 92220 FQ 035 33 1053310326 BARTON HEALTHCARE SYSTEM 01 001 10/1/2018 $286.52 0521 T1015 1 U 2201 SOUTH AVE SOUTH LAKE TAHOE CA 96150 RH 035 09 1811279763 BARTZ ALTADONNA COMMUNITY 01 002 10/1/2018 $204.29 0521 T1015 1 F 43322 GINGHAM AVE LANCASTER CA 93535 FQ 035 19 1689746208 BAUTISTA RURAL MED CLIN 01 001 10/1/2018 $ 94.48 0521 T1015 1 R 2570 JENSEN AVE SANGER CA 93657 RH 035 10 1851576888 BEAR VALLEY COMMUNITY 01 001 10/1/2018 $271.43 0521 T1015 1 U 41820 GARSTIN DRIVE BIG BEAR LAKE CA 92315 RH 035 36 1871778803 BEAR VALLEY COMMUNITY 01 001 10/1/2018 $240.02 0521 T1015 1 U 1028 W BIG BEAR BLVD BIG BEAR CITY CA 92314 RH 035 36 1073023677 BEHAVIORAL HEALTH SERVICES 01 001 10/23/2017 $169.22 0521 T1015 1 F 23251 MAIN ST CARSON CA 90745 FQ 035 19 1548659105 BEHAVIORAL HEALTH SERVICES 01 001 10/1/2018 $173.65 0521 T1015 1 F 2501 W EL SEGUNDO BLVD HAWTHORNE CA 90250 FQ 035 19 1578079919 BEHAVIORAL HEALTH SERVICES 01 001 2/4/2018 $171.25 0521 T1015 1 F 2015 W 1ST STREET SANTA ANA CA 92703 FQ 035 30 1023536992 BEHAVIORAL HEALTH SERVICES 01 001 10/1/2017 $169.22 0521 T1015 1 F 1334 N AVALON BLVD WILMINGTON CA 90744 FQ 035 19 1043621220 BENEVOLENCE INDUSTRIES INC 01 001 7/31/2018 $166.60 0521 T1015 1 F 303 N EAST STREET ANAHEIM CA 92805 FQ 035 30 1306257324 BENEVOLENCE INDUSTRIES INC 01 001 7/31/2018 $166.60 0521 T1015 1 F 934 ATLANTIC AVE LONG BEACH CA 90813 FQ 035 19 1376761940 BENEVOLENCE INDUSTRIES INC 01 001 10/1/2018 $191.52 0521 T1015 1 F 3533 W PICO BLVD LOS ANGELES CA 90019 FQ 035 19 1457781676 BENEVOLENCE INDUSTRIES INC 01 001 10/1/2017 $160.60 0521 T1015 1 F 611 E IMPERIAL HWY LOS ANGELES CA 90059 FQ 035 19 1497166672 BENEVOLENCE INDUSTRIES INC 01 001 7/31/2018 $166.60 0521 T1015 1 F 805 W LA VETA AVE ORANGE CA 92868 FQ 035 30 1578763207 BENEVOLENCE INDUSTRIES INC 01 001 10/1/2018 $191.52 0521 T1015 1 F 3631 CRENSHAW BLVD LOS ANGELES CA 90016 FQ 035 19 1902204449 BHASKAR, SHYAM MD INC 01 001 10/1/2017 $ 81.32 0521 T1015 1 R 1001 VAN DORSTEN AVE CORCORAN CA 93212 RH 035 16 1497001226 BIENVENIDOS CHILDREN CENTER 01 001 10/1/2018 $180.82 0521 T1015 1 F 507 S. ATLANTIC BLVD LOS ANGELES CA 90022 FQ 035 19 1497001226 BIENVENIDOS CHILDREN CENTER 01 002 10/1/2017 $176.21 0521 T1015 1 F 5015 WHITTIER BLVD LOS ANGELES CA 90022 FQ 035 19 1356892517 BIENVENIDOS COMMUNITY HEALTH 01 001 10/1/2017 $176.21 0521 T1015 1 F 4755 E CESAR E CHAVEZ AV LOS ANGELES CA 90022 FQ 035 19 1639553688 BIG SUR HEALTH CENTER 01 001 10/1/2017 $172.51 0521 T1015 1 R 46896 HIGHWAY 1 BIG SUR CA 93920 RH 035 27 1356438261 BIG VALLEY MEDICAL CTR 01 001 10/1/2018 $188.80 0521 T1015 1 F 554-850 MEDICAL CTR DR BIEBER CA 96009 FQ 035 18 1124115431 BLYTHE HEALTH CLINIC 01 001 10/1/2018 $160.79 0521 T1015 1 F 321 W HOBSONWAY BLYTHE CA 92225 FQ 035 33 1760584049 BOLINAS FAMILY PRACTICE 01 001 10/1/2018 $185.10 0521 T1015 1 F 88 MESA RD BOLINAS CA 94924 FQ 035 21 1154480069 BORREGO C0MMUNITY HEALTH 01 001 10/1/2018 $262.89 0521 T1015 1 F 133 WEST MAIN STREET EL CAJON CA 92020 FQ 035 37 1255490819 BORREGO COMM HLTH FNDTN 01 001 10/1/2018 $159.14 0521 T1015 1 F 88775 AVE 76 THERMAL CA 92274 FQ 035 33 1619036514 BORREGO COMM HLTH FNDTN 01 001 10/1/2018 $246.25 0521 T1015 1 F 69175 RAMON ROAD CATHEDRAL CITY CA 92234 FQ 035 33 1730249947 BORREGO COMM HLTH FNDTN 01 001 10/1/2018 $179.36 0521 T1015 1 F 55497 VAN BUREN STREET THERMAL CA 92274 FQ 035 33 1023349883 BORREGO COMM HLTH FOUNDATION 01 001 10/1/2018 $247.83 0521 T1015 1 F 1121 E WASHINGTON AVE ESCONDIDO CA 92025 FQ 035 37 1134144165 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $262.51 0521 T1015 1 F 4343 YAQUI PASS RD BORREGO SPRINGS CA 92004 FQ 035 37 1184065088 BORREGO COMMUNITY HEALTH 01 001 10/1/2017 $179.51 0521 T1015 1 F 11750 CHOLLA DRIVE DESERT HOT SPRING CA 92240 FQ 035 33 1275849283 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $283.73 0521 T1015 1 F 66675 PIERSON BLVD DESERT HOT SPRING CA 92240 FQ 035 33 1306131545 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $192.65 0521 T1015 1 F 8856 ARLINGTON AVE RIVERSIDE CA 92503 FQ 035 33 1386069995 BORREGO COMMUNITY HEALTH 01 001 10/1/2017 $182.16 0521 T1015 1 F 1180 N INDIAN CANYON DR PALM SPRINGS CA 92262 FQ 035 33 1568747137 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $237.66 0521 T1015 1 F 8851 CENTER DR LA MESA CA 91942 FQ 035 37 1780038042 BORREGO COMMUNITY HEALTH 01 001 10/1/2017 $163.49 0521 T1015 1 F 590 NORTH D STREET SAN BERNARDINO CA 92401 FQ 035 36 1790075315 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $241.48 0521 T1015 1 F 1970 UNIVERSITY AVE RIVERSIDE CA 92507 FQ 035 33 1942623657 BORREGO COMMUNITY HEALTH 01 001 10/1/2018 $290.95 0521 T1015 1 F 58581 US HIGHWAY 371 ANZA CA 92539 FQ 035 33 1942638978 BRIGHTER BEGINNINGS 01 001 10/1/2018 $240.18 0521 T1015 1 F 2727 MACDONALD AVE RICHMOND CA 94804 FQ 035 07 1962510925 CAL FAMILY HEALTH, INC 01 001 10/1/2018 $ 92.58 0521 T1015 1 R 1415 N ACACIA AVE REEDLEY CA 93654 RH 035 10 1013406610 CAMARENA HEALTH 01 001 8/13/2018 $166.60 0521 T1015 1 F 441 E YOSEMITE AVENUE MADERA CA 93638 FQ 035 20 1124533492 CAMARENA HEALTH 01 001 3/6/2018 $166.60 0521 T1015 1 F 705 W PECAN AVENUE MADERA CA 93637 FQ 035 20 1437407582 CAMARENA HEALTH 01 001 10/1/2018 $143.86 0521 T1015 1 F 49169 ROAD 426 OAKHURST CA 93644 FQ 035 20 1447309885 CAMARENA HEALTH 01 001 10/1/2018 $183.57 0521 T1015 1 F 401 TRINITY AVE CHOWCHILLA CA 93610 FQ 035 20 1588086771 CAMARENA HEALTH 01 001 10/1/2018 $172.87 0521 T1015 1 F 124 SOUTH A STREET MADERA CA 93638 FQ 035 20 1891778114 CAMARENA HEALTH 01 001 10/1/2018 $173.68 0521 T1015 1 F 344 E 6TH ST MADERA CA 93638 FQ 035 20 1891778114 CAMARENA HEALTH 01 005 6/11/2018 $171.28 0521 T1015 1 F 720 E ALMOND AVENUE MADERA CA 93637 FQ 035 20 1891778114 CAMARENA HEALTH 01 004 6/11/2018 $171.28 0521 T1015 1 F 363 E ALMOND AVENUE MADERA CA 93637 FQ 035 20 1891778114 CAMARENA HEALTH 01 002 6/11/2018 $171.28 0521 T1015 1 F 35324 HIGHWAY 41 COARSEGOLD CA 93614 FQ 035 20 1891778114 CAMARENA HEALTH 01 003 6/11/2018 $171.28 0521 T1015 1 F 1130 COUNTRY CLUB DR MADERA CA 93638 FQ 035 20 1891778114 CAMARENA HEALTH 01 006 6/11/2018 $171.28 0521 T1015 1 F 49185 ROAD 426 OAKHURST CA 93644 FQ 035 20 1902185630 CAMARENA HEALTH 01 001 10/1/2018 $142.07 0521 T1015 1 F 505 E ALMOND AVE MADERA CA 93637 FQ 035 20 1194274811 CAMINO HEALTH CENTER 01 001 10/1/2018 $209.24 0521 T1015 1 F 22481 ASPAN ST LAKE FOREST CA 92630 FQ 035 30 1366560393 CAMINO HEALTH CENTER 01 001 10/1/2018 $238.44 0521 T1015 1 F 30300 CAMINO CAPISTRANO SAN JUAN CAPISTRA CA 92675 FQ 035 30 1366560393 CAMINO HEALTH CENTER 01 002 10/1/2017 $229.83 0521 T1015 1 F 1031 AVENIDA PICO SAN CLEMENTE CA 92673 FQ 035 30 1528063153 CANBY FAMILY PRACTICE 01 001 10/1/2018 $192.06 0521 T1015 1 R 670 COUNTY ROAD 83 CANBY CA 96015 RH 035 25 1447297379 CARES COMMUNITY HEALTH 01 001 10/1/2017 $270.00 0521 T1015 1 F 1500 21ST ST SACRAMENTO CA 95811 FQ 035 34 1447281746 CASTLE FAMILY HEALTH 02 001 10/1/2018 $200.96 0521 T1015 1 R 6596 N WINTON WAY WINTON CA 95388 RH 035 24 1497778443 CASTLE FAMILY HEALTH 02 001 10/1/2018 $200.96 0521 T1015 1 R 1251 GROVE ST ATWATER CA 95301 RH 035 24 1639100027 CASTLE FAMILY HEALTH 02 001 10/1/2018 $200.96 0521 T1015 1 R 3605 HOSPITAL RD ATWATER CA 95301 RH 035 24 1871853481 CENTER FOR FAMILY HEALTH 01 001 10/1/2018 $139.22 0521 T1015 1 F 8727 VAN NUYS BLVD PANORAMA CITY CA 91402 FQ 035 19 1639207343 CENTRAL CALIFORNIA 01 001 10/1/2018 $156.20 0521 T1015 1 U 2300 7TH ST WASCO CA 93280 RH 035 15 1851429658 CENTRAL CALIFORNIA 01 001 10/1/2018 $199.02 0521 T1015 1 U 1201 JEFFERSON ST DELANO CA 93215 RH 035 15 1588972129 CENTRAL CITY COMM HEALTH CTR 01 001 10/1/2018 $160.77 0521 T1015 1 F 12511 BROOKHURST ST GARDEN GROVE CA 92840 FQ 035 30 1285788059 CENTRAL CITY COMM HLTH CTR 01 001 10/1/2018 $124.67 0521 T1015 1 F 2237 W BALL RD ANAHEIM CA 92804 FQ 035 30


1033488416 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $159.82 0521 T1015 1 F 1860 HAMNER AVE NORCO CA 92860 FQ 035 33 1174757967 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $134.23 0521 T1015 1 F 12116 BEACH BLVD STANTON CA 90680 FQ 035 30 1174996318 CENTRAL CITY COMMUNITY 01 001 1/26/2018 $157.61 0521 T1015 1 F 268 MCARTHUR WAY UPLAND CA 91786 FQ 035 36 1194265637 CENTRAL CITY COMMUNITY 01 001 10/1/2017 $139.37 0521 T1015 1 F 5715 S BROADWAY LOS ANGELES CA 90037 FQ 035 19 1235283094 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $143.01 0521 T1015 1 F 5970 S CENTRAL AVE LOS ANGELES CA 90001 FQ 035 19 1295100709 CENTRAL CITY COMMUNITY 01 001 10/1/2017 $139.37 0521 T1015 1 F 1236 E FLORENCE AVE LOS ANGELES CA 90001 FQ 035 19 1407230899 CENTRAL CITY COMMUNITY 01 001 10/1/2017 $121.49 0521 T1015 1 F 2243 W BALL ROAD ANAHEIM CA 92804 FQ 035 30 1528477882 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $162.70 0521 T1015 1 F 13742 AMAR ROAD LA PUENTE CA 91746 FQ 035 19 1669881926 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $257.27 0521 T1015 1 F 4126 N MAINE AVE BALDWIN PARK CA 91706 FQ 035 19 1669881926 CENTRAL CITY COMMUNITY 01 002 10/1/2017 $247.98 0521 T1015 1 F 4160 NORTH MAINE AVE BALDWIN PARK CA 91706 FQ 035 19 1750781548 CENTRAL CITY COMMUNITY 01 001 10/1/2018 $171.19 0521 T1015 1 F 1730 W OLYMPIC BLVD LOS ANGELES CA 90015 FQ 035 19 1972912236 CENTRAL CITY COMMUNITY 01 001 10/1/2017 $158.85 0521 T1015 1 F 10050 GARVEY AVE EL MONTE CA 91733 FQ 035 19 1992245252 CENTRAL CITY COMMUNITY 01 001 10/1/2017 $155.74 0521 T1015 1 F 81709 DR CARREON BLVD INDIO CA 92201 FQ 035 33 1487086989 CENTRAL NEIGHBORHOOD HEALTH 01 001 10/1/2018 $133.56 0521 T1015 1 F 2614 S GRAND AVENUE LOS ANGELES CA 90007 FQ 035 19 1548610322 CENTRAL NEIGHBORHOOD HEALTH 01 001 10/1/2018 $178.42 0521 T1015 1 F 2710 W MANCHESTER BLVD INGLEWOOD CA 90305 FQ 035 19 1619330438 CENTRAL NEIGHBORHOOD HEALTH 01 001 10/1/2018 $171.69 0521 T1015 1 F 17695 ARROW BLVD FONTANA CA 92335 FQ 035 36 1639336803 CENTRAL NEIGHBORHOOD HEALTH 01 001 10/1/2018 $166.98 0521 T1015 1 F 2707 S CENTRAL AVE LOS ANGELES CA 90011 FQ 035 19 1265843122 CENTRO DE SALUD DE LA 01 001 10/1/2018 $307.84 0521 T1015 1 F 3364 BEYER BLVD SAN YSIDRO CA 92173 FQ 035 37 1326486861 CENTRO DE SALUD DE LA 01 002 11/1/2017 $186.54 0521 T1015 1 F 855 THIRD AVENUE CHULA VISTA CA 91911 FQ 035 37 1326486861 CENTRO DE SALUD DE LA 01 001 10/1/2018 $200.48 0521 T1015 1 F 678 THIRD AVE CHULA VISTA CA 91910 FQ 035 37 1356750657 CENTRO DE SALUD DE LA 01 001 10/1/2017 $177.45 0521 T1015 1 F 1058 3RD AVENUE CHULA VISTA CA 91911 FQ 035 37 1538262092 CENTRO DE SALUD DE LA 01 001 10/1/2018 $250.30 0521 T1015 1 F 950 S EUCLID AVENUE SAN DIEGO CA 92114 FQ 035 37 1568845741 CENTRO DE SALUD DE LA 01 001 10/1/2017 $153.92 0521 T1015 1 F 436 S MAGNOLIA AVE EL CAJON CA 92020 FQ 035 37 1598907487 CENTRO DE SALUD DE LA 01 001 10/1/2018 $222.30 0521 T1015 1 F 2400 EAST 8TH ST NATIONAL CITY CA 91950 FQ 035 37 1851757215 CENTRO DE SALUD DE LA 01 001 10/1/2017 $160.60 0521 T1015 1 F 330-340 E 8TH STREET NATIONAL CITY CA 91950 FQ 035 37 1922051812 CENTRO DE SALUD DE LA 01 001 10/1/2018 $290.29 0521 T1015 1 F 1637 3RD AVE CHULA VISTA CA 91911 FQ 035 37 1477730737 CENTRO DE SALUD DE LA COMUNI 01 001 10/1/2018 $344.93 0521 T1015 1 F 8110 BIRMINGHAM WAY SAN DIEGO CA 92123 FQ 035 37 1437153848 CENTRO MEDICO COMMUNITY 01 001 10/1/2018 $158.19 0521 T1015 1 F 1307 W 6TH ST CORONA CA 92882 FQ 035 33 1962566265 CHILDREN'S CLINIC FAMILY 01 001 10/1/2018 $208.38 0521 T1015 1 F 730 W 3RD ST LONG BEACH CA 90802 FQ 035 19 1417023243 CHILDREN'S HEALTH CLINIC 01 001 10/1/2018 $384.29 0521 T1015 1 G 1001 POTRERO AVE SAN FRANCISCO CA 94110 FQ 035 38 1003961251 CHILDRENS HOSPITAL MEDICAL 01 003 10/1/2017 $321.70 0521 T1015 1 G 747 52ND ST OAKLAND CA 94609 FQ 035 01 1346530227 CHILDRENS HOSP RESEARCH CTR 01 001 10/1/2018 $423.95 0521 T1015 1 F 8711 MACARTHUR BLVD OAKLAND CA 94605 FQ 035 01 1982994869 CHILDRENS HOSP RESEARCH CTR 01 001 10/1/2018 $692.29 0521 T1015 1 F 2607 MYRTLE STREET OAKLAND CA 94607 FQ 035 01 1134482326 CHINATOWN SERVICE CENTER 01 001 10/1/2018 $ 63.97 0521 T1015 1 F 320 SOUTH GARFIELD AVE ALHAMBRA CA 91801 FQ 035 19 1427046754 CHINATOWN SERVICE CENTER 01 001 10/1/2018 $157.31 0521 T1015 1 F 767 N HILL ST LOS ANGELES CA 90012 FQ 035 19 1851509392 CHRISTINE C PONZIO MD 01 001 10/1/2018 $ 91.90 0521 T1015 1 R 133 FOURTH ST GONZALES CA 93926 RH 035 27 1134124001 CHUKWUEMEKA NDULUE 01 001 10/1/2018 $ 96.19 0521 T1015 1 R 620 E STREET MARYSVILLE CA 95901 RH 035 58 1134124001 CHUKWUEMEKA NDULUE 01 002 10/1/2018 $ 96.19 0521 T1015 1 R 135 SPRUCE ST GRIDLEY CA 95948 RH 035 04 1437191087 CITY AND COUNTY OF 01 001 10/1/2018 $269.31 0521 T1015 1 F 2401 KEITH ST SAN FRANCISCO CA 94124 FQ 035 38 1023050747 CITY & CO SAN FRANCISCO 01 001 10/1/2018 $269.31 0521 T1015 1 F 375 WOODSIDE AVE SAN FRANCISCO CA 94127 FQ 035 38 1053351916 CITY & CO SAN FRANCISCO 01 001 10/1/2018 $269.31 0521 T1015 1 F 50 IVY ST SAN FRANCISCO CA 94102 FQ 035 38 1356381214 CITY & CO SAN FRANCISCO 01 001 10/1/2018 $269.31 0521 T1015 1 F 1044 LARKIN ST SAN FRANCISCO CA 94109 FQ 035 38 1386686087 CITY & CO SAN FRANCISCO 01 001 10/1/2018 $269.31 0521 T1015 1 F 1050 WISCONSIN ST SAN FRANCISCO CA 94107 FQ 035 38 1538101126 CITY & CO SAN FRANCISCO 01 001 10/1/2018 $269.31 0521 T1015 1 F 99 MONTECILLO ROAD SAN RAFAEL CA 94903 FQ 035 21 1497094858 CITY & COUNTY OF SAN 01 001 10/1/2017 $160.60 0521 T1015 1 F 220 GOLDEN GATE AVE SAN FRANCISCO CA 94102 FQ 035 38 1386684140 CITY & COUNTY SAN FRAN 01 001 10/1/2018 $269.31 0521 T1015 1 F 555 COLE ST SAN FRANCISCO CA 94117 FQ 035 38 1144300476 CITY OF EL CENTR0 01 001 10/1/2018 $169.62 0521 T1015 1 U 385 W MAIN STREET EL CENTRO CA 92243 RH 035 13 1053452136 CLINICA DE SALUD DE 01 001 10/1/2018 $146.55 0521 T1015 1 F 799 FRONT ST SOLEDAD CA 93960 FQ 035 27 1013058106 CLINICA DE SALUD DEL 01 001 10/1/2018 $146.55 0521 T1015 1 F 10561 MERRITT ST CASTROVILLE CA 95012 FQ 035 27 1023159811 CLINICA DE SALUD DEL 01 001 10/1/2018 $146.55 0521 T1015 1 F 950 CIRCLE DR SALINAS CA 93905 FQ 035 27 1003173279 CLINICA DE SALUD DEL VALLE 01 001 10/1/2017 $160.60 0521 T1015 1 F 29 BISHOP STREET ROYAL OAKS CA 95076 FQ 035 44 1376684456 CLINICA DE SALUD DEL VALLE 01 001 10/1/2018 $221.33 0521 T1015 1 F 122 E SAN ANTONIO DR KING CITY CA 93930 FQ 035 27 1376684456 CLINICA DE SALUD DEL VALLE 01 002 7/23/2018 $218.27 0521 T1015 1 F 1156 FREMONT BOULEVARD SEASIDE CA 93955 FQ 035 27 1508994930 CLINICA DE SALUD DEL VALLE 01 001 10/1/2018 $142.73 0521 T1015 1 F 620 E ALVIN DR SALINAS CA 93906 FQ 035 27 1689048241 CLINICA DE SALUD DEL VALLE 01 001 10/1/2017 $160.60 0521 T1015 1 F 126 FIFTH ST GONZALES CA 93926 FQ 035 27 1962876417 CLINICA DE SALUD DEL VALLE 01 001 10/1/2017 $160.60 0521 T1015 1 F 2180 N MAIN ST SALINAS CA 93906 FQ 035 27 1386077857 CLINICA EL LAGO INC 01 001 10/1/2017 $129.93 0521 T1015 1 R 101 N PALM ST WOODLAKE CA 93286 RH 035 54 1558524264 CLINICA MSR. OSCAR A 01 001 10/1/2018 $177.31 0521 T1015 1 F 201 S ALVARADO ST LOS ANGELES CA 90057 FQ 035 19 1316033533 CLINICA MSR OSCAR A ROMERO 01 001 10/1/2018 $150.27 0521 T1015 1 F 2032 MARENGO ST LOS ANGELES CA 90033 FQ 035 19 1275629495 CLINICA MSR OSCAR ROMERO 01 001 10/1/2018 $146.60 0521 T1015 1 F 123 S ALVARADO ST LOS ANGELES CA 90057 FQ 035 19 1982820221 CLINICAS DEL CAMINO 01 001 10/1/2018 $179.33 0521 T1015 1 F 1000 NEWBURY RD NEWBURY PARK CA 91320 FQ 035 56 1023234465 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $184.18 0521 T1015 1 F 500 E MAIN ST SANTA PAULA CA 93060 FQ 035 56 1134369366 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $184.85 0521 T1015 1 F 221 VENTURA BLVD OXNARD CA 93036 FQ 035 56 1316163736 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $194.68 0521 T1015 1 F 1200 MARICOPA HWY OJAI CA 93023 FQ 035 56 1396961884 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $163.43 0521 T1015 1 F 650 META ST OXNARD CA 93030 FQ 035 56 1427276278 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $150.48 0521 T1015 1 F 4400 OLDS RD OXNARD CA 93033 FQ 035 56 1518183904 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $139.98 0521 T1015 1 F 450 W CLARA ST OXNARD CA 93033 FQ 035 56 1679631907 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $234.30 0521 T1015 1 F 200 S WELLS RD VENTURA CA 93004 FQ 035 56 1912123431 CLINICAS DEL CAMINO REAL 01 001 10/1/2018 $168.18 0521 T1015 1 F 355 CENTRAL AVE FILLMORE CA 93015 FQ 035 56 1093933194 CLINICAS DEL CAMINO REAL INC 01 001 10/1/2018 $205.25 0521 T1015 1 F 1200 N VENTURA RD OXNARD CA 93030 FQ 035 56 1609291996 CLINICAS DEL CAMINO REAL INC 01 001 10/1/2017 $160.60 0521 T1015 1 F 4370 EVE ROAD SIMI VALLEY CA 93063 FQ 035 56


1720362056 CLINICAS DEL CAMINO REAL INC 01 001 10/1/2018 $249.12 0521 T1015 1 F 1424 MADERA RD SIMI VALLEY CA 93065 FQ 035 56 1841556404 CLINICAS DEL CAMINO REAL INC 01 001 10/1/2018 $177.97 0521 T1015 1 F 4279 TIERRA REJADA ROAD MOORPARK CA 93021 FQ 035 56 1043351133 CLINICAS DE SALUD DEL 01 001 10/1/2018 $146.55 0521 T1015 1 F 808 OAK ST GREENFIELD CA 93927 FQ 035 27 1477694263 CLINICAS DE SALUD DEL 01 001 10/1/2018 $146.55 0521 T1015 1 F 219 N SANBORN RD SALINAS CA 93905 FQ 035 27 1124109202 CLINICAS DE SALUD DEL 01 001 10/1/2018 $150.82 0521 T1015 1 F 2133 WINTERHAVEN DR WINTERHAVEN CA 92283 FQ 035 13 1487741773 CLINICAS DE SALUD DEL 01 001 10/1/2018 $177.20 0521 T1015 1 F 651 WAKE AVE EL CENTRO CA 92243 FQ 035 13 1649269747 CLINICAS DE SALUD DEL 01 001 10/1/2018 $160.79 0521 T1015 1 F 900 MAIN ST BRAWLEY CA 92227 FQ 035 13 1679654750 CLINICAS DE SALUD DEL 01 001 10/1/2018 $142.92 0521 T1015 1 F 8027 HIGHWAY 111 NILAND CA 92257 FQ 035 13 1699859421 CLINICAS DE SALUD DEL 01 001 10/1/2018 $153.70 0521 T1015 1 F 1166 K ST BRAWLEY CA 92227 FQ 035 13 1932280633 CLINICAS DE SALUD DEL 01 001 10/1/2018 $193.79 0521 T1015 1 F 91275 66TH AVE MECCA CA 92254 FQ 035 33 1962599266 CLINICAS DE SALUD DEL 01 001 10/1/2018 $160.79 0521 T1015 1 F 223 W COLE RD CALEXICO CA 92231 FQ 035 13 1033593108 CLINICAS DE SALUD DEL PUEBLO 01 001 10/1/2017 $160.60 0521 T1015 1 F 1023 E FLORIDA AVE HEMET CA 92543 FQ 035 33 1710237029 CLINICAS DE SALUD DEL PUEBLO 01 001 10/1/2017 $168.59 0521 T1015 1 F 283 MAIN STREET BRAWLEY CA 92227 FQ 035 13 1932381605 CLINICAS DE SALUD DEL PUEBLO 01 001 10/1/2018 $194.79 0521 T1015 1 F 49-111 HIGHWAY 111 COACHELLA CA 92236 FQ 035 33 1033486048 CLINICA SIERRA VISTA 01 001 10/1/2018 $172.05 0521 T1015 1 F 3645 WEST SHAW AVENUE FRESNO CA 93711 FQ 035 10 1053560631 CLINICA SIERRA VISTA 01 001 10/1/2018 $140.77 0521 T1015 1 F 3727 N FIRST STREET FRESNO CA 93726 FQ 035 10 1063414548 CLINICA SIERRA VISTA 01 001 10/1/2018 $140.00 0521 T1015 1 F 234 BAKER STREET BAKERSFIELD CA 93305 FQ 035 15 1073515425 CLINICA SIERRA VISTA 01 001 10/1/2018 $190.09 0521 T1015 1 F 2400 WIBLE RD BAKERSFIELD CA 93304 FQ 035 15 1205222544 CLINICA SIERRA VISTA 01 001 10/1/2018 $149.37 0521 T1015 1 F 1015 BAKER STREET BAKERSFIELD CA 93305 FQ 035 15 1245489814 CLINICA SIERRA VISTA 01 001 10/1/2018 $195.43 0521 T1015 1 F 2740 S ELM AVE FRESNO CA 93706 FQ 035 10 1245516301 CLINICA SIERRA VISTA 01 001 10/1/2018 $147.95 0521 T1015 1 F 1611 1ST STREET BAKERSFIELD CA 93304 FQ 035 15 1255840468 CLINICA SIERRA VISTA 01 001 10/1/2018 $184.91 0521 T1015 1 F 7202 N MILLBROOK AVE FRESNO CA 93720 FQ 035 10 1326297904 CLINICA SIERRA VISTA 01 001 10/1/2018 $143.42 0521 T1015 1 F 302 FRESNO ST FRESNO CA 93706 FQ 035 10 1336398908 CLINICA SIERRA VISTA 01 001 10/1/2018 $233.69 0521 T1015 1 F 5784 S ELM AVENUE FRESNO CA 93706 FQ 035 10 1336544790 CLINICA SIERRA VISTA 01 001 10/1/2018 $154.23 0521 T1015 1 F 705 S UNION AVE BAKERSFIELD CA 93307 FQ 035 15 1356343735 CLINICA SIERRA VISTA 01 001 10/1/2018 $158.15 0521 T1015 1 F 6310 LAKE ISABELLA BLVD LAKE ISABELLA CA 93240 FQ 035 15 1427207000 CLINICA SIERRA VISTA 01 001 10/1/2018 $134.52 0521 T1015 1 F 2505 E DIVISADERO ST FRESNO CA 93721 FQ 035 10 1437308004 CLINICA SIERRA VISTA 01 001 10/1/2018 $155.63 0521 T1015 1 F 145 N. CLARK ST FRESNO CA 93701 FQ 035 10 1457353831 CLINICA SIERRA VISTA 01 001 10/1/2018 $243.40 0521 T1015 1 F 704 LEBEC RD LEBEC CA 93243 FQ 035 15 1518969211 CLINICA SIERRA VISTA 01 001 10/1/2018 $162.78 0521 T1015 1 F 1305 BEAR MOUNTAIN BLVD ARVIN CA 93203 FQ 035 15 1639171028 CLINICA SIERRA VISTA 01 001 10/1/2018 $199.81 0521 T1015 1 F 2525 N CHESTER AVE BAKERSFIELD CA 93308 FQ 035 15 1659373017 CLINICA SIERRA VISTA 01 001 10/1/2018 $154.23 0521 T1015 1 F 301 BRUNDAGE LN BAKERSFIELD CA 93304 FQ 035 15 1669621447 CLINICA SIERRA VISTA 01 001 10/1/2018 $171.01 0521 T1015 1 F 2760 S ELM AVE FRESNO CA 93706 FQ 035 10 1720347149 CLINICA SIERRA VISTA 01 001 10/1/2018 $184.40 0521 T1015 1 F 1945 N FINE AVENUE FRESNO CA 93727 FQ 035 10 1740439314 CLINICA SIERRA VISTA 01 001 10/1/2018 $139.02 0521 T1015 1 F 1350 SOUTH ORANGE AVE FRESNO CA 93702 FQ 035 10 1770895138 CLINICA SIERRA VISTA 01 001 10/1/2018 $129.00 0521 T1015 1 F 2756 S ELM AVENUE FRESNO CA 93706 FQ 035 10 1790128536 CLINICA SIERRA VISTA 01 001 10/1/2018 $158.17 0521 T1015 1 F 9001 SOUTH H STREET BAKERSFIELD CA 93307 FQ 035 15 1942508270 CLINICA SIERRA VISTA 01 001 10/1/2018 $140.48 0521 T1015 1 F 1125 E CALIFORNIA AVE BAKERSFIELD CA 93307 FQ 035 15 1992117071 CLINICA SIERRA VISTA 01 001 10/1/2018 $175.40 0521 T1015 1 F 7800 NILES ST BAKERSFIELD CA 93306 FQ 035 15 1003818444 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $139.40 0521 T1015 1 F 217 W KERN AVE MC FARLAND CA 93250 FQ 035 15 1093717779 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $233.57 0521 T1015 1 F 2000 PHYSICIANS BLVD BAKERSFIELD CA 93301 FQ 035 15 1134318959 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $131.33 0521 T1015 1 F 441 DIAZ AVE DELANO CA 93215 FQ 035 15 1437151800 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $176.99 0521 T1015 1 F 67 EVANS RD WOFFORD HEIGHTS CA 93285 FQ 035 15 1861494338 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $197.51 0521 T1015 1 F 815 MARTIN LUTHER KING B BAKERSFIELD CA 93307 FQ 035 15 1972505469 CLINICA SIERRA VISTA INC 01 001 10/1/2018 $122.55 0521 T1015 1 F 140 N STATE HIGHWAY 127 SHOSHONE CA 92384 FQ 035 14 1790100402 CLINIC SIERRA VISTA 01 001 10/1/2018 $190.37 0521 T1015 1 F 1120 EAST CHURCH AVENUE FRESNO CA 93706 FQ 035 10 1184655052 COALINGA HOSPITAL 01 003 10/1/2018 $389.89 0521 T1015 1 U 1165 PHELPS AVE COALINGA CA 93210 RH 035 10 1104955483 COALINGA VALLEY HEALTH 01 001 10/1/2018 $ 80.40 0521 T1015 1 R 36617 CENTRAL AVE HURON CA 93234 RH 035 10 1396874558 COALINGA VALLEY HEALTH 01 001 10/1/2018 $ 80.40 0521 T1015 1 R 1145 PHELPS AVE COALINGA CA 93210 RH 035 10 1174859425 COMM HLTH CTR OF CENT COAST 01 001 10/1/2018 $187.38 0521 T1015 1 F 1418 EAST MAIN STREET SANTA MARIA CA 93454 FQ 035 42 1679749501 COMM HLTH SYSTEMS INC 01 001 10/1/2018 $136.94 0521 T1015 1 F 22675 ALESSANDRO BLVD MORENO VALLEY CA 92553 FQ 035 33 1558366823 COMMUNICARE HEALTH CTRS 01 001 10/1/2018 $212.88 0521 T1015 1 F 2051 JOHN JONES RD DAVIS CA 95616 FQ 035 57 1558469064 COMMUNICARE HEALTH CTRS 01 001 10/1/2017 $225.71 0521 T1015 1 F 215 W BEAMER ST WOODLAND CA 95695 FQ 035 57 1710087515 COMMUNICARE HEALTH CTRS 01 001 10/1/2018 $211.97 0521 T1015 1 F 500B JEFFERSON BLVD WEST SACRAMENTO CA 95605 FQ 035 57 1295913366 COMMUNITY HEALTH 01 001 10/1/2018 $203.47 0521 T1015 1 F 1222 PINE ST SAINT HELENA CA 94574 FQ 035 28 1760660831 COMMUNITY HEALTH 01 001 10/1/2018 $134.53 0521 T1015 1 F 911 WASHINGTON ST CALISTOGA CA 94515 FQ 035 28 1871689315 COMMUNITY HEALTH 01 001 10/1/2018 $147.76 0521 T1015 1 F 1855 N FAIR OAKS AVE PASADENA CA 91103 FQ 035 19 1922429349 COMMUNITY HEALTH ALLIANCE 01 001 10/1/2018 $161.85 0521 T1015 1 F 10127 GARVEY AVE EL MONTE CA 91733 FQ 035 19 1578808200 COMMUNITY HEALTH ALLIANCE OF 01 001 10/1/2018 $193.81 0521 T1015 1 F 10408 VACCO ST SOUTH EL MONTE CA 91733 FQ 035 19 1720395874 COMMUNITY HEALTH ALLIANCE OF 01 001 10/1/2018 $ 78.01 0521 T1015 1 F 3160 E DEL MAR BLVD PASADENA CA 91107 FQ 035 19 1356368138 COMMUNITY HEALTH CENTER- 01 001 10/1/2018 $144.32 0521 T1015 1 F 901 S BROADWAY SANTA MARIA CA 93454 FQ 035 42 1073533089 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $148.06 0521 T1015 1 F 7512-7516 MORRO RD ATASCADERO CA 93422 FQ 035 40 1124045042 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $155.41 0521 T1015 1 F 416 SPRING ST PASO ROBLES CA 93446 FQ 035 40 1124045158 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $208.24 0521 T1015 1 F 1551 BISHOP ST SAN LUIS OBISPO CA 93401 FQ 035 40 1174911317 COMMUNITY HEALTH CENTERS 01 001 10/1/2017 $158.85 0521 T1015 1 F 430 S BLOSSER RD SANTA MARIA CA 93458 FQ 035 42 1275550295 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $144.71 0521 T1015 1 F 325 POSADA LANE TEMPLETON CA 93465 FQ 035 40 1275553257 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $205.95 0521 T1015 1 F 1551 BISHOP ST SAN LUIS OBISPO CA 93401 FQ 035 40 1295198356 COMMUNITY HEALTH CENTERS 01 001 10/1/2017 $163.49 0521 T1015 1 F 1385 MISSION ST SAN MIGUEL CA 93451 FQ 035 40 1326065103 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $139.57 0521 T1015 1 F 425 W CENTRAL AVE LOMPOC CA 93436 FQ 035 42 1336163898 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $155.41 0521 T1015 1 F 1057 E GRAND AVE ARROYO GRANDE CA 93420 FQ 035 40 1336166248 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $165.13 0521 T1015 1 F 1981 CIENAGA ST OCEANO CA 93445 FQ 035 40


1376560151 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $144.32 0521 T1015 1 F 4723 WEST MAIN STREET GUADALUPE CA 93434 FQ 035 42 1417480294 COMMUNITY HEALTH CENTERS 01 002 11/20/2017 $163.49 0521 T1015 1 F 2120 CIENAGA STREET OCEANO CA 93445 FQ 035 40 1447277355 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $155.41 0521 T1015 1 F 2801 SANTA MARIA WAY SANTA MARIA CA 93455 FQ 035 42 1548648801 COMMUNITY HEALTH CENTERS 01 001 10/1/2017 $160.60 0521 T1015 1 F 292 POSADA LANE TEMPLETON CA 93465 FQ 035 40 1841217866 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $155.41 0521 T1015 1 F 150 TEJAS PL NIPOMO CA 93444 FQ 035 40 1841217882 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $120.88 0521 T1015 1 F 660 HARBOR ST MORRO BAY CA 93442 FQ 035 40 1851417703 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $190.92 0521 T1015 1 F 1835 N BROADWAY SANTA MARIA CA 93454 FQ 035 42 1881611705 COMMUNITY HEALTH CENTERS 01 001 10/1/2018 $167.61 0521 T1015 1 F 2515 MAIN ST CAMBRIA CA 93428 FQ 035 40 1508105008 COMMUNITY HEALTH CENTERS OF 01 001 10/1/2017 $163.49 0521 T1015 1 F 4711 HWY 166 NEW CUYAMA CA 93254 FQ 035 42 1598064008 COMMUNITY HEALTH CENTERS OF 01 001 10/1/2018 $142.65 0521 T1015 1 F 260 STATION WAY ARROYO GRANDE CA 93420 FQ 035 40 1629377452 COMMUNITY HEALTH CENTERS OF 01 001 10/1/2018 $163.32 0521 T1015 1 F 77 CASA STREET SAN LUIS OBISPO CA 93405 FQ 035 40 1871010280 COMMUNITY HEALTH CENTERS OF 01 001 3/26/2018 $166.60 0521 T1015 1 F 1205 E GRAND AVE ARROYO GRANDE CA 93420 FQ 035 40 1891118147 COMMUNITY HEALTH CENTERS OF 01 001 10/1/2017 $129.02 0521 T1015 1 F 210 S PALISADE DR SANTA MARIA CA 93454 FQ 035 42 1497130280 COMMUNITY HEALTH CLINIC OLE 01 001 10/1/2017 $208.63 0521 T1015 1 F 470 CHADBOURNE ROAD FAIRFIELD CA 94534 FQ 035 48 1700976503 COMMUNITY HEALTH CLINIC OLE 01 001 10/1/2018 $223.15 0521 T1015 1 F 1141 PEAR TREE LN NAPA CA 94558 FQ 035 28 1548538911 COMMUNITY HEALTH SYSTEM INC 01 001 10/1/2018 $186.74 0521 T1015 1 F 9380 MAGNOLIA AVE RIVERSIDE CA 92503 FQ 035 33 1487706347 COMMUNITY HEALTH SYSTEMS 01 001 10/1/2018 $149.48 0521 T1015 1 F 18601 VALLEY BLVD BLOOMINGTON CA 92316 FQ 035 36 1093226243 COMMUNITY HEALTH SYSTEMS INC 01 001 10/1/2018 $191.93 0521 T1015 1 F 18651 VALLEY BLVD BLOOMINGTON CA 92316 FQ 035 36 1205102068 COMMUNITY HEALTH SYSTEMS INC 01 001 10/1/2018 $191.70 0521 T1015 1 F 2933 UNIVERSITY AVE RIVERSIDE CA 92507 FQ 035 33 1982756086 COMMUNITY HEALTH SYSTEMS INC 01 001 10/1/2018 $202.65 0521 T1015 1 F 1328 S MISSION RD FALLBROOK CA 92028 FQ 035 37 1063748242 COMMUNITY HLTH ALLIANCE 01 001 10/1/2018 $200.24 0521 T1015 1 F 1800 N LAKE AVE PASADENA CA 91104 FQ 035 19 1285059923 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $217.92 0521 T1015 1 F 1031 WATERLOO ROAD STOCKTON CA 95205 FQ 035 39 1285059923 COMMUNITY MEDICAL CENTERS 01 002 10/1/2017 $210.05 0521 T1015 1 F 2044 FAIR STREET STOCKTON CA 95206 FQ 035 39 1356723936 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $177.41 0521 T1015 1 F 1801 E MARCH LANE STOCKTON CA 95210 FQ 035 39 1417012329 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $185.40 0521 T1015 1 F 600 NUT TREE RD VACAVILLE CA 95687 FQ 035 48 1538223375 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $152.44 0521 T1015 1 F 1721 E HAMMER LN STOCKTON CA 95210 FQ 035 39 1538223375 COMMUNITY MEDICAL CENTERS 01 002 10/1/2017 $143.46 0521 T1015 1 F 432 S SAN JOAQUIN ST STOCKTON CA 95203 FQ 035 39 1578552543 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $185.40 0521 T1015 1 F 701 E CHANNEL ST STOCKTON CA 95202 FQ 035 39 1649525544 COMMUNITY MEDICAL CENTERS 01 001 10/1/2017 $160.60 0521 T1015 1 F 423 S SAN JOAQUIN ST STOCKTON CA 95203 FQ 035 39 1669720157 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $196.81 0521 T1015 1 F 2015 E MARIPOSA ROAD STOCKTON CA 95205 FQ 035 39 1699766519 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $185.40 0521 T1015 1 F 131 W A ST DIXON CA 95620 FQ 035 48 1710211214 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $151.60 0521 T1015 1 F 200 COTTAGE AVE MANTECA CA 95336 FQ 035 39 1881685964 COMMUNITY MEDICAL CENTERS 01 001 10/1/2018 $185.40 0521 T1015 1 F 2401 W TURNER RD LODI CA 95242 FQ 035 39 1609867787 COMMUNITY MEDICAL CTRS 01 001 10/1/2018 $185.40 0521 T1015 1 F 730 CENTRAL AVE TRACY CA 95376 FQ 035 39 1235500513 COMMUNITY MEDICAL WELLNESS 01 001 10/1/2018 $192.10 0521 T1015 1 F 1360 E ANAHEIM ST LONG BEACH CA 90813 FQ 035 19 1457744476 COMMUNITY MEDICINE, INC 01 001 10/1/2018 $174.41 0521 T1015 1 F 8540 ALONDRA BLVD PARAMOUNT CA 90723 FQ 035 19 1750329967 COMMUNITY MEM HLTH SYS 01 001 10/1/2018 $187.19 0521 T1015 1 U 655 VENTURA AVE OAK VIEW CA 93022 RH 035 56 1215903018 COMMUNITY MEMORIAL HEALTH 01 004 10/1/2018 $195.44 0521 T1015 1 U 242 E HARVARD BLVD SANTA PAULA CA 93060 RH 035 56 1215903018 COMMUNITY MEMORIAL HEALTH 01 003 10/1/2018 $195.44 0521 T1015 1 U 852 W VENTURA ST FILLMORE CA 93015 RH 035 56 1215903018 COMMUNITY MEMORIAL HEALTH 01 018 10/1/2017 $ 82.30 0521 T1015 1 U 258 EAST HARVARD BLVD SANTA PAULA CA 93060 RH 035 56 1215113964 COMPLETE CARE COMM HLTH CTR 01 001 10/1/2018 $202.15 0521 T1015 1 F 2928 E CESAR E CHAVEZ AV LOS ANGELES CA 90033 FQ 035 19 1811397888 COMPLETE CARE COMMUNITY 01 001 10/1/2018 $186.05 0521 T1015 1 F 5831 FIRESTONE BLVD SOUTH GATE CA 90280 FQ 035 19 1245210749 COMPREHENSIVE COMMUNITY 01 001 10/1/2018 $ 99.99 0521 T1015 1 F 5059 YORK BLVD LOS ANGELES CA 90042 FQ 035 19 1356362743 COMPREHENSIVE COMMUNITY 01 001 10/1/2018 $235.23 0521 T1015 1 F 801 S CHEVY CHASE DR GLENDALE CA 91205 FQ 035 19 1679553192 COMPREHENSIVE COMMUNITY 01 001 10/1/2018 $185.44 0521 T1015 1 F 1704 COLORADO BLVD LOS ANGELES CA 90041 FQ 035 19 1871573360 COMPREHENSIVE COMMUNITY 01 001 10/1/2018 $117.30 0521 T1015 1 F 12157 VICTORY BLVD NORTH HOLLYWOOD CA 91606 FQ 035 19 1972954071 COMPREHENSIVE COMMUNITY 01 002 12/12/2017 $163.49 0521 T1015 1 F 8316 FOOTHILL BLVD SUNLAND CA 91040 FQ 035 19 1821275132 COMPREHENSIVE HEALTH CENTER 02 001 10/1/2018 $309.56 0521 T1015 1 F 286 EUCLID AVE SAN DIEGO CA 92114 FQ 035 37 1326225632 COMPREHENSIVE HEALTH CENTER- 02 001 10/1/2018 $208.92 0521 T1015 1 F 3177 OCEAN VIEW BLVD SAN DIEGO CA 92113 FQ 035 37 1467522284 CONTRA COSTA CO HLTH SVS 01 001 10/1/2018 $411.31 0521 T1015 1 G 2500 ALHAMBRA AVE MARTINEZ CA 94553 FQ 035 07 1568540763 CONTRA COSTA CO HLTH SVS 01 001 10/1/2018 $411.31 0521 T1015 1 G 2311 LOVERIDGE RD PITTSBURG CA 94565 FQ 035 07 1942370762 CONTRA COSTA CO HLTH SVS 01 001 10/1/2018 $411.31 0521 T1015 1 G 2500 ALHAMBRA AVE MARTINEZ CA 94553 FQ 035 07 1346328507 CONTRA COSTA COUNTY 01 001 10/1/2018 $411.31 0521 T1015 1 G 3052 WILLOW PASS RD CONCORD CA 94519 FQ 035 07 1437237690 CONTRA COSTA COUNTY 01 001 10/1/2018 $411.31 0521 T1015 1 G 118 OAK ST BRENTWOOD CA 94513 FQ 035 07 1962587071 CONTRA COSTA COUNTY 01 001 10/1/2018 $411.31 0521 T1015 1 G 100 38TH ST RICHMOND CA 94805 FQ 035 07 1285712471 CONTRA COSTA REG MED CTR 01 001 10/1/2018 $411.31 0521 T1015 1 G 3505 LONE TREE WAY ANTIOCH CA 94509 FQ 035 07 1447338694 CONTRA COSTA REG MED CTR 01 001 10/1/2018 $411.31 0521 T1015 1 F 1501 3RD ST NORTH RICHMOND CA 94801 FQ 035 07 1538247788 CONTRA COSTA REG MED CTR 01 001 10/1/2018 $411.31 0521 T1015 1 F 215 PACIFICA AVE BAY POINT CA 94565 FQ 035 07 1679642904 CONTRA COSTA REG MED CTR 01 001 10/1/2018 $411.31 0521 T1015 1 G 2500 ALHAMBRA AVE MARTINEZ CA 94553 FQ 035 07 1033534466 COPPERTOWER FAMILY MEDICAL 01 001 10/1/2018 $205.64 0521 T1015 1 F 6 TARMAN DR CLOVERDALE CA 95425 FQ 035 49 1205940145 CORONA FAMILY CARE CTR 01 001 10/1/2018 $224.27 0521 T1015 1 F 505 S BUENA VISTA AVE CORONA CA 92882 FQ 035 33 1003929829 COUNTY OF LOS ANGELES 01 001 7/1/2018 $891.68 0521 T1015 1 F 335 EAST AVENUE I LANCASTER CA 93535 FQ 035 19 1235247578 COUNTY OF LOS ANGELES 01 001 7/1/2018 $614.18 0521 T1015 1 F 1108 N OLEANDER AVE COMPTON CA 90222 FQ 035 19 1285744003 COUNTY OF LOS ANGELES 01 001 7/1/2018 $769.09 0521 T1015 1 F 16350 FILBERT ST SYLMAR CA 91342 FQ 035 19 1316187255 COUNTY OF LOS ANGELES 01 001 7/1/2018 $603.90 0521 T1015 1 F 4024 NORTH DURFEE RD EL MONTE CA 91732 FQ 035 19 1407951783 COUNTY OF LOS ANGELES 01 001 7/1/2018 $769.09 0521 T1015 1 F 1500 S MCDONNELL AVE LOS ANGELES CA 90040 FQ 035 19 1780789065 COUNTY OF LOS ANGELES 01 001 7/1/2018 $769.09 0521 T1015 1 F 1605 EASTLAKE AVE LOS ANGELES CA 90033 FQ 035 19 1033596911 COUNTY OF MONTEREY 01 001 10/1/2017 $160.60 0521 T1015 1 F 1441 CONSTITUTION BLVD SALINAS CA 93906 FQ 035 27 1043262959 COUNTY OF MONTEREY 01 001 10/1/2018 $289.38 0521 T1015 1 F 1441 CONSTITUTION BLVD SALINAS CA 93906 FQ 035 27 1376956268 COUNTY OF MONTEREY 01 002 10/1/2017 $195.44 0521 T1015 1 F 1441 CONSTITUTION BLVD SALINAS CA 93906 FQ 035 27 1457303356 COUNTY OF MONTEREY 01 001 10/1/2018 $213.28 0521 T1015 1 F 1441 CONSTITUTION BLVD SALINAS CA 93906 FQ 035 27


1588617955 COUNTY OF MONTEREY 01 001 10/1/2018 $190.77 0521 T1015 1 F 3155 DE FOREST RD MARINA CA 93933 FQ 035 27 1740232644 COUNTY OF MONTEREY 01 001 10/1/2018 $200.56 0521 T1015 1 F 1441 CONSTITUTION BLVD SALINAS CA 93906 FQ 035 27 1881645158 COUNTY OF MONTEREY 01 001 10/1/2018 $190.77 0521 T1015 1 F 1156 FREMONT BLVD SEASIDE CA 93955 FQ 035 27 1881645158 COUNTY OF MONTEREY 01 002 10/1/2017 $182.43 0521 T1015 1 F 299 12TH STREET MARINA CA 93933 FQ 035 27 1699726786 COUNTY OF MONTEREY DHS 01 001 10/1/2018 $190.77 0521 T1015 1 F 559 E ALISAL ST SALINAS CA 93905 FQ 035 27 1386758225 COUNTY OF RIVERSIDE 01 001 10/1/2018 $292.60 0521 T1015 1 F 1515 N SUNRISE WAY PALM SPRINGS CA 92262 FQ 035 33 1871607713 COUNTY OF RIVERSIDE 01 001 10/1/2018 $245.99 0521 T1015 1 F 9415 MISSION BLVD RIVERSIDE CA 92509 FQ 035 33 1578535845 COUNTY OF SAN BERNARDINO 01 011 10/1/2018 $216.68 0521 T1015 1 F 11336 BARTLETT AVE ADELANTO CA 92301 FQ 035 36 1578535845 COUNTY OF SAN BERNARDINO 01 008 10/1/2017 $224.67 0521 T1015 1 F 606 E MILL STREET SAN BERNARDINO CA 92415 FQ 035 36 1578535845 COUNTY OF SAN BERNARDINO 01 001 10/1/2018 $196.29 0521 T1015 1 F 16453 BEAR VALLEY ROAD HESPERIA CA 92345 FQ 035 36 1578535845 COUNTY OF SAN BERNARDINO 01 006 10/1/2017 $228.71 0521 T1015 1 F 150 E HOLT BLVD ONTARIO CA 91761 FQ 035 36 1083955801 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $129.02 0521 T1015 1 F 1414 N CALIFORNIA STREET STOCKTON CA 95202 FQ 035 39 1538400353 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $129.02 0521 T1015 1 F 1414 N CALIFORNIA STREET STOCKTON CA 95202 FQ 035 39 1578803425 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $129.02 0521 T1015 1 F 500 W HOSPITAL RD FRENCH CAMP CA 95231 FQ 035 39 1629319447 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $129.02 0521 T1015 1 F 500 W HOSPITAL ROAD FRENCH CAMP CA 95231 FQ 035 39 1710228531 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $129.02 0521 T1015 1 F 500 W HOSPITAL ROAD FRENCH CAMP CA 95231 FQ 035 39 1891036612 COUNTY OF SAN JOAQUIN 01 001 10/1/2017 $158.85 0521 T1015 1 F 1414 N CALIFORNIA ST STOCKTON CA 95202 FQ 035 39 1114084894 COUNTY OF SANTA BARBARA 01 001 10/1/2018 $341.43 0521 T1015 1 F 931 WALNUT AVE CARPINTERIA CA 93013 FQ 035 42 1134286727 COUNTY OF SANTA BARBARA 01 001 10/1/2018 $341.43 0521 T1015 1 F 1136 E MONTECITO ST SANTA BARBARA CA 93103 FQ 035 42 1205951738 COUNTY OF SANTA BARBARA 01 001 10/1/2018 $341.43 0521 T1015 1 F 315 CAMINO DEL REMEDIO SANTA BARBARA CA 93110 FQ 035 42 1265599732 COUNTY OF SANTA BARBARA 01 001 10/1/2018 $341.43 0521 T1015 1 F 2115 CENTERPOINTE PKWY SANTA MARIA CA 93455 FQ 035 42 1326105909 COUNTY OF SANTA BARBARA 01 001 10/1/2018 $341.43 0521 T1015 1 F 301 N R ST LOMPOC CA 93436 FQ 035 42 1285629899 COUNTY OF SANTA CLARA 01 001 10/1/2018 $353.83 0521 T1015 1 F 143 N MAIN ST MILPITAS CA 95035 FQ 035 43 1326033929 COUNTY OF SANTA CLARA 01 001 10/1/2018 $353.83 0521 T1015 1 F 1993 MCKEE RD SAN JOSE CA 95116 FQ 035 43 1336326974 COUNTY OF SANTA CLARA 01 001 10/1/2018 $433.52 0521 T1015 1 F 660 S FAIROAKS AVE SUNNYVALE CA 94086 FQ 035 43 1366779399 COUNTY OF SANTA CLARA 01 001 10/1/2018 $258.63 0521 T1015 1 F 2011 LITTLE ORCHARD ST SAN JOSE CA 95125 FQ 035 43 1447645296 COUNTY OF SANTA CLARA 01 001 10/1/2017 $245.19 0521 T1015 1 F 777 EAST SANTA CLARA ST SAN JOSE CA 95112 FQ 035 43 1629301346 COUNTY OF SANTA CLARA 01 001 10/1/2018 $318.49 0521 T1015 1 F 2101 ALEXIAN DR SAN JOSE CA 95116 FQ 035 43 1578680310 COUNTY OF SANTA CRUZ DBA 01 002 10/1/2018 $364.12 0521 T1015 1 F 1080 EMELINE AVE SANTA CRUZ CA 95060 FQ 035 44 1770709149 COUNTY OF SNTA CRUZ 01 001 10/1/2018 $364.12 0521 T1015 1 F 9 CRESTVIEW DR WATSONVILLE CA 95076 FQ 035 44 1427330869 COUNTY OF SOLANO 01 001 10/1/2017 $128.72 0521 T1015 1 F 2201 COURAGE DRIVE FAIRFIELD CA 94533 FQ 035 48 1710274899 COUNTY OF SOLANO 01 001 10/1/2018 $285.80 0521 T1015 1 F 1119 E MONTE VISTA AVE VACAVILLE CA 95687 FQ 035 48 1730310236 COUNTY OF SOLANO 01 001 10/1/2018 $321.47 0521 T1015 1 F 365 TUOLUMNE ST VALLEJO CA 94590 FQ 035 48 1366648016 COUNTY OF STANISLAUS 01 001 10/1/2018 $172.62 0521 T1015 1 F 2412 3RD STREET HUGHSON CA 95326 FQ 035 50 1043451982 COUNTY OF VENTURA 01 001 10/1/2018 $145.30 0521 T1015 1 F 3100 N ROSE AVE OXNARD CA 93036 FQ 035 56 1134360076 COUNTY OF VENTURA 01 001 10/1/2018 $229.59 0521 T1015 1 F 828 VENTURA ST FILLMORE CA 93015 FQ 035 56 1154600336 COUNTY OF VENTURA 01 001 10/1/2017 $162.88 0521 T1015 1 F 2400 SOUTH C STREET OXNARD CA 93003 FQ 035 56 1174764021 COUNTY OF VENTURA 01 001 10/1/2018 $182.86 0521 T1015 1 F 612 SPRING RD MOORPARK CA 93021 FQ 035 56 1316188253 COUNTY OF VENTURA 01 001 10/1/2018 $173.95 0521 T1015 1 F 125 W THOUSAND OAKS BLVD THOUSAND OAKS CA 91360 FQ 035 56 1386886117 COUNTY OF VENTURA 01 001 10/1/2018 $240.70 0521 T1015 1 F 1227 E LOS ANGELES AVE SIMI VALLEY CA 93065 FQ 035 56 1508187329 COUNTY OF VENTURA 01 001 10/1/2018 $222.15 0521 T1015 1 F 325 W CHANNEL ISLAND BLV OXNARD CA 93033 FQ 035 56 1538300488 COUNTY OF VENTURA 01 001 10/1/2018 $184.10 0521 T1015 1 F 2000 OUTLET CENTER DR OXNARD CA 93036 FQ 035 56 1548401409 COUNTY OF VENTURA 01 001 10/1/2018 $254.85 0521 T1015 1 F 845 N 10TH ST SANTA PAULA CA 93060 FQ 035 56 1619118569 COUNTY OF VENTURA 01 001 10/1/2018 $331.77 0521 T1015 1 F 300 HILLMONT AVENUE VENTURA CA 93003 FQ 035 56 1669738159 COUNTY OF VENTURA 01 001 10/1/2017 $158.85 0521 T1015 1 F 2220 E GONZALES ROAD OXNARD CA 93036 FQ 035 56 1780821660 COUNTY OF VENTURA 01 001 10/1/2018 $161.55 0521 T1015 1 F 133 W SANTA CLARA ST VENTURA CA 93001 FQ 035 56 1841431707 COUNTY OF VENTURA 01 001 10/1/2018 $249.56 0521 T1015 1 F 254 W HARVARD BLVD SANTA PAULA CA 93060 FQ 035 56 1861633703 COUNTY OF VENTURA 01 001 10/1/2018 $195.23 0521 T1015 1 F 2240 E GONZALES RD OXNARD CA 93036 FQ 035 56 1932340890 COUNTY OF VENTURA 01 001 10/1/2018 $253.22 0521 T1015 1 F 1334 E MAIN ST SANTA PAULA CA 93060 FQ 035 56 1952542896 COUNTY OF VENTURA 01 001 10/1/2018 $233.31 0521 T1015 1 F 2400 S C ST OXNARD CA 93030 FQ 035 56 1982846366 COUNTY OF VENTURA 01 001 10/1/2018 $231.95 0521 T1015 1 F 3801 LAS POSAS RD CAMARILLO CA 93010 FQ 035 56 1992947725 COUNTY OF VENTURA 01 001 10/1/2018 $313.56 0521 T1015 1 F 4061 CENTER ST PIRU CA 93040 FQ 035 56 1225177751 CRENSHAW HEALTHCARE 01 001 10/1/2018 $249.60 0521 T1015 1 F 3756 SANTA ROSALIA DR LOS ANGELES CA 90008 FQ 035 19 1356524599 DE ANZA CLINIC 01 001 10/1/2018 $ 86.72 0521 T1015 1 R 1001 BLAIR AVE CALEXICO CA 92231 RH 035 13 1902183098 DEBORAH A HIGER 01 001 10/1/2018 $107.28 0521 T1015 1 R 725 PINE STREET MOUNT SHASTA CA 96067 RH 035 47 1316949837 DELANO COMMUNITY HEALTH 01 001 10/1/2018 $141.19 0521 T1015 1 F 1508 GARCES HWY DELANO CA 93215 FQ 035 15 1063430916 DEL PUERTO HEALTH CARE DIST 01 001 10/1/2018 $165.27 0521 T1015 1 R 1700 KEYSTONE PACIFIC PK PATTERSON CA 95363 RH 035 50 1568439081 DESERT AIDS PROJECT 01 001 10/1/2017 $263.86 0521 T1015 1 F 1695 N SUNRISE WAY PALM SPRINGS CA 92262 FQ 035 33 1437213279 DIENTES COMMUNITY DENTAL 01 001 10/1/2018 $225.46 0521 T1015 1 F 1830 COMMERCIAL WAY SANTA CRUZ CA 95065 FQ 035 44 1255609699 DIGNITY HEALTH 01 001 10/1/2018 $200.69 0521 T1015 1 U 16337 EVERHART DR WEED CA 96094 RH 035 47 1518018191 DIGNITY HEALTH 05 005 10/1/2018 $216.99 0521 T1015 1 U 315 E 13TH STREET MERCED CA 95341 RH 035 24 1518018191 DIGNITY HEALTH 05 003 10/1/2018 $216.99 0521 T1015 1 U 1248 D STREET MERCED CA 95341 RH 035 24 1518018191 DIGNITY HEALTH 05 004 10/1/2018 $216.99 0521 T1015 1 U 1260 D STREET MERCED CA 95341 RH 035 24 1568799500 DIGNITY HEALTH 01 001 10/1/2018 $264.99 0521 T1015 1 U 912 PINE STREET MOUNT SHASTA CA 96067 RH 035 47 1609246461 DIGNITY HEALTH 01 001 10/1/2017 $ 81.32 0521 T1015 1 U 2126 SOLANO STREET CORNING CA 96021 RH 035 52 1942632534 DIGNITY HEALTH 01 001 10/1/2017 $222.46 0521 T1015 1 U 408 PINE ST MOUNT SHASTA CA 96067 RH 035 47 1326106501 DON M ENDRESS, MD 01 001 10/1/2018 $ 80.92 0521 T1015 1 R 12700 WELCH ST WATERFORD CA 95386 RH 035 50 1104145861 DON MICHAEL ENDRESS MD 01 001 10/1/2018 $ 87.05 0521 T1015 1 R 3191 EL PRADO ROAD LA GRANGE CA 95329 RH 035 55 1114923919 EASTERN PLUMAS HEALTH CARE 01 001 10/1/2018 $187.35 0521 T1015 1 U 480 1ST AVE PORTOLA CA 96122 RH 035 32 1487650313 EASTERN PLUMAS HEALTH CARE 01 001 10/1/2018 $185.42 0521 T1015 1 U 7597 HWY 89 GRAEAGLE CA 96103 RH 035 32 1669478590 EASTERN PLUMAS HOSPITAL 01 001 10/1/2018 $189.82 0521 T1015 1 U 725 3RD ST LOYALTON CA 96118 RH 035 46


1831243625 EAST VALLEY COMM HLTH 01 001 10/1/2018 $180.64 0521 T1015 1 F 420 S GLENDORA AVE WEST COVINA CA 91790 FQ 035 19 1285046847 EAST VALLEY COMMUNITY HEALTH 01 001 10/1/2017 $158.85 0521 T1015 1 F 276 WEST COLLEGE STREET COVINA CA 91723 FQ 035 19 1386912202 EAST VALLEY COMMUNITY HEALTH 01 001 10/1/2018 $148.43 0521 T1015 1 F 17840 VILLA CORTA STREET LA PUENTE CA 91744 FQ 035 19 1649324443 EAST VALLEY COMMUNITY HEALTH 01 001 10/1/2018 $180.64 0521 T1015 1 F 1555 SOUTH GAREY AVE POMONA CA 91766 FQ 035 19 1649324443 EAST VALLEY COMMUNITY HEALTH 01 002 10/1/2017 $143.15 0521 T1015 1 F 2211 N ORANGE GROVE AVE POMONA CA 91767 FQ 035 19 1861983470 EAST VALLEY COMMUNITY HEALTH 01 001 9/4/2018 $178.15 0521 T1015 1 F 17800 RENAULT ST LA PUENTE CA 91744 FQ 035 19 1316044522 EISNER PEDIATRIC & 01 001 10/1/2018 $165.29 0521 T1015 1 F 1530 S OLIVE ST LOS ANGELES CA 90015 FQ 035 19 1598840258 EL CENTRO REG MED CTR 01 001 10/1/2018 $153.30 0521 T1015 1 U 495 BIRCH ST CALEXICO CA 92231 RH 035 13 1316050107 EL DORADO COUNTY COMM 01 001 10/1/2018 $169.42 0521 T1015 1 F 4327 GOLDEN CENTER DR PLACERVILLE CA 95667 FQ 035 09 1609029362 EL DORADO COUNTY COMM 01 001 10/1/2018 $169.24 0521 T1015 1 F 4641 MISSOURI FLAT RD PLACERVILLE CA 95667 FQ 035 09 1073981783 EL DORADO COUNTY COMMUNITY 01 001 10/1/2017 $160.60 0521 T1015 1 F 3100 PONTE MORINO DR CAMERON PARK CA 95682 FQ 035 09 1285044990 EL DORADO COUNTY COMMUNITY 01 001 10/1/2018 $191.09 0521 T1015 1 F 3104 PONTE MORINO DR CAMERON PARK CA 95682 FQ 035 09 1093974065 ELICA HEALTH CENTERS 01 001 10/1/2018 $241.17 0521 T1015 1 F 3701 J ST SACRAMENTO CA 95816 FQ 035 34 1093974065 ELICA HEALTH CENTERS 01 002 10/1/2017 $187.42 0521 T1015 1 F 1750 WRIGHT STREET SACRAMENTO CA 95825 FQ 035 34 1548425853 ELICA HEALTH CENTERS 01 001 10/1/2018 $181.84 0521 T1015 1 F 155 15TH ST WEST SACRAMENTO CA 95691 FQ 035 57 1083624423 EL PROYECTO DEL BARRIO 01 001 10/1/2018 $151.77 0521 T1015 1 F 8902 WOODMAN AVE ARLETA CA 91331 FQ 035 19 1093181448 EL PROYECTO DEL BARRIO INC 01 001 10/1/2018 $176.95 0521 T1015 1 F 18250 ROSCOE BLVD NORTHRIDGE CA 91325 FQ 035 19 1154730828 EL PROYECTO DEL BARRIO INC 01 001 10/1/2018 $192.98 0521 T1015 1 F 3942 MAINE AVE BALDWIN PARK CA 91706 FQ 035 19 1538130893 EL PROYECTO DEL BARRIO INC 01 001 10/1/2018 $135.81 0521 T1015 1 F 20800 SHERMAN WAY WINNETKA CA 91306 FQ 035 19 1568871143 EL PROYECTO DEL BARRIO INC 01 001 10/1/2018 $179.71 0521 T1015 1 F 9140 VAN NUYS BLVD PANORAMA CITY CA 91402 FQ 035 19 1770696023 EL PROYECTO DEL BARRIO INC 01 001 10/1/2018 $138.30 0521 T1015 1 F 150 N AZUSA AVE AZUSA CA 91702 FQ 035 19 1851486989 EUREKA COMM HEALTH CTR 01 001 10/1/2018 $190.50 0521 T1015 1 F 959 MYRTLE AVE EUREKA CA 95501 FQ 035 12 1669775730 EUREKA PEDIATRICS 01 001 10/1/2018 $ 95.49 0521 T1015 1 R 2192 CENTRAL AVE MCKINLEYVILLE CA 95519 RH 035 12 1881706380 EUREKA PEDIATRICS 01 001 10/1/2018 $ 95.50 0521 T1015 1 R 2800 HARRIS ST EUREKA CA 95503 RH 035 12 1194122457 FAMILIES TOGETHER OF ORANGE 01 001 10/1/2018 $183.06 0521 T1015 1 F 661 W FIRST ST TUSTIN CA 92780 FQ 035 30 1821186727 FAMILY HEALTHCARE 01 001 10/1/2018 $149.13 0521 T1015 1 F 400 E OAK AVE VISALIA CA 93291 FQ 035 54 1790051423 FAMILY HEALTH CARE CENTER 01 001 10/1/2018 $201.62 0521 T1015 1 F 12113 WOODRUFF AVE DOWNEY CA 90241 FQ 035 19 1215310008 FAMILY HEALTH CARE CENTERS 01 001 10/1/2018 $185.39 0521 T1015 1 F 6119 AGRA STREET BELL GARDENS CA 90201 FQ 035 19 1720115033 FAMILY HEALTH CARE CENTERS 01 001 10/1/2018 $119.16 0521 T1015 1 F 6501 GARFIELD AVE BELL GARDENS CA 90201 FQ 035 19 1922416411 FAMILY HEALTH CARE CENTERS 01 001 10/1/2018 $174.41 0521 T1015 1 F 4943 SLAUSON AVENUE MAYWOOD CA 90270 FQ 035 19 1033661558 FAMILY HEALTHCARE NETWORK 01 001 10/1/2017 $171.45 0521 T1015 1 F 927 CENTER STREET PIXLEY CA 93256 FQ 035 54 1043664766 FAMILY HEALTHCARE NETWORK 01 001 12/15/2017 $161.85 0521 T1015 1 F 1008 N CHERRY STREET TULARE CA 93274 FQ 035 54 1073997201 FAMILY HEALTHCARE NETWORK 01 001 10/1/2017 $165.85 0521 T1015 1 F 263 S WEST STREET TULARE CA 93274 FQ 035 54 1164517744 FAMILY HEALTHCARE NETWORK 01 001 10/1/2018 $177.54 0521 T1015 1 F 201 EAST LAKEVIEW AVE WOODLAKE CA 93286 FQ 035 54 1326317819 FAMILY HEALTHCARE NETWORK 01 001 10/1/2018 $123.19 0521 T1015 1 F 730 N FARMERSVILLE BLVD FARMERSVILLE CA 93223 FQ 035 54 1730502725 FAMILY HEALTHCARE NETWORK 01 001 10/1/2017 $150.42 0521 T1015 1 F 401 E SCHOOL AVE VISALIA CA 93291 FQ 035 54 1790154862 FAMILY HEALTHCARE NETWORK 01 003 6/18/2018 $173.51 0521 T1015 1 F 324 N VERMONT AVENUE DINUBA CA 93618 FQ 035 54 1790154862 FAMILY HEALTHCARE NETWORK 01 001 10/1/2018 $175.94 0521 T1015 1 F 4177 AVENUE 368 TRAVER CA 93673 FQ 035 54 1831520048 FAMILY HEALTHCARE NETWORK 01 001 10/1/2017 $136.38 0521 T1015 1 F 9416 ROAD 238 TERRA BELLA CA 93270 FQ 035 54 1972010684 FAMILY HEALTHCARE NETWORK 01 001 4/9/2018 $166.60 0521 T1015 1 F 22817 AVENUE 196 STRATHMORE CA 93267 FQ 035 54 1083611156 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $158.07 0521 T1015 1 F 1107 W POPLAR AVE PORTERVILLE CA 93257 FQ 035 54 1336237072 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $153.13 0521 T1015 1 F 31180 ROAD 72 GOSHEN CA 93227 FQ 035 54 1386738177 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $149.13 0521 T1015 1 F 35800 HIGHWAY 190 SPRINGVILLE CA 93265 FQ 035 54 1467504530 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $147.80 0521 T1015 1 F 329 W 8TH ST HANFORD CA 93230 FQ 035 16 1558454256 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $188.29 0521 T1015 1 F 41651 SIERRA DR THREE RIVERS CA 93271 FQ 035 54 1558554519 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $166.73 0521 T1015 1 F 1133 S POPLAR AVE PORTERVILLE CA 93257 FQ 035 54 1588699151 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $158.07 0521 T1015 1 F 501 N BRIDGE ST VISALIA CA 93291 FQ 035 54 1912093451 FAMILY HEALTHCARE NETWRK 01 001 10/1/2018 $149.13 0521 T1015 1 F 12586 AVENUE 408 OROSI CA 93647 FQ 035 54 1639405004 FAMILY HEALTH CENTER 01 001 10/1/2018 $111.89 0521 T1015 1 R 7350 CHURCH ST YUCCA VALLEY CA 92284 RH 035 36 1255511630 FAMILY HEALTH CENTER OF 01 001 10/1/2018 $101.69 0521 T1015 1 R 63532 29 PALMS HWY JOSHUA TREE CA 92252 RH 035 36 1023462066 FAMILY HEALTH CENTERS 01 001 10/1/2017 $196.13 0521 T1015 1 F 248 LANDIS AVE CHULA VISTA CA 91910 FQ 035 37 1174549232 FAMILY HEALTH CENTERS 01 001 10/1/2018 $219.37 0521 T1015 1 F 2391 ISLAND AVE SAN DIEGO CA 92102 FQ 035 37 1235521782 FAMILY HEALTH CENTERS 01 001 10/1/2017 $197.68 0521 T1015 1 F 2325 COMMERCIAL ST SAN DIEGO CA 92113 FQ 035 37 1336525906 FAMILY HEALTH CENTERS 01 002 10/1/2017 $196.83 0521 T1015 1 F 5160 FEDERAL BLVD SAN DIEGO CA 92105 FQ 035 37 1477953933 FAMILY HEALTH CENTERS 01 001 10/1/2017 $206.65 0521 T1015 1 F 4874 POLK AVENUE SAN DIEGO CA 92105 FQ 035 37 1508801069 FAMILY HEALTH CENTERS 01 001 10/1/2018 $219.37 0521 T1015 1 F 8788 JAMACHA RD SPRING VALLEY CA 91977 FQ 035 37 1629456900 FAMILY HEALTH CENTERS 01 001 10/1/2017 $212.53 0521 T1015 1 F 4094 4TH AVENUE SAN DIEGO CA 92103 FQ 035 37 1952729303 FAMILY HEALTH CENTERS 01 001 10/1/2017 $235.30 0521 T1015 1 F 1550 BROADWAY SAN DIEGO CA 92101 FQ 035 37 1982747671 FAMILY HEALTH CENTERS 01 001 10/1/2018 $288.54 0521 T1015 1 F 4725 MARKET STREET SAN DIEGO CA 92102 FQ 035 37 1982747671 FAMILY HEALTH CENTERS 01 002 10/1/2017 $281.19 0521 T1015 1 F 1000 EUCLID AVENUE NATIONAL CITY CA 91950 FQ 035 37 1982747671 FAMILY HEALTH CENTERS 01 003 10/1/2017 $281.19 0521 T1015 1 F 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 FQ 035 37 1982747671 FAMILY HEALTH CENTERS 01 004 10/1/2017 $281.19 0521 T1015 1 F 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 FQ 035 37 1013952597 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $348.01 0521 T1015 1 F 2204 NATIONAL AVE SAN DIEGO CA 92113 FQ 035 37 1083959464 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $186.41 0521 T1015 1 F 352 L STREET CHULA VISTA CA 91911 FQ 035 37 1174560585 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $167.19 0521 T1015 1 F 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 FQ 035 37 1346480837 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $204.89 0521 T1015 1 F 251 LANDIS AVE CHULA VISTA CA 91910 FQ 035 37 1386689701 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $219.37 0521 T1015 1 F 3705 MISSION BLVD SAN DIEGO CA 92109 FQ 035 37 1386689701 FAMILY HEALTH CENTERS OF 01 003 10/1/2018 $178.39 0521 T1015 1 F 3690 MISSION BLVD SAN DIEGO CA 92109 FQ 035 37 1528331287 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $300.62 0521 T1015 1 F 140 ELM STREET SAN DIEGO CA 92101 FQ 035 37 1588901045 FAMILY HEALTH CENTERS OF 01 001 10/1/2018 $234.64 0521 T1015 1 F 1250 6TH AVE SAN DIEGO CA 92101 FQ 035 37 1023054004 FAMILY HEALTH CENTERS OF SAN 01 001 10/1/2018 $197.20 0521 T1015 1 F 5454 EL CAJON BLVD SAN DIEGO CA 92115 FQ 035 37


1700821303 FAMILY HEALTH CENTERS OF SAN 01 001 10/1/2018 $219.37 0521 T1015 1 F 3544 30TH ST SAN DIEGO CA 92104 FQ 035 37 1932561198 FAMILY HEALTH CENTERS OF SAN 01 001 10/1/2017 $190.63 0521 T1015 1 F 525 E MAIN STREET EL CAJON CA 92020 FQ 035 37 1982635470 FAMILY HEALTH CENTERS OF SAN 01 001 10/1/2018 $219.37 0521 T1015 1 F 1643 LOGAN AVE SAN DIEGO CA 92113 FQ 035 37 1104861681 FAMILY HEALTH CTRS OF SD 01 001 10/1/2018 $219.37 0521 T1015 1 F 1111 WEST CHASE AVE EL CAJON CA 92020 FQ 035 37 1104861681 FAMILY HEALTH CTRS OF SD 01 002 10/1/2018 $177.70 0521 T1015 1 F 1234 BROADWAY EL CAJON CA 92101 FQ 035 37 1447281936 FAMILY HEALTH CTRS OF SD 01 003 10/1/2018 $177.70 0521 T1015 1 F 2114 NATIONAL AVENUE SAN DIEGO CA 92113 FQ 035 37 1447281936 FAMILY HEALTH CTRS OF SD 01 001 10/1/2018 $219.37 0521 T1015 1 F 1809 NATIONAL AVE SAN DIEGO CA 92113 FQ 035 37 1871524363 FAMILY HEALTH CTRS OF SD 01 001 10/1/2018 $165.31 0521 T1015 1 F 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 FQ 035 37 1962433458 FAMILY HEALTH CTRS OF SD 01 001 10/1/2018 $159.60 0521 T1015 1 F 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 FQ 035 37 1841525862 FAMILY HEALTH MEDICAL CENTER 01 001 10/1/2018 $ 92.25 0521 T1015 1 R 1045 5TH STREET LOS BANOS CA 93635 RH 035 24 1174503114 FAMILY HEALTH SVS ANNEX 01 001 10/1/2018 $219.38 0521 T1015 1 U 1250 E ALMOND AVE MADERA CA 93637 RH 035 20 1386670610 FAMILY HLTHCARE NETWORK 01 001 10/1/2018 $158.07 0521 T1015 1 F 33025 ROAD 159 IVANHOE CA 93235 FQ 035 54 1427282466 FAMILY HLTH CTR OF SAN DIEGO 01 001 10/1/2018 $181.23 0521 T1015 1 F 7592 BROADWAY LEMON GROVE CA 91945 FQ 035 37 1811032436 FAMILY PLANNING CENTER 01 001 10/1/2018 $134.86 0521 T1015 1 F 22310 WARDHAM AVE HAWAIIAN GARDENS CA 90716 FQ 035 19 1871697102 FAMILY PRACTICE ASSOCS 01 001 10/1/2018 $133.36 0521 T1015 1 U 1611 FEATHER RIVER BLVD OROVILLE CA 95965 RH 035 04 1700972676 FEATHER RIVER HOSP 01 001 10/1/2018 $209.73 0521 T1015 1 U 5734 CANYON VIEW DR PARADISE CA 95969 RH 035 04 1912092792 FEATHER RIVER HOSP 01 001 10/1/2018 $252.07 0521 T1015 1 U 5125 SKYWAY PARADISE CA 95969 RH 035 04 1952402844 FEATHER RIVER HOSP 01 001 10/1/2018 $190.63 0521 T1015 1 U 5730 CANYON VIEW DR PARADISE CA 95969 RH 035 04 1285054106 FEATHER RIVER HOSPITAL 01 001 10/15/2017 $176.75 0521 T1015 1 U 155 SOLANO STREET CORNING CA 96021 RH 035 52 1326262965 FIREBAUGH & MENDOTA HLTH 01 001 10/1/2018 $ 83.48 0521 T1015 1 R 944 O ST FIREBAUGH CA 93522 RH 035 10 1225252869 FIREBAUGH & MENDOTA HTH CLNC 01 001 10/1/2018 $ 61.46 0521 T1015 1 R 507 OLLER ST MENDOTA CA 93640 RH 035 10 1629175856 FIRST CARE MEDICAL 01 001 10/1/2018 $ 94.67 0521 T1015 1 R 750 E WALKER ST ORLAND CA 95963 RH 035 11 1144626649 FOOTHILL HEALTH CENTER 01 001 10/1/2017 $160.60 0521 T1015 1 F 9460 NO NAME UNO GILROY CA 95020 FQ 035 43 1326302027 FOOTHILL HEALTH CENTER 01 001 10/1/2018 $174.15 0521 T1015 1 F 1650 S WHITE ROAD SAN JOSE CA 95127 FQ 035 43 1538508015 FOOTHILL HEALTH CENTER 01 001 10/1/2018 $161.39 0521 T1015 1 F 1066 S WHITE RD SAN JOSE CA 95127 FQ 035 43 1689950248 FOOTHILL HEALTH CENTER 01 001 10/1/2017 $151.70 0521 T1015 1 F 2380 MONTPELIER DRIVE SAN JOSE CA 95116 FQ 035 43 1922485952 FOOTHILL HEALTH CENTER 01 001 10/1/2017 $160.60 0521 T1015 1 F 5504 MONTEREY HWY SAN JOSE CA 95138 FQ 035 43 1598209868 FOOTHILL HEALTH CENTER INC 01 001 3/26/2018 $166.60 0521 T1015 1 F 2680 S WHITE ROAD SAN JOSE CA 95148 FQ 035 43 1376655217 FORTUNA FAMILY MEDICAL GROUP 01 001 10/1/2018 $ 73.61 0521 T1015 1 R 874 MAIN ST FORTUNA CA 95540 RH 035 12 1033197801 FOWLER MEDICAL CENTER 01 001 10/1/2018 $ 81.05 0521 T1015 1 R 210 E MERCED ST FOWLER CA 93625 RH 035 10 1104292945 FRESNO LONG TERM CARE 01 001 10/1/2017 $175.14 0521 T1015 1 R 29424 AUBERRY RD PRATHER CA 93651 RH 035 10 1922489665 FRIENDS OF FAMILY HEALTH 01 001 10/1/2018 $178.48 0521 T1015 1 F 13152 NEWPORT AVE TUSTIN CA 92780 FQ 035 30 1871818138 FRIENDS OF THE FAMILY 01 001 10/1/2018 $220.55 0521 T1015 1 F 501 S IDAHO ST LA HABRA CA 90631 FQ 035 30 1477667384 FRONTIER VILLAGE FAMILY 01 001 10/1/2018 $ 93.45 0521 T1015 1 R 645 ANTELOPE BLVD RED BLUFF CA 96080 RH 035 52 1558491043 GARDNER FAMILY HEALTH 01 001 10/1/2018 $185.63 0521 T1015 1 F 3030 ALUM ROCK AVE SAN JOSE CA 95127 FQ 035 43 1699041566 GARDNER FAMILY HEALTH 01 001 10/1/2018 $297.57 0521 T1015 1 F 725 E SANTA CLARA ST SAN JOSE CA 95112 FQ 035 43 1922366186 GARDNER FAMILY HEALTH 01 001 10/1/2018 $243.65 0521 T1015 1 F 3351 EL CAMINO REAL ATHERTON CA 94027 FQ 035 41 1164552931 GARDNER FAMILY HLTH NTWK 01 001 10/1/2018 $185.63 0521 T1015 1 F 1621 GOLD ST ALVISO CA 95002 FQ 035 43 1144358748 GARDNER FAMILY HLTH NTWR 01 001 10/1/2018 $185.63 0521 T1015 1 F 7526 MONTEREY ST GILROY CA 95020 FQ 035 43 1407985534 GARDNER HEALTH CENTER 01 001 10/1/2018 $185.63 0521 T1015 1 F 195 E VIRGINIA ST SAN JOSE CA 95112 FQ 035 43 1548643000 GARFIELD HEALTH CENTER 01 001 10/1/2018 $162.46 0521 T1015 1 F 701 S ATLANTIC BLVD MONTEREY PARK CA 91754 FQ 035 19 1760480610 GARFIELD HEALTH CENTER 01 001 10/1/2018 $175.81 0521 T1015 1 F 210 N GARFIELD MONTEREY PARK CA 91754 FQ 035 19 1275685414 GATEWAY MEDICAL CENTER INC 02 001 10/1/2018 $ 77.42 0521 T1015 1 R 2760 BALLS FERRY RD ANDERSON CA 96007 RH 035 45 1689620478 GILROY NEIGHBORHOOD CLIN 01 001 10/1/2018 $146.36 0521 T1015 1 F 7861 MURRAY AVE GILROY CA 95020 FQ 035 43 1346283017 GLENN MEDICAL CENTER INC 02 001 10/1/2018 $120.87 0521 T1015 1 U 130 N ENRIGHT AVE WILLOWS CA 95988 RH 035 11 1356388961 GLENN MEDICAL CENTER INC 02 001 10/1/2018 $143.61 0521 T1015 1 U 1133 W SYCAMORE ST WILLOWS CA 95988 RH 035 11 1124231865 GOLDEN VALLEY HEALTH 01 001 10/1/2018 $175.62 0521 T1015 1 F 1121 HAMMOND ST MODESTO CA 95351 FQ 035 50 1649483306 GOLDEN VALLEY HEALTH 01 001 10/1/2018 $160.49 0521 T1015 1 F 725 I ST LOS BANOS CA 93635 FQ 035 24 1922249077 GOLDEN VALLEY HEALTH CENTER 01 001 10/1/2018 $167.65 0521 T1015 1 F 1200 W MAIN ST TURLOCK CA 95380 FQ 035 50 1114430568 GOLDEN VALLEY HEALTH CENTERS 01 001 1/30/2018 $173.18 0521 T1015 1 F 1199 DELBON AVENUE TURLOCK CA 95382 FQ 035 50 1114434552 GOLDEN VALLEY HEALTH CENTERS 01 002 7/23/2018 $166.60 0521 T1015 1 ? 2240 W MONTE VISTA AVE TURLOCK CA 95382 FQ 035 50 1174036776 GOLDEN VALLEY HEALTH CENTERS 01 001 1/25/2018 $173.18 0521 T1015 1 F 1120 DELBON AVENUE TURLOCK CA 95382 FQ 035 50 1316393010 GOLDEN VALLEY HEALTH CENTERS 01 001 10/1/2018 $183.76 0521 T1015 1 F 1920 MEMORIAL DRIVE CERES CA 95307 FQ 035 50 1326493115 GOLDEN VALLEY HEALTH CENTERS 01 001 10/1/2018 $173.12 0521 T1015 1 F 198 NORTH G STREET EMPIRE CA 95319 FQ 035 50 1548568421 GOLDEN VALLEY HEALTH CENTERS 01 001 10/1/2018 $163.20 0521 T1015 1 F 4150 PATTERSON ROAD RIVERBANK CA 95367 FQ 035 50 1649783184 GOLDEN VALLEY HEALTH CENTERS 01 001 1/25/2018 $173.18 0521 T1015 1 F 1199 DELBON AVENUE TURLOCK CA 95382 FQ 035 50 1659884260 GOLDEN VALLEY HEALTH CENTERS 01 001 1/25/2018 $173.18 0521 T1015 1 F 1199 DELBON AVENUE TURLOCK CA 95382 FQ 035 50 1679013726 GOLDEN VALLEY HEALTH CENTERS 01 001 10/1/2018 $184.72 0521 T1015 1 F 250 NORTHGATE DRIVE MANTECA CA 95336 FQ 035 39 1942719976 GOLDEN VALLEY HEALTH CENTERS 01 001 1/25/2018 $173.18 0521 T1015 1 F 1100 DELBON AVENUE TURLOCK CA 95382 FQ 035 50 1962680421 GOLDEN VALLEY HEALTH CENTERS 01 001 10/1/2018 $175.36 0521 T1015 1 F 2101 TENAYA DR MODESTO CA 95354 FQ 035 50 1033322839 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $162.97 0521 T1015 1 F 1130 6TH ST MODESTO CA 95354 FQ 035 50 1033322870 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.33 0521 T1015 1 F 1717 LAS VEGAS ST MODESTO CA 95358 FQ 035 50 1073733879 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $187.46 0521 T1015 1 F 127 W EL PORTAL DR MERCED CA 95348 FQ 035 24 1134332398 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $179.75 0521 T1015 1 F 637 MERCED ST NEWMAN CA 95360 FQ 035 50 1215141379 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.60 0521 T1015 1 F 1141 N OLIVE AVE TURLOCK CA 95380 FQ 035 50 1326252693 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 1510 FLORIDA AVE MODESTO CA 95350 FQ 035 50 1366655128 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 301 HOWARD RD WESTLEY CA 95387 FQ 035 50 1457565590 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $131.97 0521 T1015 1 F 2760 3RD ST CERES CA 95307 FQ 035 50 1457571259 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $135.38 0521 T1015 1 F 401 LESHER DR MERCED CA 95341 FQ 035 24 1487867503 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 1114 6TH ST MODESTO CA 95354 FQ 035 50 1609089861 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 797 W CHILDS AVE MERCED CA 95341 FQ 035 24


1629298401 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $180.76 0521 T1015 1 F 13161 JEFFERSON ST LE GRAND CA 95333 FQ 035 24 1861612665 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 1405 CALIFORNIA AVE DOS PALOS CA 93620 FQ 035 24 1932313160 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 200 C ST PATTERSON CA 95363 FQ 035 50 1932324449 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 847 W CHILDS AVE MERCED CA 95341 FQ 035 24 1992925796 GOLDEN VALLEY HEALTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 9235 E BROADWAY PLANADA CA 95365 FQ 035 24 1609096403 GOLDEN VALLEY HLTH CTR 01 001 10/1/2018 $175.62 0521 T1015 1 F 821 TEXAS AVE LOS BANOS CA 93635 FQ 035 24 1033627179 GREATER FRESNO HEALTH 01 001 4/9/2018 $155.99 0521 T1015 1 F 4770 N CEDAR AVENUE FRESNO CA 93726 FQ 035 10 1184049793 GREATER FRESNO HEALTH 01 001 10/1/2018 $158.17 0521 T1015 1 F 4011 N MARKS AVENUE FRESNO CA 93722 FQ 035 10 1598072662 GREEN VALLEY MEDICAL CLINIC 01 001 10/1/2018 $118.45 0521 T1015 1 R 41689 ROAD 128 OROSI CA 93647 RH 035 54 1467490425 HARBOR COMMUNITY CLINIC 01 001 10/1/2018 $143.00 0521 T1015 1 F 593 W 6TH ST SAN PEDRO CA 90731 FQ 035 19 1467653873 HARBOR FREE CLINIC 01 001 10/1/2018 $143.00 0521 T1015 1 F 731 S BEACON ST SAN PEDRO CA 90731 FQ 035 19 1124130620 HARMONY HEALTH MEDICAL 02 002 10/1/2017 $160.60 0521 T1015 1 F 1908 N BEALE ROAD MARYSVILLE CA 95901 FQ 035 58 1144710005 HARMONY HEALTH MEDICAL 01 001 6/5/2018 $160.60 0521 T1015 1 F 1215 PLUMAS STREET YUBA CITY CA 95991 FQ 035 51 1720502610 HARMONY HEALTH MEDICAL 01 001 10/1/2017 $160.60 0521 T1015 1 F 399 DEL NORTE AVE YUBA CITY CA 95991 FQ 035 51 1346572468 HAROLD S BUDHRAM MD INC 01 001 10/1/2018 $ 88.87 0521 T1015 1 R 5145 SHASTA DAM BLVD SHASTA LAKE CA 96019 RH 035 45 1891811907 HAZEL HAWKINS HEALTH CLN 01 001 10/1/2018 $182.48 0521 T1015 1 U 301 THE ALAMEDA SAN JUAN BAUTISTA CA 95045 RH 035 35 1033235973 HAZEL HAWKINS MEMORIAL 01 001 10/1/2018 $164.07 0521 T1015 1 U 930 SUNSET DR HOLLISTER CA 95023 RH 035 35 1205076536 HAZEL HAWKINS MEMORIAL 01 001 10/1/2018 $189.46 0521 T1015 1 U 321 1ST STREET HOLLISTER CA 95023 RH 035 35 1295288348 HEALTH ACCESS FOR ALL INC 01 001 5/1/2018 $166.60 0521 T1015 1 F 6208 SEVILLE AVE HUNTINGTON PARK CA 90255 FQ 035 19 1447703400 HEALTH ACCESS FOR ALL INC 01 001 10/1/2018 $185.99 0521 T1015 1 F 1919 WEST 7TH ST LOS ANGELES CA 90057 FQ 035 19 1538180245 HEALTH AND LIFE 01 001 10/1/2018 $119.36 0521 T1015 1 F 2200 DEL PASO BLVD SACRAMENTO CA 95815 FQ 035 34 1740336734 HEALTH AND LIFE 01 001 10/1/2018 $119.36 0521 T1015 1 F 7275 E SOUTHGATE DR SACRAMENTO CA 95823 FQ 035 34 1144600248 HEALTH AND LIFE ORGANIZATION 01 001 10/1/2018 $187.60 0521 T1015 1 F 3030 EXPLORER DRIVE SACRAMENTO CA 95827 FQ 035 34 1295044832 HEALTH AND LIFE ORGANIZATION 01 001 10/1/2018 $122.66 0521 T1015 1 F 5524 ASSEMBLY COURT SACRAMENTO CA 95823 FQ 035 34 1932624962 HEALTH AND LIFE ORGANIZTION 01 001 10/1/2017 $182.82 0521 T1015 1 F 3301 FONG RANCH ROAD SACRAMENTO CA 95834 FQ 035 34 1447279310 HEALTHRIGHT 360 02 001 10/1/2018 $228.25 0521 T1015 1 F 330 ELLIS SAN FRANCISCO CA 94102 FQ 035 38 1568556363 HEALTHRIGHT 360 02 001 10/1/2018 $306.62 0521 T1015 1 F 1748 MARKET ST SAN FRANCISCO CA 94102 FQ 035 38 1730363151 HEALTHRIGHT 360 01 001 7/15/2018 $206.44 0521 T1015 1 F 1563 MISSION ST SAN FRANCISCO CA 94103 FQ 035 38 1760427843 HEALTHRIGHT 360 01 001 10/1/2018 $139.72 0521 T1015 1 F 558 CLAYTON ST SAN FRANCISCO CA 94117 FQ 035 38 1831335116 HEALTHY HEARTS MEDICAL GROUP 01 001 10/1/2018 $ 96.71 0521 T1015 1 R 555 SIXTH ST ORANGE COVE CA 93646 RH 035 10 1114031051 HEMET FAMILY CARE CENTER 01 001 10/1/2018 $293.86 0521 T1015 1 F 880 N STATE ST HEMET CA 92543 FQ 035 33 1033390273 HERALD CHRISTIAN HEALTH 01 001 10/1/2018 $164.18 0521 T1015 1 F 923 S SAN GABRIEL BLVD SAN GABRIEL CA 91776 FQ 035 19 1063835213 HERALD CHRISTIAN HEALTH 01 001 10/1/2018 $181.13 0521 T1015 1 F 1661 HANOVER ROAD CITY OF INDUSTRY CA 91748 FQ 035 19 1386000248 HERALD CHRISTIAN HEALTH 01 001 10/1/2018 $164.17 0521 T1015 1 F 8841 GARVEY AVE ROSEMEAD CA 91770 FQ 035 19 1053733527 HI-DESERT MEMORIAL HEALTH 01 001 10/1/2017 $160.60 0521 T1015 1 F 72724 29 PALMS HIGHWAY TWENTYNINE PALMS CA 92227 FQ 035 36 1649708611 HI-DESERT MEMORIAL HEALTH 01 001 10/1/2017 $163.49 0521 T1015 1 F 57463 29 PALMS HWY YUCCA VALLEY CA 92284 FQ 035 36 1841612082 HI-DESERT MEMORIAL HEALTH 01 001 10/1/2017 $160.60 0521 T1015 1 F 58375 29 PALMS HIGHWAY YUCCA VALLEY CA 92284 FQ 035 36 1407914260 HILL COUNTRY COMM CLINIC 01 001 10/1/2018 $216.72 0521 T1015 1 F 29632 HIGHWAY 299 EAST ROUND MOUNTAIN CA 96084 FQ 035 45 1457844318 HILL COUNTRY COMM CLINIC 01 001 7/3/2018 $213.73 0521 T1015 1 F 1401 GOLD STREET RDEDDING CA 96001 FQ 035 45 1841437241 H STREET CLINIC INC 01 001 10/1/2018 $202.63 0521 T1015 1 F 1329 NORTH H ST SAN BERNARDINO CA 92405 FQ 035 36 1447287347 HUMBOLDT FAMILY CARE 01 001 10/1/2018 $118.39 0521 T1015 1 U 1733 CENTRAL AVE MCKINLEYVILLE CA 95519 RH 035 12 1255435533 HUMBOLDT OPEN DOOR CLIN 01 001 10/1/2018 $216.10 0521 T1015 1 F 770 10TH ST ARCATA CA 95521 FQ 035 12 1497840656 HUMBOLDT OPEN DOOR CLN 01 001 10/1/2018 $197.50 0521 T1015 1 F 550 E WASHINGTON BLVD CRESCENT CITY CA 95531 FQ 035 08 1003250093 HURTT FAMILY HEALTH CLINIC 01 001 10/1/2018 $188.75 0521 T1015 1 F 1100 B N. TUSTIN AVE SANTA ANA CA 92705 FQ 035 30 1144760943 HURTT FAMILY HEALTH CLINIC, 01 001 10/1/2018 $195.04 0521 T1015 1 F 947 S ANAHEIM BLVD ANAHEIM CA 92805 FQ 035 30 1306965587 HURTT FAMILY HEALTH CLINIC, 01 001 10/1/2018 $149.83 0521 T1015 1 F 1 HOPE DR TUSTIN CA 92782 FQ 035 30 1215246996 IMPERIAL BEACH COMMUNITY 01 001 10/1/2018 $220.33 0521 T1015 1 F 1016 OUTER ROAD SAN DIEGO CA 92154 FQ 035 37 1790718351 IMPERIAL BEACH HEALTH CT 01 001 10/1/2018 $169.20 0521 T1015 1 F 949 PALM AVE IMPERIAL BEACH CA 91932 FQ 035 37 1508295502 IMPERIAL VALLEY FAMILY CARE 01 001 10/1/2018 $ 97.23 0521 T1015 1 R 608 G STREET BRAWLEY CA 92227 RH 035 13 1629462312 INDIAN HEALTH CENTER 01 001 9/1/2018 $179.07 0521 T1015 1 F 2039 FOREST AVENUE SAN JOSE CA 95128 FQ 035 43 1114290780 INDIAN HEALTH CENTER OF 01 001 10/1/2018 $269.02 0521 T1015 1 F 455 O'CONNOR DRIVE SAN JOSE CA 95128 FQ 035 43 1164643862 INDIAN HEALTH CENTER OF 01 001 10/1/2018 $227.77 0521 T1015 1 F 1333 MERIDIAN AVE SAN JOSE CA 95125 FQ 035 43 1881997963 INDIAN HEALTH CENTER OF SANT 01 001 10/1/2018 $223.37 0521 T1015 1 F 1642 E CAPITOL EXPY SAN JOSE CA 95121 FQ 035 43 1861449522 INDIAN HEALTH COUNCIL 01 001 10/1/2018 $338.96 0521 T1015 1 F POST OFFICE BOX 406 PAUMA VALLEY CA 92061 FQ 035 37 1023122967 INDIO FAMILY CARE CENTER 01 001 10/1/2018 $376.48 0521 T1015 1 F 47923 OASIS ST INDIO CA 92201 FQ 035 33 1275562969 INLAND BEHAVIORAL AND HEALTH 01 001 10/1/2018 $166.17 0521 T1015 1 F 665 N D ST SAN BERNARDINO CA 92401 FQ 035 36 1578823647 INLAND BEHAVIORAL AND HEALTH 01 001 10/1/2018 $178.00 0521 T1015 1 F 1070 E RAMSEY STREET BANNING CA 92220 FQ 035 33 1386646404 JAMES CORONA MD 01 001 10/1/2018 $ 68.89 0521 T1015 1 R 203 WALKER ST ORLAND CA 95963 RH 035 11 1871778886 JAMES OOI MD APC 01 001 10/1/2018 $113.82 0521 T1015 1 R 320 SOLANO ST CORNING CA 96021 RH 035 52 1730497421 JASBIR S KANG MD AND SANJIV 01 001 10/1/2018 $104.09 0521 T1015 1 R 527 E STREET MARYSVILLE CA 95901 RH 035 58 1275752727 JOHN C FREMONT HLTHCARE 01 001 10/1/2018 $221.78 0521 T1015 1 U 6386 GREELEY HILL RD COULTERVILLE CA 95311 RH 035 22 1487877908 JOHN C FREMONT HLTHCARE 01 001 10/1/2018 $239.03 0521 T1015 1 U 5186 HOSPITAL RD MARIPOSA CA 95338 RH 035 22 1578786091 JOHN C FREMONT MED CLN 01 001 10/1/2018 $141.97 0521 T1015 1 U 5189 HOSPITAL RD MARIPOSA CA 95338 RH 035 22 1568525400 JOHN R GLYER D MILLS 01 001 10/1/2018 $ 89.47 0521 T1015 1 R 1245 S MAIN ST WILLITS CA 95490 RH 035 23 1457557126 JUDITH BRANDT DO INC 01 001 10/1/2018 $170.67 0521 T1015 1 R 3070 CAMINO HEIGHTS DR CAMINO CA 95709 RH 035 09 1124182977 JWCH INSTITUTE INC 01 001 10/1/2018 $132.61 0521 T1015 1 F 3591 E IMPERIAL HIGHWAY LYNWOOD CA 90262 FQ 035 19 1407808058 JWCH INSTITUTE INC 01 001 10/1/2018 $194.63 0521 T1015 1 F 522 S SAN PEDRO LOS ANGELES CA 90013 FQ 035 19 1538342704 JWCH INSTITUTE INC 01 001 10/1/2018 $142.09 0521 T1015 1 F 14371 CLARK AVENUE BELLFLOWER CA 90706 FQ 035 19 1770988370 JWCH INSTITUTE INC 01 001 10/1/2017 $166.15 0521 T1015 1 F 8530 FIRESTONE BLVD DOWNEY CA 90241 FQ 035 19 1861745606 JWCH INSTITUTE INC 01 001 10/1/2018 $146.90 0521 T1015 1 F 3580 E IMPERIAL HWY LYNWOOD CA 90262 FQ 035 19 1104274596 JWCH INSTITUTE, INC 01 001 10/1/2018 $176.42 0521 T1015 1 F 15898 W GALE AVE HACIENDA HEIGHTS CA 91745 FQ 035 19

PrvdrCurrent Rev Rate RevenueProvider Owner Service Current Revenue Special Zip Type CountyProvider Legal Name Rate Begin Procedure Status Physical Street Address City TypeNumber Num Location Rate Code Processing State Code Code CodeDate Code CodeType Code 1245786532 JWCH INSTITUTE, INC 01 001 3/28/2018 $180.68 0521 T1015 1 F 10750 LAUREL AVE WHITTIER CA 90605 FQ 035 19 1295829109 JWCH INSTITUTE, INC 01 001 10/1/2018 $173.22 0521 T1015 1 F 6912 AJAX AVE BELL GARDENS CA 90201 FQ 035 19 1386708634 JWCH INSTITUTE, INC 01 001 10/1/2018 $183.21 0521 T1015 1 F 12360 FIRESTONE BLVD NORWALK CA 90650 FQ 035 19 1598829350 JWCH INSTITUTE, INC 01 001 10/1/2018 $263.38 0521 T1015 1 F 954 N VERMONT AVE LOS ANGELES CA 90029 FQ 035 19 1992139216 KALEKA, VIRENDER S MD 01 001 10/1/2018 $ 78.79 0521 T1015 1 R 420 E EL MONTE WAY DINUBA CA 93618 RH 035 54 1518089507 KARTHIKEYA DEVIREDDY MD 01 001 10/1/2018 $102.00 0521 T1015 1 R 311 W I ST LOS BANOS CA 93635 RH 035 24 1154614097 KAWEAH DELTA HEALTH CARE 01 001 10/1/2018 $251.07 0521 T1015 1 U 180 E ANTELOPE AVE WOODLAKE CA 93286 RH 035 54 1841607801 KAWEAH DELTA HEALTH CARE 01 001 10/1/2018 $262.40 0521 T1015 1 U 355 MONTE VISTA DRIVE DINUBA CA 93618 RH 035 54 1043272172 KAWEAH DELTA HEALTHCARE 01 001 10/1/2018 $221.65 0521 T1015 1 U 1014 SAN JUAN AVE EXETER CA 93221 RH 035 54 1104067636 KAWEAH DELTA HLTH CARE DIST 01 001 10/1/2018 $252.45 0521 T1015 1 U 839 N SEQUOIA AVE LINDSAY CA 93247 RH 035 54 1417378597 KEDREN COMMUNITY HEALTH 01 001 10/1/2018 $196.98 0521 T1015 1 F 4211 SOUTH AVALON BLVD LOS ANGELES CA 90011 FQ 035 19 1902196256 KERN RURAL WELLNESS CENTERS 01 001 10/1/2018 $105.53 0521 T1015 1 R 146 N HILL ROAD ARVIN CA 93203 RH 035 15 1427049964 KERN VALLEY HEALTHCARE 01 003 10/1/2018 $260.89 0521 T1015 1 U 4300 BIRCH ST LAKE ISABELLA CA 93240 RH 035 15 1265521488 KINGS WINERY MEDICAL CLN 01 001 10/1/2018 $ 87.67 0521 T1015 1 F 4929 E KINGS CANYON RD FRESNO CA 93727 FQ 035 10 1164696449 KOMIN, MICHAEL MD INC 01 001 10/1/2018 $103.68 0521 T1015 1 R 1150 E LERDO HWY SHAFTER CA 93263 RH 035 15 1861525602 KOREAN COMMUNITY SERVICES 01 001 10/1/2018 $217.54 0521 T1015 1 F 7212 ORANGETHORPE AVE BUENA PARK CA 90621 FQ 035 30 1013311448 KOREAN HEALTH EDUCATION 01 002 10/1/2017 $212.50 0521 T1015 1 F 3750 WEST SIXTH ST LOS ANGELES CA 90020 FQ 035 19 1013311448 KOREAN HEALTH EDUCATION 01 001 10/1/2018 $220.46 0521 T1015 1 F 3255 WILSHIRE BLVD LOS ANGELES CA 90010 FQ 035 19 1437377454 KOREAN HEALTH EDUCATION 01 001 10/1/2018 $119.12 0521 T1015 1 F 3727 W 6TH ST LOS ANGELES CA 90020 FQ 035 19 1285785154 KRISHNAMOORTHI, MD INC 01 001 10/1/2018 $ 94.30 0521 T1015 1 R 850 CALIFORNIA ST ESCALON CA 95320 RH 035 39 1316098205 KRISHNAMOORTHI, MD INC 01 001 10/1/2018 $ 94.30 0521 T1015 1 R 324 F ST WATERFORD CA 95386 RH 035 50 1013085778 LA CLINICA DE LA RAZA 01 001 10/1/2018 $154.50 0521 T1015 1 F 4351 BROADWAY OAKLAND CA 94611 FQ 035 01 1124035159 LA CLINICA DE LA RAZA 01 001 10/1/2018 $184.98 0521 T1015 1 F 3060 E 9TH ST OAKLAND CA 94601 FQ 035 01 1144336181 LA CLINICA DE LA RAZA 01 001 10/1/2018 $216.81 0521 T1015 1 F 3451 E 12TH ST OAKLAND CA 94601 FQ 035 01 1235245275 LA CLINICA DE LA RAZA 01 002 10/1/2017 $244.03 0521 T1015 1 F 16335 E 14TH ST SAN LEANDRO CA 94578 FQ 035 01 1235245275 LA CLINICA DE LA RAZA 01 001 10/1/2018 $259.29 0521 T1015 1 F 1515 FRUITVALE AVE OAKLAND CA 94601 FQ 035 01 1326154360 LA CLINICA DE LA RAZA 01 001 10/1/2018 $191.67 0521 T1015 1 F 3050 E 16TH ST OAKLAND CA 94601 FQ 035 01 1427070374 LA CLINICA DE LA RAZA 01 001 10/1/2018 $229.85 0521 T1015 1 F 1030 INTERNATIONAL BLVD OAKLAND CA 94606 FQ 035 01 1528080470 LA CLINICA DE LA RAZA 01 004 10/1/2017 $384.85 0521 T1015 1 F 4141 HARBOR STREET PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 003 10/1/2017 $384.85 0521 T1015 1 F 610 CROWLEY AVENUE PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 005 10/1/2017 $384.85 0521 T1015 1 F 50 E 8TH STREET PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 002 10/1/2017 $384.85 0521 T1015 1 F 2000 RAILROAD AVE PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 007 10/1/2017 $384.85 0521 T1015 1 F 2555 E LELAND RD PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 009 10/1/2017 $384.85 0521 T1015 1 F 1203 W 10TH ST ANTIOCH CA 94509 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 010 10/1/2017 $384.85 0521 T1015 1 F 55 CASTLEWOOD DR PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 001 10/1/2018 $405.67 0521 T1015 1 F 335 E LELAND RD PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 011 10/1/2017 $384.85 0521 T1015 1 F 2131 CRESTVIEW LANE PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 008 10/1/2017 $384.85 0521 T1015 1 F 204 ODESSA AVE PITTSBURG CA 94565 FQ 035 07 1528080470 LA CLINICA DE LA RAZA 01 006 10/1/2017 $384.85 0521 T1015 1 F 850 E LELAND RD PITTSBURG CA 94565 FQ 035 07 1619056926 LA CLINICA DE LA RAZA 01 001 10/1/2018 $220.78 0521 T1015 1 F 4610 FOOTHILL BLVD OAKLAND CA 94601 FQ 035 01 1720243454 LA CLINICA DE LA RAZA 01 001 10/1/2018 $189.14 0521 T1015 1 F 220 HOSPITAL DRIVE VALLEJO CA 94589 FQ 035 48 1972525822 LA CLINICA DE LA RAZA 01 001 10/1/2018 $264.10 0521 T1015 1 F 2240 GLADSTONE DR PITTSBURG CA 94565 FQ 035 07 1023445780 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $250.40 0521 T1015 1 F 1700 28TH AVE OAKLAND CA 94601 FQ 035 01 1245671726 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $197.81 0521 T1015 1 F 1390 66TH AVE OAKLAND CA 94621 FQ 035 01 1316188543 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $184.62 0521 T1015 1 F 50 E LEWELLING BLVD SAN LORENZO CA 94580 FQ 035 01 1538181482 LA CLINICA DE LA RAZA INC 01 002 10/1/2017 $214.39 0521 T1015 1 F 1360 DETROIT AVENUE CONCORD CA 94520 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $226.00 0521 T1015 1 F 2000 SIERRA ROAD CONCORD CA 94518 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 004 10/1/2017 $216.11 0521 T1015 1 F 663 CANAL RD BAY POINT CA 94565 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 005 10/1/2017 $216.11 0521 T1015 1 F 2400 LISA LANE PLEASANT HILL CA 94523 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 007 10/1/2017 $220.24 0521 T1015 1 F 1146 LACEY LANE CONCORD CA 94520 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 006 10/1/2017 $220.24 0521 T1015 1 F 1187 MEADOW LANE CONCORD CA 94520 FQ 035 07 1538181482 LA CLINICA DE LA RAZA INC 01 003 10/1/2017 $214.39 0521 T1015 1 F 2217 CHARLOMAR ROAD CONCORD CA 94518 FQ 035 07 1578834164 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $236.40 0521 T1015 1 F 2021 MAIN ST OAKLEY CA 94561 FQ 035 07 1992863096 LA CLINICA DE LA RAZA INC 01 001 10/1/2018 $178.94 0521 T1015 1 F 210 HOSPITAL DR VALLEJO CA 94589 FQ 035 48 1346262292 LA CLINICA DENTAL AT 01 001 10/1/2018 $230.19 0521 T1015 1 F 747 52ND ST OAKLAND CA 94609 FQ 035 01 1851522015 LA CLINICA DE RAZA, INC 01 001 10/1/2018 $ - 0521 T1015 1 F 1926 19TH AVE OAKLAND CA 94606 AD 035 01 1851522015 LA CLINICA DE RAZA, INC 01 001 10/1/2018 $297.87 0521 T1015 1 F 1926 19TH AVE OAKLAND CA 94606 FQ 035 01 1780606632 LA CLINICA VALLEJO 01 001 10/1/2018 $152.25 0521 T1015 1 F 2920 SONOMA BLVD VALLEJO CA 94590 FQ 035 48 1992811392 LA CLINICA VALLEJO 01 001 10/1/2018 $185.82 0521 T1015 1 F 243 GEORGIA ST VALLEJO CA 94590 FQ 035 48 1396756938 LAC USC MEDICAL CENTER 01 001 7/1/2018 $993.30 0521 T1015 1 F 1200 N STATE ST LOS ANGELES CA 90033 FQ 035 19 1396859179 LAKE ELSINORE FAMILY 01 001 10/1/2018 $317.01 0521 T1015 1 F 2499 E LAKESHORE DR LAKE ELSINORE CA 92530 FQ 035 33 1306929443 LA MAESTRA FAMILY 01 001 10/1/2018 $127.76 0521 T1015 1 F 165 S FIRST ST EL CAJON CA 92019 FQ 035 37 1609849074 LA MAESTRA FAMILY CLINIC 01 001 10/1/2018 $211.90 0521 T1015 1 F 4060 FAIRMOUNT AVE SAN DIEGO CA 92105 FQ 035 37 1508949645 LA MAESTRA FAMILY CLINIC INC 01 001 10/1/2018 $131.71 0521 T1015 1 F 217 HIGHLAND AVE NATIONAL CITY CA 91950 FQ 035 37 1659490308 LA MAESTRA FAMILY CLINIC INC 01 001 10/1/2018 $149.23 0521 T1015 1 F 4305 UNIVERSITY AVE SAN DIEGO CA 92105 FQ 035 37 1891011599 LA MAESTRA FAMILY CLINIC INC 01 001 10/1/2018 $142.30 0521 T1015 1 F 7967 BROADWAY LEMON GROVE CA 91945 FQ 035 37 1629070461 LAMONT COMMUNITY HEALTH 01 001 10/1/2018 $205.18 0521 T1015 1 F 8787 HALL RD LAMONT CA 93241 FQ 035 15 1003955758 LASSEN MEDICAL GROUP INC 01 001 10/1/2018 $111.50 0521 T1015 1 R 2450 SISTER MARY COLUMBA RED BLUFF CA 96080 RH 035 52 1689713505 LASSEN MEDICAL GROUP INC 01 001 10/1/2018 $101.05 0521 T1015 1 R 20833 LONGBRANCH DR COTTONWOOD CA 96022 RH 035 45 1487764064 LAST FRONTIER HEALTHCARE 02 001 10/1/2018 $153.23 0521 T1015 1 U 229 W MCDOWELL AVE ALTURAS CA 96101 RH 035 25 1457762072 LATINO KIDS HEALTH 01 001 10/1/2017 $160.60 0521 T1015 1 F 901 W WHITTIER BLVD MONTEBELLO CA 90640 FQ 035 19


1013913300 LIFELONG MEDICAL CARE 01 001 10/1/2018 $220.72 0521 T1015 1 F 1860 ALCATRAZ AVE BERKELEY CA 94703 FQ 035 01 1154327138 LIFELONG MEDICAL CARE 01 001 10/1/2018 $263.22 0521 T1015 1 F 10700 MACARTHUR BLVD OAKLAND CA 94605 FQ 035 01 1376931295 LIFELONG MEDICAL CARE 01 001 10/1/2017 $212.35 0521 T1015 1 F 386 14TH ST OAKLAND CA 94612 FQ 035 01 1407973043 LIFELONG MEDICAL CARE 02 001 10/1/2018 $235.97 0521 T1015 1 F 1030 NEVIN AVE RICHMOND CA 94801 FQ 035 07 1457758724 LIFELONG MEDICAL CARE 01 001 10/1/2018 $250.94 0521 T1015 1 F 3075 ADELINE ST BERKELEY CA 94703 FQ 035 01 1487696191 LIFELONG MEDICAL CARE 02 001 10/1/2018 $221.16 0521 T1015 1 F 2023 VALE ROAD SAN PABLO CA 94806 FQ 035 07 1518963693 LIFELONG MEDICAL CARE 01 001 10/1/2018 $225.54 0521 T1015 1 F 2001 DWIGHT WAY BERKELEY CA 94704 FQ 035 01 1619145307 LIFELONG MEDICAL CARE 01 001 10/1/2018 $225.66 0521 T1015 1 F 9933 MACARTHUR BLVD OAKLAND CA 94605 FQ 035 01 1689670002 LIFELONG MEDICAL CARE 01 001 10/1/2018 $250.50 0521 T1015 1 F 3260 SACRAMENTO ST BERKELEY CA 94702 FQ 035 01 1720084163 LIFELONG MEDICAL CARE 01 001 10/1/2018 $229.17 0521 T1015 1 F 2031 6TH ST BERKELEY CA 94710 FQ 035 01 1568598829 LIFELONG MEDICAL CARE- 01 001 10/1/2018 $259.94 0521 T1015 1 F 616 16TH ST OAKLAND CA 94612 FQ 035 01 1225017551 LIJUN W SAKAL MD 01 002 10/1/2018 $ 87.38 0521 T1015 1 R 14662 SKYWAY MAGALIA CA 95954 RH 035 04 1124300207 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $172.81 0521 T1015 1 F 7970 N LANDER AVE HILMAR CA 95324 FQ 035 24 1295184117 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $169.28 0521 T1015 1 F 1010 W LAS PALMAS AVE PATTERSON CA 95363 FQ 035 50 1427110329 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $137.54 0521 T1015 1 F 1140 MAIN ST LIVINGSTON CA 95334 FQ 035 24 1487012779 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $171.08 0521 T1015 1 F 1617 MAIN STREET LIVINGSTON CA 95334 FQ 035 24 1528433588 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $162.82 0521 T1015 1 F 12619 BENTLEY ST WATERFORD CA 95386 FQ 035 50 1730530254 LIVINGSTON COMMUNITY HEALTH 01 001 10/1/2018 $160.89 0521 T1015 1 F 16233 KING STREET DELHI CA 95315 FQ 035 24 1952662686 LIVINGSTONE COMMUNITY 01 001 10/1/2018 $191.50 0521 T1015 1 F 12362 BEACH BLVD STANTON CA 90680 FQ 035 30 1164431383 LODI MEMORIAL HOSP 01 001 10/1/2018 $159.26 0521 T1015 1 U 387 CIVIC DR GALT CA 95632 RH 035 34 1366467375 LONG VALLEY HEALTH CTR 01 001 10/1/2018 $242.77 0521 T1015 1 F 50 BRANSCOMB RD LAYTONVILLE CA 95454 FQ 035 23 1457599631 LOS ANGELES CHRISTIAN 01 001 10/1/2018 $160.95 0521 T1015 1 F 1625 E 4TH ST LOS ANGELES CA 90033 FQ 035 19 1124372974 LOS ANGELES CHRISTIAN HEALTH 01 001 10/1/2018 $149.01 0521 T1015 1 F 1005 SOUTH CENTRAL AVE LOS ANGELES CA 90021 FQ 035 19 1497009245 LOS ANGELES CHRISTIAN HEALTH 01 001 10/1/2018 $134.92 0521 T1015 1 F 1920 MARENGO ST LOS ANGELES CA 90033 FQ 035 19 1861746612 LOS ANGELES CHRISTIAN HEALTH 01 001 10/1/2018 $140.27 0521 T1015 1 F 600 ST PAUL AVENUE LOS ANGELES CA 90017 FQ 035 19 1942398367 LOS ANGELES CHRSTN HLTH CTRS 01 001 10/1/2018 $171.47 0521 T1015 1 F 311 WINSTON ST LOS ANGELES CA 90013 FQ 035 19 1316969934 LOS ANGELES CO 01 001 7/1/2018 $898.24 0521 T1015 1 F 14445 OLIVE VIEW DR SYLMAR CA 91342 FQ 035 19 1336152578 LOS ANGELES CO 01 001 7/1/2018 $891.68 0521 T1015 1 F 335 E AVENUE K6 LANCASTER CA 93535 FQ 035 19 1467565283 LOS ANGELES CO-DHS 01 001 7/1/2018 $891.68 0521 T1015 1 F 8201 PEARBLOSSOM HWY LITTLEROCK CA 93543 FQ 035 19 1144233800 LOS ANGELES COUNTY 01 001 7/1/2018 $603.90 0521 T1015 1 F 2829 S GRAND AVE LOS ANGELES CA 90007 FQ 035 19 1154335982 LOS ANGELES COUNTY 01 001 7/1/2018 $417.66 0521 T1015 1 F 1333 CHESTNUT AVE LONG BEACH CA 90813 FQ 035 19 1427070168 LOS ANGELES COUNTY 01 001 7/1/2018 $691.67 0521 T1015 1 F 1000 W CARSON ST TORRANCE CA 90502 FQ 035 19 1467465641 LOS ANGELES COUNTY 01 001 7/1/2018 $510.39 0521 T1015 1 F 7515 VAN NUYS BLVD VAN NUYS CA 91405 FQ 035 19 1508872912 LOS ANGELES COUNTY 01 001 7/1/2018 $417.66 0521 T1015 1 F 1325 BROAD AVE WILMINGTON CA 90744 FQ 035 19 1518973940 LOS ANGELES COUNTY 01 001 7/1/2018 $417.66 0521 T1015 1 F 10005 E FLOWER AVE BELLFLOWER CA 90706 FQ 035 19 1558379990 LOS ANGELES COUNTY 01 001 7/1/2018 $510.39 0521 T1015 1 F 1212 PICO ST SAN FERNANDO CA 91340 FQ 035 19 1649383464 LOS ANGELES COUNTY 01 001 7/1/2018 $891.68 0521 T1015 1 F 38350 40TH ST E PALMDALE CA 93552 FQ 035 19 1770596439 LOS ANGELES COUNTY 01 001 7/1/2018 $603.90 0521 T1015 1 F 15930 CENTRAL AVE LA PUENTE CA 91744 FQ 035 19 1972516631 LOS ANGELES COUNTY 01 001 7/1/2018 $603.90 0521 T1015 1 F 10953 RAMONA BLVD EL MONTE CA 91731 FQ 035 19 1982611919 LOS ANGELES COUNTY 01 001 7/1/2018 $614.18 0521 T1015 1 F 5850 S MAIN ST LOS ANGELES CA 90003 FQ 035 19 1982617692 LOS ANGELES COUNTY 01 001 7/1/2018 $603.90 0521 T1015 1 F 245 S FETTERLY AVE LOS ANGELES CA 90022 FQ 035 19 1821101643 LOS ANGELES COUNTY-DHS 01 001 7/1/2018 $891.68 0521 T1015 1 F 16921 E AVENUE O PALMDALE CA 93591 FQ 035 19 1548298532 LOS ANGELES GAY AND LESBIAN 01 001 10/1/2018 $351.35 0521 T1015 1 F 1625 SCHRADER BLVD LOS ANGELES CA 90028 FQ 035 19 1720451396 LOS ANGELES GAY AND LESBIAN 01 001 10/1/2017 $342.39 0521 T1015 1 F 8745 SANTA MONICA BLVD WEST HOLLYWOOD CA 90069 FQ 035 19 1598860876 LOS PADRINOS JUVENILE 01 001 7/1/2018 $769.09 0521 T1015 1 F 7285 QUILL DR DOWNEY CA 90242 FQ 035 19 1720286750 MADERA COMMUNITY HOSP 01 001 10/1/2018 $226.51 0521 T1015 1 U 285 HOSPITAL DRIVE CHOWCHILLA CA 93610 RH 035 20 1609979707 MAD RIVER COMMUNITY HOSP 01 001 10/1/2018 $143.66 0521 T1015 1 U 3800 JANES RD ARCATA CA 95521 RH 035 12 1285804948 MARIN CITY HEALTH AND 01 002 12/12/2017 $192.80 0521 T1015 1 F 9 SILLIMAN STREET SAN FRANCISCO CA 94134 FQ 035 38 1285804948 MARIN CITY HEALTH AND 01 001 10/1/2018 $216.35 0521 T1015 1 F 630 DRAKE AVE SAUSALITO CA 94965 FQ 035 21 1457888299 MARIN CITY HEALTH AND 01 001 10/1/2017 $190.51 0521 T1015 1 F 880 LAS GALLINAS AVENUE SAN RAFAEL CA 94903 FQ 035 21 1932629334 MARIN CITY HEALTH AND 01 001 10/1/2017 $190.51 0521 T1015 1 F 630 DRAKE AVENUE MARIN CITY CA 94965 FQ 035 21 1912091018 MARIN COMM CLINIC 01 001 10/1/2018 $252.98 0521 T1015 1 F 5 BON AIR ROAD LARKSPUR CA 94939 FQ 035 21 1154503399 MARIN COMM CLINIC SAN RAFAEL 01 002 6/12/2018 $246.01 0521 T1015 1 F 411 4TH STREET SAN RAFAEL CA 94901 FQ 035 21 1154503399 MARIN COMM CLINIC SAN RAFAEL 01 001 10/1/2018 $249.45 0521 T1015 1 F 3110 KERNER BLVD SAN RAFAEL CA 94901 FQ 035 21 1003900101 MARIN COMMUNITY CLINIC 01 001 10/1/2018 $197.90 0521 T1015 1 F 6100 REDWOOD BLVD NOVATO CA 94945 FQ 035 21 1912220781 MARIN COMMUNITY CLINIC 01 001 10/1/2018 $177.60 0521 T1015 1 F 6090 REDWOOD BLVD NOVATO CA 94945 FQ 035 21 1922303437 MARIN COMMUNITY CLINIC 01 001 10/1/2018 $219.71 0521 T1015 1 F 3260 KERNER BLVD SAN RAFAEL CA 94901 FQ 035 21 1376674770 MARIO A OCHOA MD INC 01 001 10/1/2018 $101.48 0521 T1015 1 R 3275 MCCALL AVE SELMA CA 93662 RH 035 10 1629085873 MARIPOSA FAMILY MEDICINE 01 001 10/1/2018 $ 85.89 0521 T1015 1 R 5300 HIGHWAY 49 N MARIPOSA CA 95338 RH 035 22 1205002938 MARK TWAIN MEDICAL CENTER 01 001 10/1/2018 $204.27 0521 T1015 1 U 704 MOUNTAIN RANCH ROAD SAN ANDREAS CA 95249 RH 035 05 1588725196 MARK TWAIN MEDICAL CENTER 01 001 10/1/2018 $196.80 0521 T1015 1 U 3505 SPANGLER LN COPPEROPOLIS CA 95228 RH 035 05 1790846301 MARK TWAIN MEDICAL CENTER 01 001 10/1/2018 $226.64 0521 T1015 1 U 2182 HIGHWAY 4 ARNOLD CA 95223 RH 035 05 1821159443 MARK TWAIN MEDICAL CENTER 01 001 10/1/2018 $180.51 0521 T1015 1 U 1919 VISTA DEL LAGO DR VALLEY SPRINGS CA 95252 RH 035 05 1942362561 MARK TWAIN MEDICAL CENTER 01 001 10/1/2018 $163.83 0521 T1015 1 U 222 S MAIN ST ANGELS CAMP CA 95222 RH 035 05 1346226693 MARSHALL MEDICAL CENTER 01 001 10/1/2018 $171.13 0521 T1015 1 U 6065 HIGHWAY 193 GEORGETOWN CA 95634 RH 035 09 1386065480 MARSHALL MEDICAL CENTER 01 001 7/1/2018 $161.00 0521 T1015 1 U 4341 GOLDEN CENTER DR PLACERVILLE CA 95667 RH 035 09 1245343052 MARTIN LUTHER KING, JR 01 001 7/1/2018 ####### 0521 T1015 1 F 12021 WILMINGTON AVE LOS ANGELES CA 90059 FQ 035 19 1780796540 MAYVIEW COMMUNITY HLTH 01 003 10/1/2018 $176.29 0521 T1015 1 F 785 MORSE AVE SUNNYVALE CA 94085 FQ 035 43 1780796540 MAYVIEW COMMUNITY HLTH 01 001 10/1/2018 $179.80 0521 T1015 1 F 270 GRANT AVE PALO ALTO CA 94306 FQ 035 43 1780796540 MAYVIEW COMMUNITY HLTH 01 002 10/1/2018 $223.46 0521 T1015 1 F 900 MIRAMONTE AVENUE MOUNTAIN VIEW CA 94040 FQ 035 43 1164428488 MCCLOUD HEALTHCARE CLINIC 01 002 10/1/2018 $192.56 0521 T1015 1 F 116 W MINNESOTA AVE MC CLOUD CA 96057 FQ 035 47


1376893420 MCCLOUD HEALTHCARE CLINIC 01 001 10/1/2018 $162.96 0521 T1015 1 F 4309 STAGECOACH ROAD DUNSMUIR CA 96025 FQ 035 47 1497052278 MCFARLAND SINGH MEDICAL 01 001 10/1/2018 $116.77 0521 T1015 1 R 733 3RD ST MCFARLAND CA 93250 RH 035 15 1528172541 MCH MEDICAL CLINIC 01 001 10/1/2018 $184.44 0521 T1015 1 U 29099 HOSPITAL RD LAKE ARROWHEAD CA 92352 RH 035 36 1063684207 MECCA HEALTH CLINIC- 01 001 10/1/2018 $104.97 0521 T1015 1 F 91275 66TH AVE MECCA CA 92554 FQ 035 33 1851373534 MEHTON, NIRMAL S MD 01 001 10/1/2018 $ 74.76 0521 T1015 1 R 2830 EAST ST ANDERSON CA 96007 RH 035 45 1083783757 MENDOCINO COAST CLINICS 01 001 10/1/2018 $172.50 0521 T1015 1 F 205 SOUTH ST FORT BRAGG CA 95437 FQ 035 23 1285128595 MENDOCINO COAST CLINICS INC 01 001 7/2/2018 $181.48 0521 T1015 1 F 510 CYPRESS STREET FORT BRAGG CA 95437 FQ 035 23 1326335464 MENDOCINO COAST CLINICS INC 01 001 10/1/2018 $151.78 0521 T1015 1 F 510 CYPRESS ST FORT BRAGG CA 95437 FQ 035 23 1861670093 MENDOCINO COAST CLINICS INC 01 001 10/1/2018 $184.02 0521 T1015 1 F 855 SEQUOIA CIR FORT BRAGG CA 95437 FQ 035 23 1124220249 MENDOCINO COAST HEALTH 01 001 10/1/2018 $208.27 0521 T1015 1 U 721 RIVER DR FORT BRAGG CA 95437 RH 035 23 1750809463 MENDOCINO COMMUNITY HEALTH 01 001 6/5/2018 $194.96 0521 T1015 1 F 1165 SOUTH DORA ST UKIAH CA 95482 FQ 035 23 1770516304 MENDOCINO COMMUNITY HEALTH 01 001 10/1/2018 $197.69 0521 T1015 1 F 5335 LAKESHORE BLVD LAKEPORT CA 95453 FQ 035 17 1811958952 MENDOCINO COMMUNITY HEALTH 01 001 10/1/2018 $197.69 0521 T1015 1 F 333 LAWS AVE UKIAH CA 95482 FQ 035 23 1922020585 MENDOCINO COMMUNITY HEALTH 01 001 10/1/2018 $163.62 0521 T1015 1 F 45 HAZEL ST WILLITS CA 95490 FQ 035 23 1982645354 MERCED FACULTY ASSOC MED 01 001 10/1/2018 $ 93.96 0521 T1015 1 R 19901 1ST ST HILMAR CA 95324 RH 035 24 1821205469 MERCED FACULTY ASSOC MED GRP 01 001 10/1/2018 $ 93.36 0521 T1015 1 R 9696 STEPHENS ST DELHI CA 95315 RH 035 24 1306827332 MID-CITY COMM CLINIC 01 001 10/1/2018 $146.59 0521 T1015 1 F 4290 POLK AVE SAN DIEGO CA 92105 FQ 035 37 1528136389 MISSION AREA HEALTH 01 001 10/1/2018 $209.33 0521 T1015 1 F 4434 MISSION ST SAN FRANCISCO CA 94112 FQ 035 38 1558693622 MISSION AREA HEALTH ASSOC 01 001 10/1/2018 $209.82 0521 T1015 1 F 1647 VALENCIA ST SAN FRANCISCO CA 94110 FQ 035 38 1457427411 MISSION AREA HLTH ASSOC 01 001 10/1/2018 $221.42 0521 T1015 1 F 240 SHOTWELL ST SAN FRANCISCO CA 94110 FQ 035 38 1508172842 MISSION AREA HLTH ASSOC 01 001 10/1/2018 $253.52 0521 T1015 1 F 165 CAPP STREET SAN FRANCISCO CA 94110 FQ 035 38 1497063192 MISSION CITY COMM NETWORK 01 001 10/1/2017 $126.98 0521 T1015 1 F 1818 N ORANGE GROVE AVE POMONA CA 91767 FQ 035 19 1306017603 MISSION CITY COMM NETWRK 01 001 10/1/2018 $ 84.00 0521 T1015 1 F 9919 LAUREL CANYON BLVD PACOIMA CA 91331 FQ 035 19 1043593304 MISSION CITY COMMUNITY 01 001 10/1/2018 $176.37 0521 T1015 1 F 15210 PARTHENIA STREET NORTH HILLS CA 91343 FQ 035 19 1063795250 MISSION CITY COMMUNITY 01 001 10/1/2018 $226.12 0521 T1015 1 F 513 E LIME AVE MONROVIA CA 91016 FQ 035 19 1265708994 MISSION CITY COMMUNITY 01 001 10/1/2018 $248.84 0521 T1015 1 F 15201 11TH STREET VICTORVILLE CA 92395 FQ 035 36 1275786402 MISSION CITY COMMUNITY 01 001 10/1/2018 $184.69 0521 T1015 1 F 8363 RESEDA BLVD NORTHRIDGE CA 91324 FQ 035 19 1346525912 MISSION CITY COMMUNITY 01 001 10/1/2018 $197.42 0521 T1015 1 F 301 N PRAIRIE AVE INGLEWOOD CA 90301 FQ 035 19 1376770750 MISSION CITY COMMUNITY 01 001 10/1/2018 $190.44 0521 T1015 1 F 10200 SEPULVEDA BLVD MISSION HILLS CA 91345 FQ 035 19 1518402502 MISSION CITY COMMUNITY 01 001 10/1/2017 $242.49 0521 T1015 1 F 14357 7TH STREET VICTORVILLE CA 92395 FQ 035 36 1609128206 MISSION CITY COMMUNITY 01 001 10/1/2018 $246.70 0521 T1015 1 F 9919 LAUREL CANYON BLVD PACOIMA CA 91331 FQ 035 19 1609151273 MISSION CITY COMMUNITY 01 001 10/1/2018 $233.59 0521 T1015 1 F 1818 N ORANGE GROVE AVE POMONA CA 91767 FQ 035 19 1710102009 MISSION CITY COMMUNITY 01 001 10/1/2018 $146.72 0521 T1015 1 F 4842 HOLLYWOOD BLVD LOS ANGELES CA 90027 FQ 035 19 1710370747 MISSION CITY COMMUNITY 01 001 10/1/2017 $160.60 0521 T1015 1 F 8527 SEPULVEDA BOULEVARD NORTH HILLS CA 91343 FQ 035 19 1760409791 MISSION CITY COMMUNITY 01 001 10/1/2018 $145.70 0521 T1015 1 F 15206 PARTHENIA ST NORTH HILLS CA 91343 FQ 035 19 1942694096 MISSION CITY COMMUNITY 01 001 10/1/2018 $175.01 0521 T1015 1 F 1025 N WILLOW AVE LA PUENTE CA 91746 FQ 035 19 1659502664 MISSION CITY COMMUNITY NTWRK 01 001 10/1/2018 $219.91 0521 T1015 1 F 501 E HARDY STREET INGLEWOOD CA 90301 FQ 035 19 1659502664 MISSION CITY COMMUNITY NTWRK 01 002 10/1/2017 $211.97 0521 T1015 1 F 359 NORTH FAIRFAX AVE LOS ANGELES CA 90036 FQ 035 19 1326183054 MOBILE MEDICAL OFFICE 01 001 10/1/2018 $100.84 0521 T1015 1 R 301 P ST EUREKA CA 95501 RH 035 12 1669617783 MOUNTAIN COMM HEALTHCARE DST 01 001 10/1/2018 $174.17 0521 T1015 1 U 6961 HIGHWAY 3 HAYFORK CA 96041 RH 035 53 1356422307 MOUNTAIN COMMUNITIES 02 001 10/1/2018 $195.86 0521 T1015 1 U 31 EASTER AVENUE WEAVERVILLE CA 96093 RH 035 53 1881752608 MOUNTAIN EMPIRE FAMILY 01 001 10/1/2018 $169.99 0521 T1015 1 F 31115 HIGHWAY 94 CAMPO CA 91906 FQ 035 37 1487011847 MOUNTAIN HEALTH AND 01 001 10/1/2018 $161.73 0521 T1015 1 F 4690 EL CAJON BLVD SAN DIEGO CA 92115 FQ 035 37 1336592740 MOUNTAIN HEALTH & COMMUNITY 01 001 12/15/2018 $185.95 0521 T1015 1 F 1388 BUCKMAN SPRINGS RD CAMPO CA 91906 FQ 035 37 1932566395 MOUNTAIN HEALTH & COMMUNITY 01 001 10/1/2018 $174.09 0521 T1015 1 F 120 TOWN CENTER PARKWAY SANTEE CA 92071 FQ 035 37 1063613263 MOUNTAIN HLTH & COMM SVS 01 001 10/1/2018 $159.49 0521 T1015 1 F 255 N ASH ST ESCONDIDO CA 92027 FQ 035 37 1255499075 MOUNTAIN HLTH & COMM SVS 01 001 10/1/2018 $232.50 0521 T1015 1 F 1620 ALPINE BLVD ALPINE CA 91901 FQ 035 37 1861603151 MOUNTAIN HLTH & COMM SVS 01 001 10/1/2018 $125.56 0521 T1015 1 F 316 25TH ST SAN DIEGO CA 92102 FQ 035 37 1013088582 MOUNTAIN VALLEYS HEALTH 01 001 10/1/2018 $239.79 0521 T1015 1 F 610 W THIRD ST DORRIS CA 96023 FQ 035 47 1013088582 MOUNTAIN VALLEYS HEALTH 01 002 10/1/2017 $233.68 0521 T1015 1 F 20615 COMMERCE WAY BURNEY CA 96013 FQ 035 45 1013088582 MOUNTAIN VALLEYS HEALTH 01 003 5/1/2018 $236.48 0521 T1015 1 F 101 OLD MCCLOUD ROAD MT SHASTA CA 96067 FQ 035 47 1013088582 MOUNTAIN VALLEYS HEALTH 01 004 6/1/2018 $236.48 0521 T1015 1 F 50 ALAMO AVENUE WEED CA 96094 FQ 035 47 1245301308 MOUNTAIN VALLEYS HEALTH 01 001 10/1/2018 $184.10 0521 T1015 1 F 37491 ENTERPRISE DR BURNEY CA 96013 FQ 035 45 1679645121 MOUNTAIN VALLEYS HEALTH 01 001 10/1/2018 $170.75 0521 T1015 1 F 498 MAIN ST TULELAKE CA 96134 FQ 035 47 1922179498 MOUNTAIN VALLEYS HEALTH 01 001 10/1/2018 $133.78 0521 T1015 1 F 43563 STATE HIGHWAY 299 FALL RIVER MILLS CA 96028 FQ 035 45 1689863516 NATIVE AMERICAN HEALTH 01 001 10/1/2018 $407.52 0521 T1015 1 F 2950 INTERNATIONAL BLVD OAKLAND CA 94601 FQ 035 01 1407031693 NEIGHBORHOOD HEALTH CARE 01 001 10/1/2018 $175.45 0521 T1015 1 F 16650 HIGHWAY 76 PAUMA VALLEY CA 92061 FQ 035 37 1154786846 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2017 $206.25 0521 T1015 1 F 903 E DEVONSHIRE AVE HEMET CA 92543 FQ 035 33 1265618185 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $150.50 0521 T1015 1 F 426 N DATE STREET ESCONDIDO CA 92025 FQ 035 37 1437335148 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $187.21 0521 T1015 1 F 41840 ENTERPRISE CIRCLE TEMECULA CA 92590 FQ 035 33 1437335353 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $177.64 0521 T1015 1 F 425 N DATE STREET ESCONDIDO CA 92025 FQ 035 37 1487826772 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $183.71 0521 T1015 1 F 1001 E GRAND AVE ESCONDIDO CA 92025 FQ 035 37 1598703647 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $179.51 0521 T1015 1 F 460 N ELM ST ESCONDIDO CA 92025 FQ 035 37 1720264641 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $192.37 0521 T1015 1 F 728 E VALLEY PARKWAY ESCONDIDO CA 92025 FQ 035 37 1760667950 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $187.43 0521 T1015 1 F 855 E MADISON AVENUE EL CAJON CA 92020 FQ 035 37 1841617958 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $240.41 0521 T1015 1 F 26926 CHERRY HILLS BLVD MENIFEE CA 92586 FQ 035 33 1932384120 NEIGHBORHOOD HEALTHCARE 01 001 10/1/2018 $210.53 0521 T1015 1 F 10039 VINE STREET LAKESIDE CA 92040 FQ 035 37 1588072698 NEWSTART MEDICAL GROUP INC 01 001 1/15/2018 $177.85 0521 T1015 1 R 20601 W PAOLI LN WEIMAR CA 95736 RH 035 31 1497889158 NHAN HOA COMPREHENSIVE 01 001 10/1/2018 $189.47 0521 T1015 1 F 7761 GARDEN GROVE BLVD GARDEN GROVE CA 92841 FQ 035 30 1720233893 NORTH CNTY HLTH PROJECT INC 01 001 10/1/2018 $173.64 0521 T1015 1 F 3220 MISSION AVE OCEANSIDE CA 92054 FQ 035 37 1710152251 NORTH CO. HEALTH PROJECT INC 01 001 10/1/2018 $171.45 0521 T1015 1 F 727 W SAN MARCOS BLVD SAN MARCOS CA 92078 FQ 035 37


1265522619 NORTH COUNTY HEALTH CTR 01 001 10/1/2018 $358.01 0521 T1015 1 G 380 90TH ST DALY CITY CA 94015 FQ 035 41 1396852455 NORTH COUNTY HEALTH PROJ 01 001 10/1/2018 $226.55 0521 T1015 1 F 2210 MESA DR OCEANSIDE CA 92054 FQ 035 37 1396852455 NORTH COUNTY HEALTH PROJ 01 002 10/1/2017 $218.98 0521 T1015 1 F 2210 MESA DRIVE OCEANSIDE CA 92054 FQ 035 37 1427064047 NORTH COUNTY HEALTH PROJ 01 001 10/1/2018 $176.76 0521 T1015 1 F 2216 EL CAMINO REAL OCEANSIDE CA 92054 FQ 035 37 1447267349 NORTH COUNTY HEALTH PROJ 01 001 10/1/2018 $226.55 0521 T1015 1 F 1130 2ND ST ENCINITAS CA 92024 FQ 035 37 1245246917 NORTH COUNTY HEALTH PROJECT 01 001 10/1/2018 $226.55 0521 T1015 1 F 150 VALPREDA RD SAN MARCOS CA 92069 FQ 035 37 1255347704 NORTH COUNTY HEALTH PROJECT 01 001 10/1/2018 $226.55 0521 T1015 1 F 1295 CARLSBAD VILLAGE DR CARLSBAD CA 92008 FQ 035 37 1255347894 NORTH COUNTY HEALTH PROJECT 01 001 10/1/2018 $226.55 0521 T1015 1 F 2210 MESA DR OCEANSIDE CA 92069 FQ 035 37 1417321746 NORTH COUNTY HEALTH PROJECT 01 001 10/1/2017 $160.60 0521 T1015 1 F 1675 N PERRIS BLVD PERRIS CA 92571 FQ 035 33 1073529681 NORTH COUNTY HEALTH SVS 01 001 10/1/2018 $226.55 0521 T1015 1 F 217 EARLHAM ST RAMONA CA 92065 FQ 035 37 1639185317 NORTH COUNTY HLTH PRJCT, INC 01 001 10/1/2018 $226.55 0521 T1015 1 F 605 CROUCH STREET OCEANSIDE CA 92054 FQ 035 37 1639185317 NORTH COUNTY HLTH PRJCT, INC 01 002 10/1/2017 $218.98 0521 T1015 1 F 619 CROUCH STREET OCEANSIDE CA 92054 FQ 035 37 1538231832 NORTHEAST COMM CLINIC 01 001 10/1/2018 $147.83 0521 T1015 1 F 5428 N FIGUEROA ST LOS ANGELES CA 90042 FQ 035 19 1982938213 NORTHEAST COMMUNITY CLINIC 01 001 10/1/2018 $182.01 0521 T1015 1 F 1400 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1689885907 NORTHEAST COMMUNITY CLINIC, 01 001 10/1/2018 $141.68 0521 T1015 1 F 1414 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 004 10/1/2017 $240.41 0521 T1015 1 F 1414 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 001 10/1/2018 $246.70 0521 T1015 1 F 2975 ZOE AVENUE HUNTINGTON PARK CA 90255 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 002 10/1/2017 $237.79 0521 T1015 1 F 1414 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 003 10/1/2017 $237.79 0521 T1015 1 F 1403 W LOMITA BLVD HARBOR CITY CA 90710 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 005 10/1/2017 $240.41 0521 T1015 1 F 8100 SUNLAND BOULEVARD SUN VALLEY CA 91352 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 007 10/1/2017 $243.29 0521 T1015 1 F 5820 N FIGUEROA ST LOS ANGELES CA 90042 FQ 035 19 1124460274 NORTHEAST COMMUNITY CLINICS 01 006 10/1/2017 $243.29 0521 T1015 1 F 4129 E GAGE AVENUE BELL CA 90201 FQ 035 19 1881987576 NORTHEAST COMMUNITY CLINICS 01 001 10/1/2018 $201.46 0521 T1015 1 F 2822 E FLORENCE AVENUE HUNTINGTON PARK CA 90255 FQ 035 19 1952641136 NORTHEAST COMMUNITY CLINICS 01 001 10/1/2018 $214.44 0521 T1015 1 F 1403 LOMITA BLVD HARBOR CITY CA 90710 FQ 035 19 1477563518 NORTHEASTERN HEALTH CTR 01 001 10/1/2018 $164.78 0521 T1015 1 F 1850 SPRING RIDGE DR SUSANVILLE CA 96130 FQ 035 18 1336150051 NORTHEASTERN RURAL HLTH 01 002 10/1/2018 $115.91 0521 T1015 1 F 209 BIRCH STREET WESTWOOD CA 96137 FQ 035 18 1023369881 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $190.65 0521 T1015 1 F 1400 NORIEGA ST SAN FRANCISCO CA 94122 FQ 035 38 1093992844 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $255.10 0521 T1015 1 F 1715 LUNDY AVE SAN JOSE CA 95131 FQ 035 43 1104103001 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $240.61 0521 T1015 1 F 211 EASTMOOR AVE DALY CITY CA 94015 FQ 035 41 1457658734 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $116.54 0521 T1015 1 F 2308 TARAVAL ST SAN FRANCISCO CA 94116 FQ 035 38 1548697444 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $215.26 0521 T1015 1 F 1870 LUNDY AVENUE SAN JOSE CA 95131 FQ 035 43 1760746275 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $185.35 0521 T1015 1 F 1033 CLEMENT STREET SAN FRANCISCO CA 94118 FQ 035 38 1982784740 NORTH EAST MEDICAL SERVICES 01 001 10/1/2018 $170.89 0521 T1015 1 F 1450 NORIEGA STREET SAN FRANCISCO CA 94122 FQ 035 38 1336229194 NORTH EAST MEDICAL SVS 01 001 10/1/2018 $191.81 0521 T1015 1 F 82 LELAND AVE SAN FRANCISCO CA 94134 FQ 035 38 1518911304 NORTH EAST MEDICAL SVS 01 001 10/1/2018 $191.81 0521 T1015 1 F 1520 STOCKTON ST SAN FRANCISCO CA 94133 FQ 035 38 1326279852 NORTH EAST MED SRVCS 01 001 10/1/2018 $191.61 0521 T1015 1 F 2574 SAN BRUNO AVE SAN FRANCISCO CA 94134 FQ 035 38 1053312587 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $197.90 0521 T1015 1 F 12540 PIERCE ST PACOIMA CA 91331 FQ 035 19 1093716474 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $155.07 0521 T1015 1 F 7138 VAN NUYS BLVD VAN NUYS CA 91405 FQ 035 19 1114928595 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $155.07 0521 T1015 1 F 12756 VAN NUYS BLVD PACOIMA CA 91331 FQ 035 19 1184625568 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $256.09 0521 T1015 1 F 7843 LANKERSHIM BLVD NORTH HOLLYWOOD CA 91605 FQ 035 19 1235130600 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $168.17 0521 T1015 1 F 1600 SAN FERNANDO RD SAN FERNANDO CA 91340 FQ 035 19 1417958943 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $155.46 0521 T1015 1 F 11051 N O'MELVENY AVE SAN FERNANDO CA 91340 FQ 035 19 1558693655 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $210.54 0521 T1015 1 F 18533 SOLEDAD CANYON RD SANTA CLARITA CA 91351 FQ 035 19 1629079009 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $414.85 0521 T1015 1 F 14624 SHERMAN WAY VAN NUYS CA 91405 FQ 035 19 1730180118 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $155.37 0521 T1015 1 F 23763 VALENCIA BLVD VALENCIA CA 91355 FQ 035 19 1740281120 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $145.68 0521 T1015 1 F 7107 REMMET AVE CANOGA PARK CA 91303 FQ 035 19 1740437961 NORTHEAST VALLEY HEALTH 01 001 10/1/2018 $179.57 0521 T1015 1 F 1172 N MACLAY AVE SAN FERNANDO CA 91340 FQ 035 19 1881104313 NORTHEAST VALLEY HEALTH 01 001 6/5/2018 $166.60 0521 T1015 1 F 23413 LYONS AVE SANTA CLARITA CA 91355 FQ 035 19 1013199264 NORTHEAST VALLEY HEALTH CORP 01 001 10/1/2018 $192.47 0521 T1015 1 F 7223 FAIR AVE SUN VALLEY CA 91352 FQ 035 19 1154322642 NORTHEAST VLY HLTH CORP 01 001 10/1/2018 $293.10 0521 T1015 1 F 13356 ELDRIDGE AVE SYLMAR CA 91342 FQ 035 19 1417032921 NORTHERN INYO COUNTY 01 001 10/1/2018 $168.27 0521 T1015 1 U 153 PIONEER LN BISHOP CA 93514 RH 035 14 1114220357 NORTH KERN SOUTH TULARE 01 001 10/1/2018 $304.77 0521 T1015 1 R 1500 6TH AVENUE DELANO CA 93215 RH 035 15 1194974402 NORTH ORANGE COUNTY REG 01 001 10/1/2018 $156.49 0521 T1015 1 F 901 W ORANGETHORPE AVE FULLERTON CA 92832 FQ 035 30 1982654604 NORTH VALLEY FAMILY 01 001 10/1/2018 $ 98.84 0521 T1015 1 R 173 E WEBSTER ST COLUSA CA 95932 RH 035 06 1720319155 NORTH VALLEY FAMILY PHYS GRP 01 001 10/1/2018 $ 97.68 0521 T1015 1 R 501 E STREET WILLIAMS CA 95987 RH 035 06 1548301633 OAK VALLEY HOSPITAL DIST 01 001 10/1/2018 $173.09 0521 T1015 1 U 2603 PATTERSON RD RIVERBANK CA 95367 RH 035 50 1770624553 OAK VALLEY HOSPITAL DIST 01 001 10/1/2018 $156.99 0521 T1015 1 U 2080 MCHENRY AVE ESCALON CA 95320 RH 035 39 1841331626 OAK VALLEY HOSPITAL DISTRICT 01 001 10/1/2018 $165.52 0521 T1015 1 U 1420 W H ST OAKDALE CA 95361 RH 035 50 1881030401 OAK VALLEY HOSPITAL DISTRICT 01 001 10/1/2018 $182.83 0521 T1015 1 U 12146 YOSEMITE BLVD WATERFORD CA 95386 RH 035 50 1902106198 OLE HEALTH 01 001 10/1/2018 $230.31 0521 T1015 1 F 1100 TRANCAS STREET NAPA CA 94558 FQ 035 28 1033426002 OMNI FAMILY HEALTH 01 001 10/1/2018 $146.95 0521 T1015 1 F 1014 CALLOWAY DRIVE BAKERSFIELD CA 93312 FQ 035 15 1073997326 OMNI FAMILY HEALTH 01 001 10/1/2017 $163.49 0521 T1015 1 F 4151 MEXICALI DRIVE BAKERSFIELD CA 93313 FQ 035 15 1164806410 OMNI FAMILY HEALTH 01 001 10/1/2017 $178.20 0521 T1015 1 F 1022 CALLOWAY DRIVE BAKERSFIELD CA 93312 FQ 035 15 1245777358 OMNI FAMILY HEALTH 01 001 10/1/2017 $163.49 0521 T1015 1 F 925 G STREET REEDLEY CA 93654 FQ 035 10 1306852496 OMNI FAMILY HEALTH 01 001 10/1/2018 $166.66 0521 T1015 1 F 1215 JEFFERSON ST DELANO CA 93215 FQ 035 15 1326585431 OMNI FAMILY HEALTH 01 001 2/5/2018 $166.60 0521 T1015 1 F 1530 E MANNING AVENUE REEDLEY CA 93654 FQ 035 10 1366463085 OMNI FAMILY HEALTH 01 001 10/1/2018 $149.76 0521 T1015 1 F 655 S CENTRAL VALLEY HWY SHAFTER CA 93263 FQ 035 15 1376558221 OMNI FAMILY HEALTH 01 001 10/1/2018 $170.14 0521 T1015 1 F 21138 PASO ROBLES HWY LOST HILLS CA 93249 FQ 035 15 1417962457 OMNI FAMILY HEALTH 01 001 10/1/2018 $170.14 0521 T1015 1 F 1001 MAIN ST DELANO CA 93215 FQ 035 15 1467858696 OMNI FAMILY HEALTH 01 001 10/1/2017 $214.97 0521 T1015 1 F 210 N CHESTER AVE BAKERSFIELD CA 93308 FQ 035 15 1689688004 OMNI FAMILY HEALTH 01 001 10/1/2018 $170.14 0521 T1015 1 F 2101 7TH ST WASCO CA 93280 FQ 035 15


1699780536 OMNI FAMILY HEALTH 01 001 10/1/2018 $170.14 0521 T1015 1 F 1100 4TH ST TAFT CA 93268 FQ 035 15 1700804556 OMNI FAMILY HEALTH 01 001 10/1/2018 $176.86 0521 T1015 1 F 525 ROBERTS LN BAKERSFIELD CA 93308 FQ 035 15 1700891660 OMNI FAMILY HEALTH 01 001 10/1/2018 $170.14 0521 T1015 1 F 277 E FRONT ST BUTTONWILLOW CA 93206 FQ 035 15 1780928986 OMNI FAMILY HEALTH 01 001 10/1/2018 $152.37 0521 T1015 1 F 4600 PANAMA LANE BAKERSFIELD CA 93313 FQ 035 15 1801804398 OMNI FAMILY HEALTH 01 001 10/1/2018 $138.34 0521 T1015 1 F 320 JAMES ST SHAFTER CA 93263 FQ 035 15 1821237355 OMNI FAMILY HEALTH 01 001 10/1/2018 $177.25 0521 T1015 1 F 1133 N CHELSEA ST RIDGECREST CA 93555 FQ 035 15 1841476686 OMNI FAMILY HEALTH 01 001 10/1/2018 $160.61 0521 T1015 1 F 3409 CALLOWAY DR BAKERSFIELD CA 93312 FQ 035 15 1851325021 OMNI FAMILY HEALTH 01 001 10/1/2018 $151.39 0521 T1015 1 F 161 N MILL ST TEHACHAPI CA 93561 FQ 035 15 1851713929 OMNI FAMILY HEALTH 01 001 10/1/2017 $205.72 0521 T1015 1 F 4131 MING AVE BAKERSFIELD CA 93309 FQ 035 15 1861867590 OMNI FAMILY HEALTH 01 001 10/1/2017 $201.54 0521 T1015 1 F 659 CENTRAL VALLEY HWY SHAFTER CA 93263 FQ 035 15 1598858169 OPEN DOOR COMM HLTH CTRS 01 001 10/1/2018 $216.10 0521 T1015 1 F 1644 CENTRAL AVE MCKINLEYVILLE CA 95519 FQ 035 12 1689778813 OPEN DOOR COMM HLTH CTRS 01 001 10/1/2018 $216.10 0521 T1015 1 F 785 18TH ST ARCATA CA 95521 FQ 035 12 1306252051 OPEN DOOR COMMUNITY HEALTH 01 001 10/1/2017 $186.52 0521 T1015 1 F 3306 RENNER DRIVE FORTUNA CA 95540 FQ 035 12 1598178915 OPEN DOOR COMMUNITY HEALTH 01 001 10/1/2018 $185.34 0521 T1015 1 F 638 MAIN STREET FERNDALE CA 95536 FQ 035 12 1669569109 OPEN DOOR COMMUNITY HEALTH 01 001 10/1/2018 $216.10 0521 T1015 1 F 2200 TYDD STREET EUREKA CA 95501 FQ 035 12 1730330739 OPEN DOOR COMMUNITY HEALTH 01 001 10/1/2018 $226.07 0521 T1015 1 F 38883 HWY 299 WILLOW CREEK CA 95573 FQ 035 12 1922318047 OPEN DOOR COMMUNITY HEALTH 01 001 10/1/2018 $227.70 0521 T1015 1 F 3800 JANES ROAD ARCATA CA 95521 FQ 035 12 1801907449 OPERATION SAMAHAN 01 001 10/1/2018 $273.95 0521 T1015 1 F 2743 HIGHLAND AVE NATIONAL CITY CA 91950 FQ 035 37 1871680397 OPERATION SAMAHAN 01 001 10/1/2018 $150.08 0521 T1015 1 F 10737 CAMINO RUIZ SAN DIEGO CA 92126 FQ 035 37 1205134517 OPERATION SAMAHAN INC 01 001 10/1/2018 $173.95 0521 T1015 1 F 2101 GRANGER AVE NATIONAL CITY CA 91950 FQ 035 37 1275617169 OPERATION SAMAHAN INC 01 001 10/1/2018 $155.11 0521 T1015 1 F 2835 HIGHLAND AVE NATIONAL CITY CA 91950 FQ 035 37 1699216622 OPERATION SAMAHAN INC 01 001 1/29/2018 $166.60 0521 T1015 1 F 9995 CARMEL MOUNTAIN RD SAN DIEGO CA 92129 FQ 035 37 1710236120 OPERATION SAMAHAN INC 01 001 10/1/2017 $160.40 0521 T1015 1 F 9955 CARMEL MOUNTAIN RD SAN DIEGO CA 92129 FQ 035 37 1144378209 ORCHARD HOSPITAL 01 001 10/1/2018 $140.41 0521 T1015 1 U 284 SPRUCE ST GRIDLEY CA 95948 RH 035 04 1457500217 ORLAND CHILDREN'S CENTER 01 001 10/1/2018 $ 99.95 0521 T1015 1 R 116 E WALKER ST ORLAND CA 95963 RH 035 11 1063750297 OROVILLE HOSPITAL 01 001 10/1/2018 $136.78 0521 T1015 1 U 2721 OLIVE HIGHWAY OROVILLE CA 95966 RH 035 04 1215031554 OROVILLE HOSPITAL 01 001 10/1/2018 $133.36 0521 T1015 1 U 2809 OLIVE HWY OROVILLE CA 95966 RH 035 04 1538437355 OROVILLE HOSPITAL 01 001 10/1/2018 $133.36 0521 T1015 1 U 2809 OLIVE HIGHWAY OROVILLE CA 95966 RH 035 04 1679581557 OROVILLE HOSPITAL 01 001 10/1/2018 $133.36 0521 T1015 1 U 2767 OLIVE HWY OROVILLE CA 95966 RH 035 04 1740583095 OROVILLE HOSPITAL 01 001 10/1/2018 $133.91 0521 T1015 1 U 2721 OLIVE HIGHWAY OROVILLE CA 95966 RH 035 04 1780788018 OROVILLE HOSPITAL 01 001 10/1/2018 $133.36 0521 T1015 1 U 900 ORO DAM BLVD OROVILLE CA 95965 RH 035 04 1962506295 OROVILLE HOSPITAL 01 001 10/1/2018 $133.36 0521 T1015 1 U 2809 OLIVE HIGHWAY OROVILLE CA 95966 RH 035 04 1639243116 PALO ALTO COUNTY HOSPITAL 01 001 10/1/2017 $144.90 0521 T1015 1 U 3201 FIRST ST EMMETSBURG IA 50536 RH 035 ? 1811063795 PALO ALTO COUNTY HOSPITAL 01 001 10/1/2017 $129.92 0521 T1015 1 U 109 WEST ROBINS AVE GRAETTINGER IA 51342 RH 035 ? 1598183238 PANNU, AMRITPAL S MD 01 001 10/1/2018 $ 92.64 0521 T1015 1 R 129 N 5TH ST CHOWCHILLA CA 93610 RH 035 20 1982797239 PATHWAY HEALTHCARE 01 001 10/1/2018 $124.88 0521 T1015 1 R 190 S OAK AVE OAKDALE CA 95361 RH 035 50 1003863622 PEACH TREE HEALTHCARE 01 001 10/1/2018 $166.02 0521 T1015 1 F 5730 PACKARD AVE MARYSVILLE CA 95901 FQ 035 58 1164886040 PEACH TREE HEALTHCARE 01 001 10/1/2017 $195.00 0521 T1015 1 F 3810 ROSIN CT SACRAMENTO CA 95834 FQ 035 34 1316096894 PEACH TREE HEALTHCARE 01 001 10/1/2018 $168.62 0521 T1015 1 F 9980 LIVE OAK BLVD LIVE OAK CA 95953 FQ 035 51 1619361730 PEACH TREE HEALTHCARE 01 001 10/1/2017 $175.05 0521 T1015 1 F 1900 T STREET SACRAMENTO CA 95811 FQ 035 34 1619361730 PEACH TREE HEALTHCARE 01 002 10/1/2017 $160.60 0521 T1015 1 F 3911 NORWOOD AVE SACRAMENTO CA 95838 FQ 035 34 1841723327 PEACH TREE HEALTHCARE 01 002 10/1/2017 $163.49 0521 T1015 1 F 1275 THARP ROAD YUBA CITY CA 95993 FQ 035 51 1982075107 PEDIATRIC AND FAMILY MEDICAL 01 001 10/1/2017 $223.62 0521 T1015 1 F 15477 VENTURA BLVD SHERMAN OAKS CA 91403 FQ 035 19 1982075115 PEDIATRIC AND FAMILY MEDICAL 01 001 10/1/2017 $160.60 0521 T1015 1 F 6618 VAN NUYS BLVD VAN NUYS CA 91405 FQ 035 19 1386934875 PEDIATRIC & FAMILY MEDICAL 01 001 10/1/2018 $257.84 0521 T1015 1 F 1400 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1407268709 PEDIATRIC & FAMILY MEDICAL 01 001 10/1/2017 $183.41 0521 T1015 1 F 3680 E IMPERIAL HIGHWAY LYNWOOD CA 90262 FQ 035 19 1720468804 PEDIATRIC & FAMILY MEDICAL 01 001 10/1/2017 $211.79 0521 T1015 1 F 1513 S GRAND AVE LOS ANGELES CA 90015 FQ 035 19 1598869828 PEDIATRIC PRACTICE ASSOC 01 001 10/1/2018 $133.36 0521 T1015 1 U 2809 OLIVE HWY OROVILLE CA 95966 RH 035 04 1194839035 PERRIS FAMILY CARE CTR 01 001 10/1/2018 $221.10 0521 T1015 1 F 308 E SAN JACINTO AVE PERRIS CA 92570 FQ 035 33 1669870739 PETALUMA HEALTH CENTER INC 01 001 10/1/2017 $233.56 0521 T1015 1 F 5900 STATE FARM DRIVE ROHNERT PARK CA 94928 FQ 035 49 1588656268 PETALUMA HEALTH CTR, INC 01 001 10/1/2018 $221.37 0521 T1015 1 F 1179 NORTH MCDOWELL BLVD PETALUMA CA 94954 FQ 035 49 1285056994 PINE MOUNTAIN NURSING HEALTH 01 001 10/1/2017 $ 81.32 0521 T1015 1 R 16233 ASKIN DRIVE FRAZIER PARK CA 93222 RH 035 15 1437122769 PIONEERS MEMORIAL HEALTHCARE 01 001 10/1/2018 $196.68 0521 T1015 1 U 450 E BIRCH ST CALEXICO CA 92231 RH 035 13 1720401607 PIONEERS MEMORIAL HEALTHCARE 01 001 10/1/2018 $226.19 0521 T1015 1 U 751 W LEGION RD BRAWLEY CA 92227 RH 035 13 1760995625 PIONEERS MEMORIAL HEALTHCARE 01 001 6/5/2018 $166.60 0521 T1015 1 U 565 MAIN STREET BRAWLEY CA 92227 RH 035 13 1578577490 PIXLEY MEDICAL CLINIC 01 001 10/1/2018 $111.12 0521 T1015 1 R 205 E DAVIS PIXLEY CA 93256 RH 035 54 1043348543 PLUMAS HOSPITAL DISTRICT 01 001 10/1/2018 $227.22 0521 T1015 1 U 1065 BUCKS LAKE ROAD QUINCY CA 95971 RH 035 32 1881068708 PLUMAS HOSPITAL DISTRICT 01 001 10/1/2018 $187.51 0521 T1015 1 U 176 HOT SPRINGS RD GREENVILLE CA 95947 RH 035 32 1053420844 POINT REYES MEDICAL CLIN 01 001 10/1/2018 $183.01 0521 T1015 1 F #3 SIXTH ST POINT REYES CA 94956 FQ 035 21 1154788560 POMONA COMMUNITY HEALTH 01 001 10/1/2018 $178.50 0521 T1015 1 F 1556 S SULTANA AVE ONTARIO CA 91761 FQ 035 36 1417211426 POMONA COMMUNITY HEALTH 01 001 10/1/2018 $191.64 0521 T1015 1 F 1450 E HOLT AVE POMONA CA 91767 FQ 035 19 1538486741 POMONA COMMUNITY HEALTH 01 001 10/1/2018 $131.16 0521 T1015 1 F 750 S PARK AVE POMONA CA 91766 FQ 035 19 1639281413 PRIMARY CARE CONSULTANTS 01 001 10/1/2018 $ 95.18 0521 T1015 1 R 11976 ROAD 37 MADERA CA 93636 RH 035 20 1013083666 QUEENSCARE HEALTH CENTERS 01 001 10/1/2018 $189.47 0521 T1015 1 F 150 N RENO ST LOS ANGELES CA 90026 FQ 035 19 1093886251 QUEENSCARE HEALTH CENTERS 01 001 10/1/2018 $149.06 0521 T1015 1 F 184 S BIMINI PLACE LOS ANGELES CA 90004 FQ 035 19 1104075282 QUEENSCARE HEALTH CENTERS 01 001 10/1/2018 $247.23 0521 T1015 1 F 4816 EAST THIRD STREET LOS ANGELES CA 90022 FQ 035 19 1639241888 QUEENSCARE HEALTH CENTERS 01 001 10/1/2018 $189.47 0521 T1015 1 F 4618 FOUNTAIN AVE LOS ANGELES CA 90029 FQ 035 19 1801967062 QUEENSCARE HEALTH CENTERS 01 001 10/1/2018 $189.47 0521 T1015 1 F 4448 YORK BLVD LOS ANGELES CA 90041 FQ 035 19 1639186539 RANCHO LOS AMIGOS 01 001 7/1/2018 ####### 0521 T1015 1 F 7601 E IMPERIAL HWY DOWNEY CA 90242 FQ 035 19 1043395064 RANDHAWA MEDICAL GROUP 01 001 10/1/2018 $101.64 0521 T1015 1 R 1349 MAIN ST NEWMAN CA 95360 RH 035 50 1598032633 RAN HEALTH SERVICES INC 01 001 7/1/2018 $145.56 0521 T1015 1 R 489 5TH STREET GUSTINE CA 95322 RH 035 24


1275778847 REDWOOD COAST MEDICAL 01 001 10/1/2018 $181.14 0521 T1015 1 F 30 MILL ST POINT ARENA CA 95468 FQ 035 23 1366688418 REDWOOD COAST MEDICAL 01 001 10/1/2018 $185.43 0521 T1015 1 F 175 MAIN ST POINT ARENA CA 95468 FQ 035 23 1962530725 REDWOOD COAST MED SVS 01 001 10/1/2018 $187.22 0521 T1015 1 F 46900 OCEAN DR GUALALA CA 95445 FQ 035 23 1194189654 REDWOOD MEMORIAL HOSPITAL 01 001 10/1/2017 $198.09 0521 T1015 1 U 3302 RENNER DRIVE FORTUNA CA 95540 RH 035 12 1164574083 REDWOOD PEDIATRIC MED GR 01 001 10/1/2018 $ 80.98 0521 T1015 1 R 3305 RENNER DR FORTUNA CA 95540 RH 035 12 1235206087 REDWOODS RURAL HEALTH CT 01 001 10/1/2018 $189.16 0521 T1015 1 F 100 WESTCOAST RD REDWAY CA 95560 FQ 035 12 1871768200 REDWOOD WOMENS CENTER PC 01 001 10/1/2018 $119.72 0521 T1015 1 R 3309 RENNER DR FORTUNA CA 95540 RH 035 12 1083647036 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $296.33 0521 T1015 1 U 1433 N ACACIA AVE REEDLEY CA 93654 RH 035 10 1093732554 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.09 0521 T1015 1 U 119 S 6TH STREET FOWLER CA 93625 RH 035 10 1093980823 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $284.10 0521 T1015 1 U 1939 ACADEMY AVENUE SANGER CA 93657 RH 035 10 1205253374 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $271.59 0521 T1015 1 U 48677 VICTORIA LANE OAKHURST CA 93644 RH 035 20 1215110879 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $284.10 0521 T1015 1 U 216 E FRESNO ST AVENAL CA 93204 RH 035 16 1225364060 REEDLEY COMMUNITY HOSPITAL 03 001 10/1/2018 $274.94 0521 T1015 1 U 1251 DRAPER STREET KINGSBURG CA 93631 RH 035 10 1235154006 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $282.01 0521 T1015 1 U 1455 PARK BLVD ORANGE COVE CA 93646 RH 035 10 1235475484 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $284.10 0521 T1015 1 U 1310 HANNA AVENUE CORCORAN CA 93212 RH 035 16 1235578444 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $296.76 0521 T1015 1 U 444 W EL MONTE WAY DINUBA CA 93618 RH 035 54 1245694306 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $274.76 0521 T1015 1 U 1040 7TH STREET WASCO CA 93280 RH 035 15 1265530018 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.09 0521 T1015 1 U 1041 ROSE AVE SELMA CA 93662 RH 035 10 1285651745 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.09 0521 T1015 1 U 2440 W TAHOE CARUTHERS CA 93609 RH 035 10 1326063199 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $296.33 0521 T1015 1 U 372 W CYPRESS AVE REEDLEY CA 93654 RH 035 10 1326384579 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $280.96 0521 T1015 1 U 337 E KINGS STREET AVENAL CA 93204 RH 035 16 1417930892 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $289.86 0521 T1015 1 U 1025 N DOUTY ST HANFORD CA 93230 RH 035 16 1417972282 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $283.70 0521 T1015 1 U 355 S NEWMARK AVE PARLIER CA 93648 RH 035 10 1427025691 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $290.37 0521 T1015 1 U 1451 E EL MONTE WAY DINUBA CA 93618 RH 035 54 1427497866 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $284.54 0521 T1015 1 U 41696 ROAD 128 OROSI CA 93647 RH 035 54 1467678342 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $282.86 0521 T1015 1 U 11899 SHAW PLACE HANFORD CA 93230 RH 035 16 1497006126 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $280.96 0521 T1015 1 U 1150 E WASHINGTON AVE REEDLEY CA 93654 RH 035 10 1508881376 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $283.70 0521 T1015 1 U 250 W EL MONTE WAY DINUBA CA 93618 RH 035 54 1528041779 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.10 0521 T1015 1 U 16916 5TH STREET HURON CA 93234 RH 035 10 1528324167 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $280.96 0521 T1015 1 U 501 6TH STREET TAFT CA 93268 RH 035 15 1598941825 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $284.10 0521 T1015 1 U 811 E 11TH STREET REEDLEY CA 93654 RH 035 10 1679819742 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $293.00 0521 T1015 1 U 3567 W MOUNT WHITNEY AVE RIVERDALE CA 93656 RH 035 10 1689037533 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $272.50 0521 T1015 1 U 406 JAMES STREET SHAFTER CA 93263 RH 035 15 1699758003 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $256.57 0521 T1015 1 U 810 E D STREET LEMOORE CA 93245 RH 035 16 1720459514 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $231.44 0521 T1015 1 U 11976 ROAD 37 MADERA CA 93636 RH 035 20 1730550526 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $280.33 0521 T1015 1 U 49063 RD 426 OAKHURST CA 93644 RH 035 20 1811914377 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.09 0521 T1015 1 U 2141 HIGH STREET SELMA CA 93662 RH 035 10 1871839027 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $280.77 0521 T1015 1 U 275 S MADERA AVE KERMAN CA 93630 RH 035 10 1881677292 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $315.79 0521 T1015 1 U 1212 HANNA AVENUE CORCORAN CA 93212 RH 035 16 1881930964 REEDLEY COMMUNITY HOSPITAL 01 001 10/1/2018 $280.96 0521 T1015 1 U 2357 W TAHOE CARUTHERS CA 93609 RH 035 10 1902823461 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $279.09 0521 T1015 1 U 1000 S MADERA AVE KERMAN CA 93630 RH 035 10 1962805283 REEDLEY COMMUNITY HOSPITAL 01 002 10/1/2018 $273.26 0521 T1015 1 U 550 W CYPRESS AVE REEDLEY CA 93654 RH 035 10 1972586386 REEDLEY COMMUNITY HOSPITAL 02 001 10/1/2018 $264.92 0521 T1015 1 U 155 S 5TH STREET COALINGA CA 93210 RH 035 10 1366687964 REID, JOANNE E MD INC 01 001 10/1/2018 $ 81.93 0521 T1015 1 R 263 N VILLA AVE WILLOWS CA 95988 RH 035 11 1720352685 RIDGECREST REGIONAL HOSPITAL 01 001 10/1/2018 $207.89 0521 T1015 1 U 82820 TRONA ROAD TRONA CA 93562 RH 035 36 1730544313 RIDGECREST REGIONAL HOSPITAL 01 001 1/9/2018 $213.61 0521 T1015 1 U 1011 N CHINA LAKE BLVD RIDGECREST CA 93555 RH 035 15 1972813087 RIDGECREST REGIONAL HOSPITAL 01 001 10/1/2018 $299.08 0521 T1015 1 U 1111 N CHINA LAKE BLVD RIDGECREST CA 93555 RH 035 15 1124023254 RIGOBERTO O GUTIERREZ 01 001 10/1/2018 $127.62 0521 T1015 1 R 2809 OLIVE HWY OROVILLE CA 95966 RH 035 04 1417370032 RITTER CENTER 01 001 10/1/2018 $241.71 0521 T1015 1 F 16 RITTER ST SAN RAFAEL CA 94912 FQ 035 21 1043372618 RIVERBANK PRIMARY CARE 02 001 10/1/2018 $ 80.27 0521 T1015 1 R 3227 STANISLAUS ST RIVERBANK CA 95367 RH 035 50 1710172242 RIVERSIDE HEALTH CLINIC 01 001 10/1/2018 $ 84.64 0521 T1015 1 R 717 BRIDGE ST COLUSA CA 95932 RH 035 06 1003920943 RIVERSIDE NEIGHBORHOOD 01 001 10/1/2018 $276.48 0521 T1015 1 F 7140 INDIANA AVE RIVERSIDE CA 92504 FQ 035 33 1376609198 ROBERT GARDNER, MD 01 001 10/1/2018 $ 90.46 0521 T1015 1 R 6300 E HIGHWAY 20 LUCERNE CA 95458 RH 035 17 1962435586 ROCHA, MARTIN L MD INC 01 001 10/1/2018 $111.56 0521 T1015 1 R 251 N HIGHWAY 173 LAKE ARROWHEAD CA 92352 RH 035 36 1356455299 RUBIDOUX FAMILY CARE CTR 01 001 10/1/2018 $193.41 0521 T1015 1 F 5256 MISSION BLVD RIVERSIDE CA 92509 FQ 035 33 1144207671 RUSHTON, ROBERT B MD 01 001 10/1/2018 $ 87.45 0521 T1015 1 R 844 S DORA ST UKIAH CA 95482 RH 035 23 1356344758 RUSSIAN RIVER HEALTH CTR 01 001 10/1/2018 $204.30 0521 T1015 1 F 16319 THIRD ST GUERNEVILLE CA 95446 FQ 035 49 1013935923 SAC-ARROWHEAD 01 001 10/1/2018 $242.21 0521 T1015 1 F 1293 N D ST SAN BERNARDINO CA 92405 FQ 035 36 1801270137 SAC HEALTH SYSTEM 01 001 10/1/2017 $279.90 0521 T1015 1 F 250 SOUTH G STREET SAN BERNARDINO CA 92410 FQ 035 36 1013935915 SAC NORTON COMMUNITY 01 001 10/1/2018 $323.07 0521 T1015 1 F 1454 E 2ND ST SAN BERNARDINO CA 92408 FQ 035 36 1366513061 SACRAMENTO CO HEALTH DPT 01 001 10/1/2018 $261.66 0521 T1015 1 F 4600 BROADWAY SACRAMENTO CA 95820 FQ 035 34 1588756530 SACRAMENTO NATIVE 01 001 10/1/2018 $303.47 0521 T1015 1 F 2020 J ST SACRAMENTO CA 95811 FQ 035 34 1588756530 SACRAMENTO NATIVE 01 005 8/28/2018 $299.28 0521 T1015 1 F 700 SOUTHGATE ROAD SACRAMENTO CA 95815 FQ 035 34 1588756530 SACRAMENTO NATIVE 01 004 3/5/2018 $299.28 0521 T1015 1 F 2781 NORTHGATE BLVD SACRAMENTO CA 95833 FQ 035 34 1376788075 SALAS MEDICAL CLINIC INC 01 001 10/1/2018 $134.05 0521 T1015 1 R 973 N SEQUOIA AVE LINDSAY CA 93247 RH 035 54 1437549284 SALINAS VALLEY MEMORIAL 01 001 10/1/2018 $246.50 0521 T1015 1 U 850 FIFTH ST GONZALES CA 93926 RH 035 27 1730169756 SALUD PARA LA GENTE 01 004 10/1/2017 $190.16 0521 T1015 1 F 13990 CASTROVILLE BLVD CASTROVILLE CA 95012 FQ 035 27 1730169756 SALUD PARA LA GENTE 01 003 10/1/2017 $188.09 0521 T1015 1 F 208 S GREEN VALLEY RD FREEDOM CA 95019 FQ 035 44 1730169756 SALUD PARA LA GENTE 01 001 10/1/2018 $231.40 0521 T1015 1 F 204 E BEACH ST WATSONVILLE CA 95076 FQ 035 44 1730169756 SALUD PARA LA GENTE 01 002 10/1/2017 $188.09 0521 T1015 1 F 65 NIELSON ST WATSONVILLE CA 95076 FQ 035 44 1629269618 SALUD PARA LA GENTE, INC 01 001 10/1/2018 $302.19 0521 T1015 1 F 45 NIELSON ST WATSONVILLE CA 95076 FQ 035 44

PrvdrCurrent Rev Rate RevenueProvider Owner Service Current Revenue Special Zip Type CountyProvider Legal Name Rate Begin Procedure Status Physical Street Address City TypeNumber Num Location Rate Code Processing State Code Code CodeDate Code CodeType Code 1629269618 SALUD PARA LA GENTE, INC 01 002 8/27/2018 $172.57 0521 T1015 1 F 230 GREEN VALLEY ROAD FREEDOM CA 95019 FQ 035 44 1154402675 SAMUEL DIXON FAMILY 01 002 10/1/2018 $124.04 0521 T1015 1 R 30257 SAN MARTINEZ RD VAL VERDE CA 91384 RH 035 19 1154402675 SAMUEL DIXON FAMILY 01 004 10/1/2018 $173.24 0521 T1015 1 F 27225 CAMP PLENTY RD CANYON COUNTRY CA 91351 FQ 035 19 1154402675 SAMUEL DIXON FAMILY 01 005 10/1/2018 $182.23 0521 T1015 1 F 23772 NEWHALL AVE NEWHALL CA 91321 FQ 035 19 1588804819 SAN BENITO HEALTH CARE 02 001 10/1/2018 $167.44 0521 T1015 1 U 991 FOURTH STREET HOLLISTER CA 95023 RH 035 35 1295810174 SAN BENITO HEALTH FNDTN 01 001 10/1/2018 $132.88 0521 T1015 1 F 351 FELICE DR HOLLISTER CA 95023 FQ 035 35 1881703957 SAN BERNARDINO MOUNTAINS 01 001 10/1/2018 $158.34 0521 T1015 1 U 31900 HILLTOP BLVD RUNNING SPRINGS CA 92382 RH 035 36 1003902917 SAN DIEGO AMERICAN 01 001 10/1/2018 $207.58 0521 T1015 1 F 2630 1ST AVE SAN DIEGO CA 92103 FQ 035 37 1457724858 SAN DIEGO FAMILY CARE 01 001 10/1/2017 $172.14 0521 T1015 1 F 7011 LINDA VISTA RD SAN DIEGO CA 92111 FQ 035 37 1780665877 SAN DIEGO FAMILY CARE 01 001 10/1/2018 $143.34 0521 T1015 1 F 6973 LINDA VISTA RD SAN DIEGO CA 92111 FQ 035 37 1962483040 SAN DIEGO FAMILY CARE 01 001 10/1/2018 $143.16 0521 T1015 1 F 4305 UNIVERSITY AVE SAN DIEGO CA 92105 FQ 035 37 1245669555 SAN FERNANDO COMMUNITY 01 001 7/15/2018 $186.55 0521 T1015 1 F 732 MOTT STREET SAN FERNANDO CA 91340 FQ 035 19 1245669555 SAN FERNANDO COMMUNITY 01 002 10/1/2017 $160.60 0521 T1015 1 F 11134 SEPULVEDA BLVD MISSION HILLS CA 91345 FQ 035 19 1518033349 SAN FRANCISCO GENERAL 01 001 10/1/2018 $384.29 0521 T1015 1 F 1001 POTRERO AVE SAN FRANCISCO CA 94110 FQ 035 38 1144396979 SAN FRANCISCO GEN HOSP 01 001 10/1/2018 $384.29 0521 T1015 1 G 1001 POTRERO AVE SAN FRANCISCO CA 94110 FQ 035 38 1508932336 SAN FRANCISCO GEN HOSP 01 001 10/1/2018 $384.29 0521 T1015 1 G 1001 POTRERO AVE SAN FRANCISCO CA 94110 FQ 035 38 1477593259 SAN FRANCISCO HEALTH 01 001 10/1/2018 $269.31 0521 T1015 1 F 1525 SILVER AVE SAN FRANCISCO CA 94134 FQ 035 38 1588606206 SAN FRANCISCO HEALTH 01 001 10/1/2018 $269.31 0521 T1015 1 F 3850 17TH ST SAN FRANCISCO CA 94114 FQ 035 38 1932140795 SAN FRANCISCO HEALTH 01 001 10/1/2018 $269.31 0521 T1015 1 F 1301 PIERCE ST SAN FRANCISCO CA 94115 FQ 035 38 1144263518 SAN FRANCISCO HEALTH CENTER 01 001 10/1/2018 $269.31 0521 T1015 1 F 1490 MASON ST SAN FRANCISCO CA 94133 FQ 035 38 1598705451 SAN FRANCISCO HEALTH DEPT 01 001 10/1/2018 $269.31 0521 T1015 1 F 1351 24TH AVE SAN FRANCISCO CA 94122 FQ 035 38 1184913956 SAN FRANCISCO MEDICAL CENTER 01 001 10/1/2018 $ - 0521 T1015 1 F 229 7TH STREET SAN FRANCISCO CA 94103 FQ 035 38 1184913956 SAN FRANCISCO MEDICAL CENTER 01 001 10/1/2018 $195.78 0521 T1015 1 F 229 7TH STREET SAN FRANCISCO CA 94103 FQ 035 38 1487055562 SAN FRANCISCO MEDICAL CENTER 01 001 7/1/2018 $183.75 0521 T1015 1 F 3450 3RD ST SAN FRANCISCO CA 94124 FQ 035 38 1588725972 SAN JOAQUIN FAMILY HLTHCARE 01 001 10/1/2018 $129.93 0521 T1015 1 R 12683 AVENUE 416 OROSI CA 93647 RH 035 54 1265580500 SAN JOAQUIN PRIME CARE 01 001 10/1/2018 $ 86.04 0521 T1015 1 R 330 E PINE ST EXETER CA 93221 RH 035 54 1487848131 SAN JOAQUIN PRIME CARE 01 001 10/1/2018 $102.46 0521 T1015 1 R 682 E VISALIA RD FARMERSVILLE CA 93223 RH 035 54 1710172721 SAN JOAQUIN PRIME CARE 01 001 10/1/2018 $ 82.23 0521 T1015 1 R 826 E MANNING AVE REEDLEY CA 93654 RH 035 10 1982891735 SAN JOAQUIN PRIME CARE 01 001 10/1/2018 $ 98.87 0521 T1015 1 R 30924 E KINGS CANYON RD SQUAW VALLEY CA 93675 RH 035 10 1063658029 SAN JOSE FOOTHILL FAMILY 01 001 10/1/2018 $185.38 0521 T1015 1 F 2880 STORY ROAD SAN JOSE CA 95127 FQ 035 43 1447390265 SAN JOSE HIGH 01 001 10/1/2018 $140.01 0521 T1015 1 F 1149 E JULIAN ST SAN JOSE CA 95116 FQ 035 43 1932288859 SAN MATEO CLIN-39TH AVE 01 001 10/1/2018 $344.12 0521 T1015 1 G 222 W 39TH AVE SAN MATEO CA 94403 FQ 035 41 1194804013 SAN MATEO CO COMM CLINIC 01 001 10/1/2018 $349.85 0521 T1015 1 F 225 37TH AVE SAN MATEO CA 94403 FQ 035 41 1023196011 SAN MATEO CO GEN HOSP 01 001 10/1/2018 $366.37 0521 T1015 1 G 2780 JUNIPERO SERRA BLVD DALY CITY CA 94015 FQ 035 41 1568540557 SAN MATEO CO GEN HOSP 01 001 10/1/2018 $366.37 0521 T1015 1 G 630 LAUREL ST REDWOOD CITY CA 94063 FQ 035 41 1750460671 SAN MATEO CO GEN HOSP 01 001 10/1/2018 $366.37 0521 T1015 1 G 306 SPRUCE AVE S SAN FRANCISCO CA 94080 FQ 035 41 1841379765 SAN MATEO CO GEN HOSP 01 001 10/1/2018 $380.74 0521 T1015 1 G 225 CABRILLO HWY S HALF MOON BAY CA 94019 FQ 035 41 1386728533 SAN MATEO CO HEALTH SVS 01 001 10/1/2018 $341.49 0521 T1015 1 G 2710 MIDDLEFIELD RD REDWOOD CITY CA 94063 FQ 035 41 1023197944 SAN MATEO MEDICAL CENTER 01 001 10/1/2018 $477.08 0521 T1015 1 G 795 WILLOW RD MENLO PARK CA 94025 FQ 035 41 1912076662 SAN MATEO MEDICAL CENTER 01 001 10/1/2018 $366.36 0521 T1015 1 F 630 LAUREL ST REDWOOD CITY CA 94063 FQ 035 41 1467577908 SANTA BARBARA COUNTY 01 001 10/1/2018 $341.43 0521 T1015 1 F 116 S PALISADE DR SANTA MARIA CA 93454 FQ 035 42 1063438232 SANTA BARBARA NEIGHBORHOOD 01 001 10/1/2018 $189.51 0521 T1015 1 F 915 N MILPAS ST SANTA BARBARA CA 93103 FQ 035 42 1225054414 SANTA BARBARA NEIGHBORHOOD 01 001 10/1/2018 $153.08 0521 T1015 1 F 628 W MICHELTORENA ST SANTA BARBARA CA 93101 FQ 035 42 1225054414 SANTA BARBARA NEIGHBORHOOD 01 002 10/1/2017 $116.34 0521 T1015 1 F 721 CLIFF DR SANTA BARBARA CA 93109 FQ 035 42 1265458434 SANTA BARBARA NEIGHBORHOOD 01 001 10/1/2018 $146.36 0521 T1015 1 F 970 EMBARCADERO DEL MAR GOLETA CA 93117 FQ 035 42 1679997852 SANTA BARBARA NEIGHBORHOOD 01 001 3/15/2018 $164.74 0521 T1015 1 F 5580 CALLE REAL GOLETA CA 93111 FQ 035 42 1043354020 SANTA CLARA CO TB CLINIC 01 001 10/1/2018 $492.07 0521 T1015 1 F 976 LENZEN AVE SAN JOSE CA 95126 FQ 035 43 1376538991 SANTA CLARA VLY MED CTR 01 001 10/1/2018 $353.83 0521 T1015 1 F 500 TULLY RD SAN JOSE CA 95111 FQ 035 43 1922093533 SANTA CLARA VLY MED CTR 01 001 10/1/2018 $353.83 0521 T1015 1 F 7475 CAMINO ARROYO GILROY CA 95020 FQ 035 43 1972598449 SANTA CLARA VLY MED CTR 01 001 10/1/2018 $353.83 0521 T1015 1 F 750 S BASCOM AVE SAN JOSE CA 95128 FQ 035 43 1902923329 SANTA CRUZ COMMUNITY HEALTH 01 001 10/1/2018 $194.34 0521 T1015 1 F 250 LOCUST ST SANTA CRUZ CA 95060 FQ 035 44 1952749541 SANTA CRUZ COMMUNITY HEALTH 01 001 10/1/2017 $186.66 0521 T1015 1 F 21507 E CLIFF DRIVE SANTA CRUZ CA 95062 FQ 035 44 1023439759 SANTA ROSA COMMUNITY HEALTH 01 001 10/1/2018 $200.11 0521 T1015 1 F 1110 NORTH DUTTON AVENUE SANTA ROSA CA 95401 FQ 035 49 1184909103 SANTA ROSA COMMUNITY HEALTH 01 001 10/1/2018 $190.97 0521 T1015 1 F 983 SONOMA AVENUE SANTA ROSA CA 95404 FQ 035 49 1245739697 SANTA ROSA COMMUNITY HEALTH 01 001 3/5/2018 $192.06 0521 T1015 1 F 3883 AIRWAY DRIVE SANTA ROSA CA 95403 FQ 035 49 1780195255 SANTA ROSA COMMUNITY HEALTH 01 001 4/2/2018 $166.60 0521 T1015 1 F 1300 N DUTTON AVENUE SANTA ROSA CA 95401 FQ 035 49 1790970853 SANTA ROSA DEL VALLE 01 001 10/1/2018 $ 87.93 0521 T1015 1 R 1293 6TH STREET COACHELLA CA 92236 RH 035 33 1003869363 SAN YSIDRO HEALTH CENTER 01 001 10/1/2018 $206.03 0521 T1015 1 F 1136 D AVE NATIONAL CITY CA 91950 FQ 035 37 1952364747 SAN YSIDRO HEALTH CTR 01 001 10/1/2018 $239.63 0521 T1015 1 F 4004 BEYER BLVD SAN YSIDRO CA 92173 FQ 035 37 1083755631 SCHOOL HEALTH CLINICS 01 001 10/1/2018 $170.43 0521 T1015 1 F 1835 CUNNINGHAM AVE SAN JOSE CA 95122 FQ 035 43 1376683151 SCHOOL HEALTH CLINICS 01 001 10/1/2018 $113.52 0521 T1015 1 F 645 WOOL CREEK DR SAN JOSE CA 95112 FQ 035 43 1851431647 SCHOOL HEALTH CLINICS 01 001 10/1/2018 $154.26 0521 T1015 1 F 100 OAK ST SAN JOSE CA 95110 FQ 035 43 1508922089 SCHORR, MICHAEL S MD 01 002 10/1/2018 $ 96.75 0521 T1015 1 R 101 N 3RD STREET PATTERSON CA 95363 RH 035 50 1104920438 SENECA HEALTHCARE DIST 01 002 10/1/2018 $162.50 0521 T1015 1 U 199 REYNOLDS RD CHESTER CA 96020 RH 035 32 1528016987 SEQUOIA FAMILY MED CTR 01 001 10/1/2018 $ 79.40 0521 T1015 1 R 590 W PUTNAM AVE PORTERVILLE CA 93257 RH 035 54 1245623156 SERENTIY CARE HEALTH GROUP 01 001 8/1/2018 $166.60 0521 T1015 1 ? 2100 E ANAHEIM ST LONG BEACH CA 90804 FQ 035 19 1770803462 SERVE THE PEOPLE INC 01 001 10/1/2018 $190.86 0521 T1015 1 F 1206 E 17TH STREET SANTA ANA CA 92701 FQ 035 30 1336385244 SESPE MEDICAL INCORPORATED 01 001 10/1/2018 $ 72.22 0521 T1015 1 R 552 SESPE FILLMORE CA 93015 RH 035 56 1811362908 SHAFTER PEDIATRICS 01 001 10/1/2018 $104.87 0521 T1015 1 R 501 MUNZER ST SHAFTER CA 93263 RH 035 15 1033514708 SHARE OUR SELVES CORP 01 001 10/1/2018 $231.34 0521 T1015 1 F 307 PLACENTIA AVE NEWPORT BEACH CA 92663 FQ 035 30 1508073685 SHARE OUR SELVES CORP 01 001 10/1/2018 $230.26 0521 T1015 1 F 1550 SUPERIOR AVE COSTA MESA CA 92627 FQ 035 30


1295082774 SHARE OUR SELVES CORPORATION 01 001 12/15/2018 $213.72 0521 T1015 1 F 1014 N BROADWAY ST SANTA ANA CA 92701 FQ 035 30 1891710638 SHASTA COMM HEALTH CTR 01 001 10/1/2018 $260.89 0521 T1015 1 F 1035 PLACER ST REDDING CA 96001 FQ 035 45 1538181557 SHASTA COMMUNITY HEALTH 01 001 10/1/2018 $184.32 0521 T1015 1 F 1400 MARKET STREET REDDING CA 96001 FQ 035 45 1942225719 SHASTA COMMUNITY HEALTH 01 001 10/1/2018 $184.32 0521 T1015 1 F 2801 SILVER ST ANDERSON CA 96007 FQ 035 45 1952328403 SHASTA COMMUNITY HEALTH 01 001 10/1/2018 $260.89 0521 T1015 1 F 1035 PLACER STREET REDDING CA 96001 FQ 035 45 1013931476 SHASTA COMMUNITY HLTH CT 01 001 10/1/2018 $184.32 0521 T1015 1 F 16300 CLOVERDALE RD ANDERSON CA 96007 FQ 035 45 1013932797 SHASTA COMMUNITY HLTH CT 01 001 10/1/2018 $184.32 0521 T1015 1 F 4215 FRONT ST SHASTA LAKE CA 96019 FQ 035 45 1750387072 SHINGLETOWN MEDICAL CTR 01 001 10/1/2018 $186.88 0521 T1015 1 F 31292 ALPINE MEADOWS RD SHINGLETOWN CA 96088 FQ 035 45 1154679447 SHYAM BHASKAR MD INC 01 001 10/1/2017 $ 81.32 0521 T1015 1 R 1425 MAIN STREET DELANO CA 93215 RH 035 15 1316169618 SIERRA FAMILY MEDICAL CL 01 001 10/1/2018 $152.62 0521 T1015 1 F 15301 TYLER FOOTE RD NEVADA CITY CA 95959 FQ 035 29 1053456400 SIERRA PARK FAMILY 01 001 10/1/2018 $319.88 0521 T1015 1 U 85 SIERRA PARK RD MAMMOTH LAKES CA 93546 RH 035 26 1073764254 SIERRA VIEW FAMILY CLINIC 01 001 10/1/2018 $ 92.31 0521 T1015 1 R 1237 ROSE AVE SELMA CA 93662 RH 035 10 1881686301 SISKIYOU FAMILY HLTHCARE 01 001 10/1/2018 $ 95.98 0521 T1015 1 R 700 S MAIN ST YREKA CA 96097 RH 035 47 1093892275 SISKIYOU HOSPITAL, INC 01 002 10/1/2018 $340.69 0521 T1015 1 U 475 BRUCE ST YREKA CA 96097 RH 035 47 1336330646 SISKIYOU HOSPITAL, INC 01 001 10/1/2018 $236.70 0521 T1015 1 U 8 COMMERCIAL ST ETNA CA 96027 RH 035 47 1508903584 SISKIYOU MEDICAL GROUP 01 001 10/1/2018 $102.26 0521 T1015 1 R 824 PINE ST MOUNT SHASTA CA 96067 RH 035 47 1164437042 SIVALINGAM MEDICAL CORP 01 001 10/1/2018 $119.07 0521 T1015 1 R 1535 N CHINA LAKE BLVD RIDGECREST CA 93555 RH 035 15 1508078817 SOLANO COUNTY HEALTH 01 001 10/1/2018 $269.36 0521 T1015 1 F 2101 COURAGE DR FAIRFIELD CA 94533 FQ 035 48 1730391053 SOLANO COUNTY HEALTH 01 001 10/1/2018 $269.23 0521 T1015 1 F 355 TUOLUMNE ST VALLEJO CA 94590 FQ 035 48 1083845275 SOLANO COUNTY HLTH & SOCIAL 01 001 10/1/2018 $229.05 0521 T1015 1 F 2201 COURAGE DRIVE FAIRFIELD CA 94533 FQ 035 48 1003822453 SOLEDAD COMMUNITY HEALTH 01 001 10/1/2018 $144.98 0521 T1015 1 R 600 MAIN ST SOLEDAD CA 93960 RH 035 27 1770669715 SONOMA VALLEY COMM HLTH 01 001 10/1/2017 $228.47 0521 T1015 1 F 19270 SONOMA HIGHWAY 12 SONOMA CA 95476 FQ 035 49 1003014952 SONORA COMMUNITY HOSPITAL 01 001 10/1/2018 $206.71 0521 T1015 1 U 193 FAIRVIEW LN SONORA CA 95370 RH 035 55 1255472924 SOUTH BAY FAMILY 01 001 10/1/2018 $201.00 0521 T1015 1 F 1091 S LA BREA AVE INGLEWOOD CA 90301 FQ 035 19 1548301229 SOUTH BAY FAMILY HEALTH- 01 001 10/1/2018 $152.38 0521 T1015 1 F 2114 ARTESIA BLVD REDONDO BEACH CA 90278 FQ 035 19 1871634568 SOUTH BAY FAMILY HEALTH- 01 001 10/1/2018 $140.51 0521 T1015 1 F 742 W GARDENA BLVD GARDENA CA 90247 FQ 035 19 1871933945 SOUTH BAY FAMILY HEALTH CARE 01 001 10/1/2018 $174.84 0521 T1015 1 F 270 E 223RD STREET CARSON CA 90745 FQ 035 19 1396891909 SOUTH CENTRAL FAMILY 01 001 10/1/2018 $182.07 0521 T1015 1 F 4425 S CENTRAL AVE LOS ANGELES CA 90011 FQ 035 19 1669799896 SOUTH CENTRAL FAMILY 01 001 10/1/2018 $172.20 0521 T1015 1 F 2680 SATURN AVE HUNTINGTON PARK CA 90225 FQ 035 19 1487923306 SOUTH CENTRAL FAMILY HEALTH 01 001 10/1/2018 $144.41 0521 T1015 1 F 4000 S MAIN STREET LOS ANGELES CA 90037 FQ 035 19 1588908305 SOUTH CENTRAL FAMILY HEALTH 01 001 10/1/2018 $203.68 0521 T1015 1 F 3410 S HOOPER AVE LOS ANGELES CA 90011 FQ 035 19 1649792615 SOUTH CENTRAL FAMILY HEALTH 01 001 10/1/2018 $196.97 0521 T1015 1 F 1028 E VERNON AVE LOS ANGELES CA 90011 FQ 035 19 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 002 10/1/2017 $236.45 0521 T1015 1 F 2160 EUCLID AVE EAST PALO ALTO CA 94303 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 003 10/1/2017 $236.45 0521 T1015 1 F 65 TOWER ROAD SAN MATEO CA 94402 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 004 10/1/2017 $236.45 0521 T1015 1 F 1421 BAY ROAD EAST PALO ALTO CA 94303 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 001 10/1/2018 $209.46 0521 T1015 1 F 1807 BAY ROAD EAST PALO ALTO CA 94303 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 005 10/1/2017 $196.00 0521 T1015 1 F 620 NORTH ST PESCADERO CA 94060 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 006 10/1/2017 $196.00 0521 T1015 1 F 24 SECOND AVE SAN MATEO CA 94401 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 007 10/1/2017 $196.00 0521 T1015 1 F 260 VAN BUREN ROAD MENLO PARK CA 94025 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 008 10/1/2017 $196.00 0521 T1015 1 F 325 VILLA TERRACE SAN MATEO CA 94401 FQ 035 41 1184957771 SOUTH COUNTY COMM HEALTH CTR 01 009 10/1/2017 $196.00 0521 T1015 1 F 1968 OLD COUNTRY RD REDWOOD CITY CA 94063 FQ 035 41 1821170044 SOUTH COUNTY COMMUNITY 01 004 10/1/2018 $378.24 0521 T1015 1 F 1846 BAY ROAD EAST PALO ALTO CA 94303 FQ 035 41 1821170044 SOUTH COUNTY COMMUNITY 01 002 10/1/2017 $378.24 0521 T1015 1 F 1885 BAY ROAD EAST PALO ALTO CA 94303 FQ 035 41 1821170044 SOUTH COUNTY COMMUNITY 01 005 10/1/2018 $378.24 0521 T1015 1 F 1848A BAY ROAD EAST PALO ALTO CA 94303 FQ 035 41 1225357114 SOUTHERN CALIFORNIA MED CTR 01 001 10/1/2018 $198.19 0521 T1015 1 F 12100 VALLEY BLVD EL MONTE CA 91732 FQ 035 19 1255729661 SOUTHERN CALIFORNIA MEDICAL 01 001 12/15/2017 $182.59 0521 T1015 1 F 14550 HAYNES ST VAN NUYS CA 91411 FQ 035 19 1932428828 SOUTHERN CALIFORNIA MEDICAL 01 001 10/1/2018 $218.20 0521 T1015 1 F 8825 WHITTIER BLVD PICO RIVERA CA 90660 FQ 035 19 1336367515 SOUTHERN HUMBOLDT COMM 01 001 10/1/2018 $141.29 0521 T1015 1 U 509 ELM ST GARBERVILLE CA 95542 RH 035 12 1063589174 SOUTHERN INYO HOSP DIST 01 001 10/1/2018 $157.79 0521 T1015 1 U 501 E LOCUST ST LONE PINE CA 93545 RH 035 14 1811188188 SOUTHERN MONTEREY CO MEM 01 001 10/1/2018 $179.30 0521 T1015 1 U 210 CANAL ST KING CITY CA 93930 RH 035 27 1548451818 SOUTHERN MONTEREY COUNTY 01 001 10/1/2018 $156.01 0521 T1015 1 U 467 EL CAMINO REAL GREENFIELD CA 93927 RH 035 27 1174693493 SOUTHERN TRINITY HEALTH SRVS 01 001 10/1/2018 $274.31 0521 T1015 1 F 321 VAN DUZEN ROAD MAD RIVER CA 95552 FQ 035 53 1871651273 SOUTHWEST COMM HEALTH CT 01 001 10/1/2018 $243.87 0521 T1015 1 F 599 BELLEVUE AVE SANTA ROSA CA 95407 FQ 035 49 1871651273 SOUTHWEST COMM HEALTH CT 01 002 6/6/2018 $240.50 0521 T1015 1 F 789 LOMBARDI COURT SANTA ROSA CA 95407 FQ 035 49 1578631172 SOUTHWEST COMM HLTH CTR 01 001 10/1/2018 $194.75 0521 T1015 1 F 3569 ROUND BARN CIRCLE SANTA ROSA CA 95403 FQ 035 49 1558512624 SOUTHWEST COMMUNITY HEALTH 01 001 10/1/2018 $197.48 0521 T1015 1 F 711 STONY POINT ROAD SANTA ROSA CA 95407 FQ 035 49 1386712065 SOUTHWEST COMMUNITY HLTH 01 001 10/1/2018 $230.21 0521 T1015 1 F 751 LOMBARDI CT SANTA ROSA CA 95407 FQ 035 49 1841501319 SPECIALTY URGENT CARE, LP 01 001 10/1/2018 $ 93.97 0521 T1015 1 R 57402 29 PALMS HWY YUCCA VALLEY CA 92284 RH 035 36 1396941464 STANISLAUS CO HLTH SVS 01 001 10/1/2018 $212.10 0521 T1015 1 F 401 PARADISE RD MODESTO CA 95351 FQ 035 50 1427254663 STANISLAUS COUNTY HEALTH 01 001 10/1/2018 $125.49 0521 T1015 1 F 830 SCENIC DR MODESTO CA 95350 FQ 035 50 1831394998 STANISLAUS COUNTY HEALTH 01 001 10/1/2018 $162.32 0521 T1015 1 F 800 DELBON AVE TURLOCK CA 95382 FQ 035 50 1891991741 STANISLAUS COUNTY HEALTH 01 001 10/1/2018 $235.80 0521 T1015 1 F 830 SCENIC DR MODESTO CA 95350 FQ 035 50 1952506123 STANISLAUS COUNTY HEALTH 01 001 10/1/2018 $165.86 0521 T1015 1 F 3109 E WHITMORE AVE CERES CA 95307 FQ 035 50 1093910275 STANISLAUS COUNTY HLTH 01 001 10/1/2018 $192.88 0521 T1015 1 F 1209 WOODROW AVENUE MODESTO CA 95350 FQ 035 50 1356643654 ST ANTHONY FOUNDATION 01 001 10/1/2018 $241.07 0521 T1015 1 F 150 GOLDEN GATE AVENUE SAN FRANCISCO CA 94102 FQ 035 38 1063562130 ST ANTHONY MEDICAL CTR 01 001 10/1/2018 $136.00 0521 T1015 1 F 6368 HOLLYWOOD BLVD HOLLYWOOD CA 90028 FQ 035 19 1225188204 ST ANTHONY MEDICAL CTR 01 001 10/1/2018 $136.00 0521 T1015 1 F 837 W IMPERIAL HWY LOS ANGELES CA 90044 FQ 035 19 1952451031 ST ANTHONY MEDICAL CTR 01 001 10/1/2018 $136.00 0521 T1015 1 F 2515 W PICO BLVD LOS ANGELES CA 90006 FQ 035 19 1255441358 STINSON BEACH MED CTR 01 001 10/1/2018 $183.01 0521 T1015 1 F 3419 STATE ROUTE 1 STINSON BEACH CA 94970 FQ 035 21 1700915097 ST JAMES HEALTH CENTER 01 001 10/1/2018 $185.63 0521 T1015 1 F 55 E JULIAN STREET SAN JOSE CA 95112 FQ 035 43 1932249505 ST JOHN'S WELL CHILD 01 001 10/1/2018 $126.24 0521 T1015 1 F 2512 ALTA ST LOS ANGELES CA 90031 FQ 035 19


1003068206 ST JOHNS WELL CHILD 01 001 10/1/2018 $155.68 0521 T1015 1 F 6505 8TH AVE LOS ANGELES CA 90043 FQ 035 19 1013057371 ST JOHNS WELL CHILD 01 001 10/1/2018 $166.72 0521 T1015 1 F 5701 S HOOVER ST LOS ANGELES CA 90037 FQ 035 19 1861893844 ST JOHNS WELL CHILD 01 001 10/1/2018 $214.20 0521 T1015 1 F 326 W 23RD STREET LOS ANGELES CA 90007 FQ 035 19 1285874826 ST JOHN'S WELL CHILD AND 01 001 10/1/2018 $142.04 0521 T1015 1 F 808 WEST 58TH STREET LOS ANGELES CA 90037 FQ 035 19 1063836526 ST JOHNS WELL CHILD AND 01 001 10/1/2018 $201.37 0521 T1015 1 F 3628 E IMPERIAL HWY LYNWOOD CA 90262 FQ 035 19 1396981700 ST JOHNS WELL CHILD AND 01 001 10/1/2018 $166.32 0521 T1015 1 F 4085 S VERMONT AVE LOS ANGELES CA 90037 FQ 035 19 1598002628 ST JOHNS WELL CHILD AND 01 001 10/1/2017 $128.00 0521 T1015 1 F 808 W 58TH ST LOS ANGELES CA 90037 FQ 035 19 1801028303 ST JOHNS WELL CHILD AND 01 001 10/1/2017 $128.00 0521 T1015 1 F 15301 S. SAN JOSE AVE COMPTON CA 90221 FQ 035 19 1972845113 ST JOHNS WELL CHILD AND 01 001 10/1/2017 $128.00 0521 T1015 1 F 1555 W 110TH ST LOS ANGELES CA 90047 FQ 035 19 1073653630 ST JOHN'S WELL CHILD CTR 01 001 10/1/2018 $167.29 0521 T1015 1 F 1910 SOUTH MAGNOLIA AVE LOS ANGELES CA 90007 FQ 035 19 1932249596 ST JOHN'S WELL CHILD CTR 01 001 10/1/2018 $167.29 0521 T1015 1 F 2115A N WILMINGTON AVE COMPTON CA 90222 FQ 035 19 1043542111 ST JOHNS WELL CHILD FAMILY 01 001 10/1/2018 $166.50 0521 T1015 1 F 15715 S ATLANTIC AVE E RANCHO DMNGZ CA 90221 FQ 035 19 1184092017 ST JUDE NEIGHBORHOOD HEALTH 01 001 10/1/2017 $229.05 0521 T1015 1 F 1801 S GREENVILLE ST SANTA ANA CA 92704 FQ 035 30 1235627563 ST JUDE NEIGHBORHOOD HEALTH 01 001 6/19/2018 $231.80 0521 T1015 1 F 725 W LA VETA AVE ORANGE CA 92868 FQ 035 30 1316206592 ST JUDE NEIGHBORHOOD HEALTH 01 001 10/1/2018 $235.05 0521 T1015 1 F 731 S HIGHLAND AVE FULLERTON CA 92832 FQ 035 30 1316206592 ST JUDE NEIGHBORHOOD HEALTH 01 002 10/1/2017 $224.76 0521 T1015 1 F 3232 TOPAZ LANE FULLERTON CA 92831 FQ 035 30 1821494535 ST JUDE NEIGHBORHOOD HEALTH 01 001 10/1/2018 $176.51 0521 T1015 1 F 353 S MAIN ST ORANGE CA 92868 FQ 035 30 1659415131 ST VINCENT DE PAUL VILLAGE 01 002 10/1/2018 $258.25 0521 T1015 1 F 1501 IMPERIAL AVE SAN DIEGO CA 92101 FQ 035 37 1073693651 SUPRISE VALLEY HEALTH CARE 01 001 10/1/2018 $188.02 0521 T1015 1 U 745 NORTH MAIN CEDARVILLE CA 96104 RH 035 25 1356779797 SUTTER BAY HOSPITALS 01 001 10/1/2017 $ 79.80 0521 T1015 1 U 5196 HILL ROAD E LAKEPORT CA 95453 RH 035 17 1770816829 SUTTER BAY HOSPITALS 01 001 10/1/2018 $144.19 0521 T1015 1 U 5176 HILL ROAD EAST LAKEPORT CA 95453 RH 035 17 1285641167 SUTTER COAST HEALTH CTR 01 001 10/1/2018 $ 99.74 0521 T1015 1 U 785 E WASHINGTON BLVD CRESCENT CITY CA 95531 RH 035 08 1487017471 SUTTER VALLEY HOSPITALS 01 001 10/1/2017 $165.47 0521 T1015 1 U 1253 WEST I ST LOS BANOS CA 93635 RH 035 24 1740422286 SUTTER VALLEY MEDICAL 01 001 10/1/2018 $115.92 0521 T1015 1 R 16911 WILLOW GLEN RD BROWNSVILLE CA 95919 RH 035 58 1831467653 SUTTER VALLEY MEDICAL 01 001 10/1/2018 $120.86 0521 T1015 1 U 9279 LOCUST STREET PLYMOUTH CA 95669 RH 035 03 1629301775 SUTTER WEST BAY HOSPITALS 01 001 10/1/2018 $157.10 0521 T1015 1 U 750 OLD LUCERNE ROAD UPPER LAKE CA 95485 RH 035 17 1043427388 TEHAMA COUNTY 01 001 10/1/2018 $115.64 0521 T1015 1 R 1850 WALNUT ST RED BLUFF CA 96080 RH 035 52 1336173020 TELEHEALTH & VISITING 01 001 10/1/2018 $264.39 0521 T1015 1 F 2426 BUHNE ST EUREKA CA 95501 FQ 035 12 1164771747 THE ACHIEVABLE FOUNDATION 01 001 10/1/2017 $251.60 0521 T1015 1 F 5901 GREEN VALLEY CIRCLE CULVER CITY CA 90230 FQ 035 19 1134425804 THE CHILDRENS CLINIC 01 001 10/1/2018 $216.68 0521 T1015 1 F 2360 PACIFIC AVENUE LONG BEACH CA 90806 FQ 035 19 1255495552 THE CHILDRENS CLINIC 01 001 10/1/2018 $226.72 0521 T1015 1 F 1057 PINE AVE LONG BEACH CA 90813 FQ 035 19 1275917692 THE CHILDRENS CLINIC 01 001 10/1/2018 $224.73 0521 T1015 1 F 2000 SAN GABRIEL AVE LONG BEACH CA 90810 FQ 035 19 1447556170 THE CHILDRENS CLINIC 01 001 10/1/2018 $201.46 0521 T1015 1 F 17660 LAKEWOOD BLVD BELLFLOWER CA 90706 FQ 035 19 1467818583 THE CHILDRENS CLINIC 01 001 10/1/2017 $199.88 0521 T1015 1 F 1301 WEST 12TH STREET LONG BEACH CA 90813 FQ 035 19 1639233935 THE CHILDRENS CLINIC 01 001 10/1/2018 $187.46 0521 T1015 1 F 455 E COLUMBIA ST LONG BEACH CA 90806 FQ 035 19 1942345939 THE CHILDRENS CLINIC 01 001 10/1/2018 $205.11 0521 T1015 1 F 1301 WEST 12TH ST LONG BEACH CA 90813 FQ 035 19 1205250263 THE CHILDRENS CLINIC SERVING 01 001 10/1/2018 $229.01 0521 T1015 1 F 2125 SANTA FE AVENUE LONG BEACH CA 90810 FQ 035 19 1699839993 THE CHILDRENS CLINIC SERVING 01 001 10/1/2018 $122.95 0521 T1015 1 F 1060 E 70TH ST LONG BEACH CA 90805 FQ 035 19 1851775795 THE CHILDRENS CLINIC SERVING 01 001 10/15/2017 $182.82 0521 T1015 1 F 1574 LINDEN AVE LONG BEACH CA 90813 FQ 035 19 1023287679 T H E CLINIC AT RUTH 01 001 10/1/2018 $209.15 0521 T1015 1 F 3834 S WESTERN AVE LOS ANGELES CA 90062 FQ 035 19 1215358924 THE DAVIS STREET COMMUNITY 01 001 10/1/2018 $215.96 0521 T1015 1 F 3081 TEAGARDEN STREET SAN LEANDRO CA 94577 FQ 035 01 1194893248 THE LOS ANGELES FREE CLINIC 01 001 10/1/2018 $208.16 0521 T1015 1 F 8405 BEVERLY BLVD LOS ANGELES CA 90048 FQ 035 19 1235271065 THE LOS ANGELES FREE CLINIC 01 001 10/1/2018 $284.26 0521 T1015 1 F 6043 HOLLYWOOD BLVD HOLLYWOOD CA 90028 FQ 035 19 1336281179 THE LOS ANGELES FREE CLINIC 01 001 10/1/2018 $189.67 0521 T1015 1 F 5205 MELROSE AVE LOS ANGELES CA 90038 FQ 035 19 1891028171 THE NORTHEAST COMMUNITY 01 001 10/1/2018 $227.74 0521 T1015 1 F 4455 W 117 ST HAWTHORNE CA 90250 FQ 035 19 1164672853 THE NORTHEAST COMMUNITY CLIN 01 001 10/1/2018 $110.92 0521 T1015 1 F 3751 S HARVARD BLVD LOS ANGELES CA 90018 FQ 035 19 1700097540 THE NORTHEAST COMMUNITY CLNC 01 001 10/1/2018 $266.25 0521 T1015 1 F 200 E ANAHEIM STREET WILMINGTON CA 90744 FQ 035 19 1184915092 THE PEACH TREE CLINIC INC 01 001 10/1/2018 $134.88 0521 T1015 1 F 1445 VETERANS MEMORIAL YUBA CITY CA 95993 FQ 035 51 1235157967 THE PEACH TREE CLINIC INC 01 001 10/1/2018 $123.64 0521 T1015 1 F 724 5TH ST MARYSVILLE CA 95901 FQ 035 58 1508278359 THE ROADS FOUNDATION 01 001 10/1/2017 $160.60 0521 T1015 1 F 121 S LONG BEACH BLVD COMPTON CA 90221 FQ 035 19 1154336246 THOMAS, SEAN R MD INC 01 001 10/1/2018 $ 78.64 0521 T1015 1 R 6186 ADOBE RD TWENTYNINE PALMS CA 92277 RH 035 36 1386869147 THOMAS, SEAN R MD INC 01 001 10/1/2018 $ 78.64 0521 T1015 1 R 55585 29 PALMS HWY YUCCA VALLEY CA 92284 RH 035 36 1073676243 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2018 $223.97 0521 T1015 1 F 22331 MISSION BLVD HAYWARD CA 94541 FQ 035 01 1144597477 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2018 $222.44 0521 T1015 1 F 680 W TENNYSON RD HAYWARD CA 94544 FQ 035 01 1407373921 TIBURCIO VASQUEZ HEALTH 01 001 10/12/2017 $227.19 0521 T1015 1 F 1633 EAST AVE HAYWARD CA 94541 FQ 035 01 1497805790 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2018 $179.94 0521 T1015 1 F 1800 H STREET UNION CITY CA 94587 FQ 035 01 1720405491 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2018 $233.14 0521 T1015 1 F 16110 E 14TH ST SAN LEANDRO CA 94578 FQ 035 01 1861860306 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2018 $212.42 0521 T1015 1 F 28300 HUNTWOOD AVE HAYWARD CA 94544 FQ 035 01 1881983393 TIBURCIO VASQUEZ HEALTH 01 001 10/1/2017 $211.82 0521 T1015 1 F 495 WYETH ROAD HAYWARD CA 94544 FQ 035 01 1851389696 TIBURCIO VASQUEZ HLTH CT 01 001 10/1/2018 $217.36 0521 T1015 1 F 33255 9TH ST UNION CITY CA 94587 FQ 035 01 1528072527 TIPTON MEDICAL CLINIC 01 001 10/1/2018 $118.01 0521 T1015 1 R 575 N THOMPSON RD TIPTON CA 93272 RH 035 54 1497021109 TRI CITY HEALTH CENTER 01 001 10/1/2018 $208.38 0521 T1015 1 F 3607 MAIN STREET FREMONT CA 94538 FQ 035 01 1033296272 TRI-CITY HEALTH CENTER 01 001 10/1/2018 $184.59 0521 T1015 1 F 2299 MOWRY AVE FREMONT CA 94538 FQ 035 01 1780054379 TRI-CITY HEALTH CENTER 01 001 10/1/2018 $205.93 0521 T1015 1 F 40910 FREMONT BLVD FREMONT CA 94538 FQ 035 01 1780054379 TRI-CITY HEALTH CENTER 01 002 10/13/2017 $200.68 0521 T1015 1 F 40910 FREMONT BLVD FREMONT CA 94538 FQ 035 01 1942387188 TRI-CITY HEALTH CENTER 01 001 10/1/2018 $184.59 0521 T1015 1 F 39500 LIBERTY ST FREMONT CA 94538 FQ 035 01 1184791998 TRI-CITY HEALTH CENTER- 01 001 10/1/2018 $294.45 0521 T1015 1 F 1999 MOWRY AVENUE FREMONT CA 94538 FQ 035 01 1184791998 TRI-CITY HEALTH CENTER- 01 002 10/1/2017 $286.94 0521 T1015 1 F 40910 FREMONT BLVD FREMONT CA 94538 FQ 035 01 1922356369 TRI-STATE COMMUNITY 01 001 10/1/2018 $172.93 0521 T1015 1 F 1402 BAILEY AVENUE NEEDLES CA 92363 FQ 035 36 1801831227 TULARE COUNTY HLTH SVS 01 001 10/1/2018 $339.49 0521 T1015 1 F 660 E VISALIA RD FARMERSVILLE CA 93223 FQ 035 54 1417027095 UKIAH ADVENTIST HOSPITAL 01 002 10/1/2018 $172.93 0521 T1015 1 U 487 S MAIN ST LAKEPORT CA 95453 RH 035 17


1588095848 UKIAH ADVENTIST HOSPITAL 01 001 10/1/2017 $216.98 0521 T1015 1 U 850 SEQUOIA CIRCLE FORT BRAGG CA 95437 RH 035 23 1770653362 UKIAH ADVENTIST HOSPITAL 01 001 10/1/2018 $172.93 0521 T1015 1 U 1050 N STATE ST UKIAH CA 95482 RH 035 23 1952471542 UKIAH ADVENTIST HOSPITAL 01 001 10/1/2018 $172.93 0521 T1015 1 U 260 HOSPITAL DRIVE UKIAH CA 95482 RH 035 23 1174984041 UNICARE COMMUNITY HEALTH 01 001 10/1/2018 $186.11 0521 T1015 1 F 16127 FOOTHILL BLVD FONTANA CA 92335 FQ 035 36 1265854061 UNICARE COMMUNITY HEALTH 01 001 10/1/2018 $183.53 0521 T1015 1 F 570 S MT VERNON AVE SAN BERNARDINO CA 92410 FQ 035 36 1356763155 UNICARE COMMUNITY HEALTH 01 001 10/1/2018 $179.19 0521 T1015 1 F 1501 E HOLT AVENUE POMONA CA 91767 FQ 035 19 1447604582 UNICARE COMMUNITY HEALTH 01 001 10/1/2018 $177.82 0521 T1015 1 F 308 N LA CADENA DR COLTON CA 92324 FQ 035 36 1710309513 UNICARE COMMUNITY HEALTH 01 001 10/1/2018 $177.31 0521 T1015 1 F 437 N EUCLID AVE ONTARIO CA 91762 FQ 035 36 1740335678 UNITED AMERICAN INDIAN 01 001 10/1/2018 $141.91 0521 T1015 1 F 1125 W 6TH ST LOS ANGELES CA 90017 FQ 035 19 1457724924 UNITED HEALTH CENTERS 01 001 10/1/2018 $175.94 0521 T1015 1 F 601 3RD STREET PARLIER CA 93648 FQ 035 10 1497150593 UNITED HEALTH CENTERS 01 001 10/1/2018 $142.14 0521 T1015 1 F 6425 W BOWLES RAISIN CITY CA 93652 FQ 035 10 1134101686 UNITED HEALTH CENTERS- 01 001 10/1/2018 $134.80 0521 T1015 1 F 16928 11TH ST HURON CA 93234 FQ 035 10 1417939968 UNITED HEALTH CENTERS- 01 001 10/1/2018 $134.80 0521 T1015 1 F 476 E WASHINGTON AVE EARLIMART CA 93219 FQ 035 54 1649252198 UNITED HEALTH CENTERS- 01 001 10/1/2018 $134.80 0521 T1015 1 F 445 11TH ST ORANGE COVE CA 93646 FQ 035 10 1801878350 UNITED HEALTH CENTERS- 01 001 10/1/2018 $134.80 0521 T1015 1 F 650 S ZEDIKER AVE PARLIER CA 93648 FQ 035 10 1992787444 UNITED HEALTH CENTERS OF 01 001 10/1/2018 $134.80 0521 T1015 1 F 2502 E JENSEN AVE SANGER CA 93657 FQ 035 10 1477979722 UNITED HEALTH CENTERS OF THE 01 001 10/1/2018 $195.23 0521 T1015 1 F 1270 N LEMOORE AVE LEMOORE CA 93245 FQ 035 16 1528478211 UNITED HEALTH CENTERS OF THE 01 001 10/1/2018 $195.23 0521 T1015 1 F 1560 E MANNING AVE REEDLEY CA 93654 FQ 035 10 1558632570 UNITED HEALTH CENTERS OF THE 01 001 10/1/2018 $164.11 0521 T1015 1 F 1209 WHITLEY AVE CORCORAN CA 93212 FQ 035 16 1629599535 UNITED HEALTH CENTERS OF THE 01 001 2/28/2018 $166.60 0521 T1015 1 F 1570 7TH STREET SANGER CA 93657 FQ 035 10 1982079620 UNITED HEALTH CENTERS OF THE 01 001 10/1/2017 $160.60 0521 T1015 1 F 106 E MAIN ST FOWLER CA 93625 FQ 035 10 1851373401 UNITED HLTH CTRS-KERMAN 01 001 10/1/2018 $134.80 0521 T1015 1 F 517 S MADERA AVE KERMAN CA 93630 FQ 035 10 1184606634 UNITED HLTH CTRS-MENDOTA 01 001 10/1/2018 $134.80 0521 T1015 1 F 121 BARBOZA ST MENDOTA CA 93640 FQ 035 10 1093023277 UNIVERSAL COMMUNITY HEALTH 01 001 10/1/2018 $179.68 0521 T1015 1 F 1005 E WASHINGTON BLVD LOS ANGELES CA 90021 FQ 035 19 1174913776 UNIVERSAL COMMUNITY HEALTH 01 002 10/1/2018 $187.37 0521 T1015 1 F 2801 SOUTH SAN PEDRO ST LOS ANGELES CA 90011 FQ 035 19 1467634238 UNIVERSAL MEDICAL CENTER 01 001 10/1/2017 $148.94 0521 T1015 1 R 1472 B ST LIVINGSTON CA 95334 RH 035 24 1720171242 UNIVERSITY MUSLIM MED 01 001 10/1/2018 $206.75 0521 T1015 1 F 711 W FLORENCE AVE LOS ANGELES CA 90044 FQ 035 19 1730421330 UNIVERSITY MUSLIM MEDICAL 01 001 10/1/2017 $129.02 0521 T1015 1 F 7821 AVALON BLVD LOS ANGELES CA 90003 FQ 035 19 1598790529 UNIVERSITY OF CA IRVINE 01 002 10/1/2018 $240.95 0521 T1015 1 F 300 W CARL KARCHER WAY ANAHEIM CA 92801 FQ 035 30 1851325906 UNIVERSITY OF CA IRVINE 01 001 10/1/2018 $216.51 0521 T1015 1 F 800 N MAIN ST SANTA ANA CA 92701 FQ 035 30 1538407325 URBAN COMMUNITY ACTION 01 001 10/1/2018 $204.56 0521 T1015 1 F 2880 HULEN PLACE RIVERSIDE CA 92507 FQ 035 33 1811185259 URBAN INDIAN HEALTH BOARD 01 001 10/1/2018 $407.52 0521 T1015 1 F 160 CAPP ST SAN FRANCISCO CA 94110 FQ 035 38 1063573962 VALLEY CHILDRENS HOSPITAL 01 001 10/1/2018 $290.46 0521 T1015 1 U 41169 GOODWIN WAY MADERA CA 93638 RH 035 20 1588740989 VALLEY COMMUNITY HEALTHCARE 01 001 10/1/2018 $148.64 0521 T1015 1 F 6801 COLDWATER CANYON AV NORTH HOLLYWOOD CA 91605 FQ 035 19 1932501996 VALLEY COMMUNITY HEALTHCARE 01 001 10/1/2018 $202.84 0521 T1015 1 F 9119 HASKELL AVENUE NORTH HILLS CA 91343 FQ 035 19 1538606280 VALLEY HEALTHCARE CENTERS 01 001 10/1/2018 $102.17 0521 T1015 1 R 825 N SEQUOIA AVE LINDSAY CA 93247 RH 035 54 1336135912 VALLEY HEALTH CENTER 01 001 10/1/2018 $353.83 0521 T1015 1 F 2400 MOORPARK AVE SAN JOSE CA 95128 FQ 035 43 1194068379 VALLEY HEALTH TEAM 01 001 10/1/2018 $185.56 0521 T1015 1 F 702 S EIGHTH STREET KERMAN CA 93630 FQ 035 10 1033598412 VALLEY HEALTH TEAM INC 01 002 8/14/2018 $177.60 0521 T1015 1 F 601 S FIRST ST KERMAN CA 93620 FQ 035 10 1033598412 VALLEY HEALTH TEAM INC 01 001 10/1/2017 $177.60 0521 T1015 1 F 1250 SMITH STREET KINGSBURG CA 93631 FQ 035 10 1558638601 VALLEY HEALTH TEAM INC 01 001 10/1/2018 $156.84 0521 T1015 1 F 927 O STREET FIREBAUGH CA 93622 FQ 035 10 1598821027 VALLEY HEALTH TEAM INC 01 001 10/1/2018 $132.40 0521 T1015 1 F 21890 COLORADO AVE SAN JOAQUIN CA 93660 FQ 035 10 1750703237 VALLEY HEALTH TEAM INC 01 001 10/1/2018 $190.22 0521 T1015 1 F 180 W SHAW AVENUE CLOVIS CA 93612 FQ 035 10 1992183669 VALLEY HEALTH TEAM INC 01 002 11/13/2017 $210.00 0521 T1015 1 F 4711 WEST ASHLAN AVENUE FRESNO CA 93722 FQ 035 10 1962567388 VALLEY HEALTH TEAM, INC 01 001 10/1/2018 $140.84 0521 T1015 1 F 449 S MADERA AVE KERMAN CA 93630 FQ 035 10 1558801829 VANGUARD MEDICAL CORPORATION 01 001 10/1/2018 $126.92 0521 T1015 1 R 845 7TH ST WASCO CA 93280 RH 035 15 1609281310 VANGUARD MEDICAL CORPORATION 01 001 10/1/2018 $143.97 0521 T1015 1 R 565 KERN ST SHAFTER CA 93263 RH 035 15 1003842360 VENICE FAMILY CLINIC 01 001 10/1/2018 $218.93 0521 T1015 1 F 4700 INGLEWOOD BLD CULVER CITY CA 90230 FQ 035 19 1558397067 VENICE FAMILY CLINIC 01 001 10/1/2018 $255.39 0521 T1015 1 F 2509 PICO BLVD SANTA MONICA CA 90405 FQ 035 19 1669418513 VENICE FAMILY CLINIC 01 001 10/1/2018 $255.39 0521 T1015 1 F 604 ROSE AVE VENICE CA 90291 FQ 035 19 1790156917 VENICE FAMILY CLINIC 01 001 10/1/2017 $160.60 0521 T1015 1 F 4700 INGLEWOOD BLVD LOS ANGELES CA 90230 FQ 035 19 1124054564 VENICE FAMILY CLINIC- 01 001 10/1/2018 $255.39 0521 T1015 1 F 905 VENICE BLVD VENICE CA 90291 FQ 035 19 1770034530 VIA CARE COMMUNITY HEALTH 01 002 10/1/2018 $187.36 0521 T1015 1 F 607 S ATLANTIC BLVD LOS ANGELES CA 90022 FQ 035 19 1285708818 VIETNAMESE COMMUNITY OF 01 001 10/1/2018 $167.95 0521 T1015 1 F 9862 CHAPMAN AVE GARDEN GROVE CA 92841 FQ 035 30 1124241930 VIRENDER S KALEKA 01 001 10/1/2018 $ 99.19 0521 T1015 1 R 2057 HIGH ST SELMA CA 93662 RH 035 10 1568685386 VIRENDER S KALEKA, MD 01 001 10/1/2018 $ 69.63 0521 T1015 1 R 12572 AVENUE 416 OROSI CA 93647 RH 035 54 1457385163 VISALIA HEALTH CARE CTR 01 001 10/1/2018 $339.49 0521 T1015 1 F 2611 N DINUBA BLVD VISALIA CA 93291 FQ 035 54 1295822658 VISTA COMM CLINIC 01 001 10/1/2018 $177.85 0521 T1015 1 F 1000 VALE TERRACE DR VISTA CA 92084 FQ 035 37 1649363375 VISTA COMM CLINIC-WEST 01 001 10/1/2018 $177.85 0521 T1015 1 F 818 PIER VIEW WAY OCEANSIDE CA 92054 FQ 035 37 1437245412 VISTA COMMUNITY CLINIC 01 001 10/1/2018 $181.33 0521 T1015 1 F 517 N HORNE ST OCEANSIDE CA 92054 FQ 035 37 1467990614 VISTA COMMUNITY CLINIC 01 001 3/26/2018 $175.39 0521 T1015 1 F 105 DURIAN STREET VISTA CA 92083 FQ 035 37 1497203541 VISTA COMMUNITY CLINIC 01 001 10/1/2017 $170.00 0521 T1015 1 F 201 S HARBOR BLVD LA HABRA CA 90631 FQ 035 30 1649662719 VISTA COMMUNITY CLINIC 01 001 10/1/2018 $175.19 0521 T1015 1 F 30195 FRASER DRIVE LAKE ELSINORE CA 92530 FQ 035 33 1689760100 VISTA COMMUNITY CLINIC 01 001 10/1/2018 $165.25 0521 T1015 1 F 4700 N RIVER RD OCEANSIDE CA 92057 FQ 035 37 1851300123 VISTA COMMUNITY CLINIC 01 001 10/1/2018 $177.85 0521 T1015 1 F 134 GRAPEVINE ROAD VISTA CA 92083 FQ 035 37 1710254313 WAHID MEDICAL CORPORATION 01 001 10/1/2018 $114.85 0521 T1015 1 R 1108 WARD AVENUE PATTERSON CA 95363 RH 035 50 1477649119 WATTS HEALTHCARE 01 003 10/1/2017 $296.96 0521 T1015 1 F 9901 COMPTON AVENUE LOS ANGELES CA 90002 FQ 035 19 1477649119 WATTS HEALTHCARE 01 004 10/16/2017 $300.23 0521 T1015 1 F 3501 WEST JEFFERSON BLVD LOS ANGELES CA 90018 FQ 035 19 1477649119 WATTS HEALTHCARE 01 005 7/27/2018 $303.83 0521 T1015 1 F 10300 COMPTON AVE LOS ANGELES CA 90002 FQ 035 19 1477649119 WATTS HEALTHCARE 01 001 10/1/2018 $308.08 0521 T1015 1 F 10300 COMPTON AVE LOS ANGELES CA 90002 FQ 035 19 1376681486 WATTS HEALTHCARE CORPORATION 01 001 10/1/2018 $190.14 0521 T1015 1 F 10110 JUNIPER ST LOS ANGELES CA 90002 FQ 035 19

PrvdrCurrent Rev Rate RevenueProvider Owner Service Current Revenue Special Zip Type CountyProvider Legal Name Rate Begin Procedure Status Physical Street Address City TypeNumber Num Location Rate Code Processing State Code Code CodeDate Code CodeType Code 1124112933 WELLSPACE HEALTH 01 001 10/1/2018 $166.31 0521 T1015 1 F 1820 J ST SACRAMENTO CA 95811 FQ 035 34 1124112933 WELLSPACE HEALTH 01 002 10/1/2017 $157.78 0521 T1015 1 F 631 H STREET SACRAMENTO CA 95814 FQ 035 34 1124257324 WELLSPACE HEALTH 01 002 10/1/2017 $146.06 0521 T1015 1 F 811 GRAND AVENUE SACRAMENTO CA 95838 FQ 035 34 1124257324 WELLSPACE HEALTH 01 006 10/1/2018 $198.01 0521 T1015 1 F 216 N LINCOLN WAY GALT CA 95632 FQ 035 34 1124257324 WELLSPACE HEALTH 01 001 10/1/2018 $198.01 0521 T1015 1 F 3415 MLK JR BLVD SACRAMENTO CA 95817 FQ 035 34 1124257324 WELLSPACE HEALTH 01 004 10/1/2017 $146.06 0521 T1015 1 F 6060 WATT AVENUE NORTH HIGHLANDS CA 95660 FQ 035 34 1215350848 WELLSPACE HEALTH 01 001 10/1/2017 $129.02 0521 T1015 1 F 5959 GREENBACK LANE CITRUS HEIGHTS CA 95621 FQ 035 34 1225550874 WELLSPACE HEALTH 01 001 12/22/2017 $163.49 0521 T1015 1 F 11333 PROSPECT DRIVE MARTELL CA 95654 FQ 035 03 1326175100 WELLSPACE HEALTH 01 002 10/1/2017 $126.22 0521 T1015 1 F 3737 MARCONI AVENUE SACRAMENTO CA 95821 FQ 035 34 1326175100 WELLSPACE HEALTH 01 001 10/1/2018 $142.83 0521 T1015 1 F 6015 WATT AVE NORTH HIGHLANDS CA 95660 FQ 035 34 1396198982 WELLSPACE HEALTH 01 001 10/1/2017 $160.60 0521 T1015 1 F 2425 ALHAMBRA BLVD SACRAMENTO CA 95817 FQ 035 34 1437404654 WELLSPACE HEALTH 01 002 10/21/2017 $129.02 0521 T1015 1 F 1710 PRAIRIE CITY RD FOLSOM CA 95630 FQ 035 34 1437404654 WELLSPACE HEALTH 01 001 10/1/2017 $129.02 0521 T1015 1 F 10423 OLD PLACERVILLE RD SACRAMENTO CA 95827 FQ 035 34 1447332036 WELLSPACE HEALTH 01 004 10/1/2017 $145.12 0521 T1015 1 F 6879 14TH AVE SACRAMENTO CA 95820 FQ 035 34 1447332036 WELLSPACE HEALTH 01 005 10/1/2017 $145.12 0521 T1015 1 F 5321 STOCKTON BLVD SACRAMENTO CA 95820 FQ 035 34 1447332036 WELLSPACE HEALTH 01 006 10/1/2017 $145.12 0521 T1015 1 F 3900 47TH AVE SACRAMENTO CA 95824 FQ 035 34 1447332036 WELLSPACE HEALTH 01 008 10/1/2018 $207.34 0521 T1015 1 F 4150 TRUXEL ROAD SACRAMENTO CA 95834 FQ 035 34 1447332036 WELLSPACE HEALTH 01 001 10/1/2018 $207.34 0521 T1015 1 F 8233 E STOCKTON BLVD SACRAMENTO CA 95828 FQ 035 34 1811262348 WELLSPACE HEALTH 01 002 1/1/2018 $128.00 0521 T1015 1 F 3133 PROFESSIONAL DR AUBURN CA 95603 FQ 035 31 1811262348 WELLSPACE HEALTH 01 001 10/1/2017 $128.00 0521 T1015 1 F 5 MEDICAL PLAZA ROSEVILLE CA 95661 FQ 035 31 1811302045 WELLSPACE HEALTH 01 001 10/1/2017 $160.60 0521 T1015 1 F 7601 HOSPITAL DRIVE SACRAMENTO CA 95823 FQ 035 34 1538334065 WEST COUNTY HEALTH CENTER 01 001 10/1/2018 $166.76 0521 T1015 1 F 6800 PALM AVE SEBASTOPOL CA 95472 FQ 035 49 1861809501 WEST COUNTY HEALTH CENTER 01 001 10/1/2018 $187.85 0521 T1015 1 F 652 PETALUMA AVE SEBASTOPOL CA 95472 FQ 035 49 1598786352 WEST COUNTY HEALTH CENTERS 01 001 10/1/2018 $174.09 0521 T1015 1 F 16312 3RD ST GUERNEVILLE CA 95446 FQ 035 49 1598768962 WEST COUNTY HEALTH CTRS 01 001 10/1/2018 $184.41 0521 T1015 1 F 3802 MAIN ST OCCIDENTAL CA 95465 FQ 035 49 1851513469 WESTERN SIERRA MED CLIN 01 002 7/20/2018 $207.68 0521 T1015 1 F 8665 SALMON AVENUE KINGS BEACH CA 96143 FQ 035 31 1851513469 WESTERN SIERRA MED CLIN 01 003 7/20/2018 $207.68 0521 T1015 1 F 12183 LOCKSLEY LANE AUBURN CA 95602 FQ 035 31 1851513469 WESTERN SIERRA MED CLIN 01 004 7/20/2018 $207.68 0521 T1015 1 F 3111 PROFESSIONAL DRIVE AUBURN CA 95603 FQ 035 31 1851513469 WESTERN SIERRA MED CLIN 01 005 7/20/2018 $207.68 0521 T1015 1 F 10544 SPENCEVILLE ROAD PENN VALLEY CA 95946 FQ 035 29 1851513469 WESTERN SIERRA MED CLIN 01 001 10/1/2018 $210.59 0521 T1015 1 F 209 NEVADA ST DOWNIEVILLE CA 95936 FQ 035 46 1063496396 WESTERN SIERRA MEDICAL 02 001 10/1/2018 $132.69 0521 T1015 1 F 844 OLD TUNNEL ROAD GRASS VALLEY CA 95945 FQ 035 29 1306967021 WEST OAKLAND HEALTH COUN 01 001 10/1/2018 $251.42 0521 T1015 1 F 700 ADELINE ST OAKLAND CA 94607 FQ 035 01 1457471500 WEST OAKLAND HEALTH COUNCIL 01 001 10/1/2017 $ - 0521 T1015 1 A 1890 ALCATRAZ AVE BERKELEY CA 94703 AD 035 01 1831287978 WESTSIDE FAMILY HLTH CTR 01 001 10/1/2018 $152.75 0521 T1015 1 F 1711 OCEAN PARK BLVD SANTA MONICA CA 90405 FQ 035 19 1992142277 WEST SIDE HEALTH CARE 01 001 8/15/2018 $174.05 0521 T1015 1 R 100 E NORTH ST TAFT CA 93268 RH 035 15 1881730661 WESTSIDE MEDICAL GROUP 01 001 10/1/2018 $ 93.30 0521 T1015 1 R 450 OLLER ST MENDOTA CA 93640 RH 035 10 1831235605 WESTSIDE MEDICAL GROUP 01 001 10/1/2018 $105.02 0521 T1015 1 R 1107 O ST FIREBAUGH CA 93622 RH 035 10 1083003321 WHITE MEMORIAL COMMUNITY 01 001 4/1/2018 $166.60 0521 T1015 1 F 1828 E CESAR E CHAVEZ AV LOS ANGELES CA 90033 FQ 035 19 1437551652 WILLITS HOSPITAL INC 01 001 10/1/2017 $229.07 0521 T1015 1 U 3 MARCELA DR WILLITS CA 95490 RH 035 23 1376570473 WILLOW CREEK/SIX RIVERS 01 001 10/1/2018 $171.32 0521 T1015 1 U HWY 96 WILLOW CREEK CA 95573 RH 035 12 1154625085 WILLOWS FIRSTCARE INC 01 001 10/1/2018 $ 90.39 0521 T1015 1 R 460 W SYCAMORE ST WILLOWS CA 95988 RH 035 11 1932194586 WILMINGTON COMMUNITY CLN 01 001 10/1/2018 $128.98 0521 T1015 1 F 1009 N AVALON BLVD WILMINGTON CA 90744 FQ 035 19 1992736086 WINTERS HEATHCARE FNDTN 01 001 10/1/2018 $214.48 0521 T1015 1 F 23 MAIN ST WINTERS CA 95694 FQ 035 57 1417089764 WOMEN'S & CHILDREN'S 01 001 10/1/2018 $ 95.93 0521 T1015 1 R 57463 29 PALMS HWY YUCCA VALLEY CA 92284 RH 035 36 1326114158 WOMEN'S HEALTH CLINIC 01 001 10/1/2018 $384.29 0521 T1015 1 G 1001 POTRERO AVE SAN FRANCISCO CA 94110 FQ 035 38 1609926179 YASH PAL VERMA 01 001 10/1/2018 $ 90.56 0521 T1015 1 R 1850 WHITSON ST SELMA CA 93662 RH 035 10 1093095192 YEHOWA MEDICAL SERVICES 01 001 10/1/2018 $182.32 0521 T1015 1 F 1039 W FLORENCE AVENUE LOS ANGELES CA 90044 FQ 035 19 1700211703 YEHOWA MEDICAL SERVICES 01 001 10/1/2018 $173.65 0521 T1015 1 F 5320 S VERMONT AVE LOS ANGELES CA 90037 FQ 035 19 1801138698 YEHOWA MEDICAL SERVICES 01 001 10/1/2018 $182.32 0521 T1015 1 F 5720 IMPERIAL HWY SOUTH GATE CA 90280 FQ 035 19 1942640511 YUCCA FAMILY MEDICAL CARE 01 001 10/1/2018 $ 96.72 0521 T1015 1 R 57675 29 PALMS HIGHWAY YUCCA VALLEY CA 92284 RH 035 36

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