transmittal philhealth.docx

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Republic of the PhilippinesPhilippines Health Insurance Corporation

Lucena Grand Terminal, Lucena City

Category:PRIVATE-EMPLOYEDN!"IL#R"IL Transmittal No:Hospital# Health Pro$ider: SMMC Paanakan%ddress: #47 P. ALCANTARA ST. BRGY. VII-B, SAN PABLO CITY, LAGUNA Philhealth%ccreditation No&: M41017565

PHILH%LTH

N'()R

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P%TINT

C*N"IN(NT

PRI*+

"IN%L

+I%GN*I

CL%I(

%(*'NT

08-025547699-1

Romel S.Ca!"llo

Cael A#$%e& M.Ca!"llo

05-15-2016 TO05-17-2016

'(P()(-0-0-(* P+(9

4,7 EES AO'VIA LMP/

CEPALIC ILAOR

P 1/550.00

Total No& of Claims: - CL%I(

P%e3a%e$ &

%PRIL + & N**L, RN

ame S"#a!%e o o3"!al Re3%ee#!a!"e


2/7




PHILH%LTH

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0-8025422490-

5

ARLEEC+ASAY

VILLA+EVA

ARLEEC+ASAY

VILLA+EVA

04-17-2015 TO

04-18-2015

'4P4)4-0-0-4* P+40 EES AO'

VIA LMP/

CEPALIC ILAOR

P 8/ 000.00

0-8025422490-5

ARLEEC+ASAY

VILLA+EVA

ASLEY RAVEC+ASAY

VILLA+EVA

04-17-2015 TO04-18-2015

:+LL TERM AY'IRL DELIVERED

VIA SDP 1/ 550.00

0-8051251815-(

ISAEL CAI'+ECILLO

ISAEL CAI'+ECILLO

0(-19-2015 TO0(-20-2015

'(P()(-0-0-(* P+40 EES AO'

VIA LMP/CEPALIC I

LAOR

P 8/ 000.00

0-8051251815-(

ISAEL CAI'+ECILLO

;+EE ALLYSACAI'

+ECILLO

0(-19-2015 TO0(-20-2015


VIA SDP 1/ 550.00

Total No& of Claims: . CL%I(

P%e3a%e$ &


3/7

HRLN L%NI & N**L, RN





PHILH%LTH

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0-80511(4265-5

REATOC+ILLAE+SA

MICELLEC+ATOE+SA

0(-06-2015TO

0(-07-2015

'2P2)2-0-0-2* P+ 40EES AO' VIA

LMP/ CEPALIC ILAOR

P 8/ 000.00

0-80511(4265-5

REATOC+ILLAE+SA

REA MAEC+ATOE+SA

0(-06-2015TO

0(-07-2015

:+LL TERM AY'IRL DELIVERED VIA

SDP 1/ 550.00

0-8050718927-(

MAR ATOYLA+RESTA

ATAL

RA;+ELCERVAA

ATAL

0(-22-2015TO

0(-2(-2015

'4P4)4-0-0-4* P+ 41EES AO' VIALMP/ CEPALIC I

LAOR

P 8/ 000.00

0-8050718927-(

MAR ATOYLA+RESTA

ATAL

MARIELCERVAA

ATAL

0(-22-2015TO

0(-2(-2015

:+LL TERM AY'IRL DELIVERED VIA

SDP 1/ 550.00

0-8025(92277-

(


4/7

(VILLALOOS

ALAIALAI

SORIAOTO

0(-09-2015OY DELIVERED VIA

SD

Total No& of Claims: / CL%I(

P%e3a%e$ &






PHILH%LTH

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0-8025526(58-0 ROSE-APARDO TARIM ROSE-APARDO TARIM 05-06-2015 TO05-08-2015

'(P()(-0-0-(* P+(9 2,7 EES

AO' VIA LMP/CEPALIC I

LAOR

P 8/ 000.00

0-8025526(58-0

ROSE-APARDO TARIM

A:YIA TARIM05-06-2015 TO

05-08-2015


VIA SDP 1/ 550.00

0-80257848((-

0

CERRY MAYLOPE=

SERRAO

CERRY MAYLOPE=

SERRAO

04-0(-2015 TO

04-04-2015

'2P2)2-0-0-2* P+40 5,7 EESAO' VIA LMP/CEPALIC I

LAOR

P 8/ 000.00


5/7

0-80257848((-0

CERRY MAYLOPE=

SERRAO

AI=ER LOPE=SERRAO

04-0(-2015 TO04-04-2015

:+LL TERM AYOY DELIVERED

VIA SDP 1/ 550.00

Total No& of Claims: . CL%I(

P%e3a%e$ &






PHILH%LTHN'()R

N%( *"(()R

N%( *"P%TINT

C*N"IN(NTPRI*+

"IN%L+I%GN*I

CL%I(%(*'NT

0-2050(06266-7

LIE=L ALEMAAMO'+IS

LIE=L ALEMAAMO'+IS

0(-15-2015 TO0(-17-2015

'(P()(-0-0-(* P+(9 6,7 EESAO' VIA LMP/CEPALIC I

LAOR

P 8/ 000.00

0-2050(06266-

7

LIE=L ALEMA

AMO'+IS

TI::AY LAIRAMO'+IS

ALYOYO

0(-15-2015 TO

0(-17-2015


VIA SD

P 1/ 550.00

0-004(2((475- REYALDO AA


6/7

5RA=A

CORISTA


7/7

0-80506945(7-6

MARLOMARA>O

CADAI'

PRICESS ELLIEAEIDO

CADAI'

04-11-2015 TO04-12-2015


VIA SDP 1/ 550.00

0-9050089674-

(

IL:REDOMARTIE=

VILLA+EVA

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