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Okaloosa County BOCC — September 16, 2014 — Final Invoice-Intermedix — reading text
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Invoice
Date Invoice #
Advanced Data Processing, Inc. 5/31/2014 INVADPI14549
6451 N. Federal Highway
Suite 1000
Ft. Lauderdale, FL 33308
954-308-8700
Tax ID # 22-3875190
Bill To
Dino Villani
Okaloosa County
90 College Blvd East
Niceville FL 32578
Terms Due Date PO # Billing Period From Billing Period To
Net 30 6/30/2014 5/1/2014 5/18/2014
Description Quantity Rate Amount
Gross Collections 5/1/2014 - 5/18/2014 364,020.69 0.0858 0.00
Patient Refunds -4,129.15 0.0858 0.00
Medicaid Collections -33,077.57 0.0858 0.00
Net Collections 335,072.27 0.0858 28,749.20
Medicaid Account Processing Fee - 5/1/14 - 5/18/14 119.00 11.40 1,356.60
Privacy Notice Mailing - 5/1/14 - 5/18/14 1.00 754.83 754.83
Thank you for your business. Total $30,860.63