Preview
Filed: 7/21/2023 1:14 PM
JOHN D. KINARD - District Clerk
Galveston County, Texas
Envelope No. 77763446
By: Rolande Kain
THE BUZBEE LAW FIRM
7/21/2023 1:37 PM
www.txattorneys.com
JP Morgan Chase Tower
600 Travis, Suite 7500
Houston, Texas 77002
July 21, 2023
Via E-Service
Corey P. Parenton
#24095858
3500 North Causeway Blvd
Suite 820
Metairie, Louisiana 70002
Telephone: 504.838.0019
Facsimile: 504.838.0043
Counsel for Encore Dredging Partners, LLC
Re: Cause No.:22-CV-0729; Richard Villnave & Darius Stewart vs. Encore Dredging
Partners, LLC.; In the 10th Judicial District Court of Galveston County, Texas.
Counsel:
Enclosed please find the following with regard to the above-referenced matter:
ï‚· Bates label PLAINTIFF 000581 - 591 CLEAR CREEK CHIROPRACTIC
(BILLING)(DARIUS)
ï‚· Bates label PLAINTIFF 000592 - 656 CLEAR CREEK CHIROPRACTIC
(MEDICAL)(DARIUS)
ï‚· Bates label PLAINTIFF 000657 - 661 LONESTAR ORTHOPEDICS
(BILLING)(DARIUS)
ï‚· Bates label PLAINTIFF 000662 - 665 LONESTAR ORTHOPEDICS
(MEDICAL)(DARIUS)
Please consider this a formal supplement or response to any outstanding discovery,
including Requests for Production and Disclosures to which these documents may be responsive.
Should you have any questions or comments concerning this matter, please do not hesitate
to contact this office.
Very truly yours,
/s/ Daedra Minigan
Daedra Minigan
Legal Assistant of Caroline E. Adams
PLAINTIFF000581
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
02/07/2023 CSV 99203 1 NP Detailed 11 0.00 165.00
02/07/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/07/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/07/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/07/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/07/2023 CSV 97014 1 E-stim 11 0.00 45.00
02/07/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/09/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/09/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/09/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/09/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/09/2023 CSV 97014 1 E-stim 11 0.00 45.00
02/09/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/13/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/13/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/13/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/13/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/13/2023 CSV 97014 1 E-stim 11 0.00 45.00
Printed: 5/4/2023 6:18:49 PM Page 1 Of 10
PLAINTIFF000582
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
02/13/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/15/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/15/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/15/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/15/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/15/2023 CSV 97014 1 E-stim 11 0.00 45.00
02/15/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/21/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/21/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/21/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/21/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/21/2023 CSV 97014 1 E-stim 11 0.00 45.00
02/21/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/22/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/22/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/22/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/22/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/22/2023 CSV 97014 1 E-stim 11 0.00 45.00
Printed: 5/4/2023 6:18:49 PM Page 2 Of 10
PLAINTIFF000583
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
02/22/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
02/23/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
02/23/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
02/23/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
02/23/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
02/23/2023 CSV 97014 1 E-stim 11 0.00 45.00
02/23/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/01/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/01/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/01/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/01/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/01/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/01/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/02/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/02/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/02/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/02/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/02/2023 CSV 97014 1 E-stim 11 0.00 45.00
Printed: 5/4/2023 6:18:49 PM Page 3 Of 10
PLAINTIFF000584
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
03/02/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/06/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/06/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/06/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/06/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/06/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/06/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/08/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/08/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/08/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/08/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/08/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/08/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/09/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/09/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/09/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/09/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/09/2023 CSV 97014 1 E-stim 11 0.00 45.00
Printed: 5/4/2023 6:18:49 PM Page 4 Of 10
PLAINTIFF000585
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
03/09/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/09/2023 CSV 99213 1 EP Expanded 11 0.00 110.00
03/14/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/14/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/14/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/14/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/14/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/14/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/15/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/15/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/15/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/15/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/15/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/15/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/20/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/20/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/20/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/20/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
Printed: 5/4/2023 6:18:49 PM Page 5 Of 10
PLAINTIFF000586
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
03/20/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/20/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/22/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/22/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/22/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/22/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/22/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/22/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/23/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/23/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/23/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/23/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/23/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/23/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/27/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/27/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/27/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/27/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
Printed: 5/4/2023 6:18:50 PM Page 6 Of 10
PLAINTIFF000587
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
03/27/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/27/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/29/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/29/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/29/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/29/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/29/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/29/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
03/30/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
03/30/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
03/30/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
03/30/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
03/30/2023 CSV 97014 1 E-stim 11 0.00 45.00
03/30/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/10/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/10/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/10/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
04/10/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
Printed: 5/4/2023 6:18:50 PM Page 7 Of 10
PLAINTIFF000588
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
04/10/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/10/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/10/2023 CSV 99213 1 EP Expanded 11 0.00 110.00
04/13/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/13/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/13/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
04/13/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
04/13/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/13/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/17/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/17/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/17/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
04/17/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
04/17/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/17/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/19/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/19/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/19/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
Printed: 5/4/2023 6:18:50 PM Page 8 Of 10
PLAINTIFF000589
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
04/19/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
04/19/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/19/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/24/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/24/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/24/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
04/24/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
04/24/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/24/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
04/26/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
04/26/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
04/26/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
04/26/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
04/26/2023 CSV 97014 1 E-stim 11 0.00 45.00
04/26/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
05/01/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00
05/01/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00
05/01/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00
Printed: 5/4/2023 6:18:50 PM Page 9 Of 10
PLAINTIFF000590
Clear Creek Chiropractic Center
624 W Main Suite 102
League city TX 77573
Phone: 281-525-4130 Fax: 409-600-2192
Superbill
Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023
Patient Information Payor Information
Darius Stewart
2515 Winged Dove Dr.
League city , TX 77573
Account: 2279 Insurance Phone:
Date of birth: 9/25/1971 Insured ID:
Employer: Insurance Policy Group:
Insurance Plan Name:
Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy,
(M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder,
(M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar
reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of
Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt
Date Type Code Mod Units Description Date of injury POS Tax Amount
05/01/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00
05/01/2023 CSV 97014 1 E-stim 11 0.00 45.00
05/01/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00
Provider Information Total Charges $9,025.00
Name: Louie Elmer Robinson IV Total Taxes $0.00
License: 12547 Total $9,025.00
Tax ID: 82-3979184
NPI: 1508278805
Printed: 5/4/2023 6:18:50 PM Page 10 Of 10
PLAINTIFF000591
PLAINTIFF000592
Chart Notes 624 W Main Suite 102
Darius Stewart League city TX 77573
Phone: 281-525-4130
Fax: 409-600-2192
Patient: Stewart, Darius Acct #: 2279 DOB: 09/25/1971
Ins Co: Pol #: Insured ID:
Date 02/07/2023
Provider: Louie Elmer Robinson IV
Subjective:
Patient was standing in a boat duck hunting in the bay. Boat hit a dredge pipe in the intercostal canal. Boat
was going approximately 25 MPH. Boat came to an imm
Preview
Filed: 7/21/2023 1:14 PM JOHN D. KINARD - District Clerk Galveston County, Texas Envelope No. 77763446 By: Rolande Kain THE BUZBEE LAW FIRM 7/21/2023 1:37 PM www.txattorneys.com JP Morgan Chase Tower 600 Travis, Suite 7500 Houston, Texas 77002 July 21, 2023 Via E-Service Corey P. Parenton #24095858 3500 North Causeway Blvd Suite 820 Metairie, Louisiana 70002 Telephone: 504.838.0019 Facsimile: 504.838.0043 Counsel for Encore Dredging Partners, LLC Re: Cause No.:22-CV-0729; Richard Villnave & Darius Stewart vs. Encore Dredging Partners, LLC.; In the 10th Judicial District Court of Galveston County, Texas. Counsel: Enclosed please find the following with regard to the above-referenced matter: ï‚· Bates label PLAINTIFF 000581 - 591 CLEAR CREEK CHIROPRACTIC (BILLING)(DARIUS) ï‚· Bates label PLAINTIFF 000592 - 656 CLEAR CREEK CHIROPRACTIC (MEDICAL)(DARIUS) ï‚· Bates label PLAINTIFF 000657 - 661 LONESTAR ORTHOPEDICS (BILLING)(DARIUS) ï‚· Bates label PLAINTIFF 000662 - 665 LONESTAR ORTHOPEDICS (MEDICAL)(DARIUS) Please consider this a formal supplement or response to any outstanding discovery, including Requests for Production and Disclosures to which these documents may be responsive. Should you have any questions or comments concerning this matter, please do not hesitate to contact this office. Very truly yours, /s/ Daedra Minigan Daedra Minigan Legal Assistant of Caroline E. Adams PLAINTIFF000581 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 02/07/2023 CSV 99203 1 NP Detailed 11 0.00 165.00 02/07/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/07/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/07/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/07/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/07/2023 CSV 97014 1 E-stim 11 0.00 45.00 02/07/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/09/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/09/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/09/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/09/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/09/2023 CSV 97014 1 E-stim 11 0.00 45.00 02/09/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/13/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/13/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/13/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/13/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/13/2023 CSV 97014 1 E-stim 11 0.00 45.00 Printed: 5/4/2023 6:18:49 PM Page 1 Of 10 PLAINTIFF000582 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 02/13/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/15/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/15/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/15/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/15/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/15/2023 CSV 97014 1 E-stim 11 0.00 45.00 02/15/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/21/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/21/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/21/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/21/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/21/2023 CSV 97014 1 E-stim 11 0.00 45.00 02/21/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/22/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/22/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/22/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/22/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/22/2023 CSV 97014 1 E-stim 11 0.00 45.00 Printed: 5/4/2023 6:18:49 PM Page 2 Of 10 PLAINTIFF000583 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 02/22/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 02/23/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 02/23/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 02/23/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 02/23/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 02/23/2023 CSV 97014 1 E-stim 11 0.00 45.00 02/23/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/01/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/01/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/01/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/01/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/01/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/01/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/02/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/02/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/02/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/02/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/02/2023 CSV 97014 1 E-stim 11 0.00 45.00 Printed: 5/4/2023 6:18:49 PM Page 3 Of 10 PLAINTIFF000584 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 03/02/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/06/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/06/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/06/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/06/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/06/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/06/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/08/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/08/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/08/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/08/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/08/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/08/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/09/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/09/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/09/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/09/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/09/2023 CSV 97014 1 E-stim 11 0.00 45.00 Printed: 5/4/2023 6:18:49 PM Page 4 Of 10 PLAINTIFF000585 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 03/09/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/09/2023 CSV 99213 1 EP Expanded 11 0.00 110.00 03/14/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/14/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/14/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/14/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/14/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/14/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/15/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/15/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/15/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/15/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/15/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/15/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/20/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/20/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/20/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/20/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 Printed: 5/4/2023 6:18:49 PM Page 5 Of 10 PLAINTIFF000586 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 03/20/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/20/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/22/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/22/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/22/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/22/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/22/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/22/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/23/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/23/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/23/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/23/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/23/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/23/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/27/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/27/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/27/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/27/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 Printed: 5/4/2023 6:18:50 PM Page 6 Of 10 PLAINTIFF000587 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 03/27/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/27/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/29/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/29/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/29/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/29/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/29/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/29/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 03/30/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 03/30/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 03/30/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 03/30/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 03/30/2023 CSV 97014 1 E-stim 11 0.00 45.00 03/30/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/10/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/10/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/10/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 04/10/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 Printed: 5/4/2023 6:18:50 PM Page 7 Of 10 PLAINTIFF000588 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 04/10/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/10/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/10/2023 CSV 99213 1 EP Expanded 11 0.00 110.00 04/13/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/13/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/13/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 04/13/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 04/13/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/13/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/17/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/17/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/17/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 04/17/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 04/17/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/17/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/19/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/19/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/19/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 Printed: 5/4/2023 6:18:50 PM Page 8 Of 10 PLAINTIFF000589 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 04/19/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 04/19/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/19/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/24/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/24/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/24/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 04/24/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 04/24/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/24/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 04/26/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 04/26/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 04/26/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 04/26/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 04/26/2023 CSV 97014 1 E-stim 11 0.00 45.00 04/26/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 05/01/2023 CSV 97110 2 Therapuetic Exercises 2 unit 11 0.00 110.00 05/01/2023 CSV 97012 1 Traction/Mechanical 11 0.00 45.00 05/01/2023 CSV 98941 1 Manipulation 3-4 Region 11 0.00 65.00 Printed: 5/4/2023 6:18:50 PM Page 9 Of 10 PLAINTIFF000590 Clear Creek Chiropractic Center 624 W Main Suite 102 League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Superbill Superbill Date: 05/04/2023 Service 2/7/2023 thru 5/1/2023 Patient Information Payor Information Darius Stewart 2515 Winged Dove Dr. League city , TX 77573 Account: 2279 Insurance Phone: Date of birth: 9/25/1971 Insured ID: Employer: Insurance Policy Group: Insurance Plan Name: Dx: (S13.4XXA) Sprain of Cervical Ligts, Intial, (M50.11) Cervical disc, radiculopathy High level, (M50.121) Cervical disc at C4/5 radiculopathy, (M50.122) Cervical disc at C5/6 radiculopathy, (M50.123) Cervical disc at C6/7 radiculopathy, (S46.011A) Rotator cuff strain RT shoulder, (M75.51) Bursitis of RT shoulder, (M25.511) Pain in RT shoulder, (S33.5XXA) Sprain of lumbar ligts, initial, (M54.16) Radiculopathy, lumbar reg, (S23.3XXA) Sprain of ligts of thoracic spine, (M54.6) Pain in thoracic spine, (M62.830) Muscle spasm of back, (S13.4XXD) Sprain of Cervical Ligts, Subsequent, (S33.5XXD) Sprain of lumbar ligts, subsqt Date Type Code Mod Units Description Date of injury POS Tax Amount 05/01/2023 CSV 98943 1 Maunipulation Ext 11 0.00 30.00 05/01/2023 CSV 97014 1 E-stim 11 0.00 45.00 05/01/2023 CSV 97010 1 Hot/Cold Packs 11 0.00 25.00 Provider Information Total Charges $9,025.00 Name: Louie Elmer Robinson IV Total Taxes $0.00 License: 12547 Total $9,025.00 Tax ID: 82-3979184 NPI: 1508278805 Printed: 5/4/2023 6:18:50 PM Page 10 Of 10 PLAINTIFF000591 PLAINTIFF000592 Chart Notes 624 W Main Suite 102 Darius Stewart League city TX 77573 Phone: 281-525-4130 Fax: 409-600-2192 Patient: Stewart, Darius Acct #: 2279 DOB: 09/25/1971 Ins Co: Pol #: Insured ID: Date 02/07/2023 Provider: Louie Elmer Robinson IV Subjective: Patient was standing in a boat duck hunting in the bay. Boat hit a dredge pipe in the intercostal canal. Boat was going approximately 25 MPH. Boat came to an imm