The URL can be used to link to this page

Home My WebLink About06-5364 TABAS & ROSEN, P.C, BY: LEWISC. TRAUFFER 1. D. 116026-7 22ndFl.,1845 Walnut street Ph i 1 a . P A 19103 (215) S69,~5050,> P/a;ntiff(s) THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17033 ATTORNEYFOR Plaintiff vs Defendams(s) JOSEPH L. POPP, JR, 389 Big Spring Road New Cumberland, PA 17070 COURT OF COMMON PLEAS DIVISION CUMBERLAND COUNTY TERM. No. Ol. - S31.lf {!'u,trtllM IIOT I CE COMPLAINT - CIVIL ACTION AVI so You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered aga i nst you by the court wi thout further notice for any money claimed in the complaint or for any other claim or reL i ef requested by the plaintiff, You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 (717)249-3166 (800)990-9108 Le han demandado a usted en La corte. Si usted qui ere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene veinte (20) dias de plazo aL partir de la fecha de La demandanda y la notificacion. Hace falta asentar una comparencia escrita 0 en persona 0 con un abogado y entregar a la corte en for escrita sus defensas 0 sus objeci ones alas demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tamara medidas y puede continuar La demandanda en contra suya sin previo aviso 0 notificacion. Ademas, La corte puede decidir a favor deL demandante y requiere que usted cumpLa con todas las provisiones de esta demanda. Usted puede perder dinero 0 sus propiedades u otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATAMENTE. SI US TED NO TIENE ABOGADO, VAYA PERSONALMENTE 0 LLAME POR TELEFONO A LA OFICINA MENCIONADA A CONTINUACI6N. ESTA OFICINA LE PUEDE PROVEER LA INFORMACI6N NECESARIA PARA CONTRATAR A UN ABOGADO. SI USTED CARECE DE LOS MEDIOS NECESARIOS PARA CONTRATAR A UN ABOGADO, DICHA OFICINA LE PUEDE SUMINISTRAR LA I NFORMAC16N NECESARIA ACERCA DE AQUELLAS AGENCIAS QUE OFRECEN SERVICIOS LEGALES A LAS PERSONAS QUE TIENEN DERECHO A RECIBIR TAL AYUDA GRATIS 0 A UNA CUOTA REDUCIDA. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, PA 17013 (717)249-3166 ( 80 0 ) 990 -' 91 08 COMPLAINT - CIVIL ACTION THE MILTON S. HERSHEY MEDICAL CENTER VS. JOSEPH L. POPP, JR. 1. Plaintiff is a non-profit corporation located at the address indicated in the caption hereof, 2. Defendant is an individual who resides at the address indicated in the caption hereof. 3. As the result of a certain medical condition, defendant was treated by the plaintiff on Feb. 10, 2005 thru Feb. 22, 2005. 4. The amounts, quantities and nature of said medical care, the dates on which said medical care was rendered, and the charges therefore are set forth in Exhibit "A'l which is incor- porated herein as if set forth at length. 5. Said medical care was commensurate with the condition of defendant and was necessary for the health and welfare of defendant. 6. At or about the time of defendant's treatment by plain- tiff, implied, constructive and oral contracts arose between defendant and plaintiff by the terms of which defendant became obligated to pay plaintiff the charges for the medical care rendered by plaintiff to defendant. 7. Defendant refuses to pay the balance due although plaintiff has made demand that defendant do so. 8. As a result of the foregoing, there is due and owing from defendant to plaintiff the sum indicated in Exhibit "A". WHEREFORE, plaintiff demands judgment against defendant for the sum of $28,158.62 plus six percent (6%) interest per annum from the date of discharge to the date of judgment, record costs and non-record costs. TABAS & ROSEN, P.C. ~~ ~ LEWIS C, T UFFER, ESQUIRE Attorney for Plaintiff MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/11/06 at 02:55 PM Guarantor: POPP JOSEPH L JR 389 BIG SPRING RD NEW CUMBERLAN, PA 17070-0000 Date 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 U2/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 0::;:(10/05 02/10/05 102/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 1(12/10/05 I Sve Code I 16502 42210 46061 46111 46112 46122 46168 46177 46220 46352 46473 46479 46486 46487 46630 46673 46712 46717 46794 46924 46925 101003 101004 101005 101021 104002 104009 104028 104042 104060 104111 104131 104145 104711 105052 105059 105656 106011 245206 245553 246057 246332 PAGE: 1 I Units I 1 1 4 2 1 1 3 1 1 1 1 1 6 1 1 1 1 1 1 1 2 1 1 1 4 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 2 1 Patient: POPP JOSEPH L JR Visit #: 6501379 - Continue - A' { Debits Credits Description ADULT LEVEL I I TRAUMA KNEE SPLINT IV SOLUTION PRIME MACRO/MICRO TUB SECONDARY SET/TUBING HEMOCCULT, STOOL MICRO-FACIAL TRAY COLLAR RIGID (ASPEN) SIM REP FACE EAR EYE SIM REP TRK!LMB 7.6-1 ER,CRITICL CARE,30-75 CLOSED DRAIN SYSTEM S SUTURING SUPPLIES WOUND TX SUPPLIES ARTERIAL PUNCTURE BLADDER CATH, SIMPLE 12 LEAD EKG-TRACING 0 NONINVAS PULSE OX, MU IV PUMP, SINGLE LINE IV INFUSION TX 0-1 HR IV 1NF TX,EA ADDL HR ABO BLOOD GROUP ANTIBODY SCREEN RH TYPE COMPAT, IMMED SPIN ALCOHOL (ETOH), BLOOD AMYLASE, BLOOD IONIZED CALCIUM CREATININE, BLOOD GLUCOSE, BLOOD BLOOD GAS PANEL W/02 POTASSIUM (K), BLOOD SODlt~ (NA), BLOOD DRUG SCREEN, URINE PARTIAL THROMBOPLAS T PROTHROMBIN TIME CBC '\;J/PLT AUTO URINALYSIS-BASIC & MI LIDOCAINE 10MG/ML LIDOCAINE 1 ML CEFAZOLIN 1 GM/5 ML METHYLENE BLUE 10 ML 2671.00 109.00 48.00 28.00 4.00 7.00 603.00 95.00 265.00 252.00 1064.00 19.00 582.00 24.00 40.00 43.00 106.00 86.00 3.00 188.00 186.00 19.00 34.00 18.00 256.00 47.00 40.00 79.00 12.00 11.00 138.00 12.00 12.00 88.00 34.00 21.00 28.00 20.00 4.20 3.75 3.00 7.75 --------------------------------------------------------------------------------- MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/11/06 at 02:55 PM Guarantor: POPP JOSEPH L JR 389 BIG SPRING RD NEW CUMBERLAN, PA 17070-0000 Date 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 02/10/05 102/10/05 02/10/05 02/10/05 02/11/05 02/11/05 02/11/05 02/11/05 02/11/05 02/11/05 02/11/05 02/11/05 02/11/05 CJ2/11/05 02/11/05 02/11/05 02/11/0S 02/11/05 02/12/05 02/12/05 02/12/05 02/12/05 02/12/05 02/12/05 02/12/05 02/12/05 02/12/05 02/13/05 02/13/05 102/13/05 I Svc Code I 246764 305621 307101 307220 307310 310501 310516 310519 310528 310534 310560 310567 310694 310704 621044 670334 10212 246021 246057 246705 246706 248225 250092 272979 272987 274324 307101 307308 347037 670825 10212 246037 250092 272979 272987 600520 621044 627070 670334 1068 1072 10212 Description DIPHTHERIA TETANUS O. 1 KNEE 1-2 VIEWS RIGHT 1 CHEST 1 VIEW 1 PELVIS 1-2 VIEWS 1 KNEE 1-2 VIEWS LEFT 1 CT HEAD UNENHANCED 1 CT THORAX ENHANCED 1 CT ABDOMEN ENHANCED 1 CT SINUS MAXILLOFAC U 1 CT MULTIPLANAR 3D 1 CT C-SPINE UNENHANCED 1 CT PELVIS ENHANCED 1 CT TRAUMA SPINE RECON 1 OMNIPAQUE 300MG/ML 15 1 I V SODIUM CHLORIDE 0 2 IV INFUSION SET, UNIV 1 T INTERMEDIATE CARE U 1 BACITRACIN 15 GM 1 CEFAZOLIN 1 GM/5 ML 2 MORPHINE SULFATE 4 MG 1 MORPHINE SULFATE 2 MG 3 SENNA SYRUP 1ML 1 OXYCODONE APAP 1TAB 6 FAMOTIDINE 20MG PRE-M 2 CEFAZOLIN 1 GM PRE-MI 4 HUMULIN R 200 CHEST 1 VIEW 1 FEMUR AP&LAT VIEWS LE 1 MRI C SPINE UNENHANCE 1 COLLAR ASPEN CERV AD 1 T INTERMEDIATE CARE U 1 BISACODYL 10 MG 1 OXYCODONE APAP 1TAB 6 FAMOTIDINE 20MG PRE-M 2 CEFAZOLIN 1 GM PRE-MI 6 SPIRO INCENTIVE ADULT 1 I V SODIUM CHLORIDE 0 3 IV EXT SET 90" W/FLAS 1 IV INFUSION SET, UNIV 1 THERAPEUTIC ACTIV 15 1 GAIT TRAINING 15MIN 1 T INTERMEDIATE CARE U 1 PAGE: 2 Patient: POPP JOSEPH L JR Visit #: 6501379 Debits Credits I Units I 84.70 127.00 109.00 143.00 127.00 681.00 1411.00 975.00 868.00 515.00 755.00 1107.00 515.00 74.00 12.00 8.00 1415.00 4.25 3.00 2.35 6.90 5.50 6.30 19.30 20.60 48.25 109.00 150.00 1479.00 74.00 1415.00 2.10 6.30 19.30 30.90 7.00 18.00 17.00 8.00 48.00 48.00 1415.00 -------------------------------------------------------------------------------- - Continue - A -1- MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/11/06 at 02:55 PM PAGE: 3 Guarantor: POPP JOSEPH L JR 389 BIG SPRING RD NEW CUMBERLAN, PA 17070-0000 Patient: POPP JOSEPH L JR Visit #: 6501379 Date 1 Svc Code I Description I Units I Debits Credits 02/13/05 246021 BACITRACIN 15 GM 1 4.25 02/13/05 250092 OXYCODONE APAP 1TAB 6 6.30 02/13/05 272979 FAMOTIDINE 20MG PRE-M 1 9.65 02/13/05 272987 CEFAZOLIN 1 GM PRE-MI 2 10.30 02/13/05 513354 MDI TREATMENT INITIAL 1 63.00 02/13/05 600518 OPTICHAMBER 1 10.00 02/13/05 621044 I V SODIUM CHLORIDE 0 1 6.00 02/13/05 622023 IRRIGATION SOD CHL O. 1 6.00 02/14/05 1072 GAIT TRAINING 1SMIN 2 96.00 02/14/05 10212 T INTERMEDIATE CARE U 1 1415.00 02/14/05 102019 GRAM STAIN 1 24.00 02/14/05 102100 CULTURE, BACTERIAL 1 60.00 02/14/05 250092 OXYCODONE APAP 1TAB 8 8.40 02/14/05 250667 KETOROLAC TROMETHAMIN 2 2.10 02/14/05 251908 TYLENOL EXTRA STRENGT 1 2.10 02/14/05 273298 COMBIVENT INHALER 14. 1 169.12 02/14/05 307102 CHEST 2 VIEW A/P LAT 1 131.00 02/15/05 674 THER EXERCISE 15 MIN 1 48.00 02/15/05 684 GAIT TRAINING 15 MIN 2 96.00 02/15/05 246021 BACITRACIN 15 GM 1 4.25 02/15/05 250092 OXYCODONE APAP 1TAB 6 6.30 02/15/05 250667 KETOROLAC TROMETHAMIN 2 2.10 09/01/05 900011 PATIENT PAY CHECK -1 50.00- lO/21/05 900011 PATIENT PAY CHECK -1 100.00- 11/30/05 980090 HOSPITAL BAD DEBT W/O -1 23230.32- 11/30/05 980091 HOSPITAL BAD DEBT PLA 1 23230.32 * - Not posted Balance: 23230.32 I fl-3 MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/11/06 at 02:55 PM Guarantor: POPP JOSEPH L JR 389 BIG SPRING RD NEW CUMBERLAN, PA 17070-0000 Date I Svc Code I 02/15/05 02/15/05 02/15/05 11/30/05 11/30/05 230837 232440 232673 980090 980091 * - Not posted Description KETOROLAC TAB 10MG ENDOCET 5-325 TABLET COMBIVENT INHALER HOSPITAL BAD DEBT W/O HOSPITAL BAD DEBT PLA It-L( PAGE: 1 Patient: POPP JOSEPH L JR Visit #: 5289578 I Units I 10 30 15 -1 1 Debits 8.50 7.50 87.30 103.30 Balance: Credits 103.30- 103.30 I MS HERSHEY MEDICAL CENTER 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 01/11/06 at 02:56 PM PAGE: 1 Guarantor: POPP JOSEPH L JR 389 BIG SPRING RD NEW CUMBERLAN, PA 17070-0000 Patient: POPP JOSEPH L JR Visit #: 5312304 Date I Sve Code I Description I Unitsl Debits Credits 02/22/05 11/30/05 11/30/05 48230 980090 980091 DUPLEX SCN EV-LIMITED HOSPITAL BAD DEBT W/O HOSPITAL BAD DEBT PLA 1 -1 1 348.00 348.00- 348.00 * - Not posted Balance: 348.00 I IJ-{ \;. .:( . . PENNSTATE !S:I The Milton S. Hershey Medical Center ... The College of Medicme JOSEPH l. JR POPP 389 BIG SPRING RD NEW CUMBERLAN PA 17010-3102 1 or 4 STATEMENT DATE: 02109/06 LAST STATEMENT DATE: 09/30/05 A.CCOUNT # 7001465 + IF ANY QUESTIONS, PLEASE CONTACT: MSHMC PA.TIENT FINA~c;IAL SERVICES DATE';\ "~~ ",,':::;' ,:;"," "",:;,.': ::,'_:'",::_,:,: :,:}",'f:;:;:?;::::'::;'E\'.::';o ";:'__:~-;';,':.,::,,';'::::\ >>> PATIENr:.lJsEPH lJR."POPP , . 5286424- PERFOIlHED BY: JOItlIATHAN 0 ICGDfII NO DMSltJ4 OF ENT PLACE OF SVC: DP PHYSICIAN if OVl8lDS 99024 V67.09 POST -oP FOl-llP VISIT D.DD 0,00 5~046U PERFORtlED BY: GEORGE 0 HAISH III HD PUCE OF SVC: DP PHVSICIAN * DV2VOS 99211 959.8 OOTPATIENT VISIT EST' 44.00 * 0312.5105 I<<C DR AUTO PAYMENT 22,,52- if 03l2SlDS ACT 6 AUTO AL~ANCE 21.68- 0.00 5~DS387 PERFOIItED BY: .DflATHAN D ~ HI) DIVISI~ OF ENT PLACE OF S't't: OP PHYSICIAN 03118105 9921:5 879.8 WTPATIENT VISIT EST 67.00 ()It/15IOS BALKE TRANSFER TO WAR 67.00 5512304 PERFDRttED BY: KARLA ANOERSCIl tm PLACE OF SVC: OP IIlSPIT Al DZlZV05 9397126 129.81 OOPLEX SCAN EV - LDlITED 113. DO ()It/15IDB BAlKE TRANSFER TO SUAR 113.00 6501379 PERFORHED 8Y: HARl E LOBELL MD DIY OF DIAS RADIOLOGY PLACE OF S't't: INPATIENT OVID/05 7126026 807.2 CT l1DlAX N.I'aIlT'RAST 9 364, DO OY3111)!; *.C OR AUTO PAYMENT ~64.00- 0.00 OVID/OS 7Zl9n6 9.59.8 CT PELYIS ENHKED 34t. DO OY311DS *.C DR AUTO PAYMENT 34Z,OD- 0.00 OVIOl05 74160Z6 807.0' C T ASlD1EN ENHKED 374, DO 0313110; I<<C OR AUTO PAYMENT 374.00- 0.00 PERFDlltED BY: CHRISTOPHER DEFLITCH HD DIY DF EHERS JmI PLACE OF SVC: EPtERSBI:Y RIIIf OVIO/OS 00999 9.59.8 tI1 CItARGE VISIT O,OD 0.00 TRAlItl OVID/I]!; 9924S21 04/15IOS 959.8 PERFOAHED BY: DERT A CHERRY HI) TRAl.tIA SURGERY DIY TRAlItA TEAK DIAS EVAl IHT 2978,00 8AlKE TRANSFER TO WAR 2978.00 OVID/D.5 9WB ()It/IS/OS 959.8 PERFORMED BY: UI1 MALKER HD OFFICE CONSULTATION 8ALKE TRANSFER TO SUAR 171,00 117.00 ~~~~ ' , ' ;rt' ' DCHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK I I Il--~ - 1 STATEMENT OF PHYSICIAN SERVICES -- 2 or 4 PENNSTATE !Sa The Milton S. Hers~ Medical Center . The College of Medicme IF ANY QUESTIONS. PlEASE CONTACT: MSHMC PATIENT FINANCIAL SERVICES "i~!.!::ii/1it:;i;11!li; '.".'.., '" ,," '" PERFORMED BY: PLACE OF SYC: INPATIENT OVID/O.5 7212SZ6 CJSlJ,8 CT CERVICAL SPINE HNIIAN 03/31/0.5 I<<.C DR AUTO PAYMENT 02/1D/05 73S6026.LT CJS9. 7 KNEE LIMITED 54.00 03/31/0.5 I<<.C DR AUTO PAMNT 02/ID/0.5 73.56D26.RT 823.00 KNEE LIMITEO 54.00 03131/0.5 *C DR AlJTD PAYtQT 02/10/0.5 7217026 CJS9.6 PELVIS ANTERPDSTER .51. DO ()3/31/0S I<<C DR AUTO PA'ftlENT 02/10/0.5 704SOZ6 CJS9.01 03/31/0.5 02/1010.5 7637526.59 9,59.8 03/31/0.5 ()2/1D/OS 7637526 959.8 ()3/31/D.5 02/10/0.5 7M8626 802.0 03/31/0.5 02/1D/0.5 7101026 03/31/0.5 807.01 02/10/0.5 93010 ~/1.5/0.5 786..50 02/11/005 99231 ~/1.5/D.5 9,59.8 02/11/0.5 7214126 03/31/005 723.1 OVIllD.5 73S.5026 03/31/0.5 7Z9.81 OVIll0.5 7101026 03/31/0.5 512.8 JOSEPH L JR POPP 389 BIG SPRING RD NEW CUMBERLAN PA 17070-3102 STATEMENT DATE: 02/09/06 lAST STATEMENT DATE: 09/30/05 ACCOUNT # 7001465 CT HEAD lIBHKED I<<C DR AUTO PAY11ENT 342.00 342.00- 0,00 2.52.00 2.52 . 00- 0,00 49.00 q.., , 00- 0,00 49.00 49.00- 0,00 336.00 336.00- 0.00 CT CD~AL SAGmAL teLIQ I<<C DR Al1TO PAYMENT CT CDIl[WAL SAGITTAL teLIQ J<<t DR AUTO PAYMENT CT ItAXILLOF AClAL LNENH I<<C DR AUTO PAYI1ENT PERFDIltED BY: MAHESH A HAllBI HD DIY OF DIAS RADIOLOSY CHEST 1 VIEN 54. DO I<<.C DR AlJTD PAYMENT 54.00- 0.00 54,00- 0,00 54.00- 0.00 .51.00- D.DO PERFDAHED BY: CtlUSTDPHER DEFLITCH It) DIY OF EHERS ImI PLACE OF SVC: EHERSEtCY REDI EtG ELECTIlQCARDID9RAH 62.00 BALKE TRANSFER TO SUAR 6Z.00 PERFORMED BY: Rl:BERT A CHERRY HD TRAIIIA SURGERY DIV PLACE OF SVC: INPATIENT DAILY tmPITAL tARE 78.00 BALKE TRANSFER TO SUAR 78.00 PERfDll1ED BY: PAUL ULAPQS MD DIY OF DIAS RADIOLOSY HRI SPINE CERVICAL l&N 422.00 I<<.C DR AlJTD PAYMENT 4ZZ,ao- 0.00 PERFORHED BY: TIttrrll'f J PIlSHER MIl DIV OF DUG RADIOLOGY FEKJR (TKIGH) EN: JDINT 51.00 *C DR AUTO PAYMENT .51. 00- 0.00 PERFDRHED BY: HANESH A MATHEN HD DIY DF DIAS RADIOLDSY CHEST 1 VIEN .54 ,DO I<<C DR AlJTD PAYMENT .54 . 00- O.DD o CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK I I /l -7 - ' }~ ;~:, , , PENNSTATE !S The Mihan S. Hershey Medical Center .. The CoUege of Medicme JOSEPH L JR POPP 389 BIG SPRING RD NEW CUMBERLAN PA 17070-3102 PAGE 3 or 4 STATEMEtrT DATE: 02109106 lAST STATEMENT DATE: 09/30/05 ACCOUNT # 7001485 OVll/D5 99253 CJ5lJ,09 04/1.5/05 t23.00 PERFORMED IV: 11ARK. A D4AlB t1D DRTtmPAEDICS DMSIl>>I OVll/D.5 lJ9Z54- 847,9 INITIAL INPT CCHWLTATI~ 3ZZ,oo 04/1.5/05 BALKE TRANSFER TO GUAR 321.00 PERFDIlHED IV: DEAN J 8(ltSALL MD OV12lOS 99253 379.11 INITIAL INPT CCHiULTlTI~ Zn.DO 04/1.510.5 BALKE TRANSFER TO GUAR 223.00 PERFORMED IV: IDERT A CHERRY MD TRUlA SURGERY DIY OVIVD.5 1)C}231 959.8 DAILY lIJSPITAl CARE 78.0D [)(j.11.5I05 IU.LKE TRANSFER TO GUAR 78.00 02/1310.5 99231 1JS9 ,8 DAILV IIJSPITAl CARE 78.00 O4/lSID.5 8ALKE TRANSFER TO GUAR 78.00 PERFORMED IV: DANIEL E CARNEY tI) TRUlA SURGERY DIY OV14/05 CJ9231 959.8 DAILV IIJSPITAl CARE 78.00 04/1.5105 8ALKE TRANSFER TO GUAR 78.00 PERFORMED BV: ROSER H TlJ'T1lI,I MD DIY OF DIAG RADIOLDSY OV14/D5 710202& !;1l.9 CHEST Z VIENS FRl>>IT ILAT 6&.00 03l3l/D5 t<<C OR AlIT'O PAYMENT 66. DO- 0.00 BALKE: JOSEPH L JR POPP $4477 .DO * INDICATES MEN FINKIAL ACTIVITY SHE LAST 8ILL. IF VtlI HAYE AN'( QUESTIH ,ABClJT THE AIGHI" VOOR. lNSURKE CCIIPANY PAID, ctM'ACT THEM DIRECTLY. FOR AN'( OTHER QUESTIH RESARDINS VlIJR BALKE, PLEASE aNTACT !IJR. OFFICE, IF PAYMENT HAS BEEN HADE, THAt<< Yoo AND DISREGARD THIS BILL. PJDIJ lIDIY PH THN. YtIJ FOR lSINS t'lSltI: PHYSICIANS SIKIJP FOR YIlIR PHYSICIAN SERVICES. IF YOO HAYE ANY QUESTIH REGARDING THIS BILL, PLEASE ctlfTACT is AT 717-,31-5069 OR 800-ZS4-Z6lCJ, 8E'Jlr4EB4 8:0DMI AND 5:30Pt4 tOIOAV TltIIlSM NElHSOAY DR IElNEEN &:ooAM AND 4:30PM TtlJRSDAV AND FRIDAY. ~f' , o CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK I I If~ 1i.~' ~o//q \. PENNSTATE !:S The Milton S. Hershey Medical Center ., The College of Medicme JOSEPH L JR POPP 389 BIG SPRING RD NEW CUMBERLAN PA 17010-3102 4 of 4 STATEMENT DATE: 02/09106 LAST STATEMENT DATE: 09/30105 ACCOUNT # 7001465 B A.LKE suttARY RfSPIN)IBLE PARTY JH SUARAHT'DR RESJO.\SIBILITY POLICY I TOTAL t 4477 .00 _________________!..f#.f.9!!.IAlIT: PJ,,€6SE OEIACH A'1AIDJ!.!!f!.AR.!LQ.M. PQ1t'WH!.9.!. STATEI1EHT Ylttf!_YSHJR PAYllfgJl.L________ STATEMENT DATE: GUARANTOR RESPONSIBILITY: MINIMUM PAYMENT: 02109/06 $ 4477.00 $ 4471.00 BF6 MSHMC PHYSICIANS GROUP BILUNC SERVICES POBOX 854 HERSHEY PA 17033-0854 00007001465 UP 0000000000447700020906 1...11.1.1.. .1.1.11...1. .1..11'1111.. 1111..11"1111..11.1..1.1 Md MSHMC PHYSICIANS GROUP T~ PO BOX 643313 PITTSBURGH PA 15264-3313 JOSEPH L JR POPP 389 BIG SPRING RD HEW CUMBERLAN PA 17070-3102 DfflCE IfSE ONLY CHECK ONE FOR CREDIT CARD PAYMENT, PLEASE fill.. IN INFORMATION BELOW --..-- -.-..---- ... ...... ..,,,.... ---- .--.--..-- ----- -'~'...~~o:,>... "::E~....fr-; :.~~;:....~_~~ - EXP DATE 7001465 _M/C VISA _DISC *:c,_-~~ 03/02/06 He: F5BO TV?: DMND CARDHOLDER NAME (PRINT) - -- ____ ____ _ R... -:._-~----=......._----: CREDIT CARD SIGNATURE ".4(r" r..}).;~ ,c' " ~ DCHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK I I It / POPP, JOSEPH L., Jr. /,l7001465 $23,681.62 (Hasp) 4,477.00 (Phys) VERIFICATION LINDA SCHLADER hereby states that she is the Team Manager, Customer Service of the Milton S. Hershey Medical Center and verifies that the statements made in the foregoing pleading are true and correct to the best of her knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties of 18 Pa, C.S. ~4904 relating to unsworn falsification to authorities. ct4fh ~ LINDA SCHLADER DATE: 9-/-0 ~ ~ ~ ~ U\ + \\:.. ~ ~ vt ~ ~ ~ !i ~ ~ ~ C~l'..,"-A. .. ,v-\~ ".:" .'-\ ~.- ~ V) _ \)'\'i~ ,,'":... ---i \.' ;) c..; - ,. ,<".' ("., TABAS & ROSEN, P.C. BY; LEWIS C. TRAUFFER I.D. No. 60267 22nd Fl'l 1845 Walnut Street Philadelphia, PA 19103 (215)569-5050 Attorney for Plaintiff THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17033 COURT OF COMMON PLEAS CUMBERLAND COUNTY NO. 06-5364 CIVIL TERM VS JOSEPH L. POPPI JR. 389 Big Spring Road New Cumberland, PA 17070 JUDGMENT BY AGREEMENT The undersigned defendant agrees that a Judgment be entered against him in the above matter in the amount of $28/158.62 plus court costs in the amount of $157.00. Execution will be stayed pending the payment of 100.00 per month beginning Dec. 10, 2006. 1')...-5'-0c. DATE w ~pr1f.\' /1111/66 DATE ~FER,~RE Attorney for Plaintiff ~ ~ \ ~ 4- ~ .co.. ~ . o \) r :b -!- (") c -.,.. ..c:.~ .....::> = ,::;::0 CT' o Fi C1 o .." ~-n n'F: -"r<: w ::~~~\ ~ ~~~ '-:? ~ o ~ \D SHERIFF'S RETURN - OUT OF COUNTY t CA~E NO: 2006-05364 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND MILTON S HERSHEY MEDICAL CENTE VS POPP JOSEPH L JR R, Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: POPP JOSEPH L JR but was unable to locate Him in his bailiwick. He therefore deputized the sheriff of YORK County, Pennsylvania, to serve the within COMPLAINT & NOTICE On October 12th , 2006 , this office was in receipt of the attached return from YORK Sheriff's Costs: Docketing Out of County Surcharge Dep York County Postage 18.00 9.00 10.00 77.29 .87 115. 16 ~/ ~ 10/12/2006 - TABAS & ROSEN ~S.,o a,nsY'l~e: ,/" , _"','__".-,',.~",.,-,,',:,~ -~. / ~<"'. ----- -"~-~'-"''^ R. Thomas lne Sheriff of Cumberland County lI/tJl,/OC, Sworn and subscribe to before me this day of A.D. , J f o,i!.... YORKTOWNE BUSINESS FORMS, INC,~, (717) 845,5955 Fax (717) 848-8936 email: Ybf@blazenel.netT'tIJJI._Sd1lc IV IfIJ}~tuf -rw/ l.tJ, 7>f7tJ1t, .. COUNTY OF YORK OFFICE OF THE SHERIFF II SERVICE CALL (717) 771-9601 45 N. GEORGE ST., YORK, PA 17401 The Mil ton S. Hershey Medical Center SHERIFF SERVICE PROCESS RECEIPT and AFFIDAVIT OF RETURN 1 PLAINTlFF/S! 3. DEFENDANT/S! Jose h L. Popp Jr. 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION, HC TO SERVE OR DESCRIPTION OF PROPERTY TO BE lEVIED. ATTACHED, OR SOLO Joseph L. Popp Jr. 6 ADDRESS (STREET OR RFO WITH BOX NUMBER. APT NO, CITY, BORO, TWP , STATE AND liP CODE) 389 Biq SPrinq Road New Cumberland, PA 17070 7 INDICATE SERVICE Q PERSONAL 0 PERSON IN CHARGE U DEPUTIZE U CERT MAil U 1ST CLASS MAIL U POSTED '..J OTHER S~tember 26 , 20~ I, SHERIFF OF "c8a~TY, p~ do hereby de ' the sheriff of , .-ork, , ,COUNTY,to,execut~(~~~~~tur 6, cording to law. ThiS deputlzatlon being made at the request and risk of the plaIntiff, /..>';:;',:j'" ,/"."'" , SHERIFF Of 8, SPECIAL INSTRUCTIONS OR OTHER INFORMA nON THAT WIll ASSIST IN EXPEDITING SERVlCEO U T 0 F Cunberland COUNTY NOT & CIMF SERVE . AT { NOW ADVANCE FEE PAID BY ATTY. Please mail return of service to cumberland County Sheriff. Thank you. NOTE: ONLY APPUCABlE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy shentf levying upon or attaching any property under within wnt may leave same wilhout a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment. wrthoutliallllity on the part of such deputy or the sheriff to any plainlrff herein for any lois, deslludion, or removal of any property before shenff's sale \hereof 9, TYPE NAME and ADDRESS of ATTORNEY / ORIGINATOR and SIGNATUREl E WI S C. T R AUF FER 10. TELEPHONE NUMBER 11 DATE FILED 22nd Fl.) 1845 WALNUT STREET, PHILA., PA 19103 215-569-5050 ~/13/2006 12, SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW (thIS area must be completed ~ nolK:e IS \0 be maIled) 13. I acknowledge receipt of the wrrt or complaint as indicated above, 16, MJ MCGILL YCSO RESIDENCE ( ) POSTED ( POE( SHERIFF'S OFFICE ( ) OTHER ( SEE REMARKS BELOW 22, REMARKS: tiff[: 6~Ve{) tfr ) /1 La OLJ) 7!<,fIL- ib I E77if45, tJ,. 10/10/06 49 DATE 2062 Y 21 PM 3: I ? CUMBERLAND C0UN TY PENNSYLVANIA TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER, ESQUIRE I.D. #60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215)569-5050 Attorney for Plaintiff THE MILTON S. HERSHEY MEDICAL COURT OF COMMON PLEAS CENTER VS CUMBERLAND COUNTY JOSEPH L. POPP, JR. : NO. 06-5364 CIVIL TERM PRAECIPE TO SATISFY JUDGMENT TO THE OFFICE OF THE PROTHONOTARY: Please mark the Jjidgment by Agreement entered in the above matter against JOSEPH L. POPP, JR. satisfied. EWIS T FER, ESQUIRE Attorney fo Plaintiff GLV? %c?. so C1, ti 97 v sS31 Ota-I