Check Register Detail
By Group Code Report Date: 12/30/2003
By Plan Report Period: 11-01-2003 to 11-30-2003 Paid
By Location
Check # Check Incurred Dates Received Claim Ben Emp Enr SSN Claimant Dep Payee BWH Check Reg Chk
Date Date Type Lastname Amt Typ Typ
Group: 99999
Plan: 99999A
Location: 0000
Benefit Type: %
0 00205737 2/3/2004 09/08/2003-09/08/2003 10/16/2003 3048069801 % DOE 123456789 JON e JUDY WOOD MD $0.00 ($389.09) j e
0 00208974 2/24/2004 09/25/2003-09/25/2003 10/31/2003 3049450401 % DOE 123456789 JON e JERRY MCCALL MD $0.00 ($91.42) j e
0 00213900 2/12/2004 07/20/2003-07/31/2003 11/21/2003 3040470303 % DOE 123456789 JON e TNPHA HOSPICE CARE TEAM $0.00 ($705.60) j e
0 00214758 2/24/2004 09/04/2003-09/05/2003 12/3/2003 3051892801 % DOE 123456789 JON 4 ODESSA REG HOSP $0.00 ($1,492.46) j e
0 00218529 2/12/2004 11/21/2003-11/21/2003 12/18/2003 3053431401 % DOE 123456789 JON e HEALTHSOUTH HOLDINGS INC $0.00 ($26.83) j e
0 00225618 2/2/2004 12/02/2003-12/02/2003 1/22/2004 4002927201 % DOE 123456789 JON e ROBERT K BECK MD $0.00 $4.55 c a
0 00225620 2/2/2004 12/08/2003-12/08/2003 1/22/2004 4002927501 % DOE 123456789 JON e PRAGUE MUNICIPAL HOSPITAL $0.00 $105.21 c a
0 00225653 2/2/2004 12/23/2003-12/23/2003 1/26/2004 4002972901 % DOE 123456789 JON e DAVID L WILLIAMS MD $0.00 $68.60 c a
0 00225654 2/2/2004 12/15/2003-12/15/2003 1/26/2004 4002973501 % DOE 123456789 JON 1 MED SELECT $0.00 $60.20 c a
0 00225681 2/2/2004 12/09/2003-12/09/2003 1/22/2004 4002991301 % DOE 123456789 JON s JANE WILKINS CST RN $0.00 $156.00 c a
0 00225692 2/2/2004 12/10/2003-12/10/2003 1/22/2004 4002995101 % DOE 123456789 JON e QUALITY ASSURED SERV $0.00 $1,064.28 c a
0 00225843 2/3/2004 10/03/2003-10/03/2003 1/30/2004 4003051201 % DOE 123456789 JON e ALDO A BATTISTE MD $0.00 $84.49 c a
0 00225844 2/3/2004 02/05/2003-02/21/2003 1/28/2004 4003053301 % DOE 123456789 JON 3 EVA L BLANEY AA IV $0.00 $124.95 c a
0 00225845 2/3/2004 01/07/2004-01/07/2004 1/30/2004 4003053501 % DOE 123456789 JON 2 FEUERBORN & MCCRORY LLC $0.00 $75.74 c a
0 00225849 2/3/2004 12/26/2003-12/26/2003 1/30/2004 4003055501 % DOE 123456789 JON s EMAD HANNA MD $0.00 $378.00 c a
0 00225856 2/3/2004 01/02/2004-01/02/2004 1/30/2004 4003063001 % DOE 123456789 JON s MARK VIETTI MD $0.00 $18.77 c a
0 00225857 2/3/2004 01/02/2004-01/02/2004 1/30/2004 4003063501 % DOE 123456789 JON s MARK VIETTI MD $0.00 $54.97 c a
0 00225898 2/3/2004 01/03/2004-01/03/2004 1/28/2004 4003096601 % DOE 123456789 JON s JOSHUA WILLIFOORD PA $0.00 $728.53 c a
0 00225899 2/3/2004 01/06/2004-01/06/2004 1/28/2004 4003100501 % DOE 123456789 JON s WHITE ROCK OBSTETRICS & G $0.00 $12.60 c a
0 00225900 2/3/2004 01/06/2004-01/06/2004 1/28/2004 4003101301 % DOE 123456789 JON s WHITE ROCK OBSTETRICS & G $0.00 $71.51 c a
0 00225901 2/3/2004 01/09/2004-01/09/2004 1/28/2004 4003102501 % DOE 123456789 JON s WHITE ROCK OBSTETRICS & G $0.00 $1,860.60 c a
0 00225902 2/3/2004 10/04/2003-10/14/2003 1/28/2004 4003103801 % DOE 123456789 JON 1 MARTHA AGUILAR MD $0.00 $223.44 c a
0 00225916 2/3/2004 01/14/2004-01/14/2004 1/29/2004 4003123901 % DOE 123456789 JON s RD MEDICAL $0.00 $33.60 c a
0 00226039 2/4/2004 12/24/2003-12/24/2003 1/28/2004 4003180401 % DOE 123456789 JON e THE SURGERY CENTER $0.00 $840.00 c a
0 00226050 2/4/2004 12/19/2003-12/19/2003 2/2/2004 4003195101 % DOE 123456789 JON e PAULA LEWIS DO PLLC $0.00 $199.85 c a
0 00226051 2/4/2004 11/21/2003-11/21/2003 2/2/2004 4003195901 % DOE 123456789 JON e PAULA LEWIS DO PLLC $0.00 $428.40 c a
0 00226059 2/4/2004 10/21/2003-10/21/2003 2/2/2004 4003198601 % DOE 123456789 JON 1 JERRY W DODSON MD $0.00 $26.50 c a
0 00226388 2/5/2004 01/14/2004-01/14/2004 1/30/2004 4003333601 % DOE 123456789 JON 2 BURNS MD/DIANNA M $0.00 $188.08 c a
0 00226452 2/5/2004 12/01/2003-12/15/2003 1/28/2004 4003371601 % DOE 123456789 JON e HOME HEALTH SERV OF NEVAD $0.00 $989.25 c a
0 00226463 2/6/2004 12/12/2003-12/12/2003 2/3/2004 4001666302 % DOE 123456789 JON 2 FEUERBORN & MCCRORY LLC $0.00 $63.00 c a
0 00226571 2/6/2004 12/12/2003-12/12/2003 1/28/2004 4003419001 % DOE 123456789 JON s JOLLY MD/ANN $0.00 $35.00 c a
0 00226573 2/6/2004 10/21/2003-10/21/2003 1/28/2004 4003419801 % DOE 123456789 JON s MARK W HAGER MD $0.00 $1,595.75 c a
0 00226579 2/6/2004 12/18/2003-12/18/2003 1/28/2004 4003424001 % DOE 123456789 JON e TRAVIS CONKLIN OPAC $0.00 $717.50 c a
0 00226618 2/6/2004 12/16/2003-12/31/2003 1/29/2004 4003448701 % DOE 123456789 JON e HOME HEALTH SERV OF NEVAD $0.00 $1,049.89 c a
0 00227224 2/10/2004 10/22/2003-10/22/2003 2/2/2004 4003702401 % DOE 123456789 JON s KATHRYN FERRY MD $0.00 $16.59 c a
0 00227225 2/10/2004 01/07/2004-01/07/2004 2/2/2004 4003702701 % DOE 123456789 JON e REYNALDO RODRIGUEZ $0.00 $833.00 c a
0 00227249 2/10/2004 11/10/2003-11/10/2003 2/4/2004 4003715501 % DOE 123456789 JON e JOHN RAMSEY MD $0.00 $48.57 c a
0 00227250 2/10/2004 12/05/2003-12/05/2003 2/4/2004 4003716601 % DOE 123456789 JON e JOHN RAMSEY MD $0.00 $69.38 c a
0 00227368 2/10/2004 12/03/2003-12/03/2003 2/4/2004 4003762201 % DOE 123456789 JON 1 LAKE GRANBURY MEDICAL CEN $0.00 $210.46 c a
0 00227369 2/10/2004 12/03/2003-12/03/2003 2/4/2004 4003762701 % DOE 123456789 JON 3 LAKE GRANBURY MEDICAL CEN $0.00 $58.51 c a
0 00227422 2/10/2004 08/05/2003-08/05/2003 2/5/2004 4003779201 % DOE 123456789 JON s PRIYA PHILIP MD $0.00 $34.02 c a
0 00227423 2/10/2004 08/05/2003-08/05/2003 2/5/2004 4003779501 % DOE 123456789 JON s PRIYA PHILIP MD $0.00 $23.80 c a
0 00227424 2/10/2004 08/05/2003-08/05/2003 2/5/2004 4003779701 % DOE 123456789 JON s PRIYA PHILIP MD $0.00 $91.35 c a
0 00227835 2/12/2004 12/15/2003-12/19/2003 2/11/2004 4002409402 % DOE 123456789 JON 1 ANDREW R UTSINGER PT $0.00 $47.29 c a
0 00227836 2/12/2004 12/22/2003-12/29/2003 2/11/2004 4002456202 % DOE 123456789 JON 1 ANDREW R UTSINGER PT $0.00 $141.21 c a
0 00227840 2/12/2004 01/02/2004-01/09/2004 2/11/2004 4003048602 % DOE 123456789 JON 1 ANDREW R UTSINGER PT $0.00 $157.43 c a
0 00227985 2/12/2004 12/30/2003-01/29/2004 2/4/2004 4004028701 % DOE 123456789 JON s RS MEDICAL $0.00 $72.10 c a
0 00228141 2/13/2004 01/08/2004-01/09/2004 2/9/2004 4004097701 % DOE 123456789 JON e HOMER MD/KEVIN S $0.00 $48.40 c a
0 00228142 2/13/2004 01/09/2004-01/12/2004 2/9/2004 4004097901 % DOE 123456789 JON e HOMER MD/KEVIN S $0.00 $40.50 c a
0 00228367 2/16/2004 01/05/2004-01/05/2004 2/4/2004 4004234001 % DOE 123456789 JON s ST JOSEPH EMS $0.00 $206.40 c a
0 00228619 2/16/2004 01/12/2004-01/12/2004 2/11/2004 4004352701 % DOE 123456789 JON s SOUTHWEST CARDIAC ASSOCIA $0.00 $14.00 c a
0 00228820 2/17/2004 01/16/2004-01/16/2004 2/5/2004 4004386401 % DOE 123456789 JON s ROBERT MIDDENDORF $0.00 $28.35 c a
0 00228944 2/17/2004 01/16/2004-01/16/2004 2/10/2004 4004441401 % DOE 123456789 JON 1 JANITA M ARDIS MD $0.00 $25.00 c a
0 00228971 2/18/2004 09/26/2003-09/26/2003 2/18/2004 3049449302 % DOE 123456789 JON e PAGE C JORDAN MD $0.00 $141.72 c a
0 00228972 2/18/2004 10/31/2003-10/31/2003 2/18/2004 3051870502 % DOE 123456789 JON e BENJAMIN A LAMPERT $0.00 $168.43 c a
0 00228974 2/18/2004 12/02/2003-12/02/2003 2/18/2004 4001690402 % DOE 123456789 JON e ST JOHNS REG HEALTH CTR $0.00 $539.49 c a
0 00228980 2/18/2004 01/07/2004-01/07/2004 2/18/2004 4003714302 % DOE 123456789 JON e OZARK MAGNETIC IMAGING IN $0.00 $656.88 c a
0 00229362 2/19/2004 12/31/2003-12/31/2003 2/17/2004 4004692501 % DOE 123456789 JON s MILLER MD/JOHN K $0.00 $25.20 c a
0 00229409 2/20/2004 01/06/2004-01/07/2004 2/9/2004 4004097601 % DOE 123456789 JON e HOMER MD/KEVIN S $0.00 $26.60 c a
0 00229421 2/20/2004 01/06/2004-01/06/2004 2/11/2004 4004351901 % DOE 123456789 JON s ODESSA REG HOSP $0.00 $524.92 c a
0 00229502 2/20/2004 01/14/2004-01/14/2004 2/17/2004 4004718501 % DOE 123456789 JON s PRIYA PHILIP MD $0.00 $37.80 c a
0 00230023 2/24/2004 12/19/2003-12/31/2003 2/17/2004 4004987001 % DOE 123456789 JON s JOLLY MD/ANN $0.00 $263.25 c a
0 00230270 2/25/2004 12/15/2003-01/14/2004 2/16/2004 4005081601 % DOE 123456789 JON e RS MEDICAL $0.00 $37.80 c a
0 00230271 2/25/2004 01/26/2004-01/26/2004 2/18/2004 4005081901 % DOE 123456789 JON e DANIEL WILLIAMS MD $0.00 $43.93 c a
0 00230300 2/25/2004 01/19/2004-01/19/2004 2/18/2004 4005105601 % DOE 123456789 JON 3 RHONDA WARD PT $0.00 $16.84 c a
0 00230326 2/25/2004 12/08/2003-12/08/2003 2/17/2004 4005121301 % DOE 123456789 JON s PAMELA HWANG MD $0.00 $23.70 c a
0 00230355 2/25/2004 01/16/2004-01/16/2004 2/18/2004 4005141201 % DOE 123456789 JON s MARC T DICKER PHD RPA $0.00 $63.75 c a
0 00230391 2/25/2004 01/30/2004-01/30/2004 2/19/2004 4005181601 % DOE 123456789 JON s RS MEDICAL $0.00 $33.60 c a
0 00230413 2/26/2004 12/03/2003-12/07/2003 2/9/2004 3052002601 % DOE 123456789 JON s LAKE GRANBURY MEDICAL CEN $0.00 $26,626.82 c a
0 00230802 2/27/2004 01/26/2004-01/26/2004 2/20/2004 4005355601 % DOE 123456789 JON s JOHN M BOUTTE PHD $0.00 $84.38 c a
0 00230803 2/27/2004 01/28/2004-01/28/2004 2/20/2004 4005355801 % DOE 123456789 JON s RS MEDICAL $0.00 $51.60 c a
0 00230897 2/27/2004 11/14/2003-12/13/2003 2/20/2004 4005428401 % DOE 123456789 JON s RS MEDICAL $0.00 $62.10 c a
nochk0025722 2/6/2004 09/24/2003-09/24/2003 10/15/2003 3048038701 % DOE 123456789 JON 2 MICHAEL J FRANK MD $0.00 $0.00 j e
nochk0026374 2/19/2004 10/02/2003-10/02/2003 10/28/2003 3049099401 % DOE 123456789 JON 2 MARIA R GUAJARDO MD $0.00 $0.00 j e
nochk0026904 2/12/2004 09/29/2003-09/29/2003 11/4/2003 3049948801 % DOE 123456789 JON e EMCARE HTN EMERGENCY PHYS $0.00 $0.00 j e
nochk0027578 2/12/2004 09/05/2003-09/05/2003 11/11/2003 3050828701 % DOE 123456789 JON e ARNOLD O&P INC $0.00 $0.00 j e
nochk0028252 2/6/2004 11/04/2003-11/04/2003 11/24/2003 3051768201 % DOE 123456789 JON s Y. ALYSSA KIM MD $0.00 $0.00 j e
nochk0029246 2/19/2004 11/20/2003-11/20/2003 12/16/2003 3053149901 % DOE 123456789 JON 2 MARIA R GUAJARDO MD $0.00 $0.00 j e
nochk0029779 2/12/2004 11/26/2003-11/26/2003 12/23/2003 4000547501 % DOE 123456789 JON 2 MARIA R GUAJARDO MD $0.00 $0.00 j e
nochk0031347 2/2/2004 01/02/2004-01/02/2004 1/21/2004 4002480101 % DOE 123456789 JON s STEFANI WYLIE PT $0.00 $0.00 z a
nochk0031348 2/2/2004 01/05/2004-01/05/2004 1/22/2004 4002583601 % DOE 123456789 JON s STEFANI WYLIE PT $0.00 $0.00 z a
nochk0031398 2/2/2004 12/16/2003-12/16/2003 1/28/2004 4002991701 % DOE 123456789 JON e RAY A INNIS MD $0.00 $0.00 z a
nochk0031399 2/2/2004 01/06/2004-01/06/2004 1/28/2004 4002993801 % DOE 123456789 JON s RALPH F COX MD $0.00 $0.00 z a
nochk0031405 2/2/2004 12/03/2003-12/03/2003 1/28/2004 4002997501 % DOE 123456789 JON s ROBERT KAUFFMAN MD $0.00 $0.00 z a
nochk0031438 2/3/2004 01/02/2004-01/02/2004 1/26/2004 4003048101 % DOE 123456789 JON s BEATRIZ TAMAYO MD $0.00 $0.00 z a
nochk0031439 2/3/2004 01/02/2004-01/09/2004 1/30/2004 4003048601 % DOE 123456789 JON 1 ANDREW R UTSINGER PT $0.00 $0.00 z a
nochk0031440 2/3/2004 01/11/2004-01/11/2004 1/30/2004 4003050801 % DOE 123456789 JON s P GABOS $0.00 $0.00 z a
nochk0031442 2/3/2004 12/17/2003-12/17/2003 1/30/2004 4003054401 % DOE 123456789 JON s JAMES JONES $0.00 $0.00 z a
nochk0031443 2/3/2004 07/02/2003-07/02/2003 1/30/2004 4003056001 % DOE 123456789 JON s JAMES DREES $0.00 $0.00 z a
nochk0031444 2/3/2004 07/02/2003-07/02/2003 1/30/2004 4003056401 % DOE 123456789 JON s JAMES DREES $0.00 $0.00 z a
nochk0031446 2/3/2004 01/03/2004-01/04/2004 1/30/2004 4003058501 % DOE 123456789 JON s HARRIS MD/RICHARD L $0.00 $0.00 z a
nochk0031447 2/3/2004 01/06/2004-01/06/2004 1/30/2004 4003064201 % DOE 123456789 JON s ALAN R GAVECK DPM $0.00 $0.00 z a
nochk0031448 2/3/2004 01/06/2004-01/06/2004 1/30/2004 4003065101 % DOE 123456789 JON 1 ALAN R GAVECK DPM $0.00 $0.00 z a
nochk0031449 2/3/2004 01/08/2004-01/08/2004 1/30/2004 4003066001 % DOE 123456789 JON s BRAY, WILLIAM P., DC $0.00 $0.00 z a
nochk0031467 2/3/2004 01/11/2004-01/11/2004 1/28/2004 4003105001 % DOE 123456789 JON 2 NORTHWEST MEDICAL GROUP $0.00 $0.00 z a
nochk0031601 2/5/2004 06/10/2003-06/10/2003 1/30/2004 4003332701 % DOE 123456789 JON e FAJTORA MD/TIMOTHY C $0.00 $0.00 z a
nochk0031602 2/5/2004 10/28/2003-10/28/2003 1/30/2004 4003334501 % DOE 123456789 JON e RICHARD BARTLETT $0.00 $0.00 z a
nochk0031625 2/5/2004 12/27/2003-12/29/2003 1/28/2004 4003366801 % DOE 123456789 JON s SHAILESH DHADUK MD $0.00 $0.00 z a
nochk0031626 2/5/2004 12/30/2003-12/30/2003 1/28/2004 4003367101 % DOE 123456789 JON s SHAILESH DHADUK MD $0.00 $0.00 z a
nochk0031627 2/5/2004 12/31/2003-12/31/2003 1/28/2004 4003367301 % DOE 123456789 JON s SHAILESH DHADUK MD $0.00 $0.00 z a
nochk0031628 2/5/2004 01/01/2004-01/02/2004 1/28/2004 4003367901 % DOE 123456789 JON s SHAILESH DHADUK MD $0.00 $0.00 z a
nochk0031631 2/5/2004 10/17/2003-10/17/2003 1/28/2004 4003372401 % DOE 123456789 JON s ST MARYS HOSPITAL $0.00 $0.00 z a
nochk0031687 2/6/2004 08/21/2003-08/21/2003 1/28/2004 4003424601 % DOE 123456789 JON s JOSEPH VIERNOW DC $0.00 $0.00 z a
nochk0031689 2/6/2004 01/07/2003-01/24/2003 1/28/2004 4003427401 % DOE 123456789 JON 3 EVA L BLANEY AA IV $0.00 $0.00 z a
nochk0031793 2/9/2004 10/20/2003-10/21/2003 2/2/2004 4003640501 % DOE 123456789 JON s JOHN L SMART $0.00 $0.00 z a
nochk0031854 2/10/2004 01/09/2004-01/09/2004 2/4/2004 4003709101 % DOE 123456789 JON s CHARLES R JAYNES MD $0.00 $0.00 z a
nochk0031855 2/10/2004 01/08/2004-01/08/2004 2/4/2004 4003709701 % DOE 123456789 JON s JOHN T FOWLER MD $0.00 $0.00 z a
nochk0031862 2/10/2004 01/07/2004-01/07/2004 2/4/2004 4003714301 % DOE 123456789 JON e OZARK MAGNETIC IMAGING IN $0.00 $0.00 z a
nochk0031863 2/10/2004 01/12/2004-01/12/2004 2/4/2004 4003716401 % DOE 123456789 JON e JOHN RAMSEY MD $0.00 $0.00 z a
nochk0031899 2/10/2004 12/29/2003-01/05/2004 2/5/2004 4003779101 % DOE 123456789 JON s BRAZOS LUNG ASSOCIATION L $0.00 $0.00 z a
nochk0032013 2/12/2004 12/10/2003-12/12/2003 2/11/2004 4001610302 % DOE 123456789 JON 1 ANDREW R UTSINGER PT $0.00 $0.00 z a
nochk0032054 2/12/2004 01/11/2004-01/11/2004 2/5/2004 4003989701 % DOE 123456789 JON 2 CHRIST HOSPITAL $0.00 $0.00 z a
nochk0032077 2/12/2004 01/06/2004-01/06/2004 2/4/2004 4004018601 % DOE 123456789 JON s ERROL K DRAPER $0.00 $0.00 z a
nochk0032078 2/12/2004 01/09/2004-01/09/2004 2/4/2004 4004018801 % DOE 123456789 JON s ERROL K DRAPER $0.00 $0.00 z a
nochk0032079 2/12/2004 12/05/2003-12/05/2003 2/4/2004 4004019301 % DOE 123456789 JON 3 EVA L BLANEY AA IV $0.00 $0.00 z a
nochk0032149 2/13/2004 07/30/2003-07/30/2003 2/4/2004 4004108201 % DOE 123456789 JON e LAURA WRIGHT PT $0.00 $0.00 z a
nochk0032150 2/13/2004 08/18/2003-08/18/2003 2/4/2004 4004109401 % DOE 123456789 JON e LAURA WRIGHT PT $0.00 $0.00 z a
nochk0032154 2/13/2004 09/27/2002-09/27/2002 2/9/2004 4004118701 % DOE 123456789 JON 1 LLANO MEMORIAL HOSP EMERG $0.00 $0.00 z a
nochk0032258 2/16/2004 10/11/2003-10/11/2003 2/11/2004 4004352401 % DOE 123456789 JON 2 THOMAS PETERS MD $0.00 $0.00 z a
nochk0032259 2/16/2004 10/11/2003-10/11/2003 2/11/2004 4004352501 % DOE 123456789 JON 1 THOMAS PETERS MD $0.00 $0.00 z a
nochk0032355 2/17/2004 12/31/2003-12/31/2003 2/10/2004 4004441001 % DOE 123456789 JON 2 MID AMERICA RADIOLOGY $0.00 $0.00 z a
nochk0032356 2/17/2004 01/13/2004-01/13/2004 2/10/2004 4004441101 % DOE 123456789 JON e JAMES DARROW $0.00 $0.00 z a
nochk0032357 2/17/2004 01/19/2004-01/19/2004 2/10/2004 4004441201 % DOE 123456789 JON e HAROLD MILLER $0.00 $0.00 z a
nochk0032358 2/17/2004 01/08/2004-01/08/2004 2/10/2004 4004441301 % DOE 123456789 JON 3 BRADLEY CHASTANT $0.00 $0.00 z a
nochk0032359 2/17/2004 10/30/2003-10/30/2003 2/10/2004 4004441501 % DOE 123456789 JON s JOHN L SEIFERT MD $0.00 $0.00 z a
nochk0032360 2/17/2004 01/16/2004-01/16/2004 2/10/2004 4004441701 % DOE 123456789 JON e GARY ROBERTS $0.00 $0.00 z a
nochk0032367 2/18/2004 01/08/2004-01/08/2004 2/18/2004 4003066002 % DOE 123456789 JON s BRAY, WILLIAM P., DC $0.00 $0.00 z a
nochk0032405 2/18/2004 12/28/2003-12/28/2003 2/13/2004 4004517601 % DOE 123456789 JON e KYLE GROOM DO $0.00 $0.00 z a
nochk0032408 2/18/2004 01/08/2004-01/09/2004 2/10/2004 4004527201 % DOE 123456789 JON e J BARRANCO PT $0.00 $0.00 z a
nochk0032415 2/18/2004 10/17/2003-10/17/2003 2/12/2004 4004536801 % DOE 123456789 JON e WILLIAM J STROHMAN MD $0.00 $0.00 z a
nochk0032516 2/19/2004 01/08/2004-01/08/2004 2/17/2004 4004691101 % DOE 123456789 JON e JOHN R OWEN MD $0.00 $0.00 z a
nochk0032582 2/20/2004 10/22/2003-10/22/2003 2/17/2004 4004716801 % DOE 123456789 JON s KAY MORRIS MD $0.00 $0.00 z a
nochk0032583 2/20/2004 01/20/2004-01/20/2004 2/17/2004 4004717601 % DOE 123456789 JON e HALL DC/NORMAN J $0.00 $0.00 z a
nochk0032584 2/20/2004 02/28/2003-02/28/2003 2/17/2004 4004719301 % DOE 123456789 JON s TRI LE DPM $0.00 $0.00 z a
nochk0032789 2/25/2004 12/05/2003-12/05/2003 2/18/2004 4005096901 % DOE 123456789 JON s CARLTON PITTARD MD $0.00 $0.00 z a
nochk0032790 2/25/2004 01/21/2004-01/21/2004 2/18/2004 4005098001 % DOE 123456789 JON 3 RHONDA WARD PT $0.00 $0.00 z a
nochk0032796 2/25/2004 01/06/2004-01/06/2004 2/17/2004 4005120601 % DOE 123456789 JON e CENLA HEART SPECIALISTS $0.00 $0.00 z a
nochk0032824 2/25/2004 01/13/2004-01/13/2004 2/19/2004 4005179901 % DOE 123456789 JON 3 JEFFREY D SCHUSTER $0.00 $0.00 z a
nochk0032825 2/25/2004 01/19/2004-01/19/2004 2/19/2004 4005180601 % DOE 123456789 JON s ALAN R GAVECK DPM $0.00 $0.00 z a
nochk0032835 2/26/2004 01/12/2004-01/12/2004 2/4/2004 4003708101 % DOE 123456789 JON s STEFANI WYLIE PT $0.00 $0.00 z a
nochk0032853 2/26/2004 12/22/2003-12/22/2003 2/17/2004 4005207401 % DOE 123456789 JON 1 OSBORNE COUNTY MEMORIAL H $0.00 $0.00 z a
nochk0032855 2/26/2004 01/10/2004-01/10/2004 2/19/2004 4005208101 % DOE 123456789 JON e METRO MRI LIMITED PART $0.00 $0.00 z a
nochk0032885 2/26/2004 01/05/2004-01/05/2004 2/18/2004 4005288901 % DOE 123456789 JON e BENJAMIN A LAMPERT $0.00 $0.00 z a
nochk0032897 2/26/2004 01/26/2004-01/26/2004 2/20/2004 4005317201 % DOE 123456789 JON 3 RHONDA WARD PT $0.00 $0.00 z a
nopay0004367 2/24/2004 09/04/2003-09/05/2003 2/24/2004 3051892802 % DOE 123456789 JON 4 ODESSA REG HOSP $0.00 $1,492.46 n a
Total Ben Type: % $0.00 $41,641.49
Benefit Type: D
0 00220955 2/6/2004 12/11/2003-12/11/2003 1/2/2004 4000877501 D DOE 123456789 JANE s JAMES S BRADLEY DDS $0.00 ($55.00) v c
0 00222324 2/20/2004 02/03/2003-02/03/2003 1/16/2004 3024642003 D DOE 123456789 JANE 4 PERI DDS, JOSEPH H. $0.00 ($30.40) v c
0 00222904 2/6/2004 10/13/2003-10/13/2003 1/14/2004 4001713301 D DOE 123456789 JANE s ELIOT YEO DDS $0.00 ($85.00) j e
0 00223344 2/20/2004 01/05/2004-01/05/2004 1/15/2004 4001869501 D DOE 123456789 JANE e JAMES BRADLEY DDS $0.00 ($27.50) v c
0 00223677 2/20/2004 12/08/2003-12/08/2003 1/16/2004 4002056101 D DOE 123456789 JANE 1 PERI DDS, JOSEPH H. $0.00 ($160.50) v c
0 00225543 2/2/2004 01/21/2004-01/21/2004 1/29/2004 4002891401 D DOE 123456789 JANE s SMITH DDS, GREGORY R $0.00 $113.00 c a
0 00225544 2/2/2004 01/21/2004-01/21/2004 1/29/2004 4002891601 D DOE 123456789 JANE e DAVID E IJAMS $0.00 $86.00 c a
0 00225589 2/2/2004 01/22/2004-01/22/2004 1/29/2004 4002917501 D DOE 123456789 JANE s D BASTANI DDS & A BANDANI $0.00 $190.00 c a
0 00225591 2/2/2004 01/17/2004-01/17/2004 1/29/2004 4002918101 D DOE 123456789 JANE s S & R DENTAL SERVICE INC $0.00 $392.00 c a
0 00225597 2/2/2004 01/22/2004-01/22/2004 1/27/2004 4002919401 D DOE 123456789 JANE s FANAIAN DDS, M $0.00 $174.00 c a
0 00225600 2/2/2004 12/16/2003-12/16/2003 1/26/2004 4002920501 D DOE 123456789 JANE e KENNETH NGUYEN DDS APC $0.00 $275.00 c a
0 00225601 2/2/2004 01/20/2004-01/20/2004 1/26/2004 4002922101 D DOE 123456789 JANE s STEVEN R WATTS DDS $0.00 $70.00 c a
0 00225605 2/2/2004 01/15/2004-01/15/2004 1/26/2004 4002922901 D DOE 123456789 JANE 2 J MICHAEL LLOYD DDS $0.00 $167.00 c a
0 00225610 2/2/2004 01/13/2004-01/13/2004 1/26/2004 4002924501 D DOE 123456789 JANE 2 SEHNERT DDS PC PHILLIP F $0.00 $143.50 c a
0 00225612 2/2/2004 01/13/2004-01/13/2004 1/26/2004 4002925001 D DOE 123456789 JANE s SEHNERT DDS PC PHILLIP F $0.00 $70.00 c a
0 00225614 2/2/2004 01/17/2004-01/17/2004 1/26/2004 4002925301 D DOE 123456789 JANE s SHAHAB EBRAHIMIAN DDS $0.00 $215.00 c a
0 00225615 2/2/2004 01/21/2004-01/21/2004 1/28/2004 4002926301 D DOE 123456789 JANE 1 W CLARK HIGGS DDS $0.00 $29.00 c a
0 00225616 2/2/2004 01/22/2004-01/22/2004 1/28/2004 4002926501 D DOE 123456789 JANE s THOMAS W VITZ DDS $0.00 $333.50 c a
0 00225617 2/2/2004 01/21/2004-01/21/2004 1/28/2004 4002926601 D DOE 123456789 JANE s GLEN D BLANCHARD DMD $0.00 $95.00 c a
0 00225619 2/2/2004 12/31/2003-12/31/2003 1/29/2004 4002927301 D DOE 123456789 JANE e RICHARD R MECUA DDS $0.00 $395.00 c a
0 00225621 2/2/2004 01/26/2004-01/26/2004 1/29/2004 4002927701 D DOE 123456789 JANE e NORRIS DDS, DONALD G. $0.00 $17.50 c a
0 00225624 2/2/2004 01/12/2004-01/12/2004 1/29/2004 4002928701 D DOE 123456789 JANE s MYINT DDS DEAN $0.00 $267.50 c a
0 00225625 2/2/2004 01/20/2004-01/20/2004 1/29/2004 4002929201 D DOE 123456789 JANE e RENE N DEL ROSARIO DMD $0.00 $130.00 c a
0 00225626 2/2/2004 11/25/2003-11/25/2003 1/29/2004 4002929801 D DOE 123456789 JANE e BRANDON AU $0.00 $403.00 c a
0 00225635 2/2/2004 01/16/2004-01/16/2004 1/30/2004 4002937201 D DOE 123456789 JANE e PAUL H COX $0.00 $108.00 c a
0 00225733 2/3/2004 12/17/2003-12/17/2003 2/2/2004 4001404202 D DOE 123456789 JANE 2 J PERRY FIKES DDS PC $0.00 $368.50 c a
0 00225735 2/3/2004 12/17/2003-12/17/2003 2/3/2004 4002205402 D DOE 123456789 JANE e PATRICIA ZEARFOSS DDS $0.00 $69.00 c a
0 00225744 2/3/2004 01/13/2004-01/13/2004 1/26/2004 4002925901 D DOE 123456789 JANE s DAVID BERTINO DDS $0.00 $106.00 c a
0 00225756 2/3/2004 01/26/2004-01/26/2004 1/30/2004 4002999301 D DOE 123456789 JANE s JIM MCCRARY DDS $0.00 $100.00 c a
0 00225767 2/3/2004 12/16/2003-12/16/2003 2/3/2004 4003003101 D DOE 123456789 JANE s NOL BOUTTE $0.00 $235.50 c a
0 00225788 2/3/2004 01/15/2004-01/15/2004 1/29/2004 4003019801 D DOE 123456789 JANE s TED IM $0.00 $350.00 c a
0 00225795 2/3/2004 01/26/2004-01/26/2004 1/29/2004 4003021401 D DOE 123456789 JANE e DALLAS DILL DDS $0.00 $41.00 c a
0 00225808 2/3/2004 01/20/2004-01/20/2004 1/29/2004 4003030801 D DOE 123456789 JANE 1 JIM A MILES DDS $0.00 $72.00 c a
0 00225809 2/3/2004 01/19/2004-01/19/2004 1/29/2004 4003031301 D DOE 123456789 JANE e JIM A MILES DDS $0.00 $94.00 c a
0 00225812 2/3/2004 01/26/2004-01/26/2004 1/30/2004 4003032901 D DOE 123456789 JANE e THOMAS MANOLIS DDS $0.00 $126.00 c a
0 00225813 2/3/2004 01/22/2004-01/22/2004 1/30/2004 4003033101 D DOE 123456789 JANE e DAVID WEBB DDS PC $0.00 $15.00 c a
0 00225814 2/3/2004 01/26/2004-01/26/2004 1/30/2004 4003033201 D DOE 123456789 JANE 3 CHARLES M ALLEN DDS $0.00 $193.00 c a
0 00225815 2/3/2004 01/26/2004-01/26/2004 1/30/2004 4003034201 D DOE 123456789 JANE e JOSEPH E CORTEZ DDS $0.00 $91.50 c a
0 00225816 2/3/2004 01/22/2004-01/22/2004 1/30/2004 4003034701 D DOE 123456789 JANE e JEFF CORBET $0.00 $275.50 c a
0 00225817 2/3/2004 01/24/2004-01/24/2004 1/30/2004 4003035901 D DOE 123456789 JANE 2 KERRY K JOHNSON DDS $0.00 $108.00 c a
0 00225818 2/3/2004 01/20/2004-01/20/2004 1/30/2004 4003036401 D DOE 123456789 JANE e LOWELL B DAVIS DDS MS PER $0.00 $87.00 c a
0 00225819 2/3/2004 01/23/2004-01/23/2004 1/30/2004 4003037001 D DOE 123456789 JANE 1 M & C DENTAL INC $0.00 $92.50 c a
0 00225862 2/3/2004 01/22/2004-01/22/2004 1/29/2004 4003067601 D DOE 123456789 JANE e MICHAEL D TRAYLOR DDS $0.00 $452.50 c a
0 00225951 2/4/2004 01/08/2004-01/08/2004 2/4/2004 4001712302 D DOE 123456789 JANE 1 CARL D BLOOM $0.00 $75.00 c a
0 00226003 2/4/2004 01/27/2004-01/27/2004 2/2/2004 4003149401 D DOE 123456789 JANE e CLARK DDS, S CHRIS $0.00 $84.00 c a
0 00226004 2/4/2004 01/29/2004-01/29/2004 2/2/2004 4003149501 D DOE 123456789 JANE e DAVID KUTSCHER $0.00 $124.00 c a
0 00226063 2/4/2004 01/16/2004-01/16/2004 1/30/2004 4003200601 D DOE 123456789 JANE 2 PEREZ DDS, DAVID C. $0.00 $32.00 c a
0 00226064 2/4/2004 01/16/2004-01/16/2004 1/30/2004 4003201101 D DOE 123456789 JANE 1 PEREZ DDS, DAVID C. $0.00 $142.00 c a
0 00226065 2/4/2004 01/22/2004-01/22/2004 1/30/2004 4003201501 D DOE 123456789 JANE s C DYER DDS $0.00 $152.00 c a
0 00226066 2/4/2004 01/23/2004-01/23/2004 1/30/2004 4003201901 D DOE 123456789 JANE s CHILDS DDS, JOHN R $0.00 $388.50 c a
0 00226091 2/4/2004 01/23/2004-01/23/2004 2/2/2004 4003216201 D DOE 123456789 JANE e DAVID C CUNNINGHAM DDS $0.00 $96.00 c a
0 00226092 2/4/2004 01/27/2004-01/27/2004 2/2/2004 4003216301 D DOE 123456789 JANE e DAVID C CUNNINGHAM DDS $0.00 $149.50 c a
0 00226096 2/4/2004 01/29/2004-01/29/2004 2/2/2004 4003218901 D DOE 123456789 JANE s BONA/JEFFREY A $0.00 $437.50 c a
0 00226097 2/4/2004 01/26/2004-01/26/2004 2/2/2004 4003219201 D DOE 123456789 JANE s WINFRED HARRIS DDS PA $0.00 $4.00 c a
0 00226098 2/4/2004 01/27/2004-01/27/2004 2/2/2004 4003219501 D DOE 123456789 JANE e PETER HUYNH DDS $0.00 $98.00 c a
0 00226099 2/4/2004 01/22/2004-01/22/2004 2/2/2004 4003219601 D DOE 123456789 JANE e JYRON J WALLS DDS $0.00 $17.50 c a
0 00226105 2/4/2004 10/29/2003-10/29/2003 2/2/2004 4003221001 D DOE 123456789 JANE 5 PERI DDS, JOSEPH H. $0.00 $68.00 c a
0 00226106 2/4/2004 10/24/2003-10/24/2003 2/2/2004 4003221301 D DOE 123456789 JANE 4 PERI DDS, JOSEPH H. $0.00 $68.00 c a
0 00226108 2/4/2004 12/18/2003-12/18/2003 2/2/2004 4003222301 D DOE 123456789 JANE 2 CHILDRENS MED CTR OF DALL $0.00 $39.00 c a
0 00226298 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003274401 D DOE 123456789 JANE 1 RICHARD ROBERTS DDS $0.00 $155.00 c a
0 00226299 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003274501 D DOE 123456789 JANE e RICHARD ROBERTS DDS $0.00 $97.00 c a
0 00226300 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003274701 D DOE 123456789 JANE e BRADLEY M STEWART DMD $0.00 $177.00 c a
0 00226301 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003275201 D DOE 123456789 JANE e JONATHAN QUILLIAN DDS $0.00 $134.00 c a
0 00226302 2/5/2004 01/22/2004-01/22/2004 2/2/2004 4003276201 D DOE 123456789 JANE e MITCHELL WALKER DDS $0.00 $83.00 c a
0 00226303 2/5/2004 01/27/2004-01/27/2004 2/2/2004 4003277201 D DOE 123456789 JANE e JOHN O HUGGINS DDS $0.00 $100.00 c a
0 00226304 2/5/2004 01/27/2004-01/27/2004 2/2/2004 4003277301 D DOE 123456789 JANE s JOHN O HUGGINS DDS $0.00 $143.00 c a
0 00226313 2/5/2004 06/17/2003-06/17/2003 2/4/2004 4003280301 D DOE 123456789 JANE s MARIAN B AFURONG DMD $0.00 $520.00 c a
0 00226333 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003296501 D DOE 123456789 JANE 1 DORAN DDS, PETER $0.00 $110.00 c a
0 00226334 2/5/2004 01/22/2004-01/22/2004 2/2/2004 4003297201 D DOE 123456789 JANE 1 KEVIN M KILLIAN $0.00 $138.00 c a
0 00226338 2/5/2004 01/28/2004-01/28/2004 2/2/2004 4003298101 D DOE 123456789 JANE 1 ALLEN DDS, KENT W $0.00 $122.00 c a
0 00226340 2/5/2004 01/27/2004-01/27/2004 2/2/2004 4003298901 D DOE 123456789 JANE 3 ALLEN DDS, KENT W $0.00 $115.00 c a
0 00226341 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003299101 D DOE 123456789 JANE s ALLEN DDS, KENT W $0.00 $88.00 c a
0 00226342 2/5/2004 01/27/2004-01/27/2004 2/2/2004 4003299401 D DOE 123456789 JANE e SHELLI PETERS DDS $0.00 $35.00 c a
0 00226343 2/5/2004 01/27/2004-01/27/2004 2/2/2004 4003299901 D DOE 123456789 JANE 3 KENNETH WOODS $0.00 $47.00 c a
0 00226347 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003301201 D DOE 123456789 JANE e STAN M UDOUJ DMD $0.00 $137.53 c a
0 00226349 2/5/2004 01/26/2004-01/26/2004 2/2/2004 4003317601 D DOE 123456789