 |
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: % |
|
|
|
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$0.00 |
$41,641.49 |
|
|
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Type: D |
|
|
|
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|
|
| 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 |