Claims by Claim Number
By Group Code Report Date: 11/04/2003
By Plan Report Period: 10/01/2003 - 10/31/2003 Paid
By Location  


Claim
Enrollee
Dep		 Incurred
Dates
SSN		 Mem
First
Charges
Disallowed
Allowable		 PPO
Disc
Deduct		 Co-
Pays		 Coins
OOP 		COB
Reimb		 COB
Sav
Other
Paid		 Claim
Status
Group: 99999
Plan: 99999A
Location: 0000
Benefit Type: CS
  3049449302 DOE, J e 09/26-09/26/2003 123456789 PAT $346.00 $.00 $346.00 $143.55 $.00 $.00 $60.73 $.00 $.00 $.00 $141.72 f
3051870502 DOE, J e 10/31-10/31/2003 123456789 PAT $245.00 $.00 $245.00 $4.38 $.00 $.00 $72.19 $.00 $.00 $.00 $168.43 f
3051892802 DOE, J 4 09/04-09/05/2003 123456789 PAT $2,382.21 $.00 $2,382.21 $673.92 $.00 $50.00 $165.83 $.00 $.00 $.00 $1,492.46 f
3052002601 DOE, J s 12/03-12/07/2003 123456789 PAT $30,240.12 $.00 $30,240.12 $1,512.01 $.00 $500.00 $1,601.29 $.00 $.00 $.00 $26,626.82 f
4001604301 DOE, J e 10/29-10/31/2003 123456789 PAT $3,585.00 $.00 $3,585.00 $179.25 $.00 $.00 $.00 $.00 $.00 $.00 $3,405.75 f
4001604701 DOE, J e 11/01-11/07/2003 123456789 PAT $8,365.00 $.00 $8,365.00 $418.25 $.00 $.00 $.00 $.00 $.00 $.00 $7,946.75 f
4001607001 DOE, J e 12/01-12/05/2003 123456789 PAT $2,875.00 $.00 $2,875.00 $143.75 $.00 $.00 $.00 $.00 $.00 $.00 $2,731.25 f
4001610302 DOE, J 1 12/10-12/12/2003 123456789 PAT $223.00 $.00 $223.00 $48.05 $174.95 $.00 $.00 $.00 $.00 $.00 $.00 f
4001666302 DOE, J 2 12/12-12/12/2003 123456789 PAT $162.00 $.00 $162.00 $16.20 $55.80 $.00 $27.00 $.00 $.00 $.00 $63.00 f
4001690402 DOE, J e 12/02-12/02/2003 123456789 PAT $857.68 $.00 $857.68 $128.65 $.00 $.00 $189.54 $.00 $.00 $.00 $539.49 f
4002409402 DOE, J 1 12/15-12/19/2003 123456789 PAT $190.00 $.00 $190.00 $36.12 $75.05 $.00 $31.54 $.00 $.00 $.00 $47.29 f
4002456202 DOE, J 1 12/22-12/29/2003 123456789 PAT $279.00 $.00 $279.00 $43.64 $.00 $.00 $94.15 $.00 $.00 $.00 $141.21 f
4002480101 DOE, J s 01/02-01/02/2004 123456789 PAT $185.00 $185.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002583601 DOE, J s 01/05-01/05/2004 123456789 PAT $130.00 $130.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002927201 DOE, J e 12/02-12/02/2003 123456789 PAT $195.00 $.00 $195.00 $68.25 $120.25 $.00 $1.95 $.00 $.00 $.00 $4.55 f
4002927501 DOE, J e 12/08-12/08/2003 123456789 PAT $167.00 $.00 $167.00 $16.70 $.00 $.00 $45.09 $.00 $.00 $.00 $105.21 f
4002972901 DOE, J e 12/23-12/23/2003 123456789 PAT $234.25 $.00 $234.25 $136.25 $.00 $.00 $29.40 $.00 $.00 $.00 $68.60 f
4002973501 DOE, J 1 12/15-12/15/2003 123456789 PAT $225.00 $.00 $225.00 $90.00 $49.00 $.00 $25.80 $.00 $.00 $.00 $60.20 f
4002991301 DOE, J s 12/09-12/09/2003 123456789 PAT $208.00 $.00 $208.00 $52.00 $.00 $.00 $.00 $.00 $.00 $.00 $156.00 f
4002991701 DOE, J e 12/16-12/16/2003 123456789 PAT $3,412.50 $3,412.50 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002993801 DOE, J s 01/06-01/06/2004 123456789 PAT $78.00 $.00 $78.00 $14.50 $63.50 $.00 $.00 $.00 $.00 $.00 $.00 f
4002995101 DOE, J e 12/10-12/10/2003 123456789 PAT $2,534.00 $.00 $2,534.00 $760.20 $.00 $.00 $709.52 $.00 $.00 $.00 $1,064.28 f
4002997501 DOE, J s 12/03-12/03/2003 123456789 PAT $87.00 $.00 $87.00 $23.50 $63.50 $.00 $.00 $.00 $.00 $.00 $.00 f
4003048101 DOE, J s 01/02-01/02/2004 123456789 PAT $70.00 $.00 $70.00 $24.50 $45.50 $.00 $.00 $.00 $.00 $.00 $.00 f
4003048601 DOE, J 1 01/02-01/09/2004 123456789 PAT $325.00 $325.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003048602 DOE, J 1 01/02-01/09/2004 123456789 PAT $325.00 $.00 $325.00 $62.60 $.00 $.00 $104.97 $.00 $.00 $.00 $157.43 f
4003050801 DOE, J s 01/11-01/11/2004 123456789 PAT $332.07 $.00 $332.07 $99.62 $232.45 $.00 $.00 $.00 $.00 $.00 $.00 f
4003051201 DOE, J e 10/03-10/03/2003 123456789 PAT $142.00 $.00 $142.00 $21.30 $.00 $.00 $36.21 $.00 $.00 $.00 $84.49 f
4003053301 DOE, J 3 02/05-02/21/2003 123456789 PAT $436.50 $226.50 $210.00 $31.50 $.00 $.00 $53.55 $.00 $.00 $.00 $124.95 f
4003053501 DOE, J 2 01/07-01/07/2004 123456789 PAT $190.00 $.00 $190.00 $19.00 $55.80 $.00 $39.46 $.00 $.00 $.00 $75.74 f
4003054401 DOE, J s 12/17-12/17/2003 123456789 WENDY V $33.00 $33.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003055501 DOE, J s 12/26-12/26/2003 123456789 PAT $680.00 $.00 $680.00 $140.00 $.00 $.00 $162.00 $.00 $.00 $.00 $378.00 f
4003056001 DOE, J s 07/02-07/02/2003 123456789 PAT $175.00 $175.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003056401 DOE, J s 07/02-07/02/2003 123456789 PAT $645.25 $645.25 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003058501 DOE, J s 01/03-01/04/2004 123456789 PAT $395.00 $395.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003063001 DOE, J s 01/02-01/02/2004 123456789 PAT $80.00 $.00 $80.00 $53.18 $.00 $.00 $8.05 $.00 $.00 $.00 $18.77 f
4003063501 DOE, J s 01/02-01/02/2004 123456789 PAT $200.00 $.00 $200.00 $121.47 $.00 $.00 $23.56 $.00 $.00 $.00 $54.97 f
4003064201 DOE, J s 01/06-01/06/2004 123456789 PAT $285.00 $.00 $285.00 $57.00 $228.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003065101 DOE, J 1 01/06-01/06/2004 123456789 PAT $125.00 $.00 $125.00 $25.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003066001 DOE, J s 01/08-01/08/2004 123456789 PAT $85.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003066002 DOE, J s 01/08-01/08/2004 123456789 PAT $85.00 $.00 $85.00 $17.00 $68.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003096601 DOE, J s 01/03-01/03/2004 123456789 PAT $1,721.00 $.00 $1,721.00 $430.25 $250.00 $.00 $312.22 $.00 $.00 $.00 $728.53 f
4003100501 DOE, J s 01/06-01/06/2004 123456789 PAT $20.00 $.00 $20.00 $2.00 $.00 $.00 $5.40 $.00 $.00 $.00 $12.60 f
4003101301 DOE, J s 01/06-01/06/2004 123456789 PAT $113.50 $.00 $113.50 $11.35 $.00 $.00 $30.64 $.00 $.00 $.00 $71.51 f
4003102501 DOE, J s 01/09-01/09/2004 123456789 PAT $3,000.00 $.00 $3,000.00 $300.00 $42.00 $.00 $797.40 $.00 $.00 $.00 $1,860.60 f
4003103801 DOE, J JR 1 10/04-10/14/2003 123456789 PAT $399.00 $.00 $399.00 $79.80 $.00 $.00 $95.76 $.00 $.00 $.00 $223.44 f
4003105001 DOE, J 2 01/11-01/11/2004 123456789 PAT $110.00 $.00 $110.00 $38.50 $71.50 $.00 $.00 $.00 $.00 $.00 $.00 f
4003123901 DOE, J s 01/14-01/14/2004 123456789 PAT $80.00 $.00 $80.00 $32.00 $.00 $.00 $14.40 $.00 $.00 $.00 $33.60 f
4003180401 DOE, J e 12/24-12/24/2003 123456789 PAT $4,752.06 $.00 $4,752.06 $3,452.06 $.00 $100.00 $360.00 $.00 $.00 $.00 $840.00 f
4003195101 DOE, J e 12/19-12/19/2003 123456789 PAT $595.00 $.00 $595.00 $59.50 $250.00 $.00 $85.65 $.00 $.00 $.00 $199.85 f
4003195901 DOE, J e 11/21-11/21/2003 123456789 PAT $680.00 $.00 $680.00 $68.00 $.00 $.00 $183.60 $.00 $.00 $.00 $428.40 f
4003198601 DOE, J 1 10/21-10/21/2003 123456789 PAT $84.00 $.00 $84.00 $31.00 $.00 $.00 $26.50 $.00 $.00 $.00 $26.50 f
4003332701 DOE, J e 06/10-06/10/2003 123456789 PAT $205.00 $.00 $205.00 $53.71 $151.29 $.00 $.00 $.00 $.00 $.00 $.00 f
4003333601 DOE, J 2 01/14-01/14/2004 123456789 PAT $315.00 $.00 $315.00 $116.92 $.00 $10.00 $.00 $.00 $.00 $.00 $188.08 f
4003334501 DOE, J e 10/28-10/28/2003 123456789 PAT $72.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003366801 DOE, J s 12/27-12/29/2003 123456789 PAT $750.00 $750.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003367101 DOE, J s 12/30-12/30/2003 123456789 PAT $250.00 $250.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003367301 DOE, J s 12/31-12/31/2003 123456789 PAT $250.00 $250.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003367901 DOE, J s 01/01-01/02/2004 123456789 PAT $500.00 $500.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003371601 DOE, J e 12/01-12/15/2003 123456789 PAT $1,903.72 $.00 $1,903.72 $443.62 $.00 $.00 $470.85 $.00 $.00 $.00 $989.25 f
4003372401 DOE, J s 10/17-10/17/2003 123456789 PAT $70.40 $70.40 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003419001 DOE, J s 12/12-12/12/2003 123456789 PAT $50.00 $.00 $50.00 $15.00 $.00 $.00 $.00 $.00 $.00 $.00 $35.00 f
4003419801 DOE, J s 10/21-10/21/2003 123456789 PAT $2,750.00 $.00 $2,750.00 $470.36 $.00 $.00 $683.89 $.00 $.00 $.00 $1,595.75 f
4003424001 DOE, J e 12/18-12/18/2003 123456789 PAT $2,615.50 $.00 $2,615.50 $261.55 $250.00 $.00 $1,386.45 $.00 $.00 $.00 $717.50 f
4003424601 DOE, J s 08/21-08/21/2003 123456789 PAT $150.00 $150.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003427401 DOE, J 3 01/07-01/24/2003 123456789 PAT $150.00 $150.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003448701 DOE, J e 12/16-12/31/2003 123456789 PAT $1,236.29 $.00 $1,236.29 $186.40 $.00 $.00 $.00 $.00 $.00 $.00 $1,049.89 f
4003640501 DOE, J s 10/20-10/21/2003 123456789 PAT $170.00 $170.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003702401 DOE, J s 10/22-10/22/2003 123456789 KAREN R $37.00 $.00 $37.00 $13.30 $.00 $.00 $7.11 $.00 $.00 $.00 $16.59 f
4003702701 DOE, J JR e 01/07-01/07/2004 123456789 JAIME JR $1,400.00 $.00 $1,400.00 $210.00 $.00 $.00 $357.00 $.00 $.00 $.00 $833.00 f
4003708101 DOE, J s 01/12-01/12/2004 123456789 PAT $130.00 $130.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003709101 DOE, J s 01/09-01/09/2004 123456789 PAT $45.00 $.00 $45.00 $5.67 $39.33 $.00 $.00 $.00 $.00 $.00 $.00 f
4003709701 DOE, J s 01/08-01/08/2004 123456789 PAT $70.00 $.00 $70.00 $14.00 $56.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003714301 DOE, J e 01/07-01/07/2004 123456789 PAT $1,104.00 $1,104.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003714302 DOE, J e 01/07-01/07/2004 123456789 PAT $1,104.00 $.00 $1,104.00 $165.60 $.00 $.00 $281.52 $.00 $.00 $.00 $656.88 f
4003715501 DOE, J e 11/10-11/10/2003 123456789 PAT $85.00 $.00 $85.00 $15.61 $.00 $.00 $20.82 $.00 $.00 $.00 $48.57 f
4003716401 DOE, J e 01/12-01/12/2004 123456789 PAT $60.00 $.00 $60.00 $6.90 $53.10 $.00 $.00 $.00 $.00 $.00 $.00 f
4003716601 DOE, J e 12/05-12/05/2003 123456789 PAT $120.00 $.00 $120.00 $20.88 $.00 $.00 $29.74 $.00 $.00 $.00 $69.38 f
4003762201 DOE, J 1 12/03-12/03/2003 123456789 PAT $405.95 $.00 $405.95 $20.30 $35.00 $50.00 $90.19 $.00 $.00 $.00 $210.46 f
4003762701 DOE, J 3 12/03-12/03/2003 123456789 PAT $401.66 $.00 $401.66 $20.08 $248.00 $50.00 $25.07 $.00 $.00 $.00 $58.51 f
4003779101 DOE, J s 12/29-01/05/2004 123456789 PAT $674.00 $674.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003779201 DOE, J s 08/05-08/05/2003 123456789 PAT $54.00 $.00 $54.00 $5.40 $.00 $.00 $14.58 $.00 $.00 $.00 $34.02 f
4003779501 DOE, J s 08/05-08/05/2003 123456789 PAT $40.00 $.00 $40.00 $4.00 $.00 $.00 $12.20 $.00 $.00 $.00 $23.80 f
4003779701 DOE, J s 08/05-08/05/2003 123456789 PAT $145.00 $.00 $145.00 $14.50 $.00 $.00 $39.15 $.00 $.00 $.00 $91.35 f
4003989701 DOE, J 2 01/11-01/11/2004 123456789 PAT $365.00 $365.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004018601 DOE, J s 01/06-01/06/2004 123456789 PAT $80.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004018801 DOE, J s 01/09-01/09/2004 123456789 PAT $128.00 $128.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004019301 DOE, J 3 12/05-12/05/2003 123456789 PAT $56.00 $56.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004028701 DOE, J s 12/30-01/29/2004 123456789 PAT $385.00 $.00 $385.00 $97.00 $185.00 $.00 $30.90 $.00 $.00 $.00 $72.10 f
4004097601 DOE, J e 01/06-01/07/2004 123456789 PAT $69.33 $.00 $69.33 $14.43 $16.90 $.00 $11.40 $.00 $.00 $.00 $26.60 f
4004097701 DOE, J e 01/08-01/09/2004 123456789 PAT $77.27 $.00 $77.27 $8.13 $.00 $.00 $20.74 $.00 $.00 $.00 $48.40 f
4004097901 DOE, J e 01/09-01/12/2004 123456789 PAT $62.14 $.00 $62.14 $4.27 $.00 $.00 $17.37 $.00 $.00 $.00 $40.50 f
4004108201 DOE, J e 07/30-07/30/2003 123456789 PAT $236.00 $236.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004109401 DOE, J e 08/18-08/18/2003 123456789 PAT $206.00 $206.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004118701 DOE, J 1 09/27-09/27/2002 123456789 PAT $24.00 $24.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004234001 DOE, J s 01/05-01/05/2004 123456789 PAT $322.50 $.00 $322.50 $64.50 $.00 $.00 $51.60 $.00 $.00 $.00 $206.40 f
4004350201 DOE, J JR e 01/16-01/18/2004 123456789 JAIME JR $305.00 $.00 $305.00 $48.98 $.00 $.00 $76.80 $.00 $.00 $.00 $179.22 f
4004350301 DOE, J JR e 01/15-01/15/2004 123456789 JAIME JR $95.00 $.00 $95.00 $19.52 $.00 $.00 $22.64 $.00 $.00 $.00 $52.84 f
4004351901 DOE, J s 01/06-01/06/2004 123456789 PAT $789.35 $.00 $789.35 $39.46 $.00 $.00 $224.97 $.00 $.00 $.00 $524.92 f
4004352401 DOE, J IV 2 10/11-10/11/2003 123456789 PAT $50.00 $50.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004352501 DOE, J IV 1 10/11-10/11/2003 123456789 WILLIAM V $65.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004352701 DOE, J s 01/12-01/12/2004 123456789 PAT $25.00 $.00 $25.00 $5.00 $.00 $.00 $6.00 $.00 $.00 $.00 $14.00 f
4004386401 DOE, J s 01/16-01/16/2004 123456789 PAT $45.00 $.00 $45.00 $4.50 $.00 $.00 $12.15 $.00 $.00 $.00 $28.35 f
4004441001 DOE, J 2 12/31-12/31/2003 123456789 PAT $37.00 $37.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004441101 DOE, J e 01/13-01/13/2004 123456789 PAT $58.00 $.00 $58.00 $5.80 $52.20 $.00 $.00 $.00 $.00 $.00 $.00 f
4004441201 DOE, J e 01/19-01/19/2004 123456789 PAT $80.00 $.00 $80.00 $8.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004441301 DOE, J 3 01/08-01/08/2004 123456789 PAT $70.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004441401 DOE, J 1 01/16-01/16/2004 123456789 PAT $80.00 $.00 $80.00 $30.00 $.00 $.00 $25.00 $.00 $.00 $.00 $25.00 f
4004441501 DOE, J s 10/30-10/30/2003 123456789 PAT $185.00 $185.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004441701 DOE, J e 01/16-01/16/2004 123456789 PAT $74.00 $.00 $74.00 $14.80 $59.20 $.00 $.00 $.00 $.00 $.00 $.00 f
4004478601 DOE, J 1 01/09-01/09/2004 123456789 PAT $86.00 $.00 $86.00 $17.20 $68.80 $.00 $.00 $.00 $.00 $.00 $.00 f
4004509301 DOE, J 1 01/23-01/23/2004 123456789 PAT $100.00 $.00 $100.00 $21.69 $.00 $.00 $39.15 $.00 $.00 $.00 $39.16 f
4004513701 DOE, J e 11/23-11/23/2003 123456789 PAT $204.00 $204.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004514301 DOE, J s 01/20-01/20/2004 123456789 PAT $73.00 $.00 $73.00 $7.52 $.00 $.00 $19.64 $.00 $.00 $.00 $45.84 f
4004516101 DOE, J JR 1 01/16-01/16/2004 123456789 PAT $60.00 $.00 $60.00 $18.86 $41.14 $.00 $.00 $.00 $.00 $.00 $.00 f
4004516801 DOE, J e 01/19-01/19/2004 123456789 PAT $176.00 $176.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004517601 DOE, J e 12/28-12/28/2003 123456789 PAT $312.00 $312.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004527201 DOE, J e 01/08-01/09/2004 123456789 PAT $475.00 $475.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004535501 DOE, J s 01/23-01/23/2004 123456789 PAT $63.00 $.00 $63.00 $7.56 $55.44 $.00 $.00 $.00 $.00 $.00 $.00 f
4004536001 DOE, J s 01/23-01/23/2004 123456789 PAT $175.00 $.00 $175.00 $30.34 $144.66 $.00 $.00 $.00 $.00 $.00 $.00 f
4004536401 DOE, J e 11/19-11/19/2003 123456789 PAT $345.00 $.00 $345.00 $221.68 $.00 $.00 $37.00 $.00 $.00 $.00 $86.32 f
4004536801 DOE, J e 10/17-10/17/2003 123456789 PAT $150.00 $.00 $150.00 $30.00 $109.00 $.00 $11.00 $.00 $.00 $.00 $.00 f
4004574701 DOE, J s 01/11-01/11/2004 123456789 PAT $222.00 $.00 $222.00 $127.05 $94.95 $.00 $.00 $.00 $.00 $.00 $.00 f
4004579301 DOE, J s 09/15-09/15/2003 123456789 PAT $45.00 $18.00 $27.00 $.00 $27.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004656401 DOE, J s 06/03-06/03/2003 123456789 PAT $52.00 $.00 $52.00 $4.00 $48.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004657301 DOE, J JR e 01/21-01/22/2004 123456789 JAIME JR $190.00 $.00 $190.00 $39.04 $.00 $.00 $45.28 $.00 $.00 $.00 $105.68 f
4004657901 DOE, J e 01/08-01/08/2004 123456789 PAT $95.00 $.00 $95.00 $14.70 $80.30 $.00 $.00 $.00 $.00 $.00 $.00 f
4004658301 DOE, J e 08/05-08/05/2003 123456789 PAT $165.00 $165.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004659201 DOE, J e 08/04-08/04/2003 123456789 PAT $165.00 $165.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004685601 DOE, J s 01/09-02/08/2004 123456789 PAT $690.00 $.00 $690.00 $355.01 $.00 $.00 $134.00 $.00 $.00 $.00 $200.99 f
4004685901 DOE, J s 12/09-01/08/2004 123456789 PAT $690.00 $.00 $690.00 $355.01 $.00 $.00 $.00 $.00 $.00 $.00 $334.99 f
4004691101 DOE, J e 01/08-01/08/2004 123456789 PAT $131.00 $131.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004692501 DOE, J s 12/31-12/31/2003 123456789 PAT $35.00 $.00 $35.00 $7.00 $.00 $.00 $2.80 $.00 $.00 $.00 $25.20 f
4004703201 DOE, J s 01/16-01/16/2004 123456789 PAT $247.00 $.00 $247.00 $131.82 $41.50 $.00 $22.11 $.00 $.00 $.00 $51.57 f
4004703301 DOE, J e 01/20-01/20/2004 123456789 PAT $122.00 $.00 $122.00 $14.21 $63.79 $.00 $13.20 $.00 $.00 $.00 $30.80 f
4004711301 DOE, J JR e 01/23-01/23/2004 123456789 JAIME JR $95.00 $.00 $95.00 $19.52 $.00 $.00 $22.64 $.00 $.00 $.00 $52.84 f
4004711401 DOE, J e 12/31-12/31/2003 123456789 PAT $95.00 $.00 $95.00 $14.70 $.00 $.00 $32.12 $.00 $.00 $.00 $48.18 f
4004711501 DOE, J 2 01/07-01/07/2004 123456789 PAT $561.00 $.00 $561.00 $56.10 $54.67 $.00 $45.02 $.00 $.00 $.00 $405.21 f
4004716801 DOE, J s 10/22-10/22/2003 123456789 PAT $272.00 $272.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004717601 DOE, J e 01/20-01/20/2004 123456789 PAT $75.00 $.00 $75.00 $9.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004718501 DOE, J s 01/14-01/14/2004 123456789 PAT $60.00 $.00 $60.00 $6.00 $.00 $.00 $16.20 $.00 $.00 $.00 $37.80 f
4004719301 DOE, J s 02/28-02/28/2003 123456789 PAT $180.00 $.00 $180.00 $26.00 $154.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004987001 DOE, J s 12/19-12/31/2003 123456789 PAT $405.00 $.00 $405.00 $141.75 $.00 $.00 $.00 $.00 $.00 $.00 $263.25 f
4004995701 DOE, J 3 01/01-01/02/2004 123456789 PAT $4,802.00 $.00 $4,802.00 $1,440.60 $500.00 $50.00 $843.42 $.00 $.00 $.00 $1,967.98 f
4005020201 DOE, J e 01/15-01/15/2004 123456789 PAT $35.00 $.00 $35.00 $26.73 $.00 $.00 $.00 $.00 $.00 $.00 $8.27 f
4005032001 DOE, J s 01/23-01/23/2004 123456789 PAT $770.00 $.00 $770.00 $341.60 $244.02 $.00 $55.31 $.00 $.00 $.00 $129.07 f
4005032801 DOE, J e 01/16-01/16/2004 123456789 PAT $85.00 $.00 $85.00 $16.00 $65.00 $.00 $1.20 $.00 $.00 $.00 $2.80 f
4005033201 DOE, J e 01/12-01/12/2004 123456789 PAT $140.00 $.00 $140.00 $49.99 $65.00 $.00 $7.50 $.00 $.00 $.00 $17.51 f
4005033701 DOE, J e 01/09-01/09/2004 123456789 PAT $920.00 $.00 $920.00 $398.75 $65.00 $.00 $136.87 $.00 $.00 $.00 $319.38 f
4005062501 DOE, J e 02/06-02/06/2004 123456789 PAT $78.00 $.00 $78.00 $22.85 $55.15 $.00 $.00 $.00 $.00 $.00 $.00 f
4005062601 DOE, J 3 01/09-01/09/2004 123456789 PAT $265.00 $.00 $265.00 $204.21 $.00 $.00 $18.22 $.00 $.00 $.00 $42.57 f
4005081601 DOE, J e 12/15-01/14/2004 123456789 PAT $370.00 $.00 $370.00 $131.00 $185.00 $.00 $16.20 $.00 $.00 $.00 $37.80 f
4005081901 DOE, J e 01/26-01/26/2004 123456789 PAT $208.00 $.00 $208.00 $64.24 $81.00 $.00 $18.83 $.00 $.00 $.00 $43.93 f
4005096901 DOE, J s 12/05-12/05/2003 123456789 PAT $103.00 $103.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005098001 DOE, J JR 3 01/21-01/21/2004 123456789 PAT $155.00 $.00 $155.00 $54.25 $100.75 $.00 $.00 $.00 $.00 $.00 $.00 f
4005105601 DOE, J JR 3 01/19-01/19/2004 123456789 PAT $332.00 $.00 $332.00 $116.20 $182.25 $.00 $16.71 $.00 $.00 $.00 $16.84 f
4005120601 DOE, J e 01/06-01/06/2004 123456789 PAT $66.00 $.00 $66.00 $6.60 $59.40 $.00 $.00 $.00 $.00 $.00 $.00 f
4005121201 DOE, J e 10/05-10/05/2003 123456789 PAT $90.50 $90.50 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005121202 DOE, J e 10/05-10/05/2003 123456789 PAT $90.50 $.00 $90.50 $47.50 $43.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005121301 DOE, J s 12/08-12/08/2003 123456789 PAT $40.00 $.00 $40.00 $16.30 $.00 $.00 $.00 $.00 $.00 $.00 $23.70 f
4005122401 DOE, J s 01/26-01/26/2004 123456789 PAT $58.00 $.00 $58.00 $9.01 $48.99 $.00 $.00 $.00 $.00 $.00 $.00 f
4005122801 DOE, J 1 02/04-02/04/2004 123456789 PAT $80.00 $.00 $80.00 $15.83 $.00 $.00 $32.08 $.00 $.00 $.00 $32.09 f
4005123001 DOE, J s 02/02-02/02/2004 123456789 PAT $45.00 $.00 $45.00 $5.08 $39.92 $.00 $.00 $.00 $.00 $.00 $.00 f
4005123201 DOE, J e 01/25-01/25/2004 123456789 PAT $27.00 $.00 $27.00 $1.72 $25.28 $.00 $.00 $.00 $.00 $.00 $.00 f
4005123301 DOE, J e 02/02-02/02/2004 123456789 PAT $150.00 $.00 $150.00 $60.70 $89.30 $.00 $.00 $.00 $.00 $.00 $.00 f
4005123801 DOE, J 1 01/26-01/26/2004 123456789 PAT $83.00 $.00 $83.00 $48.72 $34.28 $.00 $.00 $.00 $.00 $.00 $.00 f
4005141201 DOE, J s 01/16-01/16/2004 123456789 PAT $170.00 $.00 $170.00 $42.50 $.00 $.00 $63.75 $.00 $.00 $.00 $63.75 f
4005177001 DOE, J s 01/23-01/29/2004 123456789 PAT $255.00 $.00 $255.00 $77.88 $177.12 $.00 $.00 $.00 $.00 $.00 $.00 f
4005177201 DOE, J e 01/29-01/29/2004 123456789 PAT $45.00 $.00 $45.00 $9.85 $35.15 $.00 $.00 $.00 $.00 $.00 $.00 f
4005177501 DOE, J s 01/26-01/26/2004 123456789 PAT $240.00 $.00 $240.00 $136.79 $100.66 $.00 $.77 $.00 $.00 $.00 $1.78 f
4005179901 DOE, J 3 01/13-01/13/2004 123456789 PAT $87.00 $.00 $87.00 $43.35 $43.65 $.00 $.00 $.00 $.00 $.00 $.00 f
4005180601 DOE, J s 01/19-01/19/2004 123456789 PAT $125.00 $.00 $125.00 $25.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005181601 DOE, J s 01/30-01/30/2004 123456789 PAT $80.00 $.00 $80.00 $32.00 $.00 $.00 $14.40 $.00 $.00 $.00 $33.60 f
4005207401 DOE, J 1 12/22-12/22/2003 123456789 PAT $155.20 $155.20 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005208101 DOE, J e 01/10-01/10/2004 123456789 PAT $928.00 $928.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005288901 DOE, J e 01/05-01/05/2004 123456789 PAT $70.00 $.00 $70.00 $7.00 $63.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005293201 DOE, J JR e 02/03-02/03/2004 123456789 JAIME JR $115.00 $.00 $115.00 $9.94 $.00 $.00 $31.52 $.00 $.00 $.00 $73.54 f
4005317201 DOE, J JR 3 01/26-01/26/2004 123456789 PAT $155.00 $.00 $155.00 $54.25 $100.75 $.00 $.00 $.00 $.00 $.00 $.00 f
4005354501 DOE, J e 01/16-01/16/2004 123456789 PAT $175.00 $175.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005355601 DOE, J s 01/26-01/26/2004 123456789 PAT $225.00 $.00 $225.00 $56.25 $.00 $.00 $84.37 $.00 $.00 $.00 $84.38 f
4005355801 DOE, J s 01/28-01/28/2004 123456789 PAT $485.00 $.00 $485.00 $159.50 $250.00 $.00 $23.90 $.00 $.00 $.00 $51.60 f
4005428401 DOE, J s 11/14-12/13/2003 123456789 PAT $385.00 $.00 $385.00 $137.00 $155.00 $.00 $30.90 $.00 $.00 $.00 $62.10 f
 
Total Ben Type: CS $114,151.45 $14,754.35 $99,397.10 $17,658.94 $7,121.24 $810.00 $11,147.65 $.00 $.00 $.00 $62,659.27  
 
Benefit Type: D
2063287420 DOE, J 1 02/09-02/09/2004 123456789 PAT $100.52 $.00 $100.52 $.00 $.00 $.00 $50.26 $.00 $.00 $.00 $50.26 f
2085337918 DOE, J 1 02/09-02/09/2004 123456789 PAT $116.14 $6.14 $110.00 $.00 $.00 $.00 $55.00 $.00 $.00 $.00 $55.00 f
2114179615 DOE, J 1 02/09-02/09/2004 123456789 PAT $87.50 $.00 $87.50 $.00 $.00 $.00 $43.75 $.00 $.00 $.00 $43.75 f
3001948715 DOE, J 2 02/09-02/09/2004 123456789 PAT $67.50 $.00 $67.50 $.00 $.00 $.00 $33.75 $.00 $.00 $.00 $33.75 f
3003531514 DOE, J 2 02/09-02/09/2004 123456789 PAT $105.08 $38.04 $67.04 $.00 $.00 $.00 $33.52 $.00 $.00 $.00 $33.52 f
3007056014 DOE, J 2 02/09-02/09/2004 123456789 PAT $105.00 $.00 $105.00 $.00 $.00 $.00 $52.50 $.00 $.00 $.00 $52.50 f
3009939814 DOE, J 1 02/09-02/09/2004 123456789 PAT $141.66 $.00 $141.66 $.00 $.00 $.00 $70.83 $.00 $.00 $.00 $70.83 f
3027135611 DOE, J 2 02/09-02/09/2004 123456789 PAT $114.58 $79.96 $34.62 $.00 $.00 $.00 $17.31 $.00 $.00 $.00 $17.31 f
3030370710 DOE, J 1 02/09-02/09/2004 123456789 PAT $116.00 $.00 $116.00 $.00 $.00 $.00 $58.00 $.00 $.00 $.00 $58.00 f
3034029210 DOE, J 1 02/09-02/09/2004 123456789 PAT $150.00 $.00 $150.00 $.00 $.00 $.00 $75.00 $.00 $.00 $.00 $75.00 f
3034030810 DOE, J 3 02/09-02/09/2004 123456789 PAT $157.50 $117.50 $40.00 $.00 $.00 $.00 $20.00 $.00 $.00 $.00 $20.00 f
3035083009 DOE, J JR 1 02/09-02/09/2004 123456789 ADAM JR $141.66 $.00 $141.66 $.00 $.00 $.00 $70.83 $.00 $.00 $.00 $70.83 f
3038565102 DOE, J s 06/18-06/18/2003 123456789 PAT $320.00 $.00 $320.00 $.00 $50.00 $.00 $60.00 $.00 $.00 $.00 $210.00 f
3039461208 DOE, J 1 02/09-02/09/2004 123456789 PAT $116.66 $.00 $116.66 $.00 $.00 $.00 $58.33 $.00 $.00 $.00 $58.33 f
3039472708 DOE, J 1 02/09-02/09/2004 123456789 PAT $140.83 $.00 $140.83 $.00 $.00 $.00 $70.42 $.00 $.00 $.00 $70.41 f
3040316008 DOE, J 1 02/09-02/09/2004 123456789 PAT $100.00 $50.00 $50.00 $.00 $.00 $.00 $25.00 $.00 $.00 $.00 $25.00 f
3040544508 DOE, J JR 2 02/09-02/09/2004 123456789 PAT $135.00 $.00 $135.00 $.00 $.00 $.00 $67.50 $.00 $.00 $.00 $67.50 f
3040752608 DOE, J 2 02/09-02/09/2004 123456789 PAT $113.90 $.00 $113.90 $.00 $.00 $.00 $56.95 $.00 $.00 $.00 $56.95 f
3041523108 DOE, J 2 02/09-02/09/2004 123456789 ROLANDO JR $98.21 $.00 $98.21 $.00 $.00 $.00 $49.11 $.00 $.00 $.00 $49.10 f
3041546608 DOE, J 2 02/09-02/09/2004 123456789 PAT $122.66 $.00 $122.66 $.00 $.00 $.00 $61.33 $.00 $.00 $.00 $61.33 f
3041597308 DOE, J 2 02/09-02/09/2004 123456789 PAT $125.00 $.00 $125.00 $.00 $.00 $.00 $62.50 $.00 $.00 $.00 $62.50 f
3042702007 DOE, J 1 02/09-02/09/2004 123456789 PAT $105.08 $.00 $105.08 $.00 $.00 $.00 $52.54 $.00 $.00 $.00 $52.54 f
3042955207 DOE, J 2 02/09-02/09/2004 123456789 PAT $130.00 $.00 $130.00 $.00 $.00 $.00 $65.00 $.00 $.00 $.00 $65.00 f
3043827607 DOE, J 1 02/09-02/09/2004 123456789 PAT $110.00 $.00 $110.00 $.00 $.00 $.00 $55.00 $.00 $.00 $.00 $55.00 f
3044051306 DOE, J 1 02/09-02/09/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $50.00 $.00 $.00 $.00 $50.00 f
3044160306 DOE, J 2 02/09-02/09/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $50.00 $.00 $.00 $.00 $50.00 f
3044333706 DOE, J 1 02/09-02/09/2004 123456789 PAT $135.20 $.00 $135.20 $.00 $.00 $.00 $67.60 $.00 $.00 $.00 $67.60 f
3044338306 DOE, J 1 02/09-02/09/2004 123456789 PAT $170.00 $.00 $170.00 $.00 $.00 $.00 $85.00 $.00 $.00 $.00 $85.00 f
3045342506 DOE, J 3 02/09-02/09/2004 123456789 PAT $138.88 $.00 $138.88 $.00 $.00 $.00 $69.44 $.00 $.00 $.00 $69.44 f
3045919306 DOE, J 2 02/09-02/09/2004 123456789 PAT $150.00 $.00 $150.00 $.00 $.00 $.00 $75.00 $.00 $.00 $.00 $75.00 f
3046020602 DOE, J s 07/09-07/09/2003 123456789 PAT $105.00 $.00 $105.00 $.00 $.00 $.00 $.00 $.00 $95.00 $.00 $10.00 f
3046724405 DOE, J JR 2 02/09-02/09/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $50.00 $.00 $.00 $.00 $50.00 f
3046836805 DOE, J 2 02/09-02/09/2004 123456789 PAT $213.33 $.00 $213.33 $.00 $.00 $.00 $106.67 $.00 $.00 $.00 $106.66 f
3047350105 DOE, J 3 02/09-02/09/2004 123456789 PAT $160.41 $121.03 $39.38 $.00 $.00 $.00 $19.69 $.00 $.00 $.00 $19.69 f
3049317704 DOE, J 1 02/09-02/09/2004 123456789 PAT $125.00 $.00 $125.00 $.00 $.00 $.00 $62.50 $.00 $.00 $.00 $62.50 f
3049433904 DOE, J 1 02/09-02/09/2004 123456789 PAT $119.00 $.00 $119.00 $.00 $.00 $.00 $59.50 $.00 $.00 $.00 $59.50 f
3049646304 DOE, J JR. 3 02/09-02/09/2004 123456789 PAT $143.75 $74.99 $68.76 $.00 $.00 $.00 $34.38 $.00 $.00 $.00 $34.38 f
3049703604 DOE, J JR. 1 02/09-02/09/2004 123456789 PAT $140.00 $.00 $140.00 $.00 $.00 $.00 $70.00 $.00 $.00 $.00 $70.00 f
3050372102 DOE, J 2 11/11-11/11/2003 123456789 PAT $368.00 $.00 $368.00 $.00 $.00 $.00 $184.00 $.00 $.00 $.00 $184.00 f
3051510003 DOE, J 1 02/09-02/09/2004 123456789 PAT $133.33 $.00 $133.33 $.00 $.00 $.00 $66.67 $.00 $.00 $.00 $66.66 f
3051608504 DOE, J 1 02/09-02/09/2004 123456789 PAT $125.00 $.00 $125.00 $.00 $.00 $.00 $62.50 $.00 $.00 $.00 $62.50 f
3052128703 DOE, J 1 02/09-02/09/2004 123456789 PAT $166.25 $.00 $166.25 $.00 $.00 $.00 $83.13 $.00 $.00 $.00 $83.12 f
4001404202 DOE, J 2 12/17-12/17/2003 123456789 PAT $787.00 $.00 $787.00 $.00 $50.00 $.00 $368.50 $.00 $.00 $.00 $368.50 f
4001712302 DOE, J 1 01/08-01/08/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $75.00 f
4001713302 DOE, J s 10/13-10/13/2003 123456789 PAT $85.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4001713303 DOE, J s 08/08-08/08/2003 123456789 PAT $85.00 $.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $85.00 f
4001788502 DOE, J e 01/05-01/05/2004 123456789 PAT $106.00 $.00 $106.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $106.00 f
4001804802 DOE, J 1 02/09-02/09/2004 123456789 PAT $256.25 $.00 $256.25 $.00 $.00 $.00 $128.13 $.00 $.00 $.00 $128.12 f
4001806302 DOE, J 1 02/09-02/09/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $50.00 $.00 $.00 $.00 $50.00 f
4002037102 DOE, J 4 02/09-02/09/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $43.50 $.00 $.00 $.00 $43.50 f
4002056102 DOE, J 1 12/08-12/08/2003 123456789 PAT $375.00 $2.00 $373.00 $.00 $50.00 $.00 $161.50 $.00 $135.00 $.00 $26.50 f
4002205402 DOE, J e 12/17-12/17/2003 123456789 PAT $138.00 $.00 $138.00 $.00 $.00 $.00 $69.00 $.00 $.00 $.00 $69.00 f
4002357102 DOE, J 2 02/09-02/09/2004 123456789 PAT $79.16 $.00 $79.16 $.00 $.00 $.00 $39.58 $.00 $.00 $.00 $39.58 f
4002411202 DOE, J 1 02/09-02/09/2004 123456789 PAT $136.04 $.00 $136.04 $.00 $.00 $.00 $68.02 $.00 $.00 $.00 $68.02 f
4002614102 DOE, J 2 02/09-02/09/2004 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $25.00 $.00 $.00 $.00 $25.00 f
4002656802 DOE, J 3 02/09-02/09/2004 123456789 PAT $200.00 $.00 $200.00 $.00 $.00 $.00 $100.00 $.00 $.00 $.00 $100.00 f
4002891401 DOE, J s 01/21-01/21/2004 123456789 LAURA J $113.00 $.00 $113.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $113.00 f
4002891601 DOE, J e 01/21-01/21/2004 123456789 PAT $87.00 $1.00 $86.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $86.00 f
4002917501 DOE, J s 01/22-01/22/2004 123456789 PAT $430.00 $.00 $430.00 $.00 $50.00 $.00 $190.00 $.00 $.00 $.00 $190.00 f
4002918101 DOE, J s 01/17-01/17/2004 123456789 PAT $817.00 $.00 $817.00 $.00 $50.00 $.00 $375.00 $.00 $.00 $.00 $392.00 f
4002919401 DOE, J s 01/22-01/22/2004 123456789 PAT $174.00 $.00 $174.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $174.00 f
4002920501 DOE, J e 12/16-12/16/2003 123456789 PAT $275.00 $.00 $275.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $275.00 f
4002920901 DOE, J 2 01/15-01/15/2004 123456789 PAT $211.00 $211.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002922101 DOE, J s 01/20-01/20/2004 123456789 PAT $190.00 $.00 $190.00 $.00 $50.00 $.00 $70.00 $.00 $.00 $.00 $70.00 f
4002922901 DOE, J 2 01/15-01/15/2004 123456789 PAT $172.00 $5.00 $167.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $167.00 f
4002923401 DOE, J 3 01/15-01/15/2004 123456789 PAT $153.00 $153.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002924501 DOE, J 2 01/13-01/13/2004 123456789 PAT $371.00 $54.00 $317.00 $.00 $50.00 $.00 $123.50 $.00 $.00 $.00 $143.50 f
4002925001 DOE, J s 01/13-01/13/2004 123456789 PAT $70.00 $.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $70.00 f
4002925301 DOE, J s 01/17-01/17/2004 123456789 PAT $215.00 $.00 $215.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $215.00 f
4002925901 DOE, J s 01/13-01/13/2004 123456789 PAT $106.00 $.00 $106.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $106.00 f
4002926301 DOE, J 1 01/21-01/21/2004 123456789 PAT $29.00 $.00 $29.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $29.00 f
4002926501 DOE, J JR s 01/22-01/22/2004 123456789 NORMA JR $690.00 $19.00 $671.00 $.00 $50.00 $.00 $287.50 $.00 $.00 $.00 $333.50 f
4002926601 DOE, J s 01/21-01/21/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4002926801 DOE, J 2 01/15-01/15/2004 123456789 PAT $250.00 $250.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4002927301 DOE, J e 12/31-12/31/2003 123456789 PAT $820.00 $.00 $820.00 $.00 $50.00 $.00 $375.00 $.00 $.00 $.00 $395.00 f
4002927701 DOE, J e 01/26-01/26/2004 123456789 PAT $136.00 $51.00 $85.00 $.00 $50.00 $.00 $17.50 $.00 $.00 $.00 $17.50 f
4002928701 DOE, J s 01/12-01/12/2004 123456789 PAT $585.00 $.00 $585.00 $.00 $50.00 $.00 $267.50 $.00 $.00 $.00 $267.50 f
4002929201 DOE, J e 01/20-01/20/2004 123456789 PAT $235.00 $.00 $235.00 $.00 $50.00 $.00 $55.00 $.00 $.00 $.00 $130.00 f
4002929801 DOE, J e 11/25-11/25/2003 123456789 PAT $853.00 $47.00 $806.00 $.00 $.00 $.00 $403.00 $.00 $.00 $.00 $403.00 f
4002937201 DOE, J e 01/16-01/16/2004 123456789 PAT $108.00 $.00 $108.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $108.00 f
4002999301 DOE, J s 01/26-01/26/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4003003101 DOE, J s 12/16-12/16/2003 123456789 PAT $423.00 $.00 $423.00 $.00 $.00 $.00 $187.50 $.00 $.00 $.00 $235.50 f
4003019801 DOE, J s 01/15-01/15/2004 123456789 PAT $750.00 $.00 $750.00 $.00 $50.00 $.00 $350.00 $.00 $.00 $.00 $350.00 f
4003021401 DOE, J e 01/26-01/26/2004 123456789 PAT $91.00 $10.00 $81.00 $.00 $40.00 $.00 $.00 $.00 $.00 $.00 $41.00 f
4003030801 DOE, J 1 01/20-01/20/2004 123456789 PAT $72.00 $.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $72.00 f
4003031301 DOE, J e 01/19-01/19/2004 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4003032901 DOE, J e 01/26-01/26/2004 123456789 PAT $126.00 $.00 $126.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $126.00 f
4003033101 DOE, J e 01/22-01/22/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $50.00 $.00 $15.00 $.00 $.00 $.00 $15.00 f
4003033201 DOE, J 3 01/26-01/26/2004 123456789 PAT $193.00 $.00 $193.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $193.00 f
4003034201 DOE, J e 01/26-01/26/2004 123456789 PAT $168.00 $.00 $168.00 $.00 $50.00 $.00 $26.50 $.00 $.00 $.00 $91.50 f
4003034701 DOE, J e 01/22-01/22/2004 123456789 PAT $601.00 $.00 $601.00 $.00 $50.00 $.00 $275.50 $.00 $.00 $.00 $275.50 f
4003035701 DOE, J e 11/05-11/05/2003 123456789 PAT $68.00 $68.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003035901 DOE, J 2 01/24-01/24/2004 123456789 PAT $108.00 $.00 $108.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $108.00 f
4003036401 DOE, J e 01/20-01/20/2004 123456789 PAT $217.00 $130.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4003037001 DOE, J 1 01/23-01/23/2004 123456789 PAT $395.00 $160.00 $235.00 $.00 $50.00 $.00 $92.50 $.00 $.00 $.00 $92.50 f
4003067601 DOE, J e 01/22-01/22/2004 123456789 PAT $975.00 $20.00 $955.00 $.00 $50.00 $.00 $452.50 $.00 $.00 $.00 $452.50 f
4003149401 DOE, J e 01/27-01/27/2004 123456789 PAT $84.00 $.00 $84.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $84.00 f
4003149501 DOE, J e 01/29-01/29/2004 123456789 PAT $124.00 $.00 $124.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $124.00 f
4003200601 DOE, J 2 01/16-01/16/2004 123456789 PAT $97.00 $65.00 $32.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $32.00 f
4003201101 DOE, J 1 01/16-01/16/2004 123456789 PAT $142.00 $.00 $142.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $142.00 f
4003201501 DOE, J s 01/22-01/22/2004 123456789 PAT $152.00 $.00 $152.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $152.00 f
4003201901 DOE, J s 01/23-01/23/2004 123456789 PAT $757.00 $6.00 $751.00 $.00 $50.00 $.00 $312.50 $.00 $.00 $.00 $388.50 f
4003216201 DOE, J e 01/23-01/23/2004 123456789 PAT $233.00 $41.00 $192.00 $.00 $.00 $.00 $96.00 $.00 $.00 $.00 $96.00 f
4003216301 DOE, J e 01/27-01/27/2004 123456789 PAT $349.50 $50.50 $299.00 $.00 $.00 $.00 $149.50 $.00 $.00 $.00 $149.50 f
4003217701 DOE, J e 01/12-01/12/2004 123456789 PAT $1,500.00 $1,500.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003218201 DOE, J e 08/01-08/01/2002 123456789 PAT $35.00 $35.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003218901 DOE, J s 01/29-01/29/2004 123456789 PAT $754.00 $9.00 $745.00 $.00 $50.00 $.00 $257.50 $.00 $.00 $.00 $437.50 f
4003219201 DOE, J s 01/26-01/26/2004 123456789 PAT $58.00 $.00 $58.00 $.00 $50.00 $.00 $4.00 $.00 $.00 $.00 $4.00 f
4003219501 DOE, J e 01/27-01/27/2004 123456789 PAT $98.00 $.00 $98.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $98.00 f
4003219601 DOE, J e 01/22-01/22/2004 123456789 PAT $85.00 $.00 $85.00 $.00 $50.00 $.00 $17.50 $.00 $.00 $.00 $17.50 f
4003221001 DOE, J 5 10/29-10/29/2003 123456789 PAT $70.00 $2.00 $68.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $68.00 f
4003221301 DOE, J 4 10/24-10/24/2003 123456789 PAT $70.00 $2.00 $68.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $68.00 f
4003222301 DOE, J 2 12/18-12/18/2003 123456789 PAT $180.00 $141.00 $39.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $39.00 f
4003274401 DOE, J 1 01/26-01/26/2004 123456789 PAT $155.00 $.00 $155.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $155.00 f
4003274501 DOE, J e 01/26-01/26/2004 123456789 PAT $97.00 $.00 $97.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $97.00 f
4003274701 DOE, J e 01/26-01/26/2004 123456789 PAT $177.00 $.00 $177.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $177.00 f
4003275201 DOE, J e 01/26-01/26/2004 123456789 PAT $154.00 $20.00 $134.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $134.00 f
4003276201 DOE, J e 01/22-01/22/2004 123456789 PAT $103.00 $20.00 $83.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $83.00 f
4003277201 DOE, J e 01/27-01/27/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4003277301 DOE, J s 01/27-01/27/2004 123456789 PAT $143.00 $.00 $143.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $143.00 f
4003280301 DOE, J s 06/17-06/17/2003 123456789 PAT $1,040.00 $.00 $1,040.00 $.00 $.00 $.00 $520.00 $.00 $.00 $.00 $520.00 f
4003292601 DOE, J 2 01/14-01/14/2004 123456789 PAT $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003292901 DOE, J 3 01/24-01/24/2004 123456789 PAT $108.00 $.00 $108.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $108.00 f
4003294701 DOE, J 3 11/26-11/26/2003 123456789 PAT $130.00 $130.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003296501 DOE, J 1 01/26-01/26/2004 123456789 PAT $110.00 $.00 $110.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $110.00 f
4003297201 DOE, J 1 01/22-01/22/2004 123456789 PAT $138.00 $.00 $138.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $138.00 f
4003298101 DOE, J 1 01/28-01/28/2004 123456789 PAT $178.00 $56.00 $122.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $122.00 f
4003298901 DOE, J 3 01/27-01/27/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $115.00 f
4003299101 DOE, J s 01/26-01/26/2004 123456789 PAT $88.00 $.00 $88.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $88.00 f
4003299401 DOE, J e 01/27-01/27/2004 123456789 PAT $120.00 $.00 $120.00 $.00 $50.00 $.00 $35.00 $.00 $.00 $.00 $35.00 f
4003299901 DOE, J 3 01/27-01/27/2004 123456789 PAT $144.00 $.00 $144.00 $.00 $50.00 $.00 $47.00 $.00 $.00 $.00 $47.00 f
4003301201 DOE, J e 01/26-01/26/2004 123456789 PAT $337.00 $11.95 $325.05 $.00 $50.00 $.00 $137.52 $.00 $.00 $.00 $137.53 f
4003316701 DOE, J e 01/26-01/26/2004 123456789 PAT $75.00 $75.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003317601 DOE, J e 01/26-01/26/2004 123456789 PAT $17.00 $.00 $17.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $17.00 f
4003318601 DOE, J e 01/26-01/26/2004 123456789 PAT $123.00 $.00 $123.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $123.00 f
4003326401 DOE, J s 01/29-01/29/2004 123456789 PAT $305.00 $25.00 $280.00 $.00 $50.00 $.00 $115.00 $.00 $.00 $.00 $115.00 f
4003326501 DOE, J s 12/08-12/08/2003 123456789 PAT $598.00 $.00 $598.00 $.00 $.00 $.00 $299.00 $.00 $.00 $.00 $299.00 f
4003327101 DOE, J s 01/27-01/27/2004 123456789 J YVONNE $137.00 $20.00 $117.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $117.00 f
4003327301 DOE, J e 01/22-01/22/2004 123456789 PAT $40.00 $.00 $40.00 $.00 $40.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003327501 DOE, J 2 01/23-01/23/2004 123456789 PAT $229.00 $.00 $229.00 $.00 $50.00 $.00 $10.50 $.00 $.00 $.00 $168.50 f
4003327701 DOE, J 1 01/23-01/23/2004 123456789 PAT $194.00 $11.00 $183.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $183.00 f
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4003328201 DOE, J e 01/22-01/22/2004 123456789 PAT $188.00 $.00 $188.00 $.00 $50.00 $.00 $39.50 $.00 $.00 $.00 $98.50 f
4003328301 DOE, J 3 01/26-01/26/2004 123456789 PAT $113.00 $36.00 $77.00 $.00 $50.00 $.00 $13.50 $.00 $.00 $.00 $13.50 f
4003328501 DOE, J s 01/22-01/22/2004 123456789 PAT $361.00 $.00 $361.00 $.00 $50.00 $.00 $155.50 $.00 $.00 $.00 $155.50 f
4003328801 DOE, J s 01/27-01/27/2004 123456789 PAT $195.00 $.00 $195.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $195.00 f
4003329401 DOE, J e 01/27-01/27/2004 123456789 PAT $384.00 $34.00 $350.00 $.00 $.00 $.00 $175.00 $.00 $.00 $.00 $175.00 f
4003329601 DOE, J s 01/29-01/29/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4003330201 DOE, J 2 01/19-01/19/2004 123456789 PAT $345.00 $.00 $345.00 $.00 $.00 $.00 $172.50 $.00 $.00 $.00 $172.50 f
4003330301 DOE, J 2 01/19-01/19/2004 123456789 PAT $345.00 $345.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003330701 DOE, J s 01/27-01/27/2004 123456789 PAT $199.00 $.00 $199.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $199.00 f
4003330801 DOE, J s 01/15-01/15/2004 123456789 PAT $240.00 $.00 $240.00 $.00 $50.00 $.00 $95.00 $.00 $.00 $.00 $95.00 f
4003330901 DOE, J 1 01/21-01/21/2004 123456789 PAT $85.00 $27.00 $58.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $58.00 f
4003342301 DOE, J s 12/11-12/11/2003 123456789 PAT $55.00 $55.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003343801 DOE, J JR e 10/06-10/06/2003 123456789 SIMON JR $405.00 $8.00 $397.00 $.00 $.00 $.00 $198.50 $.00 $.00 $.00 $198.50 f
4003345201 DOE, J s 01/28-01/28/2004 123456789 PAT $220.00 $.00 $220.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $220.00 f
4003346101 DOE, J e 12/31-12/31/2003 123456789 PAT $820.00 $820.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003346701 DOE, J e 01/15-01/15/2004 123456789 PAT $228.00 $17.00 $211.00 $.00 $50.00 $.00 $52.50 $.00 $.00 $.00 $108.50 f
4003347001 DOE, J s 01/05-01/05/2004 123456789 PAT $665.00 $.00 $665.00 $.00 $50.00 $.00 $275.00 $.00 $.00 $.00 $340.00 f
4003347601 DOE, J 1 01/27-01/27/2004 123456789 PAT $206.00 $.00 $206.00 $.00 $50.00 $.00 $78.00 $.00 $.00 $.00 $78.00 f
4003347701 DOE, J e 12/04-12/04/2003 123456789 PAT $186.00 $.00 $186.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $186.00 f
4003347901 DOE, J K. 2 01/28-01/28/2004 123456789 DOROTHY MEGHAN $155.00 $.00 $155.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $155.00 f
4003353701 DOE, J K. 1 01/28-01/28/2004 123456789 DENNIS ANDREW $100.00 $4.00 $96.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $96.00 f
4003408501 DOE, J s 01/28-01/28/2004 123456789 PAT $103.00 $.00 $103.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $103.00 f
4003408601 DOE, J e 01/28-01/28/2004 123456789 PAT $82.00 $.00 $82.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $82.00 f
4003408901 DOE, J s 12/11-12/11/2003 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4003409101 DOE, J 1 01/19-01/19/2004 123456789 PAT $346.00 $14.00 $332.00 $.00 $50.00 $.00 $81.00 $.00 $.00 $.00 $201.00 f
4003409401 DOE, J 1 01/27-01/27/2004 123456789 PAT $66.00 $.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4003410701 DOE, J e 01/28-01/28/2004 123456789 PAT $192.00 $.00 $192.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $192.00 f
4003434801 DOE, J 1 01/28-01/28/2004 123456789 PAT $220.00 $.00 $220.00 $.00 $50.00 $.00 $85.00 $.00 $.00 $.00 $85.00 f
4003435001 DOE, J e 01/23-01/23/2004 123456789 PAT $418.00 $.00 $418.00 $.00 $50.00 $.00 $184.00 $.00 $.00 $.00 $184.00 f
4003435601 DOE, J 2 12/17-12/17/2003 123456789 PAT $787.00 $787.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003436201 DOE, J s 12/29-12/29/2003 123456789 PAT $65.00 $14.00 $51.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $51.00 f
4003436601 DOE, J e 01/28-01/28/2004 123456789 PAT $92.00 $80.00 $12.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $12.00 f
4003436801 DOE, J 3 01/19-01/19/2004 123456789 PAT $395.00 $58.00 $337.00 $.00 $50.00 $.00 $12.50 $.00 $.00 $.00 $274.50 f
4003437701 DOE, J e 01/23-01/23/2004 123456789 PAT $488.00 $.00 $488.00 $.00 $50.00 $.00 $70.00 $.00 $.00 $.00 $368.00 f
4003438101 DOE, J 3 01/15-01/15/2004 123456789 PAT $400.00 $.00 $400.00 $.00 $50.00 $.00 $175.00 $.00 $.00 $.00 $175.00 f
4003438701 DOE, J 2 01/17-01/17/2004 123456789 LENIN JR $275.00 $85.00 $190.00 $.00 $.00 $.00 $95.00 $.00 $.00 $.00 $95.00 f
4003442101 DOE, J e 10/28-01/07/2004 123456789 PAT $651.00 $124.00 $527.00 $.00 $87.00 $.00 $219.98 $.00 $.00 $.00 $220.02 f
4003444001 DOE, J 1 01/23-01/23/2004 123456789 PAT $1,314.00 $.00 $1,314.00 $.00 $50.00 $.00 $632.00 $.00 $.00 $.00 $632.00 f
4003444401 DOE, J e 12/01-12/01/2003 123456789 PAT $783.00 $783.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003445801 DOE, J e 01/30-01/30/2004 123456789 PAT $409.00 $.00 $409.00 $.00 $50.00 $.00 $179.50 $.00 $.00 $.00 $179.50 f
4003446301 DOE, J 1 11/26-11/26/2003 123456789 PAT $130.00 $130.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003446401 DOE, J 2 11/26-11/26/2003 123456789 PAT $300.00 $300.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003446801 DOE, J s 01/27-01/27/2004 123456789 PAT $109.00 $.00 $109.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $109.00 f
4003447001 DOE, J 1 12/23-12/23/2003 123456789 PAT $212.00 $52.00 $160.00 $.00 $50.00 $.00 $26.00 $.00 $.00 $.00 $84.00 f
4003447801 DOE, J s 01/29-01/29/2004 123456789 PAT $193.00 $57.00 $136.00 $.00 $50.00 $.00 $43.00 $.00 $.00 $.00 $43.00 f
4003448101 DOE, J s 01/27-01/27/2004 123456789 PAT $75.00 $55.00 $20.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $20.00 f
4003449901 DOE, J e 01/28-01/28/2004 123456789 PAT $227.00 $.00 $227.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $227.00 f
4003452501 DOE, J 2 12/23-12/23/2003 123456789 PAT $172.00 $114.00 $58.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $58.00 f
4003455201 DOE, J 2 01/19-02/01/2004 123456789 PAT $1,650.00 $.00 $1,650.00 $.00 $50.00 $.00 $800.00 $.00 $.00 $.00 $800.00 f
4003456701 DOE, J 1 01/22-02/01/2004 123456789 PAT $1,780.00 $.00 $1,780.00 $.00 $50.00 $.00 $865.00 $.00 $.00 $.00 $865.00 f
4003457501 DOE, J 1 01/19-01/19/2004 123456789 PAT $206.00 $9.00 $197.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $197.00 f
4003458701 DOE, J 1 01/27-01/27/2004 123456789 PAT $30.00 $.00 $30.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $30.00 f
4003459301 DOE, J 2 01/22-01/22/2004 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $25.00 $.00 $.00 $.00 $25.00 f
4003459401 DOE, J 2 01/22-01/22/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $.00 $.00 $37.50 $.00 $.00 $.00 $37.50 f
4003459801 DOE, J 1 01/28-01/28/2004 123456789 PAT $119.00 $.00 $119.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $119.00 f
4003460101 DOE, J s 01/29-01/29/2004 123456789 PAT $88.00 $.00 $88.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $88.00 f
4003462101 DOE, J s 01/07-01/07/2004 123456789 PAT $4,400.00 $4,056.00 $344.00 $.00 $.00 $.00 $172.00 $.00 $.00 $.00 $172.00 f
4003463701 DOE, J 3 01/23-01/23/2004 123456789 PAT $73.00 $.00 $73.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $73.00 f
4003550301 DOE, J s 01/29-01/29/2004 123456789 PAT $64.00 $.00 $64.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $64.00 f
4003659001 DOE, J s 01/14-01/14/2004 123456789 PAT $295.00 $.00 $295.00 $.00 $50.00 $.00 $90.50 $.00 $.00 $.00 $154.50 f
4003659401 DOE, J e 01/28-01/28/2004 123456789 PAT $344.00 $20.00 $324.00 $.00 $50.00 $.00 $47.00 $.00 $.00 $.00 $227.00 f
4003660201 DOE, J 1 09/18-09/18/2003 123456789 PAT $217.00 $.00 $217.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $217.00 f
4003662001 DOE, J e 01/24-01/24/2004 123456789 PAT $145.00 $16.00 $129.00 $.00 $50.00 $.00 $29.50 $.00 $.00 $.00 $49.50 f
4003662701 DOE, J s 11/11-11/11/2003 123456789 PAT $1,187.00 $1,187.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003664001 DOE, J 1 01/27-01/27/2004 123456789 PAT $76.00 $.00 $76.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $76.00 f
4003664401 DOE, J s 01/29-01/29/2004 123456789 PAT $165.00 $15.00 $150.00 $.00 $50.00 $.00 $33.00 $.00 $.00 $.00 $67.00 f
4003665001 DOE, J s 12/08-12/08/2003 123456789 PAT $105.00 $.00 $105.00 $.00 $50.00 $.00 $27.50 $.00 $.00 $.00 $27.50 f
4003672201 DOE, J e 02/03-02/03/2004 123456789 PAT $240.00 $.00 $240.00 $.00 $50.00 $.00 $95.00 $.00 $.00 $.00 $95.00 f
4003672401 DOE, J 2 01/28-01/28/2004 123456789 PAT $85.00 $.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $85.00 f
4003673001 DOE, J s 01/26-01/26/2004 123456789 PAT $84.00 $.00 $84.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $84.00 f
4003673101 DOE, J e 01/31-01/31/2004 123456789 PAT $118.00 $.00 $118.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $118.00 f
4003707501 DOE, J s 12/31-12/31/2003 123456789 PAT $1,615.00 $28.00 $1,587.00 $.00 $.00 $.00 $793.50 $.00 $650.30 $.00 $143.20 f
4003708601 DOE, J 1 01/28-01/28/2004 123456789 PAT $261.00 $.00 $261.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $261.00 f
4003709501 DOE, J 1 12/18-12/18/2003 123456789 PAT $135.00 $.00 $135.00 $.00 $.00 $.00 $.00 $.00 $104.00 $.00 $31.00 f
4003710101 DOE, J 3 02/12-02/12/2003 123456789 PAT $52.00 $.00 $52.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $52.00 f
4003710501 DOE, J s 01/29-01/29/2004 123456789 PAT $110.00 $.00 $110.00 $.00 $50.00 $.00 $30.00 $.00 $.00 $.00 $30.00 f
4003712801 DOE, J e 01/23-01/23/2004 123456789 PAT $667.00 $.00 $667.00 $.00 $.00 $.00 $333.50 $.00 $.00 $.00 $333.50 f
4003713101 DOE, J 1 01/21-01/21/2004 123456789 PAT $200.00 $26.00 $174.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $174.00 f
4003713401 DOE, J 2 01/28-01/28/2004 123456789 PAT $324.00 $60.00 $264.00 $.00 $50.00 $.00 $107.00 $.00 $.00 $.00 $107.00 f
4003714001 DOE, J e 01/26-01/26/2004 123456789 PAT $710.00 $.00 $710.00 $.00 $50.00 $.00 $330.00 $.00 $.00 $.00 $330.00 f
4003719701 DOE, J s 01/17-01/17/2004 123456789 PAT $675.00 $.00 $675.00 $.00 $50.00 $.00 $312.50 $.00 $.00 $.00 $312.50 f
4003720801 DOE, J e 01/29-01/29/2004 123456789 PAT $160.00 $160.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003721301 DOE, J 2 01/28-01/28/2004 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $50.00 f
4003721601 DOE, J 3 01/28-01/28/2004 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $50.00 f
4003721801 DOE, J 4 01/30-01/30/2004 123456789 PAT $190.00 $.00 $190.00 $.00 $50.00 $.00 $70.00 $.00 $.00 $.00 $70.00 f
4003722101 DOE, J 3 01/30-01/30/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $50.00 $.00 $12.50 $.00 $.00 $.00 $12.50 f
4003722701 DOE, J JR. e 01/29-01/29/2004 123456789 JAMES JR. $70.00 $.00 $70.00 $.00 $50.00 $.00 $10.00 $.00 $.00 $.00 $10.00 f
4003723201 DOE, J s 11/24-11/24/2003 123456789 PAT $107.00 $.00 $107.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $107.00 f
4003723601 DOE, J 4 07/22-07/22/2003 123456789 PAT $72.00 $.00 $72.00 $.00 $.00 $.00 $36.00 $.00 $.00 $.00 $36.00 f
4003723801 DOE, J 1 01/27-01/27/2004 123456789 PAT $115.00 $45.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $70.00 f
4003723901 DOE, J s 12/22-12/22/2003 123456789 PAT $74.00 $74.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003724801 DOE, J 2 01/28-01/28/2004 123456789 PAT $301.00 $25.00 $276.00 $.00 $50.00 $.00 $47.50 $.00 $.00 $.00 $178.50 f
4003725601 DOE, J 2 02/02-02/02/2004 123456789 PAT $181.00 $2.00 $179.00 $.00 $50.00 $.00 $64.50 $.00 $.00 $.00 $64.50 f
4003726001 DOE, J e 02/02-02/02/2004 123456789 PAT $138.00 $.00 $138.00 $.00 $50.00 $.00 $44.00 $.00 $.00 $.00 $44.00 f
4003728101 DOE, J e 02/02-02/02/2004 123456789 PAT $137.00 $.00 $137.00 $.00 $50.00 $.00 $28.50 $.00 $.00 $.00 $58.50 f
4003728901 DOE, J 2 01/15-01/15/2004 123456789 PAT $211.00 $211.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003729401 DOE, J 3 01/15-01/15/2004 123456789 PAT $153.00 $153.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003729901 DOE, J 3 01/26-01/26/2004 123456789 PAT $113.00 $113.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003730201 DOE, J 2 02/02-02/02/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $50.00 $.00 $32.50 $.00 $.00 $.00 $32.50 f
4003807401 DOE, J e 02/02-02/02/2004 123456789 PAT $72.00 $.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $72.00 f
4003807801 DOE, J e 12/23-12/23/2003 123456789 PAT $65.00 $.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $65.00 f
4003808301 DOE, J s 12/11-12/11/2003 123456789 PAT $55.00 $.00 $55.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $55.00 f
4003808501 DOE, J e 02/02-02/02/2004 123456789 PAT $56.00 $.00 $56.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $56.00 f
4003808601 DOE, J s 02/04-02/04/2004 123456789 PAT $167.00 $.00 $167.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $167.00 f
4003808701 DOE, J e 01/23-01/23/2004 123456789 PAT $52.00 $.00 $52.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $52.00 f
4003808801 DOE, J e 01/29-01/29/2004 123456789 PAT $330.00 $37.00 $293.00 $.00 $50.00 $.00 $78.00 $.00 $.00 $.00 $165.00 f
4003809101 DOE, J e 01/30-01/30/2004 123456789 PAT $123.00 $.00 $123.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $123.00 f
4003809401 DOE, J e 01/29-01/29/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $75.00 f
4003809801 DOE, J s 02/02-02/02/2004 123456789 PAT $98.00 $.00 $98.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $98.00 f
4003809901 DOE, J e 02/03-02/03/2004 123456789 PAT $100.00 $46.00 $54.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $54.00 f
4003810101 DOE, J s 02/02-02/02/2004 123456789 PAT $68.00 $6.00 $62.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $62.00 f
4003810401 DOE, J e 02/03-02/03/2004 123456789 PAT $122.00 $.00 $122.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $122.00 f
4003810601 DOE, J e 02/02-02/02/2004 123456789 PAT $145.00 $.00 $145.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $145.00 f
4003810901 DOE, J s 02/02-02/02/2004 123456789 PAT $65.00 $.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $65.00 f
4003811001 DOE, J s 02/03-02/03/2004 123456789 PAT $72.00 $.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $72.00 f
4003811101 DOE, J e 01/28-01/28/2004 123456789 PAT $154.00 $.00 $154.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $154.00 f
4003811901 DOE, J e 02/03-02/03/2004 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4003812101 DOE, J e 12/23-12/23/2003 123456789 PAT $88.00 $.00 $88.00 $.00 $.00 $.00 $44.00 $.00 $.00 $.00 $44.00 f
4003812201 DOE, J e 12/18-12/18/2003 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4003812301 DOE, J e 01/29-01/29/2004 123456789 PAT $136.00 $.00 $136.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $136.00 f
4003812601 DOE, J s 01/12-01/12/2004 123456789 PAT $256.00 $.00 $256.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $256.00 f
4003812701 DOE, J e 02/03-02/03/2004 123456789 PAT $66.00 $.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4003813001 DOE, J e 02/03-02/03/2004 123456789 PAT $96.00 $.00 $96.00 $.00 $50.00 $.00 $23.00 $.00 $.00 $.00 $23.00 f
4003813101 DOE, J e 01/30-01/30/2004 123456789 PAT $85.00 $.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $85.00 f
4003868001 DOE, J 1 01/29-01/29/2004 123456789 PAT $125.00 $.00 $125.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $125.00 f
4003870901 DOE, J 2 01/22-01/22/2004 123456789 PAT $1,308.00 $58.00 $1,250.00 $.00 $50.00 $.00 $600.00 $.00 $600.00 $.00 $.00 f
4003871901 DOE, J e 02/02-02/02/2004 123456789 PAT $72.00 $72.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003872101 DOE, J 3 01/29-01/29/2004 123456789 PAT $138.00 $75.00 $63.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $63.00 f
4003872401 DOE, J 1 01/29-01/29/2004 123456789 PAT $158.00 $75.00 $83.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $83.00 f
4003872701 DOE, J 1 07/14-07/14/2003 123456789 PAT $75.00 $75.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003873201 DOE, J e 11/07-11/07/2003 123456789 PAT $790.00 $18.00 $772.00 $.00 $.00 $.00 $362.50 $.00 $.00 $.00 $409.50 f
4003873601 DOE, J e 02/02-02/02/2004 123456789 PAT $42.00 $.00 $42.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $42.00 f
4003877501 DOE, J e 02/04-02/04/2004 123456789 PAT $210.00 $.00 $210.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $210.00 f
4003877701 DOE, J s 02/04-02/04/2004 123456789 MARY ELLA $78.00 $.00 $78.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $78.00 f
4003878001 DOE, J s 01/02-01/02/2004 123456789 PAT $215.00 $.00 $215.00 $.00 $50.00 $.00 $82.50 $.00 $.00 $.00 $82.50 f
4003878201 DOE, J 3 02/03-02/03/2004 123456789 PAT $337.00 $244.00 $93.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $93.00 f
4003878901 DOE, J 2 02/03-02/03/2004 123456789 PAT $128.00 $62.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4003879101 DOE, J 1 02/03-02/03/2004 123456789 PAT $134.00 $68.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4003879301 DOE, J 3 02/02-02/02/2004 123456789 ASHLEY M $242.00 $31.00 $211.00 $.00 $50.00 $.00 $24.00 $.00 $.00 $.00 $137.00 f
4003879601 WORD JR, CHARLES 2 02/04-02/04/2004 123456789 PAT $165.00 $.00 $165.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $165.00 f
4003879801 DOE, J e 01/29-01/29/2004 123456789 PAT $770.00 $.00 $770.00 $.00 $50.00 $.00 $360.00 $.00 $.00 $.00 $360.00 f
4003880201 DOE, J 2 01/29-01/29/2004 123456789 PAT $88.00 $.00 $88.00 $.00 $50.00 $.00 $19.00 $.00 $.00 $.00 $19.00 f
4003880301 DOE, J e 02/02-02/02/2004 123456789 PAT $139.00 $11.00 $128.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $128.00 f
4003880401 DOE, J 1 02/05-02/05/2004 123456789 PAT $90.00 $.00 $90.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $90.00 f
4003881401 DOE, J 2 02/05-02/05/2004 123456789 PAT $122.00 $.00 $122.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $122.00 f
4003881501 DOE, J JR e 02/02-02/02/2004 123456789 SEVERO JR $236.00 $.00 $236.00 $.00 $50.00 $.00 $62.50 $.00 $.00 $.00 $123.50 f
4003881601 DOE, J e 02/02-02/02/2004 123456789 PAT $87.00 $7.00 $80.00 $.00 $25.00 $.00 $.00 $.00 $.00 $.00 $55.00 f
4003882501 DOE, J s 01/27-01/27/2004 123456789 PAT $366.00 $.00 $366.00 $.00 $.00 $.00 $183.00 $.00 $.00 $.00 $183.00 f
4003882801 DOE, J 1 02/01-02/01/2004 123456789 PAT $135.00 $135.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003883001 DOE, J e 01/15-01/15/2004 123456789 PAT $575.00 $.00 $575.00 $.00 $50.00 $.00 $262.50 $.00 $.00 $.00 $262.50 f
4003883101 DOE, J 2 01/30-01/30/2004 123456789 PAT $110.00 $21.00 $89.00 $.00 $50.00 $.00 $19.50 $.00 $.00 $.00 $19.50 f
4003883301 DOE, J e 01/12-02/02/2004 123456789 PAT $670.00 $51.00 $619.00 $.00 $50.00 $.00 $262.00 $.00 $.00 $.00 $307.00 f
4003883601 DOE, J 1 01/29-01/29/2004 123456789 PAT $840.00 $.00 $840.00 $.00 $.00 $.00 $420.00 $.00 $.00 $.00 $420.00 f
4003884001 DOE, J III 2 02/03-02/03/2004 123456789 PAT $140.00 $.00 $140.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $140.00 f
4003884201 DOE, J e 01/12-01/12/2004 123456789 PAT $61.00 $61.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003884701 DOE, J e 02/05-02/05/2004 123456789 PAT $112.00 $.00 $112.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $112.00 f
4003884901 DOE, J 1 01/29-01/29/2004 123456789 PAT $131.00 $.00 $131.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $131.00 f
4003885201 DOE, J e 01/26-01/26/2004 123456789 PAT $608.00 $.00 $608.00 $.00 $50.00 $.00 $279.00 $.00 $.00 $.00 $279.00 f
4003885701 DOE, J s 01/29-01/29/2004 123456789 PAT $210.00 $.00 $210.00 $.00 $50.00 $.00 $80.00 $.00 $.00 $.00 $80.00 f
4003886001 DOE, J JR 1 02/03-02/03/2004 123456789 PAT $160.00 $.00 $160.00 $.00 $50.00 $.00 $55.00 $.00 $.00 $.00 $55.00 f
4003886401 DOE, J e 02/03-02/03/2004 123456789 PAT $90.00 $.00 $90.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $90.00 f
4003886901 DOE, J 3 01/26-01/26/2004 123456789 PAT $290.00 $.00 $290.00 $.00 $.00 $.00 $145.00 $.00 $.00 $.00 $145.00 f
4003890801 DOE, J 1 07/14-07/14/2003 123456789 PAT $83.00 $.00 $83.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $83.00 f
4003890901 DOE, J e 01/30-01/30/2004 123456789 PAT $200.00 $.00 $200.00 $.00 $50.00 $.00 $75.00 $.00 $.00 $.00 $75.00 f
4003891401 DOE, J s 11/10-11/10/2003 123456789 PAT $463.00 $48.00 $415.00 $.00 $.00 $.00 $207.50 $.00 $.00 $.00 $207.50 f
4003897601 DOE, J e 02/03-02/03/2004 123456789 PAT $1,000.00 $.00 $1,000.00 $.00 $.00 $.00 $500.00 $.00 $.00 $.00 $500.00 f
4003897901 DOE, J 1 01/20-01/20/2004 123456789 PAT $390.00 $300.00 $90.00 $.00 $.00 $.00 $45.00 $.00 $.00 $.00 $45.00 f
4003898201 DOE, J s 12/29-12/29/2003 123456789 PAT $65.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003899001 DOE, J 3 01/06-01/06/2004 123456789 PAT $30.00 $30.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003899201 DOE, J e 11/25-11/25/2003 123456789 PAT $853.00 $853.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4003949001 DOE, J 4 01/24-01/24/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4003950301 DOE, J 2 01/22-02/01/2004 123456789 PAT $1,002.22 $.00 $1,002.22 $.00 $50.00 $.00 $476.11 $.00 $.00 $.00 $476.11 f
4003950401 DOE, J e 01/29-01/29/2004 123456789 PAT $112.00 $.00 $112.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $112.00 f
4003950501 DOE, J 2 01/28-01/28/2004 123456789 PAT $305.00 $.00 $305.00 $.00 $50.00 $.00 $127.50 $.00 $.00 $.00 $127.50 f
4003950601 DOE, J 1 01/29-01/29/2004 123456789 PAT $141.00 $.00 $141.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $141.00 f
4003950701 DOE, J 1 01/22-01/22/2004 123456789 PAT $60.00 $45.00 $15.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $15.00 f
4003950801 DOE, J 1 01/29-01/29/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $75.00 f
4003950901 DOE, J e 02/02-02/02/2004 123456789 PAT $199.00 $.00 $199.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $199.00 f
4003951001 DOE, J s 01/29-01/29/2004 123456789 PAT $230.00 $3.00 $227.00 $.00 $50.00 $.00 $47.50 $.00 $.00 $.00 $129.50 f
4003951101 DOE, J e 02/04-02/04/2004 123456789 PAT $114.00 $.00 $114.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $114.00 f
4003951201 DOE, J e 02/05-02/05/2004 123456789 PAT $385.00 $.00 $385.00 $.00 $50.00 $.00 $167.50 $.00 $.00 $.00 $167.50 f
4003951301 DOE, J e 01/19-01/19/2004 123456789 PAT $182.00 $.00 $182.00 $.00 $50.00 $.00 $57.50 $.00 $.00 $.00 $74.50 f
4003951401 DOE, J 2 01/30-01/30/2004 123456789 PAT $26.00 $.00 $26.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $26.00 f
4004074501 DOE, J 2 02/02-02/02/2004 123456789 BRITTANY N $117.00 $4.00 $113.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $113.00 f
4004074901 DOE, J e 01/30-01/30/2004 123456789 PAT $191.00 $.00 $191.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $191.00 f
4004075701 DOE, J s 01/28-01/28/2004 123456789 PAT $44.00 $.00 $44.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $44.00 f
4004076001 DOE, J s 01/28-01/28/2004 123456789 PAT $140.00 $31.00 $109.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $109.00 f
4004077301 DOE, J s 02/04-02/04/2004 123456789 PAT $215.00 $27.00 $188.00 $.00 $50.00 $.00 $7.50 $.00 $.00 $.00 $130.50 f
4004078501 DOE, J s 01/28-01/28/2004 123456789 PAT $41.00 $.00 $41.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $41.00 f
4004078701 DOE, J e 02/03-02/03/2004 123456789 PAT $127.00 $.00 $127.00 $.00 $50.00 $.00 $38.50 $.00 $.00 $.00 $38.50 f
4004081001 DOE, J JR 1 02/03-02/03/2004 123456789 PAT $85.00 $44.00 $41.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $41.00 f
4004081501 DOE, J JR 4 02/04-02/04/2004 123456789 TANNER JR $85.00 $44.00 $41.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $41.00 f
4004103801 DOE, J e 02/02-02/02/2004 123456789 PAT $482.00 $.00 $482.00 $.00 $.00 $.00 $241.00 $.00 $.00 $.00 $241.00 f
4004104001 DOE, J e 02/02-02/02/2004 123456789 PAT $30.00 $30.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004104401 DOE, J e 02/02-02/02/2004 123456789 PAT $58.00 $.00 $58.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $58.00 f
4004104501 DOE, J s 02/03-02/03/2004 123456789 PAT $58.00 $.00 $58.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $58.00 f
4004134901 DOE, J 2 02/01-02/01/2004 123456789 PAT $140.00 $140.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004135401 DOE, J 1 01/19-01/19/2004 123456789 PAT $480.00 $.00 $480.00 $.00 $50.00 $.00 $215.00 $.00 $.00 $.00 $215.00 f
4004135801 DOE, J s 12/17-12/17/2003 123456789 PAT $1,300.00 $.00 $1,300.00 $.00 $.00 $.00 $650.00 $.00 $650.00 $.00 $.00 f
4004138001 DOE, J 2 02/01-02/01/2004 123456789 PAT $119.00 $119.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004138601 DOE, J JR s 11/25-11/25/2003 123456789 PAT $240.00 $.00 $240.00 $.00 $.00 $.00 $120.00 $.00 $.00 $.00 $120.00 f
4004139301 DOE, J e 12/20-12/20/2003 123456789 PAT $300.00 $45.00 $255.00 $.00 $50.00 $.00 $102.50 $.00 $.00 $.00 $102.50 f
4004139501 DOE, J e 12/20-12/20/2003 123456789 PAT $800.00 $120.00 $680.00 $.00 $.00 $.00 $340.00 $.00 $.00 $.00 $340.00 f
4004139901 DOE, J e 12/05-12/05/2003 123456789 PAT $120.00 $.00 $120.00 $.00 $.00 $.00 $60.00 $.00 $.00 $.00 $60.00 f
4004140201 DOE, J 2 01/29-01/29/2004 123456789 PAT $326.00 $.00 $326.00 $.00 $50.00 $.00 $138.00 $.00 $.00 $.00 $138.00 f
4004140701 DOE, J 2 02/01-02/01/2004 123456789 PAT $135.86 $135.86 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004141101 DOE, J JR 1 02/03-02/03/2004 123456789 PAT $60.00 $40.00 $20.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $20.00 f
4004144101 DOE, J 1 01/26-01/26/2004 123456789 CARLOS JR $453.00 $5.00 $448.00 $.00 $50.00 $.00 $22.50 $.00 $.00 $.00 $375.50 f
4004144701 DOE, J 2 02/04-02/04/2004 123456789 PAT $1,705.00 $200.00 $1,505.00 $.00 $50.00 $.00 $687.50 $.00 $.00 $.00 $767.50 f
4004212901 DOE, J 3 02/04-02/04/2004 123456789 PAT $145.00 $.00 $145.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $145.00 f
4004213501 DOE, J s 02/07-02/07/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $80.00 f
4004213601 DOE, J 1 02/07-02/07/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $80.00 f
4004213701 DOE, J e 02/07-02/07/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $80.00 f
4004282001 DOE, J 2 02/04-02/04/2004 123456789 PAT $875.00 $875.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004283501 DOE, J e 02/02-02/02/2004 123456789 PAT $70.00 $.00 $70.00 $.00 $50.00 $.00 $10.00 $.00 $.00 $.00 $10.00 f
4004288001 DOE, J 1 02/01-02/01/2004 123456789 PAT $133.00 $133.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004288501 DOE, J 1 02/05-02/05/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4004293001 DOE, J e 01/30-01/30/2004 123456789 PAT $2,280.00 $1,450.00 $830.00 $.00 $.00 $.00 $415.00 $.00 $.00 $.00 $415.00 f
4004293301 DOE, J s 02/07-02/07/2004 123456789 PAT $256.00 $15.00 $241.00 $.00 $50.00 $.00 $95.50 $.00 $.00 $.00 $95.50 f
4004296901 DOE, J e 12/12-12/12/2003 123456789 PAT $1,255.00 $.00 $1,255.00 $.00 $50.00 $.00 $602.50 $.00 $.00 $.00 $602.50 f
4004354701 DOE, J e 02/09-02/09/2004 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4004354801 DOE, J e 02/09-02/09/2004 123456789 PAT $70.00 $.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $70.00 f
4004355501 DOE, J e 02/06-02/06/2004 123456789 PAT $333.00 $10.00 $323.00 $.00 $50.00 $.00 $79.00 $.00 $.00 $.00 $194.00 f
4004366401 DOE, J s 01/29-01/29/2004 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $50.00 f
4004367501 DOE, J 1 10/04-10/04/2002 123456789 ALTON JR $257.00 $257.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004368201 DOE, J 1 02/02-02/02/2004 123456789 PAT $66.00 $.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4004369301 DOE, J s 02/10-02/10/2004 123456789 PAT $65.00 $.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $65.00 f
4004369401 DOE, J 1 02/09-02/09/2004 123456789 PAT $250.00 $42.00 $208.00 $.00 $50.00 $.00 $79.00 $.00 $.00 $.00 $79.00 f
4004370601 DOE, J e 02/03-02/03/2004 123456789 PAT $743.00 $.00 $743.00 $.00 $50.00 $.00 $316.50 $.00 $.00 $.00 $376.50 f
4004371201 DOE, J t 02/06-02/06/2004 123456789 PAT $220.00 $220.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004371701 DOE, J t 01/16-01/16/2004 123456789 PAT $77.00 $.00 $77.00 $.00 $50.00 $.00 $13.50 $.00 $.00 $.00 $13.50 f
4004373401 DOE, J e 02/04-02/04/2004 123456789 PAT $215.00 $90.00 $125.00 $.00 $50.00 $.00 $37.50 $.00 $.00 $.00 $37.50 f
4004373601 DOE, J e 02/02-02/02/2004 123456789 PAT $1,300.00 $168.00 $1,132.00 $.00 $50.00 $.00 $466.00 $.00 $.00 $.00 $616.00 f
4004379501 DOE, J e 11/21-11/21/2003 123456789 PAT $125.00 $125.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004381101 DOE, J e 02/05-02/05/2004 123456789 PAT $2,378.00 $869.00 $1,509.00 $.00 $.00 $.00 $754.50 $.00 $.00 $.00 $754.50 f
4004402101 DOE, J e 02/09-02/09/2004 123456789 PAT $157.00 $37.00 $120.00 $.00 $50.00 $.00 $35.00 $.00 $.00 $.00 $35.00 f
4004402401 DOE, J e 02/04-02/04/2004 123456789 PAT $344.00 $9.00 $335.00 $.00 $50.00 $.00 $43.50 $.00 $.00 $.00 $241.50 f
4004509201 DOE, J e 02/04-02/04/2004 123456789 PAT $44.00 $.00 $44.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $44.00 f
4004511001 DOE, J 2 02/09-02/09/2004 123456789 PAT $60.00 $.00 $60.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $60.00 f
4004511301 DOE, J e 02/05-02/05/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4004556801 HARRIS SR, RONALD s 02/10-02/10/2004 123456789 PAT $156.00 $11.00 $145.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $145.00 f
4004557001 DOE, J s 01/15-01/15/2004 123456789 PAT $85.00 $.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $85.00 f
4004557301 DOE, J e 02/11-02/11/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $80.00 f
4004557801 DOE, J s 02/14-02/14/2004 123456789 PAT $118.00 $.00 $118.00 $.00 $50.00 $.00 $34.00 $.00 $.00 $.00 $34.00 f
4004557901 DOE, J s 11/24-11/24/2003 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $50.00 $.00 $.00 $.00 $50.00 f
4004558001 DOE, J e 02/10-02/10/2004 123456789 PAT $166.00 $18.00 $148.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $148.00 f
4004558101 DOE, J s 02/10-02/10/2004 123456789 PAT $165.00 $.00 $165.00 $.00 $50.00 $.00 $57.50 $.00 $.00 $.00 $57.50 f
4004558201 DOE, J e 02/12-02/12/2004 123456789 PAT $170.00 $.00 $170.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $170.00 f
4004558301 DOE, J e 02/05-02/05/2004 123456789 PAT $36.00 $.00 $36.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $36.00 f
4004559001 DOE, J s 02/05-02/05/2004 123456789 PAT $74.00 $.00 $74.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $74.00 f
4004559201 DOE, J 2 02/09-02/09/2004 123456789 PAT $39.00 $.00 $39.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $39.00 f
4004559301 DOE, J 1 02/10-02/10/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4004560001 DOE, J s 02/10-02/10/2004 123456789 PAT $164.00 $.00 $164.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $164.00 f
4004579601 DOE, J 4 01/26-01/26/2004 123456789 PAT $208.00 $15.00 $193.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $193.00 f
4004734501 DOE, J e 02/02-02/02/2004 123456789 PAT $205.00 $6.00 $199.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $199.00 f
4004735301 DOE, J s 12/29-12/29/2003 123456789 PAT $50.00 $.00 $50.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $50.00 f
4004735701 DOE, J e 02/09-02/09/2004 123456789 PAT $104.00 $.00 $104.00 $.00 $50.00 $.00 $17.50 $.00 $.00 $.00 $36.50 f
4004736301 DOE, J e 02/10-02/10/2004 123456789 PAT $222.00 $.00 $222.00 $.00 $50.00 $.00 $32.50 $.00 $.00 $.00 $139.50 f
4004736501 DOE, J e 02/05-02/05/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4004736601 DOE, J e 02/09-02/09/2004 123456789 PAT $153.00 $.00 $153.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $153.00 f
4004736701 DOE, J e 02/09-02/09/2004 123456789 PAT $97.00 $.00 $97.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $97.00 f
4004736801 DOE, J e 02/09-02/09/2004 123456789 PAT $98.00 $.00 $98.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $98.00 f
4004737001 DOE, J 3 11/26-11/26/2003 123456789 PAT $250.00 $.00 $250.00 $.00 $.00 $.00 $125.00 $.00 $.00 $.00 $125.00 f
4004737201 DOE, J 3 01/15-01/15/2004 123456789 PAT $153.00 $35.00 $118.00 $.00 $.00 $.00 $59.00 $.00 $.00 $.00 $59.00 f
4004737401 DOE, J e 02/05-02/05/2004 123456789 PAT $85.00 $.00 $85.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $85.00 f
4004737801 DOE, J e 02/09-02/09/2004 123456789 PAT $110.00 $.00 $110.00 $.00 $.00 $.00 $55.00 $.00 $.00 $.00 $55.00 f
4004738501 DOE, J JR 2 02/09-02/09/2004 123456789 PAT $125.00 $.00 $125.00 $.00 $50.00 $.00 $37.50 $.00 $.00 $.00 $37.50 f
4004738701 DOE, J 2 01/16-01/16/2004 123456789 PAT $67.00 $.00 $67.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $67.00 f
4004738801 DOE, J e 02/05-02/05/2004 123456789 PAT $130.00 $.00 $130.00 $.00 $.00 $.00 $65.00 $.00 $.00 $.00 $65.00 f
4004739201 DOE, J e 01/30-01/30/2004 123456789 PAT $83.00 $.00 $83.00 $.00 $50.00 $.00 $16.50 $.00 $.00 $.00 $16.50 f
4004739301 DOE, J e 02/10-02/10/2004 123456789 PAT $96.00 $.00 $96.00 $.00 $50.00 $.00 $23.00 $.00 $.00 $.00 $23.00 f
4004739701 DOE, J s 02/06-02/06/2004 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4004741001 DOE, J e 02/14-02/14/2004 123456789 PAT $97.00 $.00 $97.00 $.00 $50.00 $.00 $23.50 $.00 $.00 $.00 $23.50 f
4004741201 DOE, J e 02/13-02/13/2004 123456789 PAT $1,022.00 $199.00 $823.00 $.00 $50.00 $.00 $386.50 $.00 $.00 $.00 $386.50 f
4004741401 DOE, J 2 02/09-02/09/2004 123456789 PAT $30.00 $.00 $30.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $30.00 f
4004741601 DOE, J e 02/03-02/03/2004 123456789 PAT $1,000.00 $1,000.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004741701 DOE, J e 02/12-02/12/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $50.00 $.00 $32.50 $.00 $.00 $.00 $32.50 f
4004741901 DOE, J e 02/09-02/09/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $50.00 $.00 $12.50 $.00 $.00 $.00 $12.50 f
4004744201 DOE, J s 02/05-02/05/2004 123456789 PAT $140.00 $70.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $70.00 f
4004744501 DOE, J s 02/09-02/09/2004 123456789 PAT $16.00 $16.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004744601 DOE, J s 02/09-02/09/2004 123456789 PAT $55.00 $.00 $55.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $55.00 f
4004744801 DOE, J s 02/02-02/02/2004 123456789 PAT $150.00 $150.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004744901 DOE, J s 01/29-01/29/2004 123456789 PAT $864.00 $.00 $864.00 $.00 $.00 $.00 $432.00 $.00 $.00 $.00 $432.00 f
4004745101 DOE, J s 02/05-02/05/2004 123456789 PAT $431.00 $.00 $431.00 $.00 $50.00 $.00 $190.50 $.00 $.00 $.00 $190.50 f
4004745401 DOE, J s 09/30-10/30/2003 123456789 PAT $1,265.00 $135.00 $1,130.00 $.00 $.00 $.00 $565.00 $.00 $537.50 $.00 $27.50 f
4004746101 DOE, J 3 02/10-02/10/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $95.00 f
4004746201 DOE, J 1 02/09-02/09/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4004746301 DOE, J 1 01/21-01/21/2004 123456789 PAT $69.00 $.00 $69.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $69.00 f
4004746501 DOE, J 2 01/16-01/16/2004 123456789 PAT $65.00 $.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $65.00 f
4004746701 DOE, J 3 02/05-02/05/2004 123456789 PAT $45.00 $30.00 $15.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $15.00 f
4004746901 DOE, J 2 02/09-02/09/2004 123456789 PAT $800.00 $.00 $800.00 $.00 $.00 $.00 $400.00 $.00 $.00 $.00 $400.00 f
4004747201 DOE, J 2 02/09-02/09/2004 123456789 PAT $51.00 $.00 $51.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $51.00 f
4004747601 DOE, J 1 11/10-11/10/2003 123456789 PAT $165.00 $.00 $165.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $165.00 f
4004747901 DOE, J 1 02/11-02/11/2004 123456789 PAT $124.00 $.00 $124.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $124.00 f
4004748301 DOE, J s 01/15-01/15/2004 123456789 PAT $160.00 $49.00 $111.00 $.00 $50.00 $.00 $30.50 $.00 $.00 $.00 $30.50 f
4004748501 DOE, J s 02/11-02/11/2004 123456789 PAT $94.00 $.00 $94.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $94.00 f
4004761401 DOE, J e 02/09-02/09/2004 123456789 PAT $420.00 $179.00 $241.00 $.00 $50.00 $.00 $76.00 $.00 $.00 $.00 $115.00 f
4004762001 ST ANDRIE, JOYCE e 02/10-02/10/2004 123456789 PAT $770.00 $675.00 $95.00 $.00 $50.00 $.00 $22.50 $.00 $.00 $.00 $22.50 f
4004762401 DOE, J s 02/11-02/11/2004 123456789 PAT $304.00 $.00 $304.00 $.00 $50.00 $.00 $127.00 $.00 $.00 $.00 $127.00 f
4004762801 DOE, J 1 01/28-01/28/2004 123456789 PAT $178.00 $132.00 $46.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $46.00 f
4004763701 DOE, J 4 02/05-02/05/2004 123456789 PAT $136.00 $62.00 $74.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $74.00 f
4004763801 DOE, J e 02/13-02/13/2004 123456789 PAT $184.00 $29.00 $155.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $155.00 f
4004776201 DOE, J s 02/12-02/12/2004 123456789 PAT $1,159.00 $.00 $1,159.00 $.00 $50.00 $.00 $554.50 $.00 $.00 $.00 $554.50 f
4004776401 DOE, J e 02/13-02/13/2004 123456789 PAT $700.00 $565.00 $135.00 $.00 $50.00 $.00 $42.50 $.00 $.00 $.00 $42.50 f
4004776501 DOE, J 1 02/09-02/09/2004 123456789 PAT $172.00 $.00 $172.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $172.00 f
4004776601 DOE, J 1 02/10-02/10/2004 123456789 PAT $180.00 $180.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004776801 DOE, J JR s 02/12-02/12/2004 123456789 PAT $70.00 $.00 $70.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $70.00 f
4004776901 DOE, J 2 12/17-12/17/2003 123456789 PAT $120.00 $.00 $120.00 $.00 $.00 $.00 $60.00 $.00 $.00 $.00 $60.00 f
4004777001 DOE, J e 02/09-02/09/2004 123456789 PAT $826.00 $700.00 $126.00 $.00 $.00 $.00 $63.00 $.00 $.00 $.00 $63.00 f
4004777101 DOE, J 1 02/11-02/11/2004 123456789 PAT $118.00 $.00 $118.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $118.00 f
4004777201 DOE, J 4 04/28-04/28/2003 123456789 PAT $352.00 $352.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004777601 DOE, J s 02/03-02/03/2004 123456789 PAT $122.00 $.00 $122.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $122.00 f
4004777701 DOE, J 2 02/09-02/09/2004 123456789 PAT $62.00 $.00 $62.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $62.00 f
4004777801 DOE, J e 01/12-01/12/2004 123456789 PAT $61.00 $61.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004777901 DOE, J 1 12/16-12/16/2003 123456789 PAT $91.00 $40.00 $51.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $51.00 f
4004778001 DOE, J 2 02/10-02/10/2004 123456789 PAT $83.00 $83.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004778101 DOE, J JR. 3 02/01-02/01/2004 123456789 PAT $143.75 $143.75 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004778201 DOE, J s 02/05-02/05/2004 123456789 PAT $120.00 $.00 $120.00 $.00 $.00 $.00 $52.50 $.00 $.00 $.00 $67.50 f
4004778301 DOE, J s 02/06-02/06/2004 123456789 PAT $112.00 $.00 $112.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $112.00 f
4004778401 DOE, J s 02/09-02/09/2004 123456789 PAT $60.00 $.00 $60.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $60.00 f
4004778501 DOE, J 2 02/11-02/11/2004 123456789 PAT $118.00 $.00 $118.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $118.00 f
4004778601 DOE, J SR e 02/06-02/06/2004 123456789 ANDREW SR $306.00 $.00 $306.00 $.00 $50.00 $.00 $122.00 $.00 $.00 $.00 $134.00 f
4004778701 DOE, J 2 02/04-02/04/2004 123456789 PAT $105.00 $.00 $105.00 $.00 $.00 $.00 $52.50 $.00 $.00 $.00 $52.50 f
4004778801 DOE, J 3 04/19-04/19/2003 123456789 PAT $287.00 $287.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004778901 DOE, J e 02/05-02/05/2004 123456789 PAT $95.00 $.00 $95.00 $.00 $50.00 $.00 $22.50 $.00 $.00 $.00 $22.50 f
4004779001 DOE, J e 02/07-02/07/2004 123456789 PAT $121.00 $.00 $121.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $121.00 f
4004779101 DOE, J e 02/06-02/06/2004 123456789 PAT $140.00 $.00 $140.00 $.00 $.00 $.00 $70.00 $.00 $.00 $.00 $70.00 f
4004779201 DOE, J e 02/13-02/13/2004 123456789 PAT $220.00 $.00 $220.00 $.00 $.00 $.00 $110.00 $.00 $.00 $.00 $110.00 f
4004827701 DOE, J e 02/11-02/11/2004 123456789 PAT $138.00 $.00 $138.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $138.00 f
4004827801 DOE, J e 02/11-02/11/2004 123456789 PAT $170.00 $.00 $170.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $170.00 f
4004828101 DOE, J s 02/10-02/10/2004 123456789 PAT $74.00 $.00 $74.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $74.00 f
4004828201 DOE, J e 02/10-02/10/2004 123456789 PAT $74.00 $.00 $74.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $74.00 f
4004828901 DOE, J e 02/09-02/09/2004 123456789 PAT $135.00 $.00 $135.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $135.00 f
4004894001 DOE, J 1 08/01-02/08/2004 123456789 PAT $1,266.65 $.00 $1,266.65 $.00 $100.00 $.00 $583.32 $.00 $.00 $.00 $583.33 f
4004895101 DOE, J s 01/26-01/26/2004 123456789 PAT $823.00 $.00 $823.00 $.00 $50.00 $.00 $215.00 $.00 $.00 $.00 $558.00 f
4004897401 DOE, J s 01/22-01/22/2004 123456789 PAT $1,100.00 $.00 $1,100.00 $.00 $50.00 $.00 $525.00 $.00 $.00 $.00 $525.00 f
4004897701 DOE, J s 01/23-01/23/2004 123456789 PAT $875.00 $.00 $875.00 $.00 $.00 $.00 $437.50 $.00 $.00 $.00 $437.50 f
4004898001 DOE, J s 12/13-12/13/2003 123456789 PAT $550.00 $24.00 $526.00 $.00 $50.00 $.00 $150.00 $.00 $.00 $.00 $326.00 f
4004898301 DOE, J e 12/13-12/13/2003 123456789 PAT $550.00 $24.00 $526.00 $.00 $.00 $.00 $175.00 $.00 $.00 $.00 $351.00 f
4004899601 DOE, J e 12/15-12/15/2003 123456789 PAT $350.00 $.00 $350.00 $.00 $50.00 $.00 $150.00 $.00 $.00 $.00 $150.00 f
4004900601 DOE, J s 12/15-12/15/2003 123456789 PAT $350.00 $.00 $350.00 $.00 $.00 $.00 $175.00 $.00 $.00 $.00 $175.00 f
4004901601 DOE, J e 01/23-01/23/2004 123456789 PAT $1,100.00 $.00 $1,100.00 $.00 $50.00 $.00 $525.00 $.00 $.00 $.00 $525.00 f
4004902701 DOE, J e 12/20-12/20/2003 123456789 PAT $800.00 $800.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4004903001 DOE, J 3 10/06-10/06/2003 123456789 PAT $25.00 $.00 $25.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $25.00 f
4004903401 WARNER JR, BRUCE 1 02/10-02/10/2004 123456789 PAT $73.00 $.00 $73.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $73.00 f
4004903601 DOE, J t 11/11-11/11/2003 123456789 ANNIE L $180.00 $.00 $180.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $180.00 f
4004906001 DOE, J s 02/10-02/10/2004 123456789 PAT $856.00 $.00 $856.00 $.00 $50.00 $.00 $403.00 $.00 $.00 $.00 $403.00 f
4004909101 DOE, J 1 02/05-02/05/2004 123456789 PAT $105.00 $.00 $105.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $105.00 f
4004909701 DOE, J s 01/16-01/16/2004 123456789 PAT $116.00 $70.00 $46.00 $.00 $.00 $.00 $.00 $.00 $42.00 $.00 $4.00 f
4004910501 DOE, J s 09/09-09/09/2002 123456789 PAT $66.00 $.00 $66.00 $.00 $50.00 $.00 $.00 $.00 $.00 $.00 $16.00 f
4004911201 DOE, J s 12/30-12/30/2002 123456789 PAT $185.00 $.00 $185.00 $.00 $.00 $.00 $92.50 $.00 $.00 $.00 $92.50 f
4004911801 DOE, J e 12/27-12/27/2003 123456789 PAT $792.00 $22.00 $770.00 $.00 $50.00 $.00 $234.00 $.00 $.00 $.00 $486.00 f
4004912001 DOE, J e 01/10-01/15/2004 123456789 PAT $1,823.00 $209.00 $1,614.00 $.00 $50.00 $.00 $782.00 $.00 $.00 $.00 $782.00 f
4004914201 DOE, J e 01/27-01/27/2004 123456789 PAT $2,250.00 $200.00 $2,050.00 $.00 $50.00 $.00 $1,000.00 $.00 $.00 $.00 $1,000.00 f
4004916401 DOE, J e 02/10-02/10/2004 123456789 PAT $188.00 $.00 $188.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $188.00 f
4004916901 DOE, J e 02/11-02/11/2004 123456789 PAT $88.00 $.00 $88.00 $.00 $50.00 $.00 $19.00 $.00 $.00 $.00 $19.00 f
4004946901 DOE, J e 02/14-02/14/2004 123456789 PAT $110.00 $.00 $110.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $110.00 f
4004947301 DOE, J s 02/11-02/11/2004 123456789 PAT $241.00 $.00 $241.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $241.00 f
4004947601 DOE, J e 02/17-02/17/2004 123456789 PAT $198.00 $30.00 $168.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $168.00 f
4004984601 DOE, J 2 11/21-11/21/2003 123456789 PAT $210.00 $.00 $210.00 $.00 $.00 $.00 $105.00 $.00 $.00 $.00 $105.00 f
4005002001 DOE, J e 02/12-02/12/2004 123456789 PAT $255.00 $6.00 $249.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $249.00 f
4005002701 DOE, J e 02/05-02/05/2004 123456789 PAT $1,317.00 $.00 $1,317.00 $.00 $.00 $.00 $658.50 $.00 $.00 $.00 $658.50 f
4005006001 DOE, J e 02/10-02/10/2004 123456789 PAT $65.00 $.00 $65.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $65.00 f
4005006501 DOE, J s 02/05-02/05/2004 123456789 PAT $97.00 $.00 $97.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $97.00 f
4005006801 DOE, J e 02/06-02/06/2004 123456789 PAT $739.00 $.00 $739.00 $.00 $50.00 $.00 $322.50 $.00 $.00 $.00 $366.50 f
4005007101 DOE, J 3 12/01-12/01/2003 123456789 PAT $107.00 $.00 $107.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $107.00 f
4005008401 DOE, J 5 08/20-08/20/2003 123456789 PAT $86.00 $86.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005008801 DOE, J 3 09/24-09/24/2003 123456789 PAT $312.00 $312.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005009101 DOE, J 2 07/15-07/15/2003 123456789 PAT $125.00 $125.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005009401 DOE, J 2 08/13-08/13/2003 123456789 PAT $358.00 $358.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005010101 DOE, J 2 08/13-08/13/2003 123456789 PAT $224.00 $224.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005010601 DOE, J 1 09/23-09/23/2003 123456789 PAT $103.00 $103.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005011101 DOE, J 4 07/15-07/15/2003 123456789 PAT $62.00 $62.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005011401 DOE, J s 02/10-02/10/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $50.00 $.00 $15.00 $.00 $.00 $.00 $15.00 f
4005012101 DOE, J s 10/22-10/22/2003 123456789 PAT $360.00 $126.65 $233.35 $.00 $.00 $.00 $116.67 $.00 $.00 $.00 $116.68 f
4005013201 DOE, J SR s 01/07-01/07/2004 123456789 PAT $366.00 $247.00 $119.00 $.00 $50.00 $.00 $34.50 $.00 $34.50 $.00 $.00 f
4005013701 DOE, J s 01/06-01/06/2004 123456789 PAT $238.00 $.00 $238.00 $.00 $50.00 $.00 $94.00 $.00 $94.00 $.00 $.00 f
4005015301 DOE, J s 01/08-01/08/2004 123456789 PAT $532.00 $532.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005016601 DOE, J s 01/19-01/19/2004 123456789 PAT $1,015.00 $12.00 $1,003.00 $.00 $50.00 $.00 $476.50 $.00 $378.00 $.00 $98.50 f
4005018701 DOE, J JR 2 10/22-10/22/2003 123456789 CAMERON JR $110.00 $78.00 $32.00 $.00 $.00 $.00 $.00 $.00 $20.00 $.00 $12.00 f
4005019201 DOE, J 2 02/04-02/04/2004 123456789 PAT $76.00 $.00 $76.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $76.00 f
4005019301 DOE, J e 02/14-02/14/2004 123456789 PAT $400.00 $.00 $400.00 $.00 $.00 $.00 $200.00 $.00 $.00 $.00 $200.00 f
4005021701 DOE, J e 11/29-12/12/2003 123456789 PAT $813.00 $255.00 $558.00 $.00 $.00 $.00 $202.50 $.00 $.00 $.00 $355.50 f
4005021801 DOE, J 1 02/09-02/09/2004 123456789 PAT $423.00 $10.00 $413.00 $.00 $50.00 $.00 $181.50 $.00 $.00 $.00 $181.50 f
4005021901 DOE, J s 02/11-02/11/2004 123456789 PAT $175.00 $3.00 $172.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $172.00 f
4005022101 DOE, J 2 01/23-01/23/2004 123456789 PAT $229.00 $229.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005022801 DOE, J 1 01/23-01/23/2004 123456789 PAT $194.00 $194.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005023401 DOE, J s 02/09-02/09/2004 123456789 PAT $127.00 $.00 $127.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $127.00 f
4005024501 DOE, J JR 1 02/10-02/10/2004 123456789 PAT $100.00 $.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4005024801 DOE, J 1 02/13-02/13/2004 123456789 PAT $183.00 $75.00 $108.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $108.00 f
4005025301 DOE, J s 01/21-01/21/2004 123456789 PAT $64.00 $.00 $64.00 $.00 $.00 $.00 $.00 $.00 $64.00 $.00 $.00 f
4005025501 DOE, J s 02/03-02/03/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $40.00 $.00 $40.00 $.00 $.00 f
4005028901 DOE, J e 02/17-02/17/2004 123456789 PAT $112.00 $7.00 $105.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $105.00 f
4005029301 DOE, J e 02/09-02/09/2004 123456789 PAT $182.00 $.00 $182.00 $.00 $10.00 $.00 $44.00 $.00 $.00 $.00 $128.00 f
4005029801 DOE, J s 02/16-02/16/2004 123456789 PAT $145.00 $.00 $145.00 $.00 $.00 $.00 $72.50 $.00 $.00 $.00 $72.50 f
4005029901 DOE, J e 02/09-02/09/2004 123456789 PAT $275.00 $.00 $275.00 $.00 $50.00 $.00 $65.00 $.00 $.00 $.00 $160.00 f
4005030201 DOE, J e 02/13-02/13/2004 123456789 PAT $40.00 $.00 $40.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $40.00 f
4005030901 DOE, J e 02/12-02/12/2004 123456789 PAT $720.00 $.00 $720.00 $.00 $50.00 $.00 $335.00 $.00 $.00 $.00 $335.00 f
4005032401 DOE, J s 02/12-02/12/2004 123456789 PAT $1,420.00 $35.00 $1,385.00 $.00 $50.00 $.00 $667.50 $.00 $.00 $.00 $667.50 f
4005070401 DOE, J e 02/10-02/10/2004 123456789 PAT $71.00 $4.00 $67.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $67.00 f
4005070501 DOE, J e 02/19-02/19/2004 123456789 PAT $150.00 $11.00 $139.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $139.00 f
4005070801 DOE, J JR. e 01/29-01/29/2004 123456789 JAMES JR. $82.00 $.00 $82.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $82.00 f
4005071201 DOE, J s 02/17-02/17/2004 123456789 PAT $78.00 $.00 $78.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $78.00 f
4005071601 DOE, J s 02/16-02/16/2004 123456789 PAT $116.00 $.00 $116.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $116.00 f
4005072401 DOE, J JR s 02/16-02/16/2004 123456789 PAT $104.00 $.00 $104.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $104.00 f
4005072501 DOE, J 1 02/17-02/17/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $50.00 $.00 $15.00 $.00 $.00 $.00 $15.00 f
4005072801 DOE, J s 02/17-02/17/2004 123456789 PAT $86.00 $.00 $86.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $86.00 f
4005072901 DOE, J e 02/17-02/17/2004 123456789 PAT $149.00 $18.00 $131.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $131.00 f
4005073001 DOE, J e 02/18-02/18/2004 123456789 PAT $75.00 $.00 $75.00 $.00 $50.00 $.00 $12.50 $.00 $.00 $.00 $12.50 f
4005073101 DOE, J e 02/17-02/17/2004 123456789 PAT $157.00 $2.00 $155.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $155.00 f
4005073501 DOE, J e 02/18-02/18/2004 123456789 PAT $80.00 $.00 $80.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $80.00 f
4005074001 DOE, J s 11/03-11/03/2003 123456789 PAT $25.00 $.00 $25.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $25.00 f
4005074201 DOE, J 1 02/16-02/16/2004 123456789 PAT $102.00 $.00 $102.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $102.00 f
4005074301 DOE, J e 02/10-02/10/2004 123456789 PAT $524.00 $.00 $524.00 $.00 $50.00 $.00 $237.00 $.00 $.00 $.00 $237.00 f
4005074501 DOE, J e 02/18-02/18/2004 123456789 PAT $60.00 $.00 $60.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $60.00 f
4005075201 DOE, J s 02/18-02/18/2004 123456789 PAT $126.00 $60.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4005104201 DOE, J e 02/17-02/17/2004 123456789 PAT $300.00 $.00 $300.00 $.00 $50.00 $.00 $125.00 $.00 $.00 $.00 $125.00 f
4005125201 DOE, J e 01/27-01/27/2004 123456789 PAT $144.00 $3.00 $141.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $141.00 f
4005128701 DOE, J e 06/09-02/16/2004 123456789 PAT $246.00 $.00 $246.00 $.00 $50.00 $.00 $98.00 $.00 $.00 $.00 $98.00 f
4005130101 DOE, J 2 02/13-02/16/2004 123456789 PAT $308.00 $.00 $308.00 $.00 $50.00 $.00 $129.00 $.00 $.00 $.00 $129.00 f
4005130201 DOE, J 2 02/16-02/16/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4005130601 DOE, J 4 02/16-02/16/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4005130901 DOE, J 3 02/16-02/16/2004 123456789 PAT $87.00 $.00 $87.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $87.00 f
4005131101 DOE, J e 02/17-02/17/2004 123456789 PAT $198.00 $.00 $198.00 $.00 $50.00 $.00 $65.00 $.00 $.00 $.00 $83.00 f
4005131601 DOE, J 3 08/20-08/20/2003 123456789 PAT $89.00 $89.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005131901 DOE, J e 01/16-01/16/2004 123456789 PAT $66.00 $.00 $66.00 $.00 $50.00 $.00 $1.50 $.00 $.00 $.00 $14.50 f
4005132101 DOE, J 1 12/27-12/27/2003 123456789 PAT $375.00 $.00 $375.00 $.00 $50.00 $.00 $125.00 $.00 $.00 $.00 $200.00 f
4005132501 DOE, J e 02/04-02/04/2004 123456789 PAT $600.00 $600.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005132801 DOE, J e 12/06-12/27/2003 123456789 PAT $1,175.00 $90.00 $1,085.00 $.00 $50.00 $.00 $475.00 $.00 $.00 $.00 $560.00 f
4005134001 DOE, J 2 02/13-02/13/2004 123456789 PAT $172.00 $62.00 $110.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $110.00 f
4005134301 DOE, J 1 02/11-02/11/2004 123456789 PAT $285.00 $.00 $285.00 $.00 $50.00 $.00 $117.50 $.00 $.00 $.00 $117.50 f
4005135201 DOE, J 1 02/14-02/14/2004 123456789 PAT $176.00 $.00 $176.00 $.00 $50.00 $.00 $19.50 $.00 $.00 $.00 $106.50 f
4005135401 DOE, J 1 02/13-02/13/2004 123456789 PAT $114.00 $.00 $114.00 $.00 $50.00 $.00 $32.00 $.00 $.00 $.00 $32.00 f
4005135601 DOE, J e 02/06-02/06/2004 123456789 PAT $590.00 $.00 $590.00 $.00 $50.00 $.00 $270.00 $.00 $.00 $.00 $270.00 f
4005137301 DOE, J JR s 02/02-02/02/2003 123456789 PAT $139.00 $.00 $139.00 $.00 $.00 $.00 $69.50 $.00 $.00 $.00 $69.50 f
4005137501 DOE, J 3 02/16-02/16/2004 123456789 PAT $102.00 $2.00 $100.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $100.00 f
4005138901 DOE, J 1 02/12-02/12/2004 123456789 PAT $170.00 $.00 $170.00 $.00 $50.00 $.00 $60.00 $.00 $.00 $.00 $60.00 f
4005139401 DOE, J 3 01/27-01/27/2004 123456789 PAT $159.00 $.00 $159.00 $.00 $50.00 $.00 $23.00 $.00 $.00 $.00 $86.00 f
4005139601 DOE, J 3 01/13-01/13/2004 123456789 PAT $132.00 $.00 $132.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $132.00 f
4005139901 DOE, J s 02/16-02/16/2004 123456789 PAT $130.00 $130.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005145701 DOE, J 1 02/13-02/13/2004 123456789 PAT $92.00 $2.00 $90.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $90.00 f
4005146101 DOE, J s 12/29-12/29/2003 123456789 PAT $275.00 $.00 $275.00 $.00 $.00 $.00 $137.50 $.00 $.00 $.00 $137.50 f
4005146501 DOE, J e 02/03-02/03/2004 123456789 PAT $703.00 $.00 $703.00 $.00 $.00 $.00 $351.50 $.00 $.00 $.00 $351.50 f
4005146601 DOE, J e 02/09-02/09/2004 123456789 PAT $733.00 $.00 $733.00 $.00 $.00 $.00 $366.50 $.00 $.00 $.00 $366.50 f
4005147301 DOE, J s 01/27-01/27/2004 123456789 PAT $968.00 $51.00 $917.00 $.00 $50.00 $.00 $433.50 $.00 $399.60 $.00 $33.90 f
4005148601 DOE, J e 01/17-01/17/2004 123456789 PAT $400.00 $.00 $400.00 $.00 $50.00 $.00 $175.00 $.00 $.00 $.00 $175.00 f
4005150001 DOE, J 2 02/12-02/12/2004 123456789 PAT $83.00 $.00 $83.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $83.00 f
4005150101 DOE, J s 02/18-02/18/2004 123456789 PAT $230.00 $.00 $230.00 $.00 $.00 $.00 $115.00 $.00 $.00 $.00 $115.00 f
4005150201 DOE, J s 02/18-02/18/2004 123456789 PAT $1,110.00 $.00 $1,110.00 $.00 $.00 $.00 $555.00 $.00 $.00 $.00 $555.00 f
4005150301 DOE, J 1 02/16-02/16/2004 123456789 PAT $254.00 $38.00 $216.00 $.00 $50.00 $.00 $83.00 $.00 $.00 $.00 $83.00 f
4005150501 DOE, J s 02/18-02/18/2004 123456789 PAT $197.00 $10.00 $187.00 $.00 $50.00 $.00 $68.50 $.00 $.00 $.00 $68.50 f
4005150601 DOE, J s 01/21-01/21/2004 123456789 PAT $59.00 $.00 $59.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $59.00 f
4005150801 DOE, J 1 02/18-02/18/2004 123456789 PAT $109.00 $.00 $109.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $109.00 f
4005150901 DOE, J s 02/16-02/16/2004 123456789 PAT $236.00 $.00 $236.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $236.00 f
4005151201 DOE, J e 01/26-01/26/2004 123456789 PAT $103.00 $.00 $103.00 $.00 $50.00 $.00 $26.50 $.00 $.00 $.00 $26.50 f
4005151501 DOE, J e 12/31-12/31/2003 123456789 PAT $88.00 $88.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005151801 DOE, J s 11/21-11/21/2003 123456789 PAT $180.00 $180.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005152301 DOE, J s 02/16-02/16/2004 123456789 PAT $107.00 $.00 $107.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $107.00 f
4005152701 DOE, J e 02/18-02/18/2004 123456789 PAT $107.00 $.00 $107.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $107.00 f
4005153001 DOE, J e 01/28-01/28/2004 123456789 PAT $58.00 $58.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005155401 DOE, J 3 02/14-02/14/2004 123456789 PAT $143.00 $14.00 $129.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $129.00 f
4005155601 DOE, J 4 02/14-02/14/2004 123456789 PAT $138.00 $14.00 $124.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $124.00 f
4005155801 DOE, J e 02/19-02/19/2004 123456789 PAT $270.00 $.00 $270.00 $.00 $50.00 $.00 $110.00 $.00 $.00 $.00 $110.00 f
4005156001 DOE, J e 02/17-02/17/2004 123456789 PAT $157.00 $157.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005156601 DOE, J s 02/13-02/13/2004 123456789 PAT $66.00 $.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4005156801 DOE, J e 02/06-02/06/2004 123456789 PAT $668.00 $.00 $668.00 $.00 $50.00 $.00 $302.50 $.00 $.00 $.00 $315.50 f
4005157101 DOE, J 3 02/10-02/10/2004 123456789 PAT $497.00 $.00 $497.00 $.00 $50.00 $.00 $223.50 $.00 $.00 $.00 $223.50 f
4005158001 DOE, J 3 02/10-02/10/2004 123456789 PAT $497.00 $497.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005203401 DOE, J 1 02/13-02/13/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $115.00 f
4005203501 DOE, J 2 02/13-02/13/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $115.00 f
4005203701 DOE, J s 02/17-02/17/2004 123456789 PAT $62.00 $.00 $62.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $62.00 f
4005203801 DOE, J e 02/12-02/12/2004 123456789 PAT $195.00 $.00 $195.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $195.00 f
4005203901 DOE, J s 02/16-02/16/2004 123456789 PAT $45.00 $.00 $45.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $45.00 f
4005204401 DOE, J s 02/18-02/18/2004 123456789 PAT $120.00 $.00 $120.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $120.00 f
4005204501 DOE, J 1 02/18-02/18/2004 123456789 PAT $213.00 $.00 $213.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $213.00 f
4005254801 DOE, J e 02/16-02/16/2004 123456789 PAT $61.00 $61.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005255101 DOE, J e 02/17-02/17/2004 123456789 PAT $200.00 $200.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005263901 DOE, J s 02/13-02/13/2004 123456789 PAT $160.00 $1.00 $159.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $159.00 f
4005266601 DOE, J s 02/16-02/16/2004 123456789 PAT $197.00 $.00 $197.00 $.00 $40.00 $.00 $.00 $.00 $.00 $.00 $157.00 f
4005268101 DOE, J e 02/10-02/10/2004 123456789 PAT $190.00 $15.00 $175.00 $.00 $50.00 $.00 $62.50 $.00 $.00 $.00 $62.50 f
4005268601 DOE, J s 10/21-10/21/2003 123456789 PAT $451.00 $365.00 $86.00 $.00 $.00 $.00 $12.50 $.00 $.00 $.00 $73.50 f
4005269001 DOE, J JR 1 02/16-02/16/2004 123456789 PAT $425.00 $20.91 $404.09 $.00 $50.00 $.00 $177.03 $.00 $.00 $.00 $177.06 f
4005269701 DOE, J JR e 02/16-02/16/2004 123456789 SIMON JR $95.00 $.00 $95.00 $.00 $50.00 $.00 $22.50 $.00 $.00 $.00 $22.50 f
4005270101 DOE, J 2 02/13-02/13/2004 123456789 PAT $480.00 $121.00 $359.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $359.00 f
4005270601 DOE, J 1 02/13-02/13/2004 123456789 PAT $240.00 $81.00 $159.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $159.00 f
4005271101 DOE, J 2 02/17-02/17/2004 123456789 PAT $395.00 $2.51 $392.49 $.00 $.00 $.00 $196.24 $.00 $.00 $.00 $196.25 f
4005271701 DOE, J s 02/10-02/10/2004 123456789 PAT $176.00 $6.00 $170.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $170.00 f
4005279001 DOE, J 1 12/30-12/30/2003 123456789 PAT $48.00 $.00 $48.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $48.00 f
4005279701 DOE, J 2 02/17-02/17/2004 123456789 PAT $920.00 $.00 $920.00 $.00 $50.00 $.00 $435.00 $.00 $.00 $.00 $435.00 f
4005280801 DOE, J 1 12/30-12/30/2003 123456789 PAT $74.00 $52.00 $22.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $22.00 f
4005302201 DOE, J e 02/21-02/21/2004 123456789 PAT $400.00 $.00 $400.00 $.00 $.00 $.00 $200.00 $.00 $.00 $.00 $200.00 f
4005302401 DOE, J 4 12/02-12/02/2003 123456789 PAT $46.00 $46.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005303001 DOE, J s 02/05-02/05/2004 123456789 PAT $97.00 $97.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005304401 DOE, J e 02/18-02/18/2004 123456789 PAT $460.00 $.00 $460.00 $.00 $50.00 $.00 $200.00 $.00 $.00 $.00 $210.00 f
4005304701 DOE, J s 02/17-02/17/2004 123456789 PAT $67.00 $.00 $67.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $67.00 f
4005307101 DOE, J 2 02/09-02/09/2004 123456789 PAT $105.00 $.00 $105.00 $.00 $.00 $.00 $52.50 $.00 $.00 $.00 $52.50 f
4005307901 DOE, J 1 02/09-02/09/2004 123456789 PAT $258.00 $.00 $258.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $258.00 f
4005308801 DOE, J 3 02/09-02/09/2004 123456789 PAT $258.00 $.00 $258.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $258.00 f
4005350701 DOE, J e 02/17-02/17/2004 123456789 PAT $115.00 $.00 $115.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $115.00 f
4005351901 DOE, J s 02/17-02/17/2004 123456789 PAT $102.00 $.00 $102.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $102.00 f
4005433201 DOE, J 3 02/03-02/03/2004 123456789 PAT $337.00 $93.00 $244.00 $.00 $50.00 $.00 $97.00 $.00 $.00 $.00 $97.00 f
4005433401 DOE, J JR 1 10/01-10/01/2003 123456789 PAT $275.00 $275.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005434601 DOE, J e 02/16-02/16/2004 123456789 PAT $306.00 $61.00 $245.00 $.00 $50.00 $.00 $97.50 $.00 $.00 $.00 $97.50 f
4005435001 DOE, J e 02/16-02/16/2004 123456789 PAT $354.00 $21.00 $333.00 $.00 $.00 $.00 $84.50 $.00 $.00 $.00 $248.50 f
4005436001 DOE, J s 11/11-11/11/2003 123456789 PAT $162.00 $162.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005436201 DOE, J s 02/18-02/18/2004 123456789 PAT $202.00 $.00 $202.00 $.00 $50.00 $.00 $76.00 $.00 $.00 $.00 $76.00 f
4005437301 DOE, J s 02/03-02/03/2004 123456789 PAT $895.00 $.00 $895.00 $.00 $.00 $.00 $447.50 $.00 $354.00 $.00 $93.50 f
4005437801 DOE, J e 02/18-02/18/2004 123456789 PAT $2,808.00 $758.00 $2,050.00 $.00 $50.00 $.00 $1,000.00 $.00 $.00 $.00 $1,000.00 f
4005438101 DOE, J e 02/04-02/04/2004 123456789 PAT $1,055.00 $.00 $1,055.00 $.00 $.00 $.00 $527.50 $.00 $.00 $.00 $527.50 f
4005438301 DOE, J e 11/02-11/02/2003 123456789 PAT $634.00 $65.00 $569.00 $.00 $.00 $.00 $229.00 $.00 $.00 $.00 $340.00 f
4005442001 DOE, J 1 02/20-02/20/2004 123456789 PAT $165.00 $.00 $165.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $165.00 f
4005442301 DOE, J 2 02/03-02/03/2004 123456789 PAT $62.00 $.00 $62.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $62.00 f
4005442401 DOE, J 1 02/03-02/03/2004 123456789 PAT $68.00 $2.00 $66.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $66.00 f
4005442701 DOE, J 2 02/16-02/16/2004 123456789 PAT $186.00 $.00 $186.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $186.00 f
4005442901 DOE, J 1 02/16-02/16/2004 123456789 PAT $168.00 $.00 $168.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $168.00 f
4005455101 DOE, J s 02/17-02/17/2004 123456789 PAT $90.00 $.00 $90.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $90.00 f
4005455201 DOE, J s 02/19-02/19/2004 123456789 PAT $190.00 $.00 $190.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $190.00 f
4005455301 DOE, J 1 02/16-02/16/2004 123456789 PAT $236.00 $.00 $236.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $236.00 f
4005455701 DOE, J 1 12/30-12/30/2003 123456789 PAT $48.00 $48.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
4005455801 DOE, J e 02/17-02/17/2004 123456789 PAT $254.00 $.00 $254.00 $.00 $.00 $.00 $127.00 $.00 $.00 $.00 $127.00 f
4005455901 DOE, J e 02/19-02/19/2004 123456789 PAT $209.00 $.00 $209.00 $.00 $.00 $.00 $104.50 $.00 $.00 $.00 $104.50 f
4005456701 DOE, J 1 12/06-12/27/2003 123456789 PAT $2,235.00 $400.00 $1,835.00 $.00 $.00 $.00 $875.00 $.00 $.00 $.00 $960.00 f
4005457201 DOE, J e 02/19-02/19/2004 123456789 PAT $145.00 $3.00 $142.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $142.00 f
 
Total Ben Type: D $183,902.06 $36,772.79 $147,129.27 $.00 $9,142.00 $.00 $50,439.11 $.00 $4,197.90 $.00 $83,350.26  
 
>Benefit Type: M
2023417302 DOE, J e 02/26-02/26/2002 123456789 PAT $366.00 $.00 $366.00 $.00 $250.00 $.00 $11.60 $.00 $.00 $.00 $104.40 f
2083885203 DOE, J JR 1 08/26-08/26/2002 123456789 PAT $275.00 $.00 $275.00 $.00 $275.00 $.00 $.00 $.00 $.00 $.00 $.00 f
2086762102 DOE, J s 08/28-08/28/2002 123456789 PAT $87.00 $27.32 $59.68 $.00 $.00 $10.00 $.30 $.00 $.00 $.00 $49.38 f
2086762103 DOE, J s 08/28-08/28/2002 123456789 PAT $3.67 $.00 $3.67 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $3.67 f
2104859802 DOE, J e 10/17-10/17/2002 123456789 PAT $11.91 $.00 $11.91 $1.80 $.00 $.00 $1.01 $.00 $.00 $.00 $9.10 f
2104859803 DOE, J e 10/17-10/17/2002 123456789 PAT $73.09 $.00 $73.09 $28.45 $.00 $10.00 $.31 $.00 $.00 $.00 $34.33 f
3009476503 DOE, J e 01/29-02/02/2003 123456789 PAT $34,260.85 $34,260.85 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
3011341002 DOE, J 1 01/28-01/28/2003 123456789 PAT $25.00 $.00 $25.00 $12.50 $.00 $.00 $1.25 $.00 $.00 $.00 $11.25 f
3023010602 DOE, J 2 12/09-12/09/2001 123456789 PAT $95.00 $.00 $95.00 $16.36 $.00 $10.00 $.00 $.00 $.00 $.00 $68.64 f
3024669402 DOE, J s 03/18-03/18/2003 123456789 PAT $81.00 $3.00 $78.00 $.00 $.00 $10.00 $.00 $.00 $53.00 $.00 $15.00 f
3033049403 DOE, J s 04/22-04/22/2003 123456789 PAT $384.97 $.00 $384.97 $160.00 $.00 $.00 $22.50 $.00 $.00 $.00 $202.47 f
3035088002 DOE, J 2 01/16-01/16/2003 123456789 PAT $62.50 $.00 $62.50 $15.00 $.00 $10.00 $.00 $.00 $.00 $.00 $37.50 f
3035088003 DOE, J 2 01/16-01/16/2003 123456789 PAT $37.50 $.00 $37.50 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $37.50 f
3035089102 DOE, J 2 01/29-01/29/2003 123456789 PAT $62.50 $.00 $62.50 $15.00 $.00 $10.00 $.00 $.00 $.00 $.00 $37.50 f
3035089103 DOE, J 2 01/29-01/29/2003 123456789 PAT $37.50 $.00 $37.50 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $37.50 f
3035089302 DOE, J 2 02/10-02/10/2003 123456789 PAT $62.50 $.00 $62.50 $15.00 $.00 $10.00 $.00 $.00 $.00 $.00 $37.50 f
3035089303 DOE, J 2 02/10-02/10/2003 123456789 PAT $37.50 $.00 $37.50 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $37.50 f
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3047182301 DOE, J s 10/08-10/10/2003 123456789 PAT $8,732.02 $8,732.02 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
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3047906803 DOE, J e 05/02-05/02/2003 123456789 PAT $462.28 $.00 $462.28 $256.48 $.00 $.00 $.00 $.00 $.00 $.00 $205.80 f
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3049099402 DOE, J JR 2 10/02-10/02/2003 123456789 PAT $65.00 $.00 $65.00 $37.06 $.00 $10.00 $.00 $.00 $.00 $.00 $17.94 f
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3049883601 DOE, J e 11/12-11/14/2003 123456789 PAT $13,746.48 $.00 $13,746.48 $9,946.48 $.00 $.00 $380.00 $.00 $.00 $.00 $3,420.00 f
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3050292401 DOE, J 2 11/03-11/04/2003 123456789 PAT $9,602.08 $.00 $9,602.08 $3,840.84 $.00 $.00 $576.12 $.00 $.00 $.00 $5,185.12 f
3050314102 DOE, J e 01/27-06/04/2003 123456789 PAT $160.00 $20.00 $140.00 $.00 $.00 $.00 $56.00 $.00 $.00 $.00 $84.00 f
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3050363902 DOE, J s 11/01-11/01/2003 123456789 PAT $83.00 $.00 $83.00 $25.31 $.00 $10.00 $.64 $.00 $.00 $.00 $47.05 f
3050366402 DOE, J 2 10/27-10/27/2003 123456789 PAT $82.00 $82.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
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3050395102 DOE, J JR s 10/17-10/17/2003 123456789 PAT $3,837.58 $.00 $3,837.58 $383.76 $500.00 $100.00 $856.15 $.00 $.00 $.00 $1,997.67 f
3050403302 DOE, J e 10/30-11/05/2003 123456789 PAT $5,698.00 $5,698.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
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3050786002 DOE, J 2 11/03-11/03/2003 123456789 PAT $95.00 $.00 $95.00 $23.16 $.00 $10.00 $.00 $.00 $.00 $.00 $61.84 f
3050828702 DOE, J e 09/05-09/05/2003 123456789 PAT $135.00 $.00 $135.00 $33.75 $.00 $.00 $.00 $.00 $.00 $.00 $101.25 f
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3051278702 DOE, J e 10/29-10/29/2003 123456789 PAT $234.00 $.00 $234.00 $105.00 $.00 $.00 $.00 $.00 $.00 $.00 $129.00 f
3051359302 DOE, J 1 07/24-07/24/2003 123456789 PAT $132.14 $132.14 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 $.00 f
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