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Text File  |  1996-02-07  |  31KB  |  411 lines
  1. 409   0     76 11  1841  6 519 3500  0 00  0                              
  2. 0930601    AGADW010Again, Dwyght       237            O10                 
  3. 0930601    ANALO011Anaya, Lorena                      H10                 
  4. 0930601    BRADO010Bray, Don Key       2500           O10                 
  5. 0930601    BRIJA013Brimley, Jay        103            O10.00              
  6. 0930603    RODES010Rodriguez, Estella  00010000       H10                 
  7. 0930601    CHOCL010Chowder, C.         788            P13                 
  8. 0930601    BRIJA014Brimley, Jay        103            O10.00              
  9. 0930601    DUDST010Dude, Stephanie     2301           P19                 
  10. 0930601    ESTPO010Ester, Polly        432            O10                 
  11. 0930601    GONIB010Gone, I. B.         450            P30                 
  12. 0930601    SHAIM010Sharpe, I. M.       00010000       H10                 
  13. 0930602    ANALO010Anaya, Lorena       00000200       H10                 
  14. 0930602    BRIJA010Brimley, Jay        00010000       H10                 
  15. 0930602    MARMA011Martin, Marie       023            O10.00              
  16. 0930603    BRIJA011Brimley, Jay        00010000       H10                 
  17. 0930603    BRIJA012Brimley, Jay        00010000       H10                 
  18. 0930603    GOOHE010Goodman, Hesa                      R22                 
  19. 0930603    KLICA010Klinger, Carl P.    378            O10                 
  20. 0930601    BRUTO010Bruno, Tony         00000100       H5                  
  21. 0930601    OHAPA011O'Hara, Patrick     00000104       H10                 
  22. 0930705   4        Bc/Bs 250           0001           I32.00    0.00      
  23. C930705   4AGADW010Bc/Bs 250           0001           I    32.00          
  24. 0930705    BRIJA011Brimley, Jay        00010000       H10                 
  25. 0930705    DUDST010Dude, Stephanie     2333           P27.8               
  26. 0930705    TELWI010Tell, Will          234            O5                  
  27. 0930705    YOUMI010Younglblood, Michael638            P8                  
  28. 0930706    BRADO010Bray, Don Key       00000200       H10                 
  29. 0930706   9        Fhp/240                            I0.00     0.00      
  30. C930706   9BRADO010Fhp/240                            I    70.00          
  31. 0930706   9        Fhp/250                            I0.00     0.00      
  32. C930706   9BRIJA010Fhp/250                            I    40.00          
  33. 0930706   8        Cigna/34            000012         I0.00     0.00      
  34. C930706   8ANALO011Cigna/34            000012         I    65.00          
  35. 0930706  11        Hum/240                            I0.00     0.00      
  36. C930706  11BRUTO010Hum/240                            I    20.60          
  37. 0930706    CHOCL010Chowder, C.         832            P15.6               
  38. 0930706  12        Jh/250              2301           I76.00    0.00      
  39. C930706  12DUDST010Jh/250              2301           I    76.00          
  40. 0930706    ESTPO010Ester, Polly        00000200       H10                 
  41. 0930706   7        Inter/367                          I0.00     0.00      
  42. C930706   7ESTPO010Inter/367                          I    22.50          
  43. 0930706  12        Jh/57               00018          I32.00    0.00      
  44. C930706  12GOORI010Jh/57               00018          I    32.00          
  45. 0930706    OHAPA011O'Hara, Patrick     453            O10                 
  46. 0930706  10        Aetna/780           00019          I0.00     0.00      
  47. C930706  10OHAPA011Aetna/780           00019          I    36.00          
  48. 0930706    RODES010Rodriguez, Estella  1204           O10                 
  49. 0930706    SHAIM010Sharpe, I. M.       00010000       H10                 
  50. 0930706   7        Inter/578                          I         0.00      
  51. C930706   7SHAIM010Inter/578                          I   115.00          
  52. 0930706   5        Champva/456         000023         I48.00    0.00      
  53. C930706   5YOUMI010Champva/456         000023         I    48.00          
  54. 0930706   7        Intergroup                         I0.00     0.00      
  55. C930706   7ESTPO010Intergroup                         I     0.00          
  56. C930706  10OHAPA011Aetna/780           00019          I     0.00          
  57. C930706   8ANALO011Cigna/34            000012         I     0.00          
  58. C930706   9BRADO010Fhp/240                            I     0.00          
  59. C930706   9BRIJA010Fhp/250                            I     0.00          
  60. C930706  11BRUTO010Hum/240                            I     0.00          
  61. C930706   7ESTPO010Inter/367                          I     0.00          
  62. C930706   7SHAIM010Inter/578                          I     0.00          
  63. 0930707   8        Cigna/450                          I0.00     0.00      
  64. C930707   8ANALO010Cigna/450                          I     0.00          
  65. 0930707    ANALO010Anaya, Lorena       00000200       H10                 
  66. 0930707  11        Hum/250                            I0.00     0.00      
  67. C930707  11BRAKA010Hum/250                            I     0.00          
  68. C930707   9BRIJA011Fhp/250                            I     0.00          
  69. C930707   9BRIJA012Fhp/250                            I     0.00          
  70. 0930707   9        Fhp/250                            I0.00     0.00      
  71. C930707   9BRIJA013Fhp/250                            I     0.00          
  72. C930707   9BRIJA014Fhp/250                            I     0.00          
  73. 0930707   3        Champ/238           00015          I52.00    0.00      
  74. C930707   3CHOCL010Champ/238           00015          I    52.00          
  75. 0930707   1        Medicare/450        00019          I24.00    0.00      
  76. C930707   1DOVBE010Medicare/450        00019          I    24.00          
  77. 0930707    FARJA010Farnsworth, Janet   1321           P21                 
  78. 0930707  12        Jh/438              00026          I96.00    0.00      
  79. C930707  12FARJA010Jh/438              00026          I    96.00          
  80. 0930707    GOOHE010Goodman, Hesa       01000001       S21                 
  81. 0930707    GOOHE010Goodman, Hesa       88.00 ap       I0                  
  82. 0930707   1        Medicare/450        00019          I72.00    0.00      
  83. C930707   1HYNHE010Medicare/450        00019          I    72.00          
  84. 0930707    LONHO010Long, Howie         00000100       H5                  
  85. C930707  11LONHO010Hum/250                            I     0.00          
  86. 0930707   7        Inter/250                          I0.00     0.00      
  87. C930707   7MARMA011Inter/250                          I     0.00          
  88. 0930707    OLSOL010Olsen, Ole          00000005       H5                  
  89. 0930707  10        Aetna/250                          I0.00     0.00      
  90. C930707  10RODES010Aetna/250                          I     0.00          
  91. C930707  11TELWI010Hum/250                            I     0.00          
  92. 0930809  13        Mu/250              000002         I6.40     0.00      
  93. C930809  13AGADW010Mu/250              000002         I     6.40          
  94. 0930602    MARMA011Martin, Marie       023            O10                 
  95. 0930809    HYNHE010Hynd, Herbie        00000003       S3.2                
  96. C930707   8KLICA010Cigna/450                          I     0.00          
  97. 0930809    LONHO010Long, Howie         342            O5.00               
  98. C930707  11OLSOL010Hum/250                            I     0.00          
  99. 0930809    TIMMA010Times, Manny        00000100       H5                  
  100. 0930809    BRIJA01WBrimley, Jay        00010000       H10                 
  101. 0930810   4        Bcbs/250            00003          I32.00    0.00      
  102. C930810   4AGADW010Bcbs/250            00003          I    32.00          
  103. 0930810    ANALO010Anaya, Lorena       358            O10                 
  104. 0930810    ANALO011Anaya, Lorena       358            O10                 
  105. 0930810   9        Fhp/450                            I0.00     0.00      
  106. C930810   9BRIJA011Fhp/450                            I     0.00          
  107. 0930810    BRIJA014Brimley, Jay        00010000       H10                 
  108. 0930810    CHOCL010Chowder, C.         Credit C       R7.2                
  109. 0930810    DOVBE010Dover, Ben          00000002       S2.4                
  110. 0930810  12        Jh/250              00042          I111.20   0.00      
  111. C930810  12DUDST010Jh/250              00042          I   111.20          
  112. 0930810    FARJA010Farnsworth, Janet   00000103       S8                  
  113. 0930810   8        Cigna/250                          I0.00     0.00      
  114. C930810   8GOORI010Cigna/250                          I     0.00          
  115. 0930810  10        Aetna/250                          I0.00     0.00      
  116. C930810  10HYNHE010Aetna/250                          I     0.00          
  117. 0930810    KLICA010Klinger, Carl P.    432            O10                 
  118. 0930810   4        Bcbs/250            0507           I16.00    0.00      
  119. C930810   4LONHO010Bcbs/250            0507           I    16.00          
  120. 0930810    MARMA011Martin, Marie       037            O10.00              
  121. 0930810    OLSOL010Olsen, Ole          00000100       H5                  
  122. 0930810    TELWI010Tell, Will          00000005       H5                  
  123. 0930810   6        Feca/450            1245           I19.60    0.00      
  124. C930810   6TELWI010Feca/450            1245           I    19.60          
  125. 0930810    YOUMI010Younglblood, Michael00010002       S12                 
  126. 0930810   5        Champva/250         5403           I32.00    0.00      
  127. C930810   5YOUMI010Champva/250         5403           I    32.00          
  128. 0930810  11        Hum/250                            I0.00     0.00      
  129. C930810  11TELWI010Hum/250                            I     0.00          
  130. 0930811    AGADW010Again, Dwyght       00000004       S4.4                
  131. 0930811   8        Cigna/250                          I0.00     0.00      
  132. C930811   8ANALO010Cigna/250                          I     0.00          
  133. 0930811   9        Fhp/250                            I0.00     0.00      
  134. C930811   9BRADO010Fhp/250                            I     0.00          
  135. 0930811  11        Hum/450                            I0.00     0.00      
  136. C930811  11BRAKA010Hum/450                            I     0.00          
  137. 0930811    BRIJA012Brimley, Jay        00000200       H10                 
  138. 0930811    BRUTO010Bruno, Tony         00000100       H5                  
  139. 0930811   3        Champus/250         4520           I62.40    0.00      
  140. C930811   3CHOCL010Champus/250         4520           I    62.40          
  141. 0930810   1        Medicare/250        13004          I72.00    0.00      
  142. C930810   1DOVBE010Medicare/250        13004          I    72.00          
  143. 0930810   4        Bcbs/250            00004          I4.80     0.00      
  144. C930810   4DOVBE010Bcbs/250            00004          I     4.80          
  145. 0930811    DUDST010Dude, Stephanie     2365           P6                  
  146. 0930811    ESTPO010Ester, Polly        589            O10                 
  147. 0930811   7        Inter/250                          I0.00     0.00      
  148. C930811   7ESTPO010Inter/250                          I     0.00          
  149. 0930811  12        Jh/450              00148          I84.00    0.00      
  150. C930811  12FARJA010Jh/450              00148          I    84.00          
  151. 0930811   4        Bcbs/250            1305           I84.00    0.00      
  152. C930811   4GOOHE010Bcbs/250            1305           I    84.00          
  153. 0930811  12        Jh/250              1308           I32.00    0.00      
  154. C930811  12GOORI010Jh/250              1308           I    32.00          
  155. 0930811   1        Medicare/250        3405           I60.00    0.00      
  156. C930811   1HYNHE010Medicare/250        3405           I    60.00          
  157. C930811  11LONHO010Hum/450                            I     0.00          
  158. 0930811    OHAPA011O'Hara, Patrick     487            O10.00              
  159. 0930811  10        Aetna/250                          I0.00     0.00      
  160. C930811  10OHAPA011Aetna/250                          I     0.00          
  161. 0930811   4        Bcbs/250            4300           I5.60     0.00      
  162. C930811   4OLSOL010Bcbs/250            4300           I     5.60          
  163. 0930811    RODES010Rodriguez, Estella  00000200       H10                 
  164. C930811  10RODES010Aetna/250                          I     0.00          
  165. C930811   7SHAIM010Inter/250                          I     0.00          
  166. 0930913    BRIJA01WBrimley, Jay        312            O10.00              
  167. 0930913   9        Fhp/450                            I0.00     0.00      
  168. C930913   9BRIJA01WFhp/450                            I     0.00          
  169. 0930913    BRIJA010Brimley, Jay        312            O10.00              
  170. 0930913    BRUTO010Bruno, Tony         2048           O5                  
  171. 0930913    DUDST010Dude, Stephanie     2422           P6                  
  172. 0930913    FARJA010Farnsworth, Janet   1432           P8.00               
  173. 0930913    HYNHE010Hynd, Herbie        00000001       S1.6                
  174. 0930913    OLSOL010Olsen, Ole          00000005       H5                  
  175. C930913   9OLSOL010Fhp/450                            I     0.00          
  176. 0930913    TELWI010Tell, Will          350            O5                  
  177. 0930913    TIMMA010Times, Manny        722            O5                  
  178. 0930914  13        Mu/450              45003          I6.40     0.00      
  179. C930914  13AGADW010Mu/450              45003          I     6.40          
  180. 0930914    ANALO011Anaya, Lorena       00000200       H10                 
  181. 0930914  11        Hum/450                            I0.00     0.00      
  182. C930914  11BRAKA010Hum/450                            I     0.00          
  183. 0930914   9        Fhp/250                            I0.00     0.00      
  184. C930914   9BRIJA012Fhp/250                            I     0.00          
  185. C930914   9BRIJA014Fhp/250                            I     0.00          
  186. 0930914    GOOHE010Goodman, Hesa       00000103       S8                  
  187. 0930914    GOOHE010Goodman, Hesa       Credit C       R40                 
  188. 0930914  12        Jh/250              345            I32.00    0.00      
  189. C930914  12GOORI010Jh/250              345            I    32.00          
  190. 0930914   8        Cigna/450                          I0.00     0.00      
  191. C930914   8GOORI010Cigna/450                          I     0.00          
  192. 0930914  10        Aetna/250                          I0.00     0.00      
  193. C930914  10HYNHE010Aetna/250                          I     0.00          
  194. 0930914    LONHO010Long, Howie         00000100       H5                  
  195. C930914  11LONHO010Hum/450                            I     0.00          
  196. 0930914   4        Bcbs/450            65001          I5.60     0.00      
  197. C930914   4LONHO010Bcbs/450            65001          I     5.60          
  198. 0930914    MARMA011Martin, Marie       048            O10.00              
  199. 0930914    RODES010Rodriguez, Estella  00000200       H10                 
  200. 0930914   6        Feca/250            3444           I11.00    0.00      
  201. C930914   6TELWI010Feca/250            3444           I    11.00          
  202. C930914  11TIMMA010Hum/450                            I     0.00          
  203. 0930915   4        Mu/450              456            I84.48    0.00      
  204. C930915   4AGADW010Mu/450              456            I    84.48          
  205. 0930915   8        Cigna/450                          I0.00     0.00      
  206. C930915   8ANALO010Cigna/450                          I     0.00          
  207. C930915   8ANALO011Cigna/450                          I     0.00          
  208. 0930915    BRIJA013Brimley, Jay        00000105       H10                 
  209. 0930915  11        Hum/450                            I0.00     0.00      
  210. C930915  11BRUTO010Hum/450                            I     0.00          
  211. 0930915   3        Champus/450         5670           I28.80    0.00      
  212. C930915   3CHOCL010Champus/450         5670           I    28.80          
  213. 0930915    DOVBE010Dover, Ben          00000002       S2                  
  214. 0930915   1        Medicare/450        3017           I48.00    0.00      
  215. C930915   1DOVBE010Medicare/450        3017           I    48.00          
  216. 0930915   4        Bcbs/450            00080          I14.40    0.00      
  217. C930915   4DOVBE010Bcbs/450            00080          I    14.40          
  218. 0930915  12        Jh/450              00078          I24.00    0.00      
  219. C930915  12DUDST010Jh/450              00078          I    24.00          
  220. 0930915   7        Inter/450                          I0.00     0.00      
  221. C930915   7ESTPO010Inter/450                          I     0.00          
  222. 0930915  12        Jh/450              000085         I32.00    0.00      
  223. C930915  12FARJA010Jh/450              000085         I    32.00          
  224. 0930915    KLICA010Klinger, Carl P.    00000200       H10                 
  225. C930915   8KLICA010Cigna/450                          I     0.00          
  226. C930915   7MARMA011Inter/450                          I     0.00          
  227. 0930915  10        Aetna/450                          I0.00     0.00      
  228. C930915  10OHAPA011Aetna/450                          I     0.00          
  229. C930915  10RODES010Aetna/450                          I     0.00          
  230. C930915  11TELWI010Hum/450                            I     0.00          
  231. 0930915    YOUMI010Younglblood, Michael669            P30.6               
  232. 0930915   5        Champva/450         000067         I48.00    0.00      
  233. C930915   5YOUMI010Champva/450         000067         I    48.00          
  234. 0930915   1        Medicare/250        00089          I64.00    0.00      
  235. C930915   1HYNHE010Medicare/250        00089          I    64.00          
  236. C930914  11OLSOL010Hum/450                            I     0.00          
  237. 0931018    ANALO011Anaya, Lorena       471            O10                 
  238. 0931018    ESTPO010Ester, Polly        649            O10                 
  239. 0931018    OHAPA011O'Hara, Patrick     00010000       H10                 
  240. 0931018    RODES010Rodriguez, Estella  433            O10                 
  241. 0931018    TELWI010Tell, Will                         O5                  
  242. 0931019    TELWI010Tell, Will          00000001       H5                  
  243. C931019  11TELWI010Hum/450                            I     0.00          
  244. 0931019  13        Mu/450              45029          I16.90    0.00      
  245. C931019  13AGADW010Mu/450              45029          I    16.90          
  246. 0931019    AGADW010Again, Dwyght       00000002       S2.4                
  247. 0931019    BRADO010Bray, Don Key       2566           O10                 
  248. 0931019  11        Hum/450                            I0.00     0.00      
  249. C931019  11BRAKA010Hum/450                            I     0.00          
  250. 0931019   9        Fhp/450                            I0.00     0.00      
  251. C931019   9BRIJA010Fhp/450                            I     0.00          
  252. C931019   9BRIJA01WFhp/450                            I     0.00          
  253. C931019   9BRIJA013Fhp/450                            I     0.00          
  254. C931019  11BRUTO010Hum/450                            I     0.00          
  255. 0931019    CHOCL010Chowder, C.         Credit C       R10.2               
  256. 0931019  12        Jh/450              00104          I24.00    0.00      
  257. C931019  12DUDST010Jh/450              00104          I    24.00          
  258. 0931019   4        Bcbs/450            23001          I32.00    0.00      
  259. C931019   4GOOHE010Bcbs/450            23001          I    32.00          
  260. 0931019   1        Medicare/450        000304         I32.00    0.00      
  261. C931019   1HYNHE010Medicare/450        000304         I    32.00          
  262. 0931019  10        Aetna/450                          I0.00          0.00 
  263. C931019  10HYNHE010Aetna/450                          I     0.00          
  264. 0931019   4        Bcbs/450            30008          I5.60     0.00      
  265. C931019   4LONHO010Bcbs/450            30008          I     5.60          
  266. 0931019    MARMA011Martin, Marie       00000200       H10                 
  267. 0931019    OLSOL010Olsen, Ole          00000100       H5                  
  268. C930810  11OLSOL010Hum/250                            I     0.00          
  269. 0930914   4        Bcbs/450            0000125        I29.60    0.00      
  270. C930914   4OLSOL010Bcbs/450            0000125        I    29.60          
  271. C931019   9OLSOL010Fhp/450                            I     0.00          
  272. C931019  11OLSOL010Hum/450                            I     0.00          
  273. 0931019   4        Bcbs/450            30051          I29.60    0.00      
  274. C931019   4OLSOL010Bcbs/450            30051          I    29.60          
  275. 0931019    TIMMA010Times, Manny        804            O5                  
  276. C930914  11BRAKA010Hum/450                            I     0.00          
  277. 0931020   8        Cigna/450                          I0.00     0.00      
  278. C931020   8ANALO011Cigna/450                          I     0.00          
  279. 0931020    BRUTO010Bruno, Tony         00000100       H5                  
  280. 0931020   1        Medicare/450        4507           I40.00    0.00      
  281. C931020   1DOVBE010Medicare/450        4507           I    40.00          
  282. 0931020   4        Bcbs/450            1475           I9.60     0.00      
  283. C931020   4DOVBE010Bcbs/450            1475           I     9.60          
  284. 0931020    DUDST010Dude, Stephanie     Credit C       R12                 
  285. 0931020    GOOHE010Goodman, Hesa       Credit C       R12                 
  286. 0931020  12        Jh/450              451            I58.40    0.00      
  287. C931020  12GOORI010Jh/450              451            I    58.40          
  288. C931020   8GOORI010Cigna/450                          I     0.00          
  289. 0931020    HYNHE010Hynd, Herbie        00000001       S1                  
  290. 0931020    KLICA010Klinger, Carl P.    00000100       H10                 
  291. 0931020  11        Hum/450                            I0.00     0.00      
  292. C931020  11LONHO010Hum/450                            I     0.00          
  293. 0931020   7        Inter/450                          I0.00     0.00      
  294. C931020   7MARMA011Inter/450                          I     0.00          
  295. 0931020  10        Aetna/450                          I0.00     0.00      
  296. C931020  10RODES010Aetna/450                          I     0.00          
  297. 0931020    SHAIM010Sharpe, I. M.       789            O10                 
  298. 0931020   6        Feca/250            1278           I21.60    0.00      
  299. C931020   6TELWI010Feca/250            1278           I    21.60          
  300. 0931020  13        Mu/250              00457          I7.00     0.00      
  301. C931020  13TIMMA010Mu/250              00457          I     7.00          
  302. C931020  11TIMMA010Hum/450                            I     0.00          
  303. 0931020    YOUMI010Younglblood, Michael00010003       S13                 
  304. 0931020   5        Champva/250         0578           I122.40   0.00      
  305. C931020   5YOUMI010Champva/250         0578           I   122.40          
  306. 0931122    AGADW010Again, Dwyght       00000002       S2.6                
  307. 0931122   4        Bcbs/450            578            I46.08    0.00      
  308. C931122   4AGADW010Bcbs/450            578            I    46.08          
  309. 0931122    ANALO011Anaya, Lorena       522            O10                 
  310. 0931122    BRIJA014Brimley, Jay        410            O10                 
  311. 0931122    FARJA010Farnsworth, Janet   Credit C       R8                  
  312. 0931122    SHAIM010Sharpe, I. M.       00010000       H10                 
  313. 0931122    YOUMI010Younglblood, Michael00000103       S8                  
  314. 0931123   8        Cigna/450                          I0.00     0.00      
  315. C931123   8ANALO011Cigna/450                          I     0.00          
  316. 0931123    BRADO010Bray, Don Key       3020           O10                 
  317. 0931123    BRUTO010Bruno, Tony         3012           O5.00               
  318. 0931123    DUDST010Dude, Stephanie     Credit C       R6                  
  319. 0931123   7        Inter/250                          I0.00     0.00      
  320. C931123   7ESTPO010Inter/250                          I     0.00          
  321. 0931123  12        Jh/450              2147           I64.00    0.00      
  322. C931123  12GOORI010Jh/450              2147           I    64.00          
  323. 0931123  12        Jh/450              2278           I52.00    0.00      
  324. C931123  12GOORI010Jh/450              2278           I    52.00          
  325. 0931123   8        Cigna/450                          I0.00     0.00      
  326. C931123   8GOORI010Cigna/450                          I     0.00          
  327. 0931123  10        Aetna/450                          I0.00     0.00      
  328. C931123  10HYNHE010Aetna/450                          I     0.00          
  329. 0931123    KLICA010Klinger, Carl P.    00010000       H10                 
  330. 0931123   4        Bcbs/450            6588           I9.60     0.00      
  331. C931123   4LONHO010Bcbs/450            6588           I     9.60          
  332. C931123  10OHAPA011Aetna/450                          I     0.00          
  333. 0931123   4        Bcbs/450            6589           I31.20    0.00      
  334. C931123   4OLSOL010Bcbs/450            6589           I    31.20          
  335. 0931123   9        Fhp/450                            I0.00     0.00      
  336. C931123   9OLSOL010Fhp/450                            I     0.00          
  337. 0931123    RODES010Rodriguez, Estella  00010000       H10                 
  338. C931123  10RODES010Aetna/450                          I     0.00          
  339. 0931123   6        Feca/450            8722           I12.00    0.00      
  340. C931123   6TELWI010Feca/450            8722           I    12.00          
  341. 0931124   9        Fhp/450                            I0.00     0.00      
  342. C931124   9BRADO010Fhp/450                            I     0.00          
  343. 0931124  11        Hum/250                            I0.00     0.00      
  344. C931124  11BRAKA010Hum/250                            I     0.00          
  345. C931124  11BRUTO010Hum/250                            I     0.00          
  346. 0931124    CHOCL010Chowder, C.         00000102       S7.2                
  347. 0931124   3        Champus/250         5799           I40.80    0.00      
  348. C931124   3CHOCL010Champus/250         5799           I    40.80          
  349. 0931124    DOVBE010Dover, Ben          00000003       S3.6                
  350. 0931124   4        Bcbs/450            5012           I6.40     0.00      
  351. C931124   4DOVBE010Bcbs/450            5012           I     6.40          
  352. 0931124  12        Jh/250              00225          I48.00    0.00      
  353. C931124  12DUDST010Jh/250              00225          I    48.00          
  354. 0931124   4        Bcbs/450            1423           I48.00    0.00      
  355. C931124   4GOOHE010Bcbs/450            1423           I    48.00          
  356. 0931124   1        Medicare/450        000452         I20.00    0.00      
  357. C931124   1HYNHE010Medicare/450        000452         I    20.00          
  358. 0931124   8        Cigna/450                          I0.00     0.00      
  359. C931124   8KLICA010Cigna/450                          I     0.00          
  360. 0931124    MARMA011Martin, Marie       00000200       H10                 
  361. 0931124   7        Inter/450                          I0.00     0.00      
  362. C931124   7MARMA011Inter/450                          I     0.00          
  363. 0931124    OLSOL010Olsen, Ole          00000100       H5                  
  364. C931124  11OLSOL010Hum/250                            I     0.00          
  365. C931124   7SHAIM010Inter/450                          I     0.00          
  366. C931124  11TELWI010Hum/250                            I     0.00          
  367. 0931124  13        Mu/250              000351         I22.60    0.00      
  368. C931124  13TIMMA010Mu/250              000351         I    22.60          
  369. 0931124    TIMMA010Times, Manny        00000100       H5                  
  370. C931124  11TIMMA010Hum/250                            I     0.00          
  371. 0931124   5        Champva/250         6001           I52.00    0.00      
  372. C931124   5YOUMI010Champva/250         6001           I    52.00          
  373. C930707   8ANALO010Cigna/450                          I     0.00          
  374. C930811   8ANALO010Cigna/250                          I     0.00          
  375. C930915   8ANALO010Cigna/450                          I     0.00          
  376. 0930601   7        Inter/450           01047          T200.00             
  377. 0930601   8        Cigna/450           00452          T280.00             
  378. 0930915    ANALO011Anaya, Lorena       Insuranc       I40                 
  379. 0930601   9        Fhp/450             24789          T350.00             
  380. 0931122   7        Inter/450           05418          T200.00             
  381. 0930705  10        Aetna/450           10421          T300.00             
  382. 0930601  10        Aetna/450           10082          T300.00             
  383. 0930705  11        Hum/450             09271          T600.00             
  384. 0931018   7        Inter/450           04500          T200.00             
  385. 0930809   7        Inter/450           02718          T200.00             
  386. 0930809   8        Cigna/450           01309          T280.00             
  387. 0930809   9        Fhp/450             32408          T350.00             
  388. 0930601  11        Hum/450             04021          T600.00             
  389. 0930705   7        Inter/450           02025          T200.00             
  390. 0931122   8        Cigna/450           04395          T280.00             
  391. 0931018  12        Jh/250              000125         I32.00    0.00      
  392. C931018  12FARJA010Jh/250              000125         I    32.00          
  393. 0931018   8        Cigna/450           03667          T280.00             
  394. 0931018   9        Fhp/450             47822          T350.00             
  395. 0930809  10        Aetna/450           20014          T300.00             
  396. 0931019   8        Cigna/450                          I0.00     0.00      
  397. C931019   8KLICA010Cigna/450                          I     0.00          
  398. 0930809  11        Hum/450             15700          T600.00             
  399. 0930913   7        Inter/450           03329          T200.00             
  400. 0931122   9        Fhp/450             53299          T350.00             
  401. 0930913   8        Cigna/450           02142          T280.00             
  402. 0930705   8        Cigna/450           00933          T280.00             
  403. 0931122  10        Aetna/450           40427          T300.00             
  404. 0930913   9        Fhp/450             39920          T350.00             
  405. 0931018  10        Aetna/450           35109          T300.00             
  406. 0930913  10        Aetna/450           28137          T300.00             
  407. 0931122  11        Hum/450             46807          T600.00             
  408. 0930705   9        Fhp/450             29324          T350.00             
  409. 0930913  11        Hum/450             21044          T600.00             
  410. 0931018  11        Hum/450             33075          T600.00             
  411.