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Text File  |  1995-07-12  |  2KB  |  26 lines
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  2.                                                                         10:42:17
  3.   Date   Inv.  Dr Transaction                       Ck/no.  Ins. Amount    Total
  4. 00001.00 Abraczinskas, Donald                                                   
  5. 10/29/92 00000 02 1001     CHG - ADJ Credits                 P   -16.92   -16.92
  6. 10/29/92 00000 02 2001     BCBSPA- HD 8/92          7571143  Y   -26.71   -43.63
  7. 10/29/92 00000 02 2001     MEDB- HD 9/92            88863523 Y   -15.26   -58.89
  8. 11/10/92 00000 02 2001     BCBSPA-HD 9/92           7635509  Y    -3.82   -62.71
  9. 01/04/93 10312 02 1000     HD 12/92                          Y   360.00   297.29
  10. 01/08/93 10226 02 3000     ADJ CREDITS HD 11/92              P  -169.07   128.22
  11. 01/08/93 10226 02 2000     MEDB HD 11/92            90100797 Y  -152.74   -24.52
  12. 03/26/93 10421 02 3001     Cash Recv -                       P  -100.00  -124.52
  13. 03/26/93 10422 02 3001     Cash Recv -                       P  -150.00  -274.52
  14. 04/22/93 10425 02 90220    Hospital Admission                Y   120.00  -154.52
  15. 04/22/93 10425 02 90220    Hospital Admission                Y   120.00   -34.52
  16. 04/22/93 10425 02 90260    Ward Visit                        Y    50.00    15.48
  17. 04/22/93 10425 02 90270    ISC                               Y    60.00    75.48
  18. 04/22/93 10425 02 99221    Init. Hospital Care 30 m          Y    95.00   170.48
  19. 04/22/93 10425 02 99231    Subsequent Hospital Care          Y    70.00   240.48
  20. 04/22/93 10425 02 99233    Subsequent Hospital Care          Y    90.00   330.48
  21. 04/22/93 10425 02 99231    Subsequent Hospital Care          Y    70.00   400.48
  22. 04/22/93 10425 02 99232    Subsequent Hospital Care          Y    80.00   480.48
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  25.                                Continue (Y/N).Y                                 
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