Spreadsheet: 99075d1297848405-copy-data-from-a-sheet-to-other-based-on-a-criteria-2-5-2011ec-ft
Sheet: Sheet1

Upfront Reduction (not appr) | Invoice # | Service Date | Product Number | Credit Amt | [NAME] | Original | Approved | Not Approv | Deductible | Co-insurance | Write off | Adjust | Payment | Notes | Credit Balance
BATCHID: | 02/05/2011EC
Third Party
Trans #: | 76143 | Check#: [PHONE] | Payment: | 99 | Amount Posted | 99 |  | 0
Account #: | 2146 | BROADSPIRE WC*
Patient Name: | PINTO, GENO
44127-[PHONE] | 2010-12-18 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99 | 0
Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Trans #: | 76144 | Check#: [PHONE] | Payment: | 236.63 | Amount Posted | 236.63 |  | 0
Account #: | 3450 | SERVICE CONCEPTS WC*
Patient Name: | WEBSTER, REGINA
244883-[PHONE] | 2010-12-27 00:00:00 | SKIN0001 | 0 | 0 | 32 | 32 | 25.6 |  | 0 | 0 | 0 | 0 | 25.6 | Pend
244883-[PHONE] | 2010-12-27 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 9.84 |  | 0 | 0 | 0 | 0 | 9.84 | Pend
244883-[PHONE] | 2010-12-27 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
244883-[PHONE] | 2010-12-27 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 26.24 |  | 0 | 0 | 0 | 0 | 26.24 | Pend
244883-[PHONE] | 2010-12-27 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
244883-[PHONE] | 2010-12-27 00:00:00 | BIOI0001 | 0 | 0 | 99 | 99 | 20.87 |  | 0 | 0 | 0 | 0 | 20.87 | Pend
Carrier Totals: | 0 | 355.61 | 355.61 | 236.63 |  | 0 | 0 | 0 | 0 | 236.63 | 0
Totals: | 0 | 355.61 | 355.61 | 236.63 |  | 0 | 0 | 0 | 0 | 236.63
Trans #: | 76105 | Check#: [PHONE] | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2039 | AMERIPRISE PIP
Patient Name: | MACDOUGALL, PAULINE
269119-[PHONE] | 2011-01-23 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
269119-[PHONE] | 2011-01-23 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
269119-[PHONE] | 2011-01-23 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
269119-[PHONE] | 2011-01-23 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76099 | Check#: [PHONE] | Payment: | 1528.42 | Amount Posted | 1528.42 |  | 0
Account #: | 2039 | AMERIPRISE PIP
Patient Name: | CHIOREAN, MONA
249430-[PHONE] | 2010-12-03 00:00:00 | FLEI0001 | 0 |  | 1195 | 1195 | 1195 | 0 | 0 | 0 | 0 | 0 | 1195
249430-[PHONE] | 2010-12-03 00:00:00 | SKIN0001 | 0 |  | 19.55 | 19.552 | 19.55 | 0 | 0 | 0 | 0 | 0 | 19.55
249430-[PHONE] | 2010-12-03 00:00:00 | LOTI0001 | 0 |  | 8.11 | 8.11 | 8.11 | 0 | 0 | 0 | 0 | 0 | 8.11
249430-[PHONE] | 2010-12-03 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
249430-[PHONE] | 2010-12-03 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
249430-[PHONE] | 2010-12-03 00:00:00 | CHAR0002 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
249430-[PHONE] | 2010-12-03 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
Carrier Totals: | 0 | 1528.42 | 1528.422 | 1528.42 | 0 | 0 | 0 | 0 | 0 | 1528.42 | 0
Totals: | 0 | 1528.42 | 1528.422 | 1528.42 | 0 | 0 | 0 | 0 | 0 | 1528.42
Trans #: | 76122 | Check#: [PHONE] | Payment: | 99 | Amount Posted | 99 |  | 0
Account #: | 2142 | LIBERTY MUTUAL WC*
Patient Name: | [NAME], WILLIAM H
70680-[PHONE] | 2010-12-14 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99 | 0
Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Trans #: | 76121 | Check#: [PHONE] | Payment: | 342.39 | Amount Posted | 342.39 |  | 0
Account #: | 2142 | LIBERTY MUTUAL WC*
Patient Name: | ORTIZ, [NAME]
116043-[PHONE] | 2010-05-26 00:00:00 | SKIN0001 | 0 |  | 48 | 48 | 48 | 0 | 0 | 0 | 0 | 0 | 48
116043-[PHONE] | 2010-05-26 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.89 |  | 0 | 0 | 0 | 0 | 10.89 | Pend
116043-[PHONE] | 2010-05-26 00:00:00 | ELEC0001 | 0 | 0 | 195.12 | 195.12 | 147.12 |  | 0 | 0 | 0 | 0 | 147.12 | Pend
116043-[PHONE] | 2010-05-26 00:00:00 | BATT0001 | 0 | 0 | 27 | 27 | 7.38 |  | 0 | 0 | 0 | 0 | 7.38 | Pend
116043-[PHONE] | 2010-05-26 00:00:00 | DELI0001 | 0 |  | 30 | 30 | 30 | 0 | 0 | 0 | 0 | 0 | 30
116043-[PHONE] | 2010-05-26 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 427.65 | 427.65 | 342.39 | 0 | 0 | 0 | 0 | 0 | 342.39 | 0
Totals: | 0 | 427.65 | 427.65 | 342.39 | 0 | 0 | 0 | 0 | 0 | 342.39
Trans #: | 76118 | Check#: [PHONE] | Payment: | 768.91 | Amount Posted | 768.91 |  | 0
Account #: | 2142 | LIBERTY MUTUAL WC*
Patient Name: | [NAME], RONLEY
265474-[PHONE] | 2010-12-29 00:00:00 | KNEE0001 | 0 |  | 495 | 495 | 495 | 0 | 0 | 0 | 0 | 0 | 495
265474-[PHONE] | 2010-12-29 00:00:00 | SKIN0001 | 0 |  | 16 | 16 | 16 | 0 | 0 | 0 | 0 | 0 | 16
265474-[PHONE] | 2010-12-29 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 16.83 |  | 0 | 0 | 0 | 0 | 16.83 | Pend
265474-[PHONE] | 2010-12-29 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
265474-[PHONE] | 2010-12-29 00:00:00 | BATT0004 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
265474-[PHONE] | 2010-12-29 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
265474-[PHONE] | 2010-12-29 00:00:00 | DELI0001 | 0 |  | 30 | 30 | 30 | 0 | 0 | 0 | 0 | 0 | 30
Carrier Totals: | 0 | 780.61 | 780.61 | 768.91 | 0 | 0 | 0 | 0 | 0 | 768.91 | 0
Totals: | 0 | 780.61 | 780.61 | 768.91 | 0 | 0 | 0 | 0 | 0 | 768.91
Trans #: | 76100 | Check#: [PHONE] | Payment: | 289.13 | Amount Posted | 289.13 |  | 0
Account #: | 3054 | ACAIDIA INS WC*
Patient Name: | DOYLE, [NAME]
257704-[PHONE] | 2011-01-10 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
257704-[PHONE] | 2011-01-10 00:00:00 | LOTI0002 | 0 |  | 28.53 | 28.53 | 28.53 | 0 | 0 | 0 | 0 | 0 | 28.53
257704-[PHONE] | 2011-01-10 00:00:00 | ELEC0002 | 0 |  | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6
257704-[PHONE] | 2011-01-10 00:00:00 | BATT0002 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
257704-[PHONE] | 2011-01-10 00:00:00 | DELI0001 | 0 |  | 30 | 30 | 30 | 0 | 0 | 0 | 0 | 0 | 30
Carrier Totals: | 0 | 289.13 | 289.13 | 289.13 | 0 | 0 | 0 | 0 | 0 | 289.13 | 0
Totals: | 0 | 289.13 | 289.13 | 289.13 | 0 | 0 | 0 | 0 | 0 | 289.13
Trans #: | 76123 | Check#: 08025097 | Payment: | 99 | Amount Posted | 99 |  | 0
Account #: | 1548 | STATE WORKERS INS FUND WC*
Patient Name: | RUCK, SHAWN
44614-[PHONE] | 2010-12-14 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99 | 0
Totals: | 0 | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Trans #: | 76142 | Check#: [PHONE] | Payment: | 207.59 | Amount Posted | 207.59 |  | 0
Account #: | 2739 | XCHANGING FL WC*
Patient Name: | VITAKIS, KALLIOPE
79205-[PHONE] | 2010-03-27 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
79205-[PHONE] | 2010-03-27 00:00:00 | LOTI0001 | 0 |  | 9.51 | 9.51 | 9.51 | 0 | 0 | 0 | 0 | 0 | 9.51
79205-[PHONE] | 2010-03-27 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
79205-[PHONE] | 2010-03-27 00:00:00 | BATT0004 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
Carrier Totals: | 0 | 207.59 | 207.59 | 207.59 | 0 | 0 | 0 | 0 | 0 | 207.59 | 0
Totals: | 0 | 207.59 | 207.59 | 207.59 | 0 | 0 | 0 | 0 | 0 | 207.59
Trans #: | 76107 | Check#: 1063109 | Payment: | 277.49 | Amount Posted | 277.49 |  | 0
Account #: | 2842 | BUILDERS MUTUAL INS WC
Patient Name: | BOWERS, [NAME]
269084-[PHONE] | 2011-01-24 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
269084-[PHONE] | 2011-01-24 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 16.89 |  | 0 | 0 | 0 | 0 | 16.89 | Pend
269084-[PHONE] | 2011-01-24 00:00:00 | ELEC0002 | 0 |  | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6
269084-[PHONE] | 2011-01-24 00:00:00 | BATT0002 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
269084-[PHONE] | 2011-01-24 00:00:00 | DELI0001 | 0 |  | 30 | 30 | 30 | 0 | 0 | 0 | 0 | 0 | 30
Carrier Totals: | 0 | 289.13 | 289.13 | 277.49 | 0 | 0 | 0 | 0 | 0 | 277.49 | 0
Totals: | 0 | 289.13 | 289.13 | 277.49 | 0 | 0 | 0 | 0 | 0 | 277.49
Trans #: | 76145 | Check#: [PHONE] | Payment: | 75.63 | Amount Posted | 75.63 |  | 0
Account #: | 1532 | SPECIALTY RISK SERVICES WC*
Patient Name: | SAEED, ZAKI
264100-[PHONE] | 2011-01-16 00:00:00 | KIT0002 | 0 | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63 | Pend
Carrier Totals: | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63 | 0
Totals: | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63
Trans #: | 76149 | Check#: [PHONE] | Payment: | 75.62 | Amount Posted | 75.62 |  | 0
Account #: | 1532 | SPECIALTY RISK SERVICES WC*
Patient Name: | TODD JR, ED
250896-[PHONE] | 2011-01-03 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 75.62 |  | 0 | 0 | 0 | 0 | 75.62 | Pend
Carrier Totals: | 0 | 120 | 120 | 75.62 |  | 0 | 0 | 0 | 0 | 75.62 | 0
Totals: | 0 | 120 | 120 | 75.62 |  | 0 | 0 | 0 | 0 | 75.62
Trans #: | 76157 | Check#: [PHONE] | Payment: | 75.63 | Amount Posted | 75.63 |  | 0
Account #: | 2478 | SRS WC*
Patient Name: | PEARSON, PATRICIA
264076-[PHONE] | 2011-01-16 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63 | Pend
Carrier Totals: | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63 | 0
Totals: | 0 | 120 | 120 | 75.63 |  | 0 | 0 | 0 | 0 | 75.63
Trans #: | 76124 | Check#: 1622255 | Payment: | 1504.96 | Amount Posted | 1504.96 |  | 0
Account #: | 1151 | ACS WC*
Patient Name: | DRUMHELLER, KIM
276541-[PHONE] | 2010-12-30 00:00:00 | FLEI0001 | 0 | 0 | 1495 | 1495 | 1196 |  | 0 | 0 | 0 | 0 | 1196 | Pend
276541-[PHONE] | 2010-12-30 00:00:00 | SKIN0001 | 0 | 0 | 16 | 16 | 12.8 |  | 0 | 0 | 0 | 0 | 12.8 | Pend
276541-[PHONE] | 2010-12-30 00:00:00 | LOTI0001 | 0 | 0 | 9.51 | 9.51 | 5.88 |  | 0 | 0 | 0 | 0 | 5.88 | Pend
276541-[PHONE] | 2010-12-30 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
276541-[PHONE] | 2010-12-30 00:00:00 | BATT0004 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
276541-[PHONE] | 2010-12-30 00:00:00 | CHAR0002 | 0 | 0 | 99 | 99 | 79.2 |  | 0 | 0 | 0 | 0 | 79.2 | Pend
276541-[PHONE] | 2010-12-30 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
Carrier Totals: | 0 | 1830.59 | 1830.59 | 1504.96 | 0 | 0 | 0 | 0 | 0 | 1504.96 | 0
Totals: | 0 | 1830.59 | 1830.59 | 1504.96 | 0 | 0 | 0 | 0 | 0 | 1504.96
Trans #: | 76120 | Check#: 16682692 | Payment: | 334.49 | Amount Posted | 334.49 |  | 0
Account #: | 1394 | KEMI WC*
Patient Name: | FOSTER, RICHARD
223119-[PHONE] | 2010-12-25 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
223119-[PHONE] | 2010-12-25 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.65 |  | 0 | 0 | 0 | 0 | 10.65 | Pend
223119-[PHONE] | 2010-12-25 00:00:00 | BATT0002 | 0 | 0 | 36 | 36 | 26.04 |  | 0 | 0 | 0 | 0 | 26.04 | Pend
223119-[PHONE] | 2010-12-25 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
223119-[PHONE] | 2010-12-25 00:00:00 | BIOI0001 | 0 | 0 | 99 | 99 | 79.2 |  | 0 | 0 | 0 | 0 | 79.2 | Pend
223119-[PHONE] | 2010-12-25 00:00:00 | ELEC0008 | 0 |  | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6
Carrier Totals: | 0 | 388.13 | 388.13 | 334.49 | 0 | 0 | 0 | 0 | 0 | 334.49 | 0
Totals: | 0 | 388.13 | 388.13 | 334.49 | 0 | 0 | 0 | 0 | 0 | 334.49
Trans #: | 76101 | Check#: 1897168 | Payment: | 94.2 | Amount Posted | 94.2 |  | 0
Account #: | 3459 | CROWN HEALTH CARE W/C*
Patient Name: | SMITH, SANDRA
255318-[PHONE] | 2011-01-07 00:00:00 | SKIN0001 | 0 | 0 | 32 | 32 | 3.23 |  | 0 | 0 | 0 | 0 | 3.23 | Pend
255318-[PHONE] | 2011-01-07 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 8.97 |  | 0 | 0 | 0 | 0 | 8.97 | Pend
255318-[PHONE] | 2011-01-07 00:00:00 | ELEC0001 | 0 | 0 | 130.08 | 130.08 | 48 |  | 0 | 0 | 0 | 0 | 48 | Pend
255318-[PHONE] | 2011-01-07 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
255318-[PHONE] | 2011-01-07 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 10 |  | 0 | 0 | 0 | 0 | 10 | Pend
Carrier Totals: | 0 | 256.61 | 256.61 | 94.2 |  | 0 | 0 | 0 | 0 | 94.2 | 0
Totals: | 0 | 256.61 | 256.61 | 94.2 |  | 0 | 0 | 0 | 0 | 94.2
Trans #: | 76126 | Check#: [PHONE] | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2457 | PROGRESSIVE PIP*
Patient Name: | MORRISON, ANASTASA
264427-[PHONE] | 2011-01-17 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
264427-[PHONE] | 2011-01-17 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
264427-[PHONE] | 2011-01-17 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
264427-[PHONE] | 2011-01-17 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76127 | Check#: [PHONE] | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2457 | PROGRESSIVE PIP*
Patient Name: | HANSON, CHRISTOPHER
261344-[PHONE] | 2011-01-15 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
261344-[PHONE] | 2011-01-15 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
261344-[PHONE] | 2011-01-15 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
261344-[PHONE] | 2011-01-15 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76128 | Check#: [PHONE] | Payment: | 368.73 | Amount Posted | 368.73 |  | 0
Account #: | 2457 | PROGRESSIVE PIP*
Patient Name: | DEAN, CRISTIN
251754-[PHONE] | 2011-01-06 00:00:00 | SKIN0001 | 0 |  | 58.66 | 58.65600000000001 | 58.66 | 0 | 0 | 0 | 0 | 0 | 58.66
251754-[PHONE] | 2011-01-06 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
251754-[PHONE] | 2011-01-06 00:00:00 | ELEC0001 | 0 |  | 212.64 | 212.64 | 212.64 | 0 | 0 | 0 | 0 | 0 | 212.64
251754-[PHONE] | 2011-01-06 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
251754-[PHONE] | 2011-01-06 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
Carrier Totals: | 0 | 368.73 | 368.726 | 368.73 | 0 | 0 | 0 | 0 | 0 | 368.73 | 0
Totals: | 0 | 368.73 | 368.726 | 368.73 | 0 | 0 | 0 | 0 | 0 | 368.73
Trans #: | 76125 | Check#: [PHONE] | Payment: | 120 | Amount Posted | 120 |  | 0
Account #: | 2457 | PROGRESSIVE PIP*
Patient Name: | [NAME], BRANDY GIRVIN
250931-[PHONE] | 2011-01-04 00:00:00 | KIT0005 | 0 |  | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Carrier Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120 | 0
Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Trans #: | 76115 | Check#: 276715 | Payment: | 378.57 | Amount Posted | 378.57 |  | 0
Account #: | 2975 | AFFINITY SERVICE WC*
Patient Name: | CHAMBLISS, [NAME]
240967-[PHONE] | 2010-12-23 00:00:00 | SKIN0001 | 0 |  | 48 | 48 | 48 | 0 | 0 | 0 | 0 | 0 | 48
240967-[PHONE] | 2010-12-23 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 11.49 |  | 0 | 0 | 0 | 0 | 11.49 | Pend
240967-[PHONE] | 2010-12-23 00:00:00 | ELEC0001 | 0 |  | 195.12 | 195.12 | 195.12 | 0 | 0 | 0 | 0 | 0 | 195.12
240967-[PHONE] | 2010-12-23 00:00:00 | BATT0001 | 0 | 0 | 27 | 27 | 20.76 |  | 0 | 0 | 0 | 0 | 20.76 | Pend
240967-[PHONE] | 2010-12-23 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
240967-[PHONE] | 2010-12-23 00:00:00 | BIOI0001 | 0 | 0 | 99 | 99 | 79.2 |  | 0 | 0 | 0 | 0 | 79.2 | Pend
Carrier Totals: | 0 | 427.65 | 427.65 | 378.57 |  | 0 | 0 | 0 | 0 | 378.57 | 0
Totals: | 0 | 427.65 | 427.65 | 378.57 |  | 0 | 0 | 0 | 0 | 378.57
Trans #: | 76119 | Check#: 2914188 | Payment: | 288.52 | Amount Posted | 288.52 |  | 0
Account #: | 1378 | INSERVCO WC*
Patient Name: | MCFADDEN, DAWN
245748-[PHONE] | 2010-12-30 00:00:00 | SKIN0001 | 0 | 0 | 32 | 32 | 25.6 |  | 0 | 0 | 0 | 0 | 25.6 | Pend
245748-[PHONE] | 2010-12-30 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 17.64 |  | 0 | 0 | 0 | 0 | 17.64 | Pend
245748-[PHONE] | 2010-12-30 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
245748-[PHONE] | 2010-12-30 00:00:00 | BATT0004 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
245748-[PHONE] | 2010-12-30 00:00:00 | BIOI0001 | 0 | 0 | 99 | 99 | 79.2 |  | 0 | 0 | 0 | 0 | 79.2 | Pend
Carrier Totals: | 0 | 325.61 | 325.61 | 288.52 |  | 0 | 0 | 0 | 0 | 288.52 | 0
Totals: | 0 | 325.61 | 325.61 | 288.52 |  | 0 | 0 | 0 | 0 | 288.52
Trans #: | 76213 | Check#: 300133775 | Payment: | 45 | Amount Posted | 45 |  | 0
Account #: | 1265 | COMP CHOICE WC
Patient Name: | FRESQUEZ, WANDA
250223-[PHONE] | 2010-12-06 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
Carrier Totals: | 0 | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45 | 0
Totals: | 0 | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
Trans #: | 76197 | Check#: 300133776 | Payment: | 168.29 | Amount Posted | 168.29 |  | 0
Account #: | 1265 | COMP CHOICE WC
Patient Name: | FRESQUEZ, WANDA
250223-[PHONE] | 2010-12-06 00:00:00 | SKIN0001 | 0 | 0 | 16 | 16 | 12.8 |  | 0 | 0 | 0 | 0 | 12.8 | Pend
250223-[PHONE] | 2010-12-06 00:00:00 | LOTI0001 | 0 | 0 | 9.51 | 9.51 | 3.09 |  | 0 | 0 | 0 | 0 | 3.09 | Pend
250223-[PHONE] | 2010-12-06 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
250223-[PHONE] | 2010-12-06 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 22.32 |  | 0 | 0 | 0 | 0 | 22.32 | Pend
Carrier Totals: | 0 | 191.59 | 191.59 | 168.29 |  | 0 | 0 | 0 | 0 | 168.29 | 0
Totals: | 0 | 191.59 | 191.59 | 168.29 |  | 0 | 0 | 0 | 0 | 168.29
Trans #: | 76112 | Check#: 31002552 | Payment: | 90.56 | Amount Posted | 90.56 |  | 0
Account #: | 2820 | EMC WC
Patient Name: | MIRAVAL, LAURA M
255751-[PHONE] | 2011-01-16 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 75.56 |  | 0 | 0 | 0 | 0 | 75.56 | Pend
255751-[PHONE] | 2011-01-16 00:00:00 | DELI0001 | 0 |  | 15 | 15 | 15 | 0 | 0 | 0 | 0 | 0 | 15
Carrier Totals: | 0 | 135 | 135 | 90.56 | 0 | 0 | 0 | 0 | 0 | 90.56 | 0
Totals: | 0 | 135 | 135 | 90.56 | 0 | 0 | 0 | 0 | 0 | 90.56
Trans #: | 76114 | Check#: 42467234 | Payment: | 197.32 | Amount Posted | 197.32 |  | 0
Account #: | 1136 | ESIS FL WC
Patient Name: | [NAME], WILLIAM
193823-[PHONE] | 2010-10-30 00:00:00 | SKIN0001 | 0 | 0 | 32 | 32 | 25.6 |  | 0 | 0 | 0 | 0 | 25.6 | Pend
193823-[PHONE] | 2010-10-30 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 17.64 |  | 0 | 0 | 0 | 0 | 17.64 | Pend
193823-[PHONE] | 2010-10-30 00:00:00 | ELEC0002 | 0 | 0 | 162.6 | 162.6 | 130.08 |  | 0 | 0 | 0 | 0 | 130.08 | Pend
193823-[PHONE] | 2010-10-30 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
Carrier Totals: | 0 | 253.13 | 253.13 | 197.32 |  | 0 | 0 | 0 | 0 | 197.32 | 0
Totals: | 0 | 253.13 | 253.13 | 197.32 |  | 0 | 0 | 0 | 0 | 197.32
Trans #: | 76113 | Check#: 42467237 | Payment: | 197.32 | Amount Posted | 197.32 |  | 0
Account #: | 1136 | ESIS FL WC
Patient Name: | [NAME], WILLIAM
220549-[PHONE] | 2010-11-30 00:00:00 | SKIN0001 | 0 | 0 | 32 | 32 | 25.6 |  | 0 | 0 | 0 | 0 | 25.6 | Pend
220549-[PHONE] | 2010-11-30 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 17.64 |  | 0 | 0 | 0 | 0 | 17.64 | Pend
220549-[PHONE] | 2010-11-30 00:00:00 | ELEC0002 | 0 | 0 | 162.6 | 162.6 | 130.08 |  | 0 | 0 | 0 | 0 | 130.08 | Pend
220549-[PHONE] | 2010-11-30 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
Carrier Totals: | 0 | 253.13 | 253.13 | 197.32 |  | 0 | 0 | 0 | 0 | 197.32 | 0
Totals: | 0 | 253.13 | 253.13 | 197.32 |  | 0 | 0 | 0 | 0 | 197.32
Trans #: | 76234 | Check#: 42990644 | Payment: | 90.56 | Amount Posted | 90.56 |  | 0
Account #: | 1514 | SENTRY WC*
Patient Name: | FISHER, CAROLYN
268107-[PHONE] | 2011-01-21 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 75.56 |  | 0 | 0 | 0 | 0 | 75.56 | Pend
268107-[PHONE] | 2011-01-21 00:00:00 | DELI0001 | 0 |  | 15 | 15 | 15 | 0 | 0 | 0 | 0 | 0 | 15
Carrier Totals: | 0 | 135 | 135 | 90.56 | 0 | 0 | 0 | 0 | 0 | 90.56 | 0
Totals: | 0 | 135 | 135 | 90.56 | 0 | 0 | 0 | 0 | 0 | 90.56
Trans #: | 76226 | Check#: 42990719 | Payment: | 165.49 | Amount Posted | 165.49 |  | 0
Account #: | 1514 | SENTRY WC*
Patient Name: | HERNANDEZ, AMANDA
269001-[PHONE] | 2011-01-23 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
269001-[PHONE] | 2011-01-23 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.89 |  | 0 | 0 | 0 | 0 | 10.89 | Pend
269001-[PHONE] | 2011-01-23 00:00:00 | ELEC0002 | 0 | 0 | 162.6 | 162.6 | 122.6 |  | 0 | 0 | 0 | 0 | 122.6 | Pend
Carrier Totals: | 0 | 223.13 | 223.13 | 165.49 |  | 0 | 0 | 0 | 0 | 165.49 | 0
Totals: | 0 | 223.13 | 223.13 | 165.49 |  | 0 | 0 | 0 | 0 | 165.49
Trans #: | 76174 | Check#: 505656 | Payment: | 59.22 | Amount Posted | 59.22 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | RAMOS, ARIEL
276214-[PHONE] | 2010-12-30 00:00:00 | SKIN0001 | 0 |  | 19.55 | 19.552 | 19.55 | 0 | 0 | 0 | 0 | 0 | 19.55
276214-[PHONE] | 2010-12-30 00:00:00 | LOTI0001 | 0 | 0 | 8.11 | 8.11 | 3.63 |  | 0 | 0 | 0 | 0 | 3.63 | Pend
276214-[PHONE] | 2010-12-30 00:00:00 | ELEC0001 | 0 | 0 | 141.76 | 141.76 | 12.26 |  | 0 | 0 | 0 | 0 | 12.26 | Pend
276214-[PHONE] | 2010-12-30 00:00:00 | BATT0004 | 0 | 0 | 20 | 20 | 4.92 |  | 0 | 0 | 0 | 0 | 4.92 | Pend
276214-[PHONE] | 2010-12-30 00:00:00 | LW48-21 | 0 | 0 | 45 | 45 | 18.86 |  | 0 | 0 | 0 | 0 | 18.86 | Pend
Carrier Totals: | 0 | 234.42 | 234.422 | 59.22 |  | 0 | 0 | 0 | 0 | 59.22 | 0
Totals: | 0 | 234.42 | 234.422 | 59.22 |  | 0 | 0 | 0 | 0 | 59.22
Trans #: | 76108 | Check#: 6431752 | Payment: | 296.46 | Amount Posted | 296.46 |  | 0
Account #: | 1218 | CHUBB WC
Patient Name: | LITTLE, [NAME]
246296-[PHONE] | 2010-12-28 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
246296-[PHONE] | 2010-12-28 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.38 |  | 0 | 0 | 0 | 0 | 10.38 | Pend
246296-[PHONE] | 2010-12-28 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
246296-[PHONE] | 2010-12-28 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 25 |  | 0 | 0 | 0 | 0 | 25 | Pend
246296-[PHONE] | 2010-12-28 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46 | 0
Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46
Trans #: | 76109 | Check#: 6431754 | Payment: | 296.46 | Amount Posted | 296.46 |  | 0
Account #: | 1218 | CHUBB WC
Patient Name: | FAULKNER, JACQUELINE A
237208-[PHONE] | 2010-12-19 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
237208-[PHONE] | 2010-12-19 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.38 |  | 0 | 0 | 0 | 0 | 10.38 | Pend
237208-[PHONE] | 2010-12-19 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
237208-[PHONE] | 2010-12-19 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 25 |  | 0 | 0 | 0 | 0 | 25 | Pend
237208-[PHONE] | 2010-12-19 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46 | 0
Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46
Trans #: | 76103 | Check#: 64645180 | Payment: | 195.49 | Amount Posted | 195.49 |  | 0
Account #: | 1311 | ESIS WC
Patient Name: | SANCHEZ, JORGE
249863-[PHONE] | 2011-01-01 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
249863-[PHONE] | 2011-01-01 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.89 |  | 0 | 0 | 0 | 0 | 10.89 | Pend
249863-[PHONE] | 2011-01-01 00:00:00 | ELEC0002 | 0 | 0 | 162.6 | 162.6 | 122.6 |  | 0 | 0 | 0 | 0 | 122.6 | Pend
249863-[PHONE] | 2011-01-01 00:00:00 | DELI0001 | 0 |  | 30 | 30 | 30 | 0 | 0 | 0 | 0 | 0 | 30
Carrier Totals: | 0 | 253.13 | 253.13 | 195.49 | 0 | 0 | 0 | 0 | 0 | 195.49 | 0
Totals: | 0 | 253.13 | 253.13 | 195.49 | 0 | 0 | 0 | 0 | 0 | 195.49
Trans #: | 76102 | Check#: 64645272 | Payment: | 154.6 | Amount Posted | 154.6 |  | 0
Account #: | 1311 | ESIS WC
Patient Name: | SANCHEZ, JORGE
53816-[PHONE] | 2010-12-01 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
53816-[PHONE] | 2010-12-01 00:00:00 | ELEC0002 | 0 | 0 | 162.6 | 162.6 | 122.6 |  | 0 | 0 | 0 | 0 | 122.6 | Pend
Carrier Totals: | 0 | 194.6 | 194.6 | 154.6 |  | 0 | 0 | 0 | 0 | 154.6 | 0
Totals: | 0 | 194.6 | 194.6 | 154.6 |  | 0 | 0 | 0 | 0 | 154.6
Trans #: | 76104 | Check#: 64647118 | Payment: | 89 | Amount Posted | 89 |  | 0
Account #: | 1311 | ESIS WC
Patient Name: | CARRIZAL, LAURA
230151-[PHONE] | 2011-01-18 00:00:00 | FLET0001 | 0 |  | 89 | 89 | 89 | 0 | 0 | 0 | 0 | 0 | 89
Carrier Totals: | 0 | 89 | 89 | 89 | 0 | 0 | 0 | 0 | 0 | 89 | 0
Totals: | 0 | 89 | 89 | 89 | 0 | 0 | 0 | 0 | 0 | 89
Trans #: | 76130 | Check#: 654210 | Payment: | 183.12 | Amount Posted | 183.12 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | CALVIN, NATASHA
234918-[PHONE] | 2010-12-16 00:00:00 | LOTI0002 | 0 | 0 | 32.43 | 32.43 | 21.36 |  | 0 | 0 | 0 | 0 | 21.36 | Pend
234918-[PHONE] | 2010-12-16 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
234918-[PHONE] | 2010-12-16 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 194.19 | 194.19 | 183.12 | 0 | 0 | 0 | 0 | 0 | 183.12 | 0
Totals: | 0 | 194.19 | 194.19 | 183.12 | 0 | 0 | 0 | 0 | 0 | 183.12
Trans #: | 76138 | Check#: 654676 | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | CHEEK, KIMBRA
224025-[PHONE] | 2010-12-04 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
224025-[PHONE] | 2010-12-04 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
224025-[PHONE] | 2010-12-04 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
224025-[PHONE] | 2010-12-04 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76129 | Check#: 654864 | Payment: | 59.1 | Amount Posted | 0 |  | 0
Account #: | 2143 | STATE FARM PIP
Carrier Totals: | 0 | 0 | 0 | 0 |  | 0 |  |  | 0 | 0 | 0
Totals: | 0 | 0 | 0 | 0 |  | 0 |  |  | 0 | 0
Trans #: | 76106 | Check#: 7293390 | Payment: | 572.16 | Amount Posted | 572.16 |  | 0
Account #: | 1167 | AMERISURE WC*
Patient Name: | YOST, DWAYNE
273946-[PHONE] | 2010-12-30 00:00:00 | SKIN0001 | 0 | 0 | 16 | 16 | 12.8 |  | 0 | 0 | 0 | 0 | 12.8 | Pend
273946-[PHONE] | 2010-12-30 00:00:00 | LOTI0001 | 0 | 0 | 9.51 | 9.51 | 5.88 |  | 0 | 0 | 0 | 0 | 5.88 | Pend
273946-[PHONE] | 2010-12-30 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
273946-[PHONE] | 2010-12-30 00:00:00 | BATT0004 | 0 |  | 36 | 36 | 36 | 0 | 0 | 0 | 0 | 0 | 36
273946-[PHONE] | 2010-12-30 00:00:00 | CHAR0002 | 0 | 0 | 99 | 99 | 79.2 |  | 0 | 0 | 0 | 0 | 79.2 | Pend
273946-[PHONE] | 2010-12-30 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
273946-[PHONE] | 2010-12-30 00:00:00 | DELI0001 | 0 | 0 | 30 | 30 | 24 |  | 0 | 0 | 0 | 0 | 24 | Pend
273946-[PHONE] | 2010-12-30 00:00:00 | FLEI0001 | 0 | 0 | 299 | 299 | 239.2 |  | 0 | 0 | 0 | 0 | 239.2 | Pend
Carrier Totals: | 0 | 664.59 | 664.59 | 572.16 |  | 0 | 0 | 0 | 0 | 572.16 | 0
Totals: | 0 | 664.59 | 664.59 | 572.16 |  | 0 | 0 | 0 | 0 | 572.16
Trans #: | 76139 | Check#: 760053 | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | DUNAWAY, CAROLYN M
254762-[PHONE] | 2011-01-06 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
254762-[PHONE] | 2011-01-06 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
254762-[PHONE] | 2011-01-06 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
254762-[PHONE] | 2011-01-06 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76247 | Check#: 77710931 | Payment: | 162.6 | Amount Posted | 162.6 |  | 0
Account #: | 2181 | TRAVELERS WC*
Patient Name: | ART, TIMOTHY
78942-[PHONE] | 2010-03-11 00:00:00 | ELEC0002 | 0 |  | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6
Carrier Totals: | 0 | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6 | 0
Totals: | 0 | 162.6 | 162.6 | 162.6 | 0 | 0 | 0 | 0 | 0 | 162.6
Trans #: | 76190 | Check#: 780044 | Payment: | 318.73 | Amount Posted | 318.73 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | LOTT, MIA
241529-[PHONE] | 2010-12-24 00:00:00 | SKIN0001 | 0 |  | 58.66 | 58.65600000000001 | 58.66 | 0 | 0 | 0 | 0 | 0 | 58.66
241529-[PHONE] | 2010-12-24 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
241529-[PHONE] | 2010-12-24 00:00:00 | ELEC0001 | 0 |  | 212.64 | 212.64 | 212.64 | 0 | 0 | 0 | 0 | 0 | 212.64
241529-[PHONE] | 2010-12-24 00:00:00 | BATT0001 | 0 |  | 15 | 15 | 15 | 0 | 0 | 0 | 0 | 0 | 15
Carrier Totals: | 0 | 318.73 | 318.726 | 318.73 | 0 | 0 | 0 | 0 | 0 | 318.73 | 0
Totals: | 0 | 318.73 | 318.726 | 318.73 | 0 | 0 | 0 | 0 | 0 | 318.73
Trans #: | 76140 | Check#: 794920 | Payment: | 233.29 | Amount Posted | 233.29 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | PAYNE, SHEILA
269513-[PHONE] | 2011-01-23 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
269513-[PHONE] | 2011-01-23 00:00:00 | LOTI0002 | 0 |  | 32.43 | 32.43 | 32.43 | 0 | 0 | 0 | 0 | 0 | 32.43
269513-[PHONE] | 2011-01-23 00:00:00 | ELEC0001 | 0 |  | 141.76 | 141.76 | 141.76 | 0 | 0 | 0 | 0 | 0 | 141.76
269513-[PHONE] | 2011-01-23 00:00:00 | BATT0004 | 0 |  | 20 | 20 | 20 | 0 | 0 | 0 | 0 | 0 | 20
Carrier Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29 | 0
Totals: | 0 | 233.29 | 233.294 | 233.29 | 0 | 0 | 0 | 0 | 0 | 233.29
Trans #: | 76132 | Check#: 847836 | Payment: | 120 | Amount Posted | 120 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | VELASQUEZ, [NAME]
277659-[PHONE] | 2011-01-14 00:00:00 | KIT0005 | 0 |  | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Carrier Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120 | 0
Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Trans #: | 76133 | Check#: 847860 | Payment: | 96 | Amount Posted | 96 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | WITHALL, JEAN
273806-[PHONE] | 2011-01-15 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96 | Pend
Carrier Totals: | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96 | 0
Totals: | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96
Trans #: | 76116 | Check#: 85985514 | Payment: | 281.43 | Amount Posted | 281.43 |  | 0
Account #: | 2072 | GEICO PIP*
Patient Name: | BRICE, [NAME]
232681-[PHONE] | 2010-12-14 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
232681-[PHONE] | 2010-12-14 00:00:00 | LOTI0002 | 0 | 0 | 32.43 | 32.43 | 10.89 |  | 0 | 0 | 0 | 0 | 10.89 | Pend
232681-[PHONE] | 2010-12-14 00:00:00 | ELEC0002 | 0 | 0 | 177.2 | 177.2 | 122.6 |  | 0 | 0 | 0 | 0 | 122.6 | Pend
232681-[PHONE] | 2010-12-14 00:00:00 | BATT0002 | 0 | 0 | 20 | 20 | 9.84 |  | 0 | 0 | 0 | 0 | 9.84 | Pend
232681-[PHONE] | 2010-12-14 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 367.73 | 367.734 | 281.43 | 0 | 0 | 0 | 0 | 0 | 281.43 | 0
Totals: | 0 | 367.73 | 367.734 | 281.43 | 0 | 0 | 0 | 0 | 0 | 281.43
Trans #: | 76117 | Check#: 85986879 | Payment: | 256.91 | Amount Posted | 256.91 |  | 0
Account #: | 2072 | GEICO PIP*
Patient Name: | WOERNER, PHILIP
241260-[PHONE] | 2010-12-23 00:00:00 | SKIN0001 | 0 |  | 39.1 | 39.104 | 39.1 | 0 | 0 | 0 | 0 | 0 | 39.1
241260-[PHONE] | 2010-12-23 00:00:00 | LOTI0002 | 0 | 0 | 32.43 | 32.43 | 10.89 |  | 0 | 0 | 0 | 0 | 10.89 | Pend
241260-[PHONE] | 2010-12-23 00:00:00 | ELEC0001 | 0 | 0 | 141.76 | 141.76 | 98.08 |  | 0 | 0 | 0 | 0 | 98.08 | Pend
241260-[PHONE] | 2010-12-23 00:00:00 | BATT0004 | 0 | 0 | 20 | 20 | 9.84 |  | 0 | 0 | 0 | 0 | 9.84 | Pend
241260-[PHONE] | 2010-12-23 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 332.29 | 332.294 | 256.91 | 0 | 0 | 0 | 0 | 0 | 256.91 | 0
Totals: | 0 | 332.29 | 332.294 | 256.91 | 0 | 0 | 0 | 0 | 0 | 256.91
Trans #: | 76135 | Check#: 876188 | Payment: | 120 | Amount Posted | 120 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | CARBONARO, CHRISTOPHER
251215-[PHONE] | 2011-01-05 00:00:00 | KIT0005 | 0 |  | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Carrier Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120 | 0
Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Trans #: | 76111 | Check#: 900797533 | Payment: | 296.46 | Amount Posted | 296.46 |  | 0
Account #: | 2713 | AUTO OWNERS WC*
Patient Name: | MCSTINE, LEONARD
235471-[PHONE] | 2010-12-24 00:00:00 | SKIN0001 | 0 |  | 32 | 32 | 32 | 0 | 0 | 0 | 0 | 0 | 32
235471-[PHONE] | 2010-12-24 00:00:00 | LOTI0002 | 0 | 0 | 28.53 | 28.53 | 10.38 |  | 0 | 0 | 0 | 0 | 10.38 | Pend
235471-[PHONE] | 2010-12-24 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
235471-[PHONE] | 2010-12-24 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 25 |  | 0 | 0 | 0 | 0 | 25 | Pend
235471-[PHONE] | 2010-12-24 00:00:00 | BIOI0001 | 0 |  | 99 | 99 | 99 | 0 | 0 | 0 | 0 | 0 | 99
Carrier Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46 | 0
Totals: | 0 | 325.61 | 325.61 | 296.46 | 0 | 0 | 0 | 0 | 0 | 296.46
Trans #: | 76110 | Check#: 900797534 | Payment: | 531.39 | Amount Posted | 531.39 |  | 0
Account #: | 2713 | AUTO OWNERS WC*
Patient Name: | MCSTINE, LEONARD
235469-[PHONE] | 2010-11-24 00:00:00 | SKIN0001 | 0 |  | 16 | 16 | 16 | 0 | 0 | 0 | 0 | 0 | 16
235469-[PHONE] | 2010-11-24 00:00:00 | LOTI0001 | 0 | 0 | 9.51 | 9.51 | 3.46 |  | 0 | 0 | 0 | 0 | 3.46 | Pend
235469-[PHONE] | 2010-11-24 00:00:00 | ELEC0001 | 0 |  | 130.08 | 130.08 | 130.08 | 0 | 0 | 0 | 0 | 0 | 130.08
235469-[PHONE] | 2010-11-24 00:00:00 | BATT0004 | 0 | 0 | 36 | 36 | 25 |  | 0 | 0 | 0 | 0 | 25 | Pend
235469-[PHONE] | 2010-11-24 00:00:00 | LW48-21 | 0 |  | 45 | 45 | 45 | 0 | 0 | 0 | 0 | 0 | 45
235469-[PHONE] | 2010-11-24 00:00:00 | NECK0001 | 0 | 0 | 495 | 495 | 311.85 |  | 0 | 0 | 0 | 0 | 311.85 | Pend
Carrier Totals: | 0 | 731.59 | 731.59 | 531.39 |  | 0 | 0 | 0 | 0 | 531.39 | 0
Totals: | 0 | 731.59 | 731.59 | 531.39 |  | 0 | 0 | 0 | 0 | 531.39
Trans #: | 76141 | Check#: 919666 | Payment: | 1851.97 | Amount Posted | 1851.97 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | DZURIKANIN, DAWN
253840-[PHONE] | 2010-12-07 00:00:00 | COMB0001 | 0 | 0 | 1800 | 1800 | 1440 |  | 0 | 0 | 0 | 0 | 1440 | Pend
253841-[PHONE] | 2010-12-13 00:00:00 | BACK0001 | 0 | 0 | 556 | 556 | 411.97 |  | 0 | 0 | 0 | 0 | 411.97 | Pend
Carrier Totals: | 0 | 2356 | 2356 | 1851.97 |  | 0 | 0 | 0 | 0 | 1851.97 | 0
Totals: | 0 | 2356 | 2356 | 1851.97 |  | 0 | 0 | 0 | 0 | 1851.97
Trans #: | 76166 | Check#: 963443 | Payment: | 45.48 | Amount Posted | 45.48 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | KOONCE, JEFFREY
271666-[PHONE] | 2010-12-29 00:00:00 | SKIN0001 | 0 |  | 19.55 | 19.552 | 19.55 | 0 | 0 | 0 | 0 | 0 | 19.55
271666-[PHONE] | 2010-12-29 00:00:00 | LOTI0001 | 0 | 0 | 8.11 | 8.11 | 3.63 |  | 0 | 0 | 0 | 0 | 3.63 | Pend
271666-[PHONE] | 2010-12-29 00:00:00 | ELEC0001 | 0 | 0 | 141.76 | 141.76 | 6.13 |  | 0 | 0 | 0 | 0 | 6.13 | Pend
271666-[PHONE] | 2010-12-29 00:00:00 | BATT0004 | 0 | 0 | 20 | 20 | 4.92 |  | 0 | 0 | 0 | 0 | 4.92 | Pend
271666-[PHONE] | 2010-12-29 00:00:00 | LW48-21 | 0 | 0 | 45 | 45 | 11.25 |  | 0 | 0 | 0 | 0 | 11.25 | Pend
Carrier Totals: | 0 | 234.42 | 234.422 | 45.48 |  | 0 | 0 | 0 | 0 | 45.48 | 0
Totals: | 0 | 234.42 | 234.422 | 45.48 |  | 0 | 0 | 0 | 0 | 45.48
Trans #: | 76134 | Check#: 995350 | Payment: | 96 | Amount Posted | 96 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | RECINE, LINDSAY
236989-[PHONE] | 2010-12-18 00:00:00 | KIT0005 | 0 | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96 | Pend
Carrier Totals: | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96 | 0
Totals: | 0 | 120 | 120 | 96 |  | 0 | 0 | 0 | 0 | 96
Trans #: | 76131 | Check#: 995569 | Payment: | 120 | Amount Posted | 120 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | [NAME], DENISE
249985-[PHONE] | 2011-01-02 00:00:00 | TEMP0015 | 0 |  | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Carrier Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120 | 0
Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Trans #: | 76136 | Check#: 995683 | Payment: | 120 | Amount Posted | 120 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | PRIDDY, PHYLLIS
256396-[PHONE] | 2011-01-08 00:00:00 | KIT0005 | 0 |  | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Carrier Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120 | 0
Totals: | 0 | 120 | 120 | 120 | 0 | 0 | 0 | 0 | 0 | 120
Trans #: | 76137 | Check#: 995697 | Payment: | 240 | Amount Posted | 240 |  | 0
Account #: | 2143 | STATE FARM PIP
Patient Name: | KNEPPER, PAUL
257411-[PHONE] | 2011-01-09 00:00:00 | TEMP0049 | 0 |  | 240 | 240 | 240 | 0 | 0 | 0 | 0 | 0 | 240
Carrier Totals: | 0 | 240 | 240 | 240 | 0 | 0 | 0 | 0 | 0 | 240 | 0
Totals: | 0 | 240 | 240 | 240 | 0 | 0 | 0 | 0 | 0 | 240
Third Party Totals: | 0 | 18958.3 | 18958.33 | 16121.67 | 0 | 0 | 0 | 0 | 0 | 16121.67 | 0
Batch ID Totals: | 0 | 18958.3 | 18958.33 | 16121.67 | 0 | 0 | 0 | 0 | 0 | 16121.67 | 0
Grand Totals: | 0 | 18958.3 | 18958.33 | 16121.67 | 0 | 0 | 0 | 0 | 0 | 16121.67 | 0 | Total Amount Posted to General [NAME] from the Batch: | 0