| V515P00257 | V515C69298... | 0 | | Q999: Other Medical Services | $1,365.00 | 2006 | 11001532 |
| V515P00257 | V515C69528... | 0 | | Q999: Other Medical Services | $1,105.00 | 2006 | 11101090 |
| V515P00257 | V515C69667... | 0 | | Q999: Other Medical Services | $1,105.00 | 2006 | 11225455 |
| V515P00257 | V515C67228... | 0 | | Q999: Other Medical Services | $4,290.00 | 2006 | 11759083 |
| V515P00257 | 0 | | Q999: Other Medical Services | $0.00 | 2006 | 11965281 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $700.00 | 2007 | 14255270 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $1,170.00 | 2007 | 14293247 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $2,700.00 | 2007 | 14462558 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $3,115.00 | 2007 | 14490706 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $500.00 | 2007 | 14578154 |
| V515P00257 | V515C77040... | 0 | | Q999: Other Medical Services | $800.00 | 2007 | 14691028 |
| V515P00257 | V515C77040 | 0 | | Q999: Other Medical Services | $1,170.00 | 2007 | 14799030 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $520.00 | 2008 | 18442748 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $3,000.00 | 2008 | 18663543 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $3,500.00 | 2008 | 19098601 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $1,000.00 | 2008 | 19245952 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $1,000.00 | 2008 | 19480597 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $1,000.00 | 2008 | 19826309 |
| V515P00257 | V515C87114... | 0 | | Q999: Other Medical Services | $1,000.00 | 2008 | 20206127 |
