DJB3030305... | DJBEDG0840... | 33 | | Q999: Other Medical Services | $9,769.48 | 2009 | 21036522 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($719.36) | 2009 | 21082413 |
DJB4140704... | DJBSPGIB11... | 1 | | Q999: Other Medical Services | ($925.20) | 2009 | 21117298 |
DJB3151102... | DJBYAZIB12... | 0 | | Q999: Other Medical Services | $41,886.00 | 2009 | 21123338 |
DJB2010405... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($332.83) | 2009 | 21155250 |
DJB2010406... | DJBALXIB15... | 0 | | Q999: Other Medical Services | $3,336.96 | 2009 | 21170758 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $4,136.32 | 2009 | 21176615 |
DJB3030305... | DJBEDG0920... | 0 | | Q999: Other Medical Services | $3,379.56 | 2009 | 21194673 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($179.84) | 2009 | 21194769 |
DJB4140704... | DJBSPGIB11... | 2 | | Q999: Other Medical Services | $10.63 | 2009 | 21222430 |
DJB2010407... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $5,454.80 | 2009 | 21227802 |
DJB4110305... | DJBPEKIB11... | 0 | | Q522: Radiology Services | $6,305.20 | 2009 | 21267952 |
DJB5030212... | DJBP0503IB... | 0 | | Q999: Other Medical Services | $4,818.24 | 2009 | 21270487 |
DJB2010405... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $7,870.80 | 2009 | 21272914 |
DJB4140704... | DJBSPGIB11... | 1 | | Q999: Other Medical Services | ($112.71) | 2009 | 21304640 |
DJB2010406... | DJBALXIB15... | 0 | | Q999: Other Medical Services | $2,464.80 | 2009 | 21312101 |
DJB2010406... | DJBALXIB15... | 1 | | Q999: Other Medical Services | ($1,099.68) | 2009 | 21326232 |
DJB2010407... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($3,440.72) | 2009 | 21326243 |
DJB5030212... | DJBBIGIB11... | 0 | | Q999: Other Medical Services | $23,461.20 | 2009 | 21359294 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $3,776.64 | 2009 | 21385043 |
DJB2010407... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($4,133.06) | 2009 | 21400600 |
DJB2010405... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($1,424.24) | 2009 | 21423072 |
DJB4110305... | DJBPEKIB11... | 0 | | Q522: Radiology Services | $11,095.60 | 2009 | 21436447 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $3,776.64 | 2009 | 21467853 |
DJB2010407... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $5,454.80 | 2009 | 21486665 |
DJB2010406... | DJBALXIB15... | 1 | | Q999: Other Medical Services | ($720.48) | 2009 | 21530615 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $4,808.76 | 2009 | 21531186 |
DJB2010407... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($786.75) | 2009 | 21552551 |
DJB3151102... | DJBYAZIB12... | 0 | | Q999: Other Medical Services | $46,396.80 | 2009 | 21571453 |
DJB2010406... | DJBALXIB15... | 1 | | Q999: Other Medical Services | ($251.68) | 2009 | 21602582 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $4,808.76 | 2009 | 21608385 |
DJB2010406... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $4,136.32 | 2009 | 21614994 |
DJB2010405... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $7,870.80 | 2009 | 21615027 |
DJB2010407... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $5,538.72 | 2009 | 21634819 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($517.04) | 2009 | 21634842 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($1,092.80) | 2009 | 21688177 |
DJB2090301... | DJBMCKIB11... | 1 | | Q522: Radiology Services | ($983.62) | 2009 | 21688195 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($2,058.29) | 2009 | 21747531 |
DJB2010407... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($377.64) | 2009 | 21747535 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($168.60) | 2009 | 21748569 |
DJB4110305... | DJBP0411IB... | 0 | | Q522: Radiology Services | $23,311.90 | 2009 | 21767627 |
DJB2090301... | DJBMCKIB11... | 0 | | Q522: Radiology Services | $24,443.88 | 2009 | 21785660 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($179.84) | 2009 | 21800458 |
DJB2010406... | DJBALXIB15... | 1 | | Q503: Dentistry Services | ($510.02) | 2009 | 21800505 |
DJB2010407... | DJBALXIB15... | 0 | | Q503: Dentistry Services | $4,720.50 | 2009 | 21809955 |