| DJBMCK5B21... | 0 | | AN91: Other Medical (Basic) | $671.89 | 2005 | 6234461 |
| DJBMCK5B21... | 0 | | Q201: General Health Care Services | $160.00 | 2005 | 6283683 |
| DJBMCK5B21... | 0 | | Q513: Orthopedic Services | $75.00 | 2005 | 6937284 |
| DJBMCK5B21... | 0 | | Q513: Orthopedic Services | $250.00 | 2005 | 7055395 |
| DJBMCK5B21... | 0 | | Q513: Orthopedic Services | $125.00 | 2005 | 7203312 |
| DJBMCK5B21... | 1 | | Q513: Orthopedic Services | $208.00 | 2005 | 7310518 |
| DJBMCK5B21... | 0 | | Q513: Orthopedic Services | $80.00 | 2005 | 7620016 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8183704 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8251457 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8276548 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $556.00 | 2006 | 8303241 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8477930 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8577776 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $150.00 | 2006 | 8660720 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $800.00 | 2006 | 8859558 |
| DJBMCK5B21... | 1 | | AN91: Other Medical (Basic) | $561.11 | 2006 | 8877454 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $150.00 | 2006 | 8886878 |
DJB20903BP... | DJGMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 8957593 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $902.00 | 2006 | 9041162 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 9049579 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 9217633 |
DJB20903BP... | DMBMCKFB21... | 0 | | Q513: Orthopedic Services | $1,374.00 | 2006 | 9347568 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $100.00 | 2006 | 9403715 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 9411575 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q999: Other Medical Services | $152.00 | 2006 | 9508482 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 9588711 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $935.00 | 2006 | 9596250 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q999: Other Medical Services | $180.00 | 2006 | 9689542 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $100.00 | 2006 | 9794079 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $627.00 | 2006 | 9929930 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 9975106 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 10070699 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $140.00 | 2006 | 10134559 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $496.00 | 2006 | 10252818 |
| DJBMCKFB21... | 0 | | AN91: Other Medical (Basic) | $120.00 | 2006 | 10346045 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $160.00 | 2006 | 10720787 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $60.00 | 2006 | 11012991 |
| DJBMCK5B21... | 1 | | Q513: Orthopedic Services | ($75.00) | 2006 | 11095035 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $160.00 | 2006 | 11184268 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $100.00 | 2006 | 11277143 |
| DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 11648054 |
DJB20903BP... | DJBMCKFB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2006 | 11835118 |
| DJB20903BP... | 0 | | AN91: Other Medical (Basic) | $0.00 | 2006 | 11952495 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 11986529 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $85.00 | 2007 | 12024630 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $133.00 | 2007 | 12077704 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $85.00 | 2007 | 12211374 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $1,732.00 | 2007 | 12287327 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $902.00 | 2007 | 12427488 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 12578523 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $133.00 | 2007 | 12679896 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 12688662 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 12925359 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 12963493 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 13109217 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $133.00 | 2007 | 13156791 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $597.00 | 2007 | 13316990 |
DJB20903BP... | DJBMCKGB22... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 13561492 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 13658612 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 13726776 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 13875433 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $900.00 | 2007 | 13959139 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 14050947 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14075811 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 14180343 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14276496 |
DJB20903BP... | DJBMCKGB11... | 0 | | Q513: Orthopedic Services | $597.00 | 2007 | 14514264 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14528533 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q999: Other Medical Services | $88.00 | 2007 | 14574032 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $1,351.00 | 2007 | 14650532 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $722.00 | 2007 | 14681314 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14758529 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $722.00 | 2007 | 14786014 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14889156 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 14918518 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15060848 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15119033 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $150.00 | 2007 | 15119078 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15144736 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $150.00 | 2007 | 15284661 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15319642 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $3,009.00 | 2007 | 15418672 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15472464 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 15472507 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $84.00 | 2007 | 15481913 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 15610069 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $150.00 | 2007 | 15618801 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2007 | 15682247 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 15771763 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $493.00 | 2007 | 15820416 |
DJB20903BP... | DJBMCKGB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2007 | 15961711 |
| DJB20903BP... | 0 | | Q513: Orthopedic Services | $0.00 | 2007 | 15988642 |
| DJB20903BP... | 0 | | Q513: Orthopedic Services | $0.00 | 2007 | 16010839 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2008 | 16185090 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $492.00 | 2008 | 16185095 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2008 | 16326683 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $66.00 | 2008 | 16397382 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2008 | 16544928 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $88.00 | 2008 | 16545398 |
DJB20903BP... | DJBMCKHB21... | 0 | | Q513: Orthopedic Services | $80.00 | 2008 | 16730331 |