Case Number: 86D 00148
File Date: 09/05/1986
BLUMA, CINDY
Address:
DOB:
Attorney:
AYON, MICHAEL
Address:
MANHATTAN KS 66502
DOB:
Attorney:
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 25809 | 01/17/1996 | AYON, MICHAELL | 260.00 |
| 26482 | 02/06/1996 | AYON, M/MAX COMFORT SERV | 120.00 |
| 26524 | 02/06/1996 | AYON,M/MAXIMUM COMFORT | 0.04 |
| 27130 | 02/27/1996 | AYON,M/MAXIMUM COMFORT | 120.04 |
| 27564 | 03/07/1996 | AYON,M/MAXIMUM COMFORT SE | 120.04 |
| 28305 | 03/28/1996 | AYON,M/MAXIMUM COMF SERV | 120.04 |
| 28819 | 04/11/1996 | AYON,M/MAXIMUM COMFORT | 120.04 |
| 28952 | 04/15/1996 | AYON,M/MAIXMUM COMFORT | 120.04 |
| 30061 | 05/15/1996 | AYON,M/MAXIMUM COMFORT | 120.03 |
| 30894 | 06/10/1996 | AYON,M/MAXIMUM COMF SERV | 120.04 |
| 30895 | 06/10/1996 | AYON,M/MAXIMUM COMF SERV | 120.04 |
| 31933 | 07/11/1996 | AYON,M/MAXIMUM COMFORT | 120.04 |
| 32495 | 07/25/1996 | ADJUSTMENT | 120.04 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| C/S #351 | 01/17/1996 | 260.00 | AYON, MICHAELL |
| C/S/ #2471 | 02/06/1996 | 120.00 | AYON, M/MAX COMFORT SERV |
| C/S (ADJ) #2471 | 02/06/1996 | 0.04 | AYON,M/MAXIMUM COMFORT |
| C/S #2484 | 02/27/1996 | 120.04 | AYON,M/MAXIMUM COMFORT |
| C/S #2494 | 03/07/1996 | 120.04 | AYON,M/MAXIMUM COMFORT SE |
| C/S #2506 | 03/28/1996 | 120.04 | AYON,M/MAXIMUM COMF SERV |
| C/S #2520 | 04/11/1996 | 120.04 | AYON,M/MAXIMUM COMFORT |
| C/S #2521 | 04/15/1996 | 120.04 | AYON,M/MAIXMUM COMFORT |
| C/S #2556 | 05/15/1996 | 120.03 | AYON,M/MAXIMUM COMFORT |
| C/S-(DTD 5-24)-#2585 | 06/10/1996 | 120.04 | AYON,M/MAXIMUM COMF SERV |
| C/S-(DTD 6-7)#2586 | 06/10/1996 | 120.04 | AYON,M/MAXIMUM COMF SERV |
| C/S #2613 | 07/11/1996 | 120.04 | AYON,M/MAXIMUM COMFORT |
| ADJUST SRS | 07/25/1996 | 0.00 | AYON, MICHAEL |
| C/S PMT (IWO) | 07/25/1996 | 120.04 | AYON, MICHAEL |