Case Number: 95D 00163
File Date: 10/19/1995
ST OF KS EX REL SRS
Address:
DOB:
Attorney:
BELL, JOYCE A
Address:
ST GEORGE KS 66535
DOB:
Attorney:
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 24038 | 11/21/1995 | BELL,J/VALLEY VISTA G.S.C | 71.00 |
| 24478 | 12/04/1995 | J BELL, VALLEY VISTA G | 12.50 |
| 24776 | 12/13/1995 | BELL,J/VALLEY VISTA G.S.C | 12.50 |
| 25246 | 01/02/1996 | BELL,J/VALLEY VISTA G.S.C | 12.50 |
| 25710 | 01/12/1996 | BELL,J/VALLEY VISTA G.S.C | 12.50 |
| 26017 | 01/24/1996 | BELL, J/VALLEY VISTA SMC | 12.50 |
| 30042 | 05/14/1996 | BELL,J/FEDERAL SETOFF | 0.00 |
| 30471 | 05/30/1996 | BELL,J/MIDW HEALTH SERV | 12.50 |
| 31007 | 06/11/1996 | BELL,J/STATE SETOFF | 0.00 |
| 31634 | 07/02/1996 | BELL,J/MIDWEST HEALTH SER | 25.00 |
| 32659 | 07/31/1996 | BELL,J/MW HEALTH SERV | 25.00 |
| 33606 | 08/27/1996 | BELL,J/MW HEALTH SERVICES | 25.00 |
| 34870 | 09/25/1996 | BELL,J/MIDWEST HEALTH SER | 25.00 |
| 35942 | 10/29/1996 | BELL,J/MIDWEST HEALTH SER | 12.50 |
| 36208 | 11/04/1996 | BELL,J/MIDWEST HEALTH SRV | 12.50 |
| 36453 | 11/12/1996 | BELL,J/MIDWEST HEALTH SRV | 12.50 |
| 37085 | 12/02/1996 | BELL,J/MIDWEST HEALTH SRV | 12.50 |
| 37796 | 12/18/1996 | BELL,J/MIDWEST HEALTH SRV | 12.50 |
| 38177 | 12/31/1996 | BELL, J/MIDWEST HEALTH | 12.50 |
| 38677 | 01/14/1997 | BELL, JOYCE/MIDWEST HEALT | 12.50 |
| 39118 | 01/28/1997 | BELL, J/MIDWEST HEALTH | 12.50 |
| 40032 | 02/24/1997 | BELL,J/MIDWEST HEALTH SRV | 12.50 |
| 40567 | 03/05/1997 | BELL,J/MIDWEST HLTH SERV | 12.50 |
| 41152 | 03/19/1997 | BELL, JOYCE/MIDWEST HEALT | 12.50 |
| 42429 | 04/18/1997 | BELL,J/STATE SETOFF | 0.00 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| C/S #5118 | 11/21/1995 | 71.00 | BELL,J/VALLEY VISTA G.S.C |
| C/S #5154 | 12/04/1995 | 12.50 | J BELL, VALLEY VISTA G |
| C/S #5186 | 12/13/1995 | 12.50 | BELL,J/VALLEY VISTA G.S.C |
| C/S #5251 | 01/02/1996 | 12.50 | BELL,J/VALLEY VISTA G.S.C |
| C/S #5287 | 01/12/1996 | 12.50 | BELL,J/VALLEY VISTA G.S.C |
| C/S#5338 | 01/24/1996 | 12.50 | BELL, J/VALLEY VISTA SMC |
| C/S-(5-8-96)-FEDERAL | 05/14/1996 | 37.40 | BELL,J/FEDERAL SETOFF |
| C/S #060697 | 05/30/1996 | 12.50 | BELL,J/MIDW HEALTH SERV |
| C/S-(5-28-96)-STATE | 06/11/1996 | 94.53 | BELL,J/STATE SETOFF |
| C/S #061494 | 07/02/1996 | 25.00 | BELL,J/MIDWEST HEALTH SER |
| C/S #062142 | 07/31/1996 | 25.00 | BELL,J/MW HEALTH SERV |
| C/S #062945 | 08/27/1996 | 25.00 | BELL,J/MW HEALTH SERVICES |
| C/S #063993 | 09/25/1996 | 25.00 | BELL,J/MIDWEST HEALTH SER |
| C/S #064479 | 10/29/1996 | 12.50 | BELL,J/MIDWEST HEALTH SER |
| C/S #064950 | 11/04/1996 | 12.50 | BELL,J/MIDWEST HEALTH SRV |
| C/S #065067 | 11/12/1996 | 12.50 | BELL,J/MIDWEST HEALTH SRV |
| C/S #065477 | 12/02/1996 | 12.50 | BELL,J/MIDWEST HEALTH SRV |
| C/S #065905 | 12/18/1996 | 12.50 | BELL,J/MIDWEST HEALTH SRV |
| C/S-CK#66294 | 12/31/1996 | 12.50 | BELL, J/MIDWEST HEALTH |
| C/S-CK#66648 | 01/14/1997 | 12.50 | BELL, JOYCE/MIDWEST HEALT |
| C/S-CK#66943 | 01/28/1997 | 12.50 | BELL, J/MIDWEST HEALTH |
| C/S #067568 | 02/24/1997 | 12.50 | BELL,J/MIDWEST HEALTH SRV |
| C/S #067916 | 03/05/1997 | 12.50 | BELL,J/MIDWEST HLTH SERV |
| C/S-CK#68404 | 03/19/1997 | 12.50 | BELL, JOYCE/MIDWEST HEALT |
| C/S-(4-12-97)-STATE | 04/18/1997 | 183.87 | BELL,J/STATE SETOFF |