| CLAIM |
PATIENT |
ADDRESS |
TOTAL CHARGE |
TOTAL PAYMENTS |
BALANCE |
| 00002 |
GEORGE CLINTON |
1 BIMMINY ROAD |
$17,012.34 |
$851.00 |
$16,161.34 |
| 00003 |
JAMES BROWN |
1900 GOODFOOT ST. |
$8,082.00 |
$620.75 |
$7,461.25 |
| 00004 |
DUKE NUKEM |
100 BLASTER AVE. |
$3,001.00 |
$0.00 |
$3,001.00 |
| 00005 |
BILLY BOBB |
575 SOUTHERN PKWY. |
$6,001.25 |
$1,655.00 |
$4,346.25 |
| 00006 |
JAMES BOND |
007 UNDERCOVER AVE. |
$5,000.75 |
$0.00 |
$5,000.75 |
| 00007 |
CLARK KENT |
220 EAST 42ND ST. |
$1,000.50 |
$250.00 |
$750.50 |
| 00008 |
JOHNNY BRAVO |
100 WHATEVER AVE. |
$9,215.25 |
$3,109.00 |
$6,106.25 |
| 00009 |
FRED FLINTSTONE |
17 ROCKY WAY |
$5,040.75 |
$1,999.00 |
$3,041.75 |
| 00010 |
BARNEY RUBBLE |
19 ROCKY WAY |
$17,005.50 |
$0.00 |
$17,005.50 |
| 00011 |
WILMA FLINTSTONE |
17 ROCKY WAY |
$4,041.00 |
$600.00 |
$3,441.00 |
|