Case Number: 93D 00081
File Date: 06/09/1993
CSE RECEIVABLES
Address:
DOB:
Attorney:
ROMERO, TAMARA D
Address:
TOPEKA KS 66604
DOB:
Attorney:
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 8468 | 01/18/1994 | ROMERO/PARKVIEW HOSP | 30.00 |
| 8613 | 01/31/1994 | ROMERO/PARKVIEW HOSP | 10.00 |
| 8770 | 02/14/1994 | ROMERO/PARKVIEW HOSP | 9.25 |
| 8962 | 02/28/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 9224 | 03/21/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 9278 | 03/28/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 9563 | 04/15/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 9654 | 04/25/1994 | ROMERO/PARKVIEW HOSP | 9.25 |
| 9719 | 04/29/1994 | ROMERO, TAMARA D | 0.00 |
| 9956 | 05/16/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 10050 | 05/23/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 10172 | 06/01/1994 | ROMERO/PARKVIEW HOSPITAL | 10.00 |
| 10260 | 06/06/1994 | ROMERO/PARKVIEW HOSP | 9.25 |
| 10418 | 06/21/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 10631 | 07/07/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 10785 | 07/19/1994 | ROMERO/PARKVIEW HOSPITAL | 9.25 |
| 16750 | 02/16/1995 | ROMERO, TAMARA D | 0.00 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| JDG 7860 NOV&DEC/CSE | 01/18/1994 | 30.00 | ROMERO/PARKVIEW HOSP |
| JUDG 7902 TO CSE | 01/31/1994 | 10.00 | ROMERO/PARKVIEW HOSP |
| JUDG 7994 TO CSE | 02/14/1994 | 9.25 | ROMERO/PARKVIEW HOSP |
| JUDG 8044 TO CSE | 02/28/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8141 TO CSE | 03/21/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8206 TO CSE | 03/28/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8244 TO CSE | 04/15/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8314 TO CSE | 04/25/1994 | 9.25 | ROMERO/PARKVIEW HOSP |
| SRS SETOFF - STATE | 04/29/1994 | 328.00 | ROMERO, TAMARA D |
| JUDG 8437 TO CSE | 05/16/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| C/S 0008479 TO CSE | 05/23/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8502 TO CSE | 06/01/1994 | 10.00 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8530 TO CSE | 06/06/1994 | 9.25 | ROMERO/PARKVIEW HOSP |
| JUDG 8591 TO CSE | 06/21/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8632 TO CSE | 07/07/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| JUDG 8714 TO CSE | 07/19/1994 | 9.25 | ROMERO/PARKVIEW HOSPITAL |
| SRS SETOFF - UNEMPLO | 02/16/1995 | 331.00 | ROMERO, TAMARA D |