123

July 01, 2014 through July 31, 2014
JPMorgan Chase Bank, N.A.

P O Box 659754
San Antonio, TX 78265 - 9754
Account Number:
000000882333842
CUSTOMER SERVICE INFORMATION

Web site:
www.Chase.com
Service Center:
1-877-425-8100
Deaf and Hard of Hearing: 1-800-242-7383
Para Espanol:
1-888-622-4273
International Calls:
1-713-262-1679
00654060601000000026
PALMARIS IMAGING OF ARIZONA PLLC

GREG SNEAD
16091 SWINGLEY RIDGE ROAD, STE 100
CHESTERFIELD MO 63017-2056
CHECKING SUMMARY
Chase Analysis Business Checking

INSTANCES
Beginning Balance
Deposits and Additions
Electronic Withdrawals
Fees and Other Withdrawals
Ending Balance
AMOUNT
$33,645.33
447
5
1
453
303,606.41
- 191,607.09
- 2,792.11
$142,852.54
DEPOSITS AND ADDITIONS

DATE
DESCRIPTION
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/01
07/02
07/02
07/02
07/02
07/02
07/02
Lockbox No: 2966117 For 87 Items At 16:00 8 Trn: 1500278182Lb

Unitedhealthcare Hcclaimpmt 272615455
CCD ID: 1411289245
Anthem Bcbs of M Hcclaimpmt 3320219491
CCD ID: 2860257201
Wps
Med B Pymt 1003124116
CCD ID: 9166123060
Tricare West Hcclaimpmt 272615455
CCD ID: 1100000001
Golden Rule Insu Hcclaimpmt 272615455
CCD ID: 1376028756
US Treasury 310 EDI Misc 36001200
CTX ID: 101036151
Palmetto Gba/Rrb Hcclaimpmt 1003124116
CCD ID: 1571062326
CTX ID: 101036151
CCD ID: 1100000001
CTX ID: 101036151
Palm J11 Part B Hcclaimpmt 1003124116
CCD ID: 9149204101
CCD ID: 1111187726
CTX ID: 101036151
Wps
Med B Pymt 1003124116
CCD ID: 9166123060
Umr Missouri Con Hcclaimpmt 272615455
CCD ID: 1431652936
CCD ID: 1100000001
CCD ID: 9149204101
CCD ID: 1262574977
AMOUNT
$3,793.66
1,073.99
478.57
432.19
273.03
169.61
101.72
86.15
42.83
38.85
33.03
15.79
9.00
8.23
7,686.95
5,442.30
430.84
320.27
219.15
197.81
Page 1 of 12

Account Number:
000000882333842
(continued)
DATE
DESCRIPTION
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/02
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/03
07/07
07/07
07/07
07/07
07/07
07/07

CCD ID: 2860257201
Aetna As01
Hcclaimpmt 1003124116
CCD ID: 1066033492
Hcusa
CCD ID: 1431702094
CCD ID: 1100000001
CCD ID: 2431652936
Aetna H09
CCD ID: 1066033492
CTX ID: 101036151
CTX ID: 101036151
CCD ID: 1100000001
Umr Quaker Windo Hcclaimpmt 272615455
CCD ID: 1430813428
CCD ID: 1100000001
Covcares VA Clm Hcclaimpmt 1326057365
CCD ID: 1541576305
CTX ID: 101036151
CTX ID: 101036151
Wps
Med B Pymt 1003124116
CCD ID: 9166123060
Healthy Alliance Hcclaimpmt 3320304808
CCD ID: 1371216698
CCD ID: 9149204101
CCD ID: 1371216698
Transfirst LLC Bkcd Stlmt 39300980302680 CCD ID: 1752598308
Chc Missouri Aso Hcclaimpmt 1326057365
CCD ID: 1431372307
CCD ID: 1111187726
CCD ID: 1431372307
Ch&L MO
CCD ID: 1751296086
Noridian S. CA Med B Pay 1003124116
CCD ID: S450173185
CCD ID: 1431372307
Aetna A04
CCD ID: 1066033492
Aetna As01
CCD ID: 1066033492
CCD ID: 2860257201
CCD ID: 1431372307
CCD ID: 1376028756
CCD ID: 1431372307
CCD ID: 1100000001
Hmo Missouri, IN Hcclaimpmt 3320305841
CCD ID: 8371216690
CTX ID: 101036151
CCD ID: 1431372307
Fehbp
CCD ID: 5382242132
CCD ID: 1262574977
Noridian Waorak Med B Pay 1003124116
CCD ID: 4450173185
CTX ID: 101036151
Fehbp
CCD ID: 5382242132
MO Social Servcs Hcclaimpmt 100312411677524 CCD ID: 1446000987
Wps
Med B Pymt 1003124116
CCD ID: 9166123060
CCD ID: 9149204101
United Health CA Hcclaimpmt 272615455
CCD ID: 1362739571
Hcusa
CCD ID: 1431702094
AMOUNT
187.14
176.80
88.99
68.11
52.59
42.55
39.57
27.90
9.07
8.91
7.59
7.42
2.34
2.34
3,252.96
5,420.84
2,846.94
1,946.02
1,670.51
1,211.44
993.23
735.85
553.54
256.10
245.47
192.14
158.63
139.96
136.91
116.26
115.85
82.32
68.50
66.46
17.83
13.42
12.87
9.32
7.14
6.00
4.32
4,142.74
10,977.90
3,542.71
3,101.75
1,187.15
765.61
Page 2 of 12

Account Number:
(continued)
DATE
DESCRIPTION
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/07
07/08
07/08
07/08
07/08
07/08
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/09
07/10
Acs State Health Hcclaimpmt 126683120140704 CCD ID: 1582479287

Noridian S. CA Med B Pay 1003124116
CCD ID: S450173185
CCD ID: 1431372307
Chc VA Aso
CCD ID: 1541576305
CTX ID: 101036151
Kc Gc Hmo
CCD ID: 1480840330
Ch&L MO
CCD ID: 1751296086
CTX ID: 101036151
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 1571062326
CCD ID: 1571062326
Kansas Aso
CCD ID: 1480840330
Cahaba Gba, LLC DTC Depos 1003124116
CCD ID: 9143611001
Chc VA Hmo
CCD ID: 1541576305
Fehbp
CCD ID: 5382242132
Umr Compass Rose Hcclaimpmt 272615455
CCD ID: 1526048633
Aetna A04
CCD ID: 1066033492
Kc Gc Hmo
CCD ID: 1480840330
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 1100000001
CCD ID: 1100000001
Aetna As01
CCD ID: 1066033492
Wps
Med B Pymt 1003124116
CCD ID: 9166123060
CCD ID: 9149204101
CCD ID: 1376028756
Aetna A04
CCD ID: 1066033492
Wps
CCD ID: 9166123060
CCD ID: 1411289245
CCD ID: 1431372307
CCD ID: 9149204101
CCD ID: 1100000001
CCD ID: 2860257201
Aetna H09
CCD ID: 1066033492
CCD ID: 1431372307
Noridian S. CA Hcclaimpmt 1003124116
CCD ID: S450173185
Hcusa
CCD ID: 1431702094
CCD ID: 1111187726
CCD ID: 1431372307
CTX ID: 101036151
CCD ID: 1100000001
CTX ID: 101036151
Fehbp
CCD ID: 5382242132
AMOUNT
624.90
298.17
223.14
218.49
175.38
150.02
92.37
62.00
59.75
49.62
35.90
33.42
33.23
32.38
30.99
27.25
25.05
16.50
9.09
6.27
2.11
1.71
0.03
9,434.87
6,161.20
535.95
142.86
66.77
863.74
2,650.57
2,165.94
627.06
615.62
496.01
358.00
230.31
85.84
81.53
51.35
19.00
18.38
18.16
11.04
8.78
6.96
1.79
1,777.85
Page 3 of 12
10654060602000000066
000000882333842

Account Number:
000000882333842
(continued)
DATE
DESCRIPTION
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/10
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/11
07/14
07/14

CCD ID: 1371216698
CCD ID: 1111187726
CCD ID: 1371216698
Aetna As01
CCD ID: 1066033492
Ch&L MO
CCD ID: 1751296086
CCD ID: 1100000001
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 1430813428
CCD ID: 2860257201
Kc Gc Hmo
CCD ID: 1480840330
CCD ID: 8371216690
Coventryc3
CCD ID: 2870507647
Umr Nreca
CCD ID: 1530116145
CCD ID: 9149204101
CCD ID: 1571062326
CCD ID: 1262574977
CCD ID: 1571062326
Kc Gc Hmo
CCD ID: 1480840330
CCD ID: 2371216698
Kc Gc Ch&L
CCD ID: 1751296086
Aetna As01
CCD ID: 1066033492
CCD ID: 1100000001
CCD ID: 1262574977
CTX ID: 101036151
Aetna A04
CCD ID: 1066033492
CCD ID: 1100000001
CCD ID: 1362739571
CCD ID: 1431652936
Wps
CCD ID: 9166123060
CCD ID: 1541576305
CCD ID: 1100000001
Aetna A04
CCD ID: 1066033492
CTX ID: 101036151
Aetna As01
CCD ID: 1066033492
Kansas Aso
CCD ID: 1480840330
CCD ID: 1111187726
CCD ID: 9149204101
CCD ID: 1100000001
CCD ID: 1100000001
CCD ID: 1262574977
Umr Royal Oak En Hcclaimpmt 272615455
CCD ID: 1582498652
Umr Herzog Contr Hcclaimpmt 272615455
CCD ID: 1430918005
AMOUNT
2,716.09
1,102.77
923.54
567.80
455.16
414.44
271.28
203.77
196.72
168.92
164.60
119.85
80.71
80.63
68.93
62.02
60.60
53.29
40.47
27.57
21.88
19.20
17.53
9.93
9.15
8.00
5.62
4.22
3,911.41
697.79
467.78
296.87
212.02
179.25
136.09
114.34
101.85
92.57
82.52
79.63
57.22
47.26
17.22
10.56
10.44
10,351.97
568.88
Page 4 of 12

Account Number:
(continued)
DATE
DESCRIPTION
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/14
07/15
07/15
07/15
07/15
07/15
07/15
07/15
07/15
07/15
07/15
07/15
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
Chc VA Aso
CCD ID: 1541576305
CTX ID: 101036151
CCD ID: 2860257201
CCD ID: 1376028756
Fehbp
CCD ID: 5382242132
CCD ID: 1571062326
CCD ID: 1431372307
Aetna A04
CCD ID: 1066033492
Chc Missouri Hcclaimpmt 1003124116
CCD ID: 1431372307
CCD ID: 1262574977
CCD ID: 1431372307
Hcusa
CCD ID: 1431702094
Wps
CCD ID: 9166123060
CCD ID: 1100000001
CCD ID: 1100000001
CCD ID: 1431372307
CCD ID: S450173185
Anthem
Anthem 3320537244
CCD ID: 1311440175
CCD ID: 1431372307
Wps
CCD ID: 9166123060
CTX ID: 101036151
Noridian Waorak Hcclaimpmt 1003124116
CCD ID: 4450173185
CCD ID: 9149204101
CCD ID: 9149204101
Wps
CCD ID: 9166123060
CCD ID: 1411289245
CCD ID: 1100000001
CCD ID: 1111187726
CCD ID: 1100000001
CCD ID: 1376028756
CCD ID: 2860257201
CCD ID: 1362739571
Wps
CCD ID: 9166123060
CCD ID: 1100000001
CCD ID: 1431652936
CCD ID: 9149204101
CCD ID: 1362739571
CCD ID: 1431372307
CCD ID: 2860257201
Hcusa
CCD ID: 1431702094
CCD ID: 1571062326
CCD ID: 1431372307
Kc Gc Hmo
CCD ID: 1480840330
AMOUNT
502.26
421.98
242.73
239.20
194.79
192.49
190.84
147.64
116.64
115.20
95.19
71.10
65.14
48.81
28.99
26.56
15.40
13.74
10.78
10.58
6.66
1.77
0.72
7,838.67
8,310.95
7,624.93
6,234.66
1,132.16
160.82
136.95
70.13
67.97
61.07
34.53
5,020.62
6,406.74
592.72
545.93
515.79
360.17
288.24
247.22
162.76
153.62
148.71
82.65
64.38
Page 5 of 12
10654060603000000066
000000882333842

Account Number:
000000882333842
(continued)
DATE
DESCRIPTION
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/16
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/17
07/18
07/18
07/18
07/18
07/18
07/18
07/18
07/18
07/18
07/18
Kc Gc Hmo
CCD ID: 1480840330
CTX ID: 101036151
CCD ID: 1431372307
CTX ID: 101036151
KS Ppo Ch&L
CCD ID: 1751296086
CTX ID: 101036151
CTX ID: 101036151
CCD ID: 1262574977
Kc Gc Ch&L
CCD ID: 1751296086
CTX ID: 101036151
Wps
CCD ID: 9166123060
CCD ID: 1371216698
CCD ID: 9149204101
CCD ID: 1371216698
CCD ID: 1431372307
CCD ID: S450173185
CCD ID: 1100000001
Aetna As01
CCD ID: 1066033492
CCD ID: 1362739571
CCD ID: 1111187726
Ch&L MO
CCD ID: 1751296086
CCD ID: 1376028756
CCD ID: 2860257201
CCD ID: 1430813428
Aetna As01
CCD ID: 1066033492
CCD ID: 8371216690
CCD ID: 1111187726
CTX ID: 101036151
CCD ID: 2371216698
CTX ID: 101036151
CCD ID: 1100000001
CCD ID: 1431372307
CCD ID: 1571062326
Aetna A04
CCD ID: 1066033492
CTX ID: 101036151
CTX ID: 101036151
MO Social Servcs Hcclaimpmt 100312411600477 CCD ID: 1446000987
CCD ID: 1100000001
Wps
CCD ID: 9166123060
CCD ID: 1541576305
Aetna As01
CCD ID: 1066033492
CCD ID: 2860257201
CCD ID: 1111187726
Uhc Ntca Group H Hcclaimpmt 272615455
CCD ID: 1788000370
AMOUNT
49.42
40.14
34.59
17.84
12.20
8.00
5.42
5.27
5.25
2.13
5,304.25
4,725.99
2,782.99
1,648.21
1,180.80
407.96
326.73
305.24
304.51
303.89
147.68
124.91
104.30
94.78
78.48
59.81
39.94
39.26
28.91
17.61
17.07
12.59
9.76
9.15
8.64
2.34
1.65
3,373.97
14,717.59
305.24
228.03
223.52
167.65
154.96
128.95
41.76
30.42
Page 6 of 12

Account Number:
(continued)
DATE
DESCRIPTION
07/18
07/18
07/18
07/18
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/21
07/22
07/22
07/22
07/22
07/22
07/22
07/22
07/22
07/22
07/22
07/23
07/23
07/23
07/23
Aetna A04
CCD ID: 1066033492
CCD ID: 1100000001
CCD ID: 9149204101
CTX ID: 101036151
Wps
CCD ID: 9166123060
CCD ID: 9149204101
CCD ID: 1100000001
Hcusa
CCD ID: 1431702094
Ch&L MO
CCD ID: 1751296086
CTX ID: 101036151
CCD ID: S450173185
CCD ID: 1100000001
CCD ID: 1431372307
CTX ID: 101036151
CCD ID: 1431372307
CCD ID: 1100000001
CCD ID: 1262574977
CCD ID: 1111187726
CCD ID: 1431372307
Ngs, Inc.
CCD ID: A351840597
CCD ID: 1100000001
CTX ID: 101036151
CCD ID: 2860257201
Chc VA Hmo
CCD ID: 1541576305
Aetna As01
CCD ID: 1066033492
CCD ID: 1262574977
CCD ID: 1362739571
CCD ID: 1100000001
Fehbp
CCD ID: 7382242132
CCD ID: 1100000001
CCD ID: 1411289245
CCD ID: 2860257201
Wps
CCD ID: 9166123060
CCD ID: 1100000001
CCD ID: S450173185
CCD ID: 1571062326
CCD ID: 9149204101
CCD ID: 1262574977
CCD ID: 1376028756
Wps
CCD ID: 9166123060
CCD ID: 9149204101
CCD ID: 1431372307
AMOUNT
22.30
12.59
7.19
5.80
1,366.19
1,689.76
1,401.82
564.77
374.40
355.52
201.57
201.09
151.08
120.28
106.98
90.13
86.37
86.02
81.79
58.67
57.57
51.92
35.54
33.70
17.16
15.00
10.97
10.80
9.93
9.14
6.74
5.72
1.05
4,907.69
2,426.39
1,511.42
563.97
532.96
210.72
166.35
160.51
139.92
9.28
2,437.91
4,215.33
2,553.88
881.05
Page 7 of 12
10654060604000000066
000000882333842

Account Number:
000000882333842
(continued)
DATE
DESCRIPTION
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/23
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24
07/24

CCD ID: 1431652936
Hcusa
CCD ID: 1431702094
CCD ID: 1431372307
CCD ID: 1430813428
Chc VA Aso
CCD ID: 1541576305
KS Ppo Ch&L
CCD ID: 1751296086
Kansas Aso
CCD ID: 1480840330
CCD ID: 1431372307
Fehbp
CCD ID: 5382242132
CCD ID: S450173185
CCD ID: 1262574977
Fehbp
CCD ID: 5382242132
Kc Gc Ch&L
CCD ID: 1751296086
CCD ID: 1100000001
CCD ID: 2860257201
Kc Gc Hmo
CCD ID: 1480840330
CTX ID: 101036151
CCD ID: 1571062326
CCD ID: 2431652936
Kc Gc Hmo
CCD ID: 1480840330
Fehbp
CCD ID: 5382242132
KS Ppo Ch&L
CCD ID: 1751296086
Aetna A04
CCD ID: 1066033492
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 1431372307
CTX ID: 101036151
CCD ID: 1371216698
Wps
CCD ID: 9166123060
CCD ID: 1371216698
CCD ID: 1111187726
CCD ID: 1362739571
CCD ID: 8371216690
Ch&L MO
CCD ID: 1751296086
Aetna As01
CCD ID: 1066033492
CCD ID: 2860257201
CCD ID: S450173185
CCD ID: 2371216698
Coventryc3
CCD ID: 2870507647
CCD ID: 1262574977
CTX ID: 101036151
Aetna As01
CCD ID: 1066033492
CCD ID: 9149204101
CTX ID: 101036151
CTX ID: 101036151
AMOUNT
576.09
305.81
274.35
212.50
206.84
169.60
167.98
98.90
98.37
79.12
77.23
69.51
67.07
63.07
61.18
59.37
58.31
54.70
37.34
23.59
22.96
12.60
11.45
10.61
8.93
8.87
1.65
471.63
2,498.50
1,608.54
588.84
447.52
368.70
276.44
258.16
205.39
182.39
155.00
149.46
115.72
75.56
61.72
57.82
35.00
31.07
22.58
17.83
Page 8 of 12

Account Number:
(continued)
DATE
DESCRIPTION
07/24
07/24
07/24
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/25
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/28
07/29
07/29
07/29
07/29
07/29
07/29
07/29
07/29
Aetna A04
CCD ID: 1066033492
CCD ID: 1100000001
Fehbp
CCD ID: 7382242132
Wps
CCD ID: 9166123060
CCD ID: S450173185
Aetna A04
CCD ID: 1066033492
Aetna As01
CCD ID: 1066033492
CCD ID: 1100000001
CCD ID: 1111187726
CCD ID: 1541576305
Electronic Comme Hcclaimpmt 272615455
CCD ID: 1341858379
Kansas Aso
CCD ID: 1480840330
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 9149204101
CTX ID: 101036151
CCD ID: 1100000001
CCD ID: 1262574977
CCD ID: 1100000001
Optum Coresource Hcclaimpmt 272615455
CCD ID: 1351846036
CCD ID: 2860257201
Hcusa
CCD ID: 1431702094
CTX ID: 101036151
CCD ID: 1431372307
CCD ID: 1431372307
CCD ID: 1262574977
CCD ID: 1100000001
Wps
CCD ID: 9166123060
CCD ID: 1100000001
Ch&L MO
CCD ID: 1751296086
CCD ID: S450173185
Umr Nreca
CCD ID: 1530116145
Fehbp
CCD ID: 5382242132
CCD ID: 1431372307
CCD ID: 1100000001
Wps
CCD ID: 9166123060
CCD ID: 1411289245
CCD ID: 9149204101
CCD ID: S450173185
Aetna As01
CCD ID: 1066033492
Aetna A04
CCD ID: 1066033492
CCD ID: 1111187726
AMOUNT
12.61
7.89
6.68
6,463.76
947.83
900.16
449.98
244.25
140.26
139.21
122.65
107.19
71.30
44.50
37.76
37.34
32.70
28.99
17.22
9.36
1,490.92
1,467.44
633.08
564.84
470.46
298.65
156.97
137.85
115.49
112.09
98.57
57.98
35.71
27.64
26.79
19.94
10.36
8.52
7.26
4,435.16
13,455.44
1,808.67
1,757.59
290.53
82.20
58.53
49.22
Page 9 of 12
10654060605000000066
000000882333842

Account Number:
000000882333842
(continued)
DATE
DESCRIPTION
07/29
07/29
07/29
07/29
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/30
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31
07/31

CCD ID: 2860257201
CCD ID: 1571062326
CCD ID: 1571062326
CTX ID: 101036151
CCD ID: 1431372307
CCD ID: 1431652936
Wps
CCD ID: 9166123060
CCD ID: 1431372307
CCD ID: 1362739571
Electronic Comme Hcclaimpmt 272615455
CCD ID: 1341858379
CCD ID: 9149204101
CCD ID: 1430813428
Kc Gc Hmo
CCD ID: 1480840330
Hcusa
CCD ID: 1431702094
KS Ppo Ch&L
CCD ID: 1751296086
Umr Nreca
CCD ID: 1530116145
Fehbp
CCD ID: 5382242132
CTX ID: 101036151
KS Ppo Ch&L
CCD ID: 1751296086
CCD ID: 1100000001
Umr Holder Const Hcclaimpmt 272615455
CCD ID: 1582535136
CCD ID: 1431372307
Umr Allied Solut Hcclaimpmt 272615455
CCD ID: 1352125376
CCD ID: 2860257201
Kansas Aso
CCD ID: 1480840330
CTX ID: 101036151
CTX ID: 101036151
CTX ID: 101036151
CTX ID: 101036151
CTX ID: 101036151
Optum Coresource Hcclaimpmt 272615455
CCD ID: 1351846036
CCD ID: 1371216698
Wps
CCD ID: 9166123060
CCD ID: 9149204101
CCD ID: 1371216698
CCD ID: 2860257201
Ch&L MO
CCD ID: 1751296086
CCD ID: 1431372307
CCD ID: 1431372307
Aetna As01
CCD ID: 1066033492
CCD ID: 1111187726
Aetna H09
CCD ID: 1066033492
Fehbp
CCD ID: 5382242132
AMOUNT
42.10
40.13
37.34
28.13
1,292.28
670.97
471.08
413.83
379.58
295.31
236.91
197.79
165.39
151.68
142.52
137.38
96.00
95.77
58.58
54.97
41.78
38.64
33.41
29.21
24.33
22.83
11.84
8.00
3.68
2.34
1.76
1.65
4,573.84
3,337.55
2,762.88
1,727.89
1,421.40
666.27
534.93
514.47
211.56
126.07
118.71
98.32
62.93
47.38
41.78
Page 10 of 12

Account Number:
000000882333842
(continued)
DESCRIPTION

CCD ID: 1571062326
Aetna A04
CCD ID: 1066033492
CTX ID: 101036151
CTX ID: 101036151
AMOUNT
Total Deposits and Additions
5.92
5.60
4.47
1.79
$303,606.41
ELECTRONIC WITHDRAWALS
DATE
DESCRIPTION
07/10
07/14
07/18
07/18
07/31
Transfirst LLC Discount 39300980302680 CCD ID: 1752598308

07/14 Online Transfer To Chk ...3834 Transaction#: 4033746118
Tricare West Reversal 272615455
CCD ID: 1100000001
Tricare West Reversal 272615455
CCD ID: 1100000001
07/31 Online Transfer To Chk ...3834 Transaction#: 4064696661
AMOUNT
$289.26
141,000.00
305.24
12.59
50,000.00
Total Electronic Withdrawals
$191,607.09
FEES AND OTHER WITHDRAWALS

DATE
DESCRIPTION
07/15
Account Analysis Settlement Charge
AMOUNT
$2,792.11
Total Fees & Other Withdrawals
$2,792.11
Your service charges, fees and earnings credit have been calculated through account analysis.
DAILY ENDING BALANCE

DATE
AMOUNT
DATE
AMOUNT
07/01
$40,201.98
07/17
76,374.96
07/02
55,220.62
07/18
95,477.10
07/03
75,501.45
07/21
102,678.78
07/07
101,427.08
07/22
113,307.99
07/08
117,768.73
07/23
126,234.16
07/09
126,078.81
07/24
133,889.21
07/10
135,442.09
07/25
143,683.67
07/11
141,956.91
07/28
149,424.23
07/14
14,636.97
07/29
171,509.27
07/15
43,517.70
07/30
176,588.78
07/16
58,287.51
07/31
142,852.54
Page 11 of 12
10654060606000000066
DATE
07/31
07/31
07/31
07/31

Account Number:
000000882333842
BALANCING YOUR CHECKBOOK

Note: Ensure your checkbook register is up to date with all transactions to date whether they are included on your
statement or not.
1. Write in the Ending Balance shown on this statement:
Step 1 Balance: $
2. List and total all deposits & additions not shown on this statement:
Date
Amount
Date
Amount
Date
Amount
3. Add Step 2 Total to Step 1 Balance.
Step 2 Total:
$_________________
Step 3 Total:
$_________________
4. List and total all checks, ATM withdrawals, debit card purchases and other withdrawals
not shown on this statement.
Check Number or Date
Amount
Check Number or Date
Amount
Step 4 Total:
-$_________________
5. Subtract Step 4 Total from Step 3 Total. This should match your Checkbook Balance:
$_________________
IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR ELECTRONIC FUNDS TRANSFERS:Call or write us at the phone number or address on
the front of this statement (non-personal accounts contact Customer Service) if you think your statement or receipt is incorrect or if you
need more information about a transfer listed on the statement or receipt. We must hear from you no later than 60 days after we sent you
the FIRST statement on which the problem or error appeared. Be prepared to give us the following information:
Your name and account number
The dollar amount of the suspected error
A description of the error or transfer you are unsure of, why you believe it is an error, or why you need more information.
We will investigate your complaint and will correct any error promptly. If we take more than 10 business days (or 20 business days for
new accounts) to do this, we will credit your account for the amount you think is in error so that you will have use of the money during the
time it takes us to complete our investigation .
IN CASE OF ERRORS OR QUESTIONS ABOUT NON-ELECTRONIC TRANSACTIONS:Contact the bank immediately if your statement is
incorrect or if you need more information about any non-electronic transactions (checks or deposits) on this statement. If any such error
appears, you must notify the bank in writing no later than 30 days after the statement was made available to you. For more complete
details, see the Account Rules and Regulations or other applicable account agreement that governs your account.
JPMorgan Chase Bank, N.A. Member FDIC
Page 12 of 12

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July 01, 2014 through July 31, 2014

JPMorgan Chase Bank, N.A.

CUSTOMER SERVICE INFORMATION

PALMARIS IMAGING OF ARIZONA PLLC

Chase Analysis Business Checking

DEPOSITS AND ADDITIONS

Lockbox No: 2966117 For 87 Items At 16:00 8 Trn: 1500278182Lb

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

Anthem Bcbs of M Hcclaimpmt 3320241546

July 01, 2014 through July 31, 2014

Acs State Health Hcclaimpmt 126683120140704 CCD ID: 1582479287

DEPOSITS AND ADDITIONS

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

Healthy Alliance Hcclaimpmt 3320474718

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

Umr Missouri Con Hcclaimpmt 272615455

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

Anthem Bcbs of M Hcclaimpmt 3320861673

July 01, 2014 through July 31, 2014

DEPOSITS AND ADDITIONS

Palmetto Gba/Rrb Hcclaimpmt 1003124116

Total Deposits and Additions

Transfirst LLC Discount 39300980302680 CCD ID: 1752598308

Total Electronic Withdrawals

FEES AND OTHER WITHDRAWALS

Account Analysis Settlement Charge

Total Fees & Other Withdrawals

DAILY ENDING BALANCE

July 01, 2014 through July 31, 2014

BALANCING YOUR CHECKBOOK

3. Add Step 2 Total to Step 1 Balance.

Check Number or Date

JPMorgan Chase Bank, N.A. Member FDIC

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