1 01/15/2005 *** END OF HISTORY DISPLAY *** CLEAR EXIT PF1 PAGE AHEAD PF2 PAGE BACK PF4 RETURN PF5 HELP PF6 MAIN MENU 4A0 04,005 EFTA01683175 FSXMHST1 CLAIMS MAINFRAME SYSTEM 03/02/2006 PAGE: 1 OF 1 CASE HISTORY 09:19 RECEIPT DATE: 11/14/2003 RECEIPT NUMBER: MSC-04-063-10062 ACTION CODE A