Contents
- Index
Sales by Pay Source
SALES BY PAY SOURCE
01/01/96 THROUGH 12/15/96 AS RUN ON 12/15/97 PG: 1
Pay Source Category Current YTD % of Initial
Insurance/Pay Source Dollars Total Non-Allowed
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PR PATIENT RESPONSIBLE
-------------------------
PATIENT RESPONSIBLE 330,030.23 16.51%
TOTAL PR 330,030.23 16.51% 0.00
AA AUTO ACCIDENT
-------------------------
855 AMERICAN FAMILY 150.00 0.01%
856 MARYLAND INSURANCE 138.00 0.01%
TOTAL AA 288.00 0.01% 0.00
BCBS BLUE CROSS
-------------------------
0248 BC&BS UNITED OF WI 54.00 0.00%
0687 BC/BS OF WI 1,868.00 0.09%
0765 BC/BS OF MN 3,397.80 0.17%
TOTAL BCBS 5,319.80 0.27% 0.00
BLH BIG LAKE HOSP.
-------------------------
0334 EQUICOR 9,152.30 0.46%
0469 PEKIN INSURANCE CO 2,955.80 0.15%
0496 FIREMANS FUND INS 935.00 0.05%
0757 HERITAGE NAT HEALTH 75.00 0.00%
0815 HRM CLAIM MANAGEMENT 1,060.00 0.05%
TOTAL BLH 14,178.10 0.71% 0.00
CASH CASH SALES
-------------------------
0579 DEAN HEALTH PLAN INC 225.00 0.01%
0592 WASHINGTON NATIONAL INSURA 32.00 0.00%
TOTAL CASH 257.00 0.01% 0.00
FCI FEDERAL CORRECTIONAL INST
-------------------------
0027 BC/BS OF IL 459.00 0.02%
0033 EMPLOYERS HEALTH INS 8,640.00 0.43%
0068 WI EL EMP HEALTH PL 59.00 0.00%
0178 GEHA 159.00 0.01%
0197 HIRSP 1,613.00 0.08%
0279 WELS VEBA GROUP 16.00 0.00%
0439 KELLY-SPRINGFIELD 312.00 0.02%
0441 HARTFORD INSURANCE 7,375.00 0.37%
0504 HERITAGE INSURANCE 3,167.00 0.16%
0594 ASSOC. FOR HEALTH CARE 530.00 0.03%
0644 BC/BS OF WI 4,925.30 0.25%
0686 SEABURY & SMITH 380.50 0.02%
0738 ALLIANCE 9,681.75 0.48%
0780 UNITY HEALTH PLANS 34,318.80 1.72%
0839 HUMANA CLAIMS 589.00 0.03%
0852 METRAHEALTH 755.00 0.04%
0855 JOS HUBER BREWING CO 230.00 0.01%
0861 MC HENRY COUNTY HEALTH CA 1,727.00 0.09%
179 LOUD SPEAKER COMPONENTS 685.00 0.03%