Check Register Summary
By Group Code Report Date: 12/18/2003 By Plan Report Period: 11/01/2003 - 11/30/2003 Paid By Location
	Claims		Manual		Voids		Net Issued		Adjustments		NoPay		Refund		Net Benefit
	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total
Group: 999999
Benefit Type: D
	16	$4,206.83	0	$.00	1	$.00	17	$4,206.83	0	$.00	0	$.00	0	$.00	17	$4,206.83
Total Ben Type: D	16	$4,206.83	0	$.00	1	$.00	17	$4,206.83	0	$.00	0	$.00	0	$.00	17	$4,206.83
Benefit Type: M
	104	$29,245.69	0	$.00	0	$.00	104	$29,245.69	1	($132.80)	1	$132.80	1	($676.61)	107	$28,569.08
Total Ben Type: M	104	$29,245.69	0	$.00	0	$.00	104	$29,245.69	1	($132.80)	1	$132.80	1	($676.61)	107	$28,569.08
Benefit Type: Y
	2	$5,587.33	0	$.00	0	$.00	2	$5,587.33	0	$.00	0	$.00	0	$.00	2	$5,587.33
Total Ben Type: Y	2	$5,587.33	0	$.00	0	$.00	2	$5,587.33	0	$.00	0	$.00	0	$.00	2	$5,587.33
Total Group: 999999	122	$39,039.85	0	$.00	1	$.00	123	$39,039.85	1	($132.80)	1	$132.80	1	($676.61)	126	$38,363.24
	Claims		Manual		Voids		Net Issued		Adjustments		NoPay		Refund		Net Benefit
	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total	Count	Total
TOTAL	122	$39,039.85	0	$.00	1	$.00	123	$39,039.85	1	($132.80)	1	$132.80	1	($676.61)	126	$38,363.24
Check Register Summary Requestor: John Employer Report Date: 12/18/2003 Inc No Check: YES Sort fields: Selected values: Group 999999 Benefit Type(s): ALL Date: Paid Report Period: 11/01/2003 - 11/30/2003