Length Of Stay
By Group Code Report Date: 11/07/2003 By Plan Report Period: 10/01/2003 - 10/31/2003 Paid By Location
	Provider	Suffix	Name	Admits	Days	Charge	Allowable	PPO Disc	Paid	Avg Stay	Avg Chrg	Avg Pd	AvgDly Chrg	AvgDly Paid
Group: 99999
Benefit Type: M
Diagnosis:
	123456789	.	GENERAL HOSPITAL	3	5	$21,894.70	$2,399.50	$.00	$1,719.60	1	$7,298.23	$573.20	$4,378.94	$343.92
Total Diagnosis				3	5	$21,894.70	$2,399.50	$.00	$1,719.60	1	$7,298.23	$573.20	$4,378.94	$343.92
Total Ben Type: M				3	5	$21,894.70	$2,399.50	$.00	$1,719.60	1	$7,298.23	$573.20	$4,378.94	$343.92
Total Group: 99999				3	5	$21,894.70	$2,399.50	$.00	$1,719.60	1	$7,298.23	$573.20	$4,378.94	$343.92
	Provider	Suffix	Name	Admits	Days	Charge	Allowable	PPO Disc	Paid	Avg Stay	Avg Chrg	Avg Pd	AvgDly Chrg	AvgDly Paid
TOTAL				3	5	$21,894.70	$2,399.50	$.00	$1,719.60	1	$7,298.23	$573.20	$4,378.94	$343.92
Length Of Stay Requestor: John Employer Report Date: 11/07/2003 Sort fields: Selected values: Group 99999 Benefit Type(s): ALL Date: Paid Report Period: 10/01/2003 - 10/31/2003 Report by: All I/P Facility