Referral Analysis
By Group Code Report Date: 11/06/2003
  Report Period: 10/01/2003 - 10/31/2003 Processed
   
Mem
Last		 Mem
First
SSN
Dep
DOB
Ref Date
Ref No
Ref Prov
Ref Prov TIN
Ref To Prov		 Ref To
Prov TIN
Diag
Units
Apprvd Amt
Status
Group: 99998
DOE JOHN 123456789 5 01/01/2002 2001/01/24 p00025795         486 2 .00 o
DOE JOHN 123456789 s 01/01/1963 2001/01/19 p00025759         78791 2 .00 o
DOE JOHN 123456789 e 01/01/1962 2001/01/05 p00025768         56211 0 .00 o
DOE JOHN 123456789 s 01/01/1954 2001/01/22 p00025674         55321 0 .00 o
DOE JOHN 123456789 1 01/01/1999 2001/01/03 p00025617         4809 3 .00 o
DOE JOHN 123456789 2 01/01/1987 2001/01/07 p00025883         78650 0 .00 o
DOE JOHN 123456789 s 01/01/1954 2001/01/13 p00025669         78650 0 .00 o
DOE JOHN 123456789 e 01/01/1941 2001/01/18 p00025634         72210 0 .00 o
DOE JOHN 123456789 e 01/01/1953 2001/01/15 p00025716         486 3 .00 o
DOE JOHN 123456789 e 01/01/1953 2001/01/19 p00025783         1625 1 .00 o
DOE JOHN 123456789 e 01/01/1953 2001/01/29 p00025787         1625 1 .00 o
DOE JOHN 123456789 e 01/01/1953 2001/01/05 p00025863         78609 0 .00 o
DOE JOHN 123456789 e 01/01/1974 2001/01/04 p00025828         475 0 .00 o
DOE JOHN 123456789 s 01/01/1976 2001/01/05 p00025654         72743 0 .00 o
DOE JOHN 123456789 s 01/01/1949 2001/01/17 p00025740         7291 1 .00 o
DOE JOHN 123456789 e 01/01/1982 2001/01/09 p00025555         7327 0 .00 o
DOE JOHN 123456789 s 01/01/1941 2001/01/25 p00025816         25010 6 .00 o
DOE JOHN 123456789 s 01/01/1941 2001/01/03 p00025830         99662 0 .00 o
DOE JOHN 123456789 s 01/01/1957 2001/01/07 p00025880         2189 0 .00 o
DOE JOHN 123456789 2 01/01/1998 2001/01/01 p00025612         2765 2 .00 o
DOE JOHN 123456789 s 01/01/1950 2001/01/17 p00025596         71509 0 .00 o
DOE JOHN 123456789 1 01/01/1985 2001/01/31 p00022117         74769 0 .00 o
DOE JOHN 123456789 s 01/01/1958 2001/01/06 p00025854         2765 0 .00 o
DOE JOHN 123456789 e 01/01/1974 2001/01/08 p00025393         6259 0 .00 o
DOE JOHN 123456789 s 01/01/1978 2001/01/19 p00025707         78930 1 .00 o
DOE JOHN 123456789 e 01/01/1960 2001/01/03 p00025882         042 4 .00 o
DOE JOHN 123456789 e 01/01/1949 2001/01/12 p00025676         41401 0 .00 o
DOE JOHN 123456789 s 01/01/1967 2001/01/09 p00025623         7222 2 .00 o
DOE JOHN 123456789 s 01/01/1967 2001/01/11 p00025710         7222 5 .00 o
DOE JOHN 123456789 s 01/01/1967 2001/01/16 p00025717         72402 6 .00 o
DOE JOHN 123456789 s 01/01/1967 2001/01/03 p00025862         72210 2 .00 o
DOE JOHN 123456789 s 01/01/1959 2001/01/03 p00025620         4809 4 .00 o
DOE JOHN 123456789 s 01/01/1959 2001/01/09 p00025670         1629 1 .00 o
DOE JOHN 123456789 s 01/01/1959 2001/01/09 p00025672         1629 1 .00 o
DOE JOHN 123456789 1 01/01/1987 2001/01/29 p00025808         29633 4 .00 o
DOE JOHN 123456789 s 01/01/1957 2001/01/13 p00025704         78650 0 .00 o
DOE JOHN 123456789 s 01/01/1945 2001/01/22 p00025785         57510 2 .00 o
DOE JOHN 123456789 s 01/01/1962 2001/01/15 p00025671         49392 1 .00 o
DOE JOHN 123456789 e 01/01/1941 2001/01/11 p00025714         3310 3 .00 o
DOE JOHN 123456789 e 01/01/1944 2001/01/10 p00025677         43310 1 .00 o
DOE JOHN 123456789 2 01/01/1990 2001/01/28 p00025794         5409 1 .00 o
DOE JOHN 123456789 s 01/01/1948 2001/01/21 p00025778         496 15 .00 o
DOE JOHN 123456789 s 01/01/1948 2001/01/05 p00025824         496 0 .00 o
DOE JOHN 123456789 e 01/01/1972 2001/01/03 p00025630         37152 0 .00 o
DOE JOHN 123456789 s 01/01/1968 2001/01/24 p00025806         49390 4 .00 o
DOE JOHN 123456789 1 01/01/1995 2001/01/11 p00025622         74423 0 .00 o
DOE JOHN 123456789 e 01/01/1947 2001/01/06 p00025886         486 0 .00 o
DOE JOHN 123456789 s 01/01/1960 2001/01/09 p00025885         2189 0 .00 o
DOE JOHN 123456789 2 01/01/2003 2001/01/22 p00025782         7869 4 .00 o
DOE JOHN 123456789 s 01/01/1938 2001/01/13 p00025887         6256 0 .00 o
DOE JOHN 123456789 e 01/01/1942 2001/01/01 p00025613         6823 4 .00 o
DOE JOHN 123456789 e 01/01/1942 2001/01/05 p00025776         6829 10 .00 o
DOE JOHN 123456789 2 01/01/1993 2001/01/22 p00025781         5409 5 .00 o
DOE JOHN 123456789 e 01/01/1955 2001/01/29 p00025777         6202 0 .00 o
DOE JOHN 123456789 s 01/01/1947 2001/01/09 p00025635         78701 2 .00 o
DOE JOHN 123456789 s 01/01/1964 2001/01/04 p00025520         7226 0 .00 o
DOE JOHN 123456789 s 01/01/1964 2001/01/04 p00025537         7226 3 .00 o
DOE JOHN 123456789 s 01/01/1977 2001/01/05 p00025618         07811 1 .00 o
DOE JOHN 123456789 e 01/01/1967 2001/01/10 p00025629         V5339 1 .00 o
DOE JOHN 123456789 s 01/01/1956 2001/01/10 p00025638         6829 4 .00 o
DOE JOHN 123456789 e 01/01/1936 2001/01/16 p00025675         72190 0 .00 o
DOE JOHN 123456789 e 01/01/1936 2001/01/19 p00025766         71590 4 .00 o
DOE JOHN 123456789 e 01/01/1936 2001/01/19 p00025767         71590 4 .00 o
DOE JOHN 123456789 e 01/01/1936 2001/01/01 p00025818         71590 6 .00 o
DOE JOHN 123456789 e 01/01/1936 2001/01/06 p00025827         71590 4 .00 o
DOE JOHN 123456789 s 01/01/1943 2001/01/26 p00025797         6823 5 .00 o
DOE JOHN 123456789 s 01/01/1943 2001/01/02 p00025829         6829 2 .00 o
DOE JOHN 123456789 s 01/01/1948 2001/01/09 p00025640         6256 1 .00 o
DOE JOHN 123456789 e 01/01/1970 2001/01/08 p00025668         4321 3 .00 o
DOE JOHN 123456789 t 01/01/1950 2001/01/05 p00025616         2189 0 .00 o
DOE JOHN 123456789 e 01/01/1944 2001/01/16 p00025715         78820 0 .00 o
 
Total Group: 99998
                        141 .00  
 
Mem
Last		 Mem
First
SSN
Dep
DOB
Ref Date
Ref No
Ref Prov
Ref Prov TIN
Ref To Prov		 Ref To
Prov TIN
Diag
Units
Apprvd Amt
Status
 
TOTAL
                        141 .00  
 
Referral Analysis
Requestor: John Employer
Report Date: 11/06/2003
Sort fields: Selected values:
Group 99998
Report Period: 10/01/2003 - 10/31/2003