THIS FORM IS FAXED TO YOU DAILY SO THAT YOU MAY SEE WHERE YOUR MONEY IS IN THE PAYMENT PROCESS. THIS SCREEN IS DOWNLOADED DIRECTLY FROM THE MEDICARE COMPUTER SYSTEM

SUPPLIER NUMBER: ( YOUR SUPPLIER NUMBER )
AMOUNT PENDING ON PAYMENT FLOOR: $39,778.65

  # OF CLAIMS ON FLOOR: 47

CURRENT PAYMENT HISTORY ( THIS PORTION AVAILABLE IN REGION "C" ONLY )


DATE: 1999/10/04 1999/09/30  1999/09/29
$5,198.16  $1,544.97 $17,900.56

# OF CHECKS   

1

1

2


NOTE: MULTIPLE CHECKS CAN BE CUT ON ANY GIVEN DAY

                                            

CLAIMS SUBMITTED  AMOUNT
QUERY SUSPENSE  25  $47,553.02
OTHER SUSPENSE  29  $45,152.46
COMPLETED HELD 47 $55,572.11
TOTAL  101  $148,277.59


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