Sample Report #2 P A Y M E N T S ======================================== C a s h R e c e i p t s --------------------------------------- 000018 PAYMMENT REVERSAL- INSURA 0.00 0.00 0.00 0 0.00 0.00 90.00 -0.22 2 0.15 45.00 000020 INSURANCE TAKE BACK 0.00 0.00 0.00 0 0.00 0.00 78.50 -0.19 1 0.08 78.50 00003 PERSONAL CK PAYMENT 0.00 -602.48 19.79 33 36.26 -18.25 -13231.29 32.64 663 51.16 -19.95 00004 INSURANCE PAYMENT 0.00 -1063.18 34.93 28 30.77 -37.97 -12529.03 30.91 306 23.61 -40.94 00005 MEDICARE PAYMENT 0.00 0.00 0.00 0 0.00 0.00 -1547.14 3.82 33 2.55 -46.88 00006 BLUE CROSS PAYMENT 0.00 -1378.48 45.28 30 32.97 -45.94 -13402.09 33.07 290 22.38 -46.21 00022 PATIENT REFUND 0.00 0.00 0.00 0 0.00 0.00 10.00 -0.02 1 0.08 10.00 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** Cash Receipts TOTALS -3044.14 100.00 91 100.00 -40531.05 100.00 1296 100.00 ========= ====== ===== ====== ========= ====== ===== ====== **** PAYMENT TOTALS **** -3044.14 100.00 91 100.00 -40531.05 100.00 1296 100.00 DATE : 07/18/2003 Sample Practice PAGE : 0 CLINIC PRODUCTIVITY ANALYSIS REPORT ALL OFFICES ALL DOCTORS ==================================================================================================================================== CPT CPT CPT CURRENT % OF # OF % OF AVERAGE YTD % OF # OF % OF YTD CODE DESCRIPTION FEE TOTAL TOTAL TRANS TRANS FEE TOTAL TOTAL TRANS TRANS AVG FEE ===================================================================================================================================== A D J U S T M E N T S ======================================== A c c o u n t A d j u s t m e n t s --------------------------------------- 00007 WRITE OFF 0.00 -835.68 59.75 41 31.30 -20.38 -6759.99 37.63 322 12.88 -20.99 00020 TRANSFER OUT 0.00 -727.01 51.98 33 25.19 -22.03 -20504.08 114.12 850 34.00 -24.12 00021 TRANSFER IN 0.00 727.01 -51.98 33 25.19 22.03 20504.08 -114.1 850 34.00 24.12 00090 CONTRACTUAL ADJUSTMENT 0.00 -562.93 40.25 24 18.32 -23.45 -9980.95 55.55 439 17.56 -22.73 00998 POSTING ERROR (CREDIT) 0.00 0.00 0.00 0 0.00 0.00 -1527.15 8.50 27 1.08 -56.56 00999 POSTING ERROR (DEBIT) 0.00 0.00 0.00 0 0.00 0.00 301.66 -1.68 12 0.48 25.13 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** Account Adjustments TOTALS -1398.61 100.00 131 100.00 -17966.43 100.00 2500 100.00 ========= ====== ===== ====== ========= ====== ===== ====== **** ADJUSTMENT TOTALS **** -1398.61 100.00 131 100.00 -17966.43 100.00 2500 100.00 DATE : 07/18/2003 Sample Practice PAGE : 0 CLINIC PRODUCTIVITY ANALYSIS REPORT ALL OFFICES ALL DOCTORS ==================================================================================================================================== CPT CPT CPT CURRENT % OF # OF % OF AVERAGE YTD % OF # OF % OF YTD CODE DESCRIPTION FEE TOTAL TOTAL TRANS TRANS FEE TOTAL TOTAL TRANS TRANS AVG FEE ===================================================================================================================================== C H A R G E S ======================================== --------------------------------------- V2203 SPHERE, BIFOCAL, PLUS OR 0.00 0.00 0.00 0 0.00 0.00 129.00 0.19 1 0.08 129.00 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** TOTALS 0.00 0.00 0 0.00 129.00 0.19 1 0.08 P R O F E S S I O N A L S E R V I C S --------------------------------------- 92015 REFRACTION 20.00 280.00 20.44 14 46.67 20.00 10555.00 15.74 525 40.29 20.10 92020 GONIOSCOPY 50.00 0.00 0.00 0 0.00 0.00 280.00 0.42 5 0.38 56.00 92083 VISUAL FIELDS EXT 100.00 0.00 0.00 0 0.00 0.00 2130.00 3.18 24 1.84 88.75 92225 EXTENDED OPHTHALMOSCOPY 50.00 0.00 0.00 0 0.00 0.00 140.00 0.21 3 0.23 46.66 99202 OFFICE VISIT- NEW 65.00 0.00 0.00 0 0.00 0.00 195.00 0.29 3 0.23 65.00 99211 OFFICE VISIT- ESTABLISHED 25.00 0.00 0.00 0 0.00 0.00 150.00 0.22 4 0.31 37.50 99212 OFFICE VISIT-EP 40.00 40.00 2.92 1 3.33 40.00 305.00 0.45 7 0.54 43.57 99213 OFFICE VISIT 60.00 0.00 0.00 0 0.00 0.00 1670.00 2.49 36 2.76 46.38 99213D DILATED FUNDUS EXAM 25.00 0.00 0.00 0 0.00 0.00 275.00 0.41 11 0.84 25.00 99214 OFFICE VISIT ESTABLISHED 85.00 0.00 0.00 0 0.00 0.00 380.00 0.57 5 0.38 76.00 V2025 DELUX FRAMES 0.00 0.00 0.00 0 0.00 0.00 159.00 0.24 1 0.08 159.00 V2117 LENTICULAR, ASPHERIC, PER 139.00 0.00 0.00 0 0.00 0.00 260.00 0.39 1 0.08 260.00 V2744 PHOTOCHROMATIC 0.00 0.00 0.00 0 0.00 0.00 255.00 0.38 3 0.23 85.00 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** PROFESSIONAL SERVICS TOTALS 320.00 23.36 15 50.00 16754.00 24.98 628 48.20 C O N T A C T L E N S E S --------------------------------------- 92310 CONTACT LENS FITTING 70.00 0.00 0.00 0 0.00 0.00 500.00 0.75 7 0.54 71.42 V2530 CONTACTS 0.00 0.00 0.00 0 0.00 0.00 507.20 0.76 6 0.46 84.53 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** CONTACT LENSES TOTALS 0.00 0.00 0 0.00 1007.20 1.50 13 1.00 F R A M E S E R V I C E S --------------------------------------- V2020 FRAMES 0.00 0.00 0.00 0 0.00 0.00 3818.75 5.69 26 2.00 146.87 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** FRAME SERVICES TOTALS 0.00 0.00 0 0.00 3818.75 5.69 26 2.00 A D D - O N S --------------------------------------- V2740 SOLID TINTS 0.00 0.00 0.00 0 0.00 0.00 20.00 0.03 1 0.08 20.00 V2799 POLYCARBONATE 0.00 0.00 0.00 0 0.00 0.00 499.00 0.74 14 1.07 35.64 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** ADD-ONS TOTALS 0.00 0.00 0 0.00 519.00 0.77 15 1.15 M I S C E L L A N E O U S --------------------------------------- 99070 SILICONE PLUGS 75.00 0.00 0.00 0 0.00 0.00 25.00 0.04 1 0.08 25.00 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** MISCELLANEOUS TOTALS 0.00 0.00 0 0.00 25.00 0.04 1 0.08 P R O F E S S I O N A L S E R V I C S --------------------------------------- 92004 COMPREHENSIVE OPHTHALMIC 70.00 0.00 0.00 0 0.00 0.00 70.00 0.10 1 0.08 70.00 V2100 SV LENSES 0.00 0.00 0.00 0 0.00 0.00 1435.20 2.14 22 1.69 65.23 V2750 ANTI REF COATING;PLASTIC 0.00 0.00 0.00 0 0.00 0.00 518.00 0.77 8 0.61 64.75 V2781 PROGRESSIVE LENS 0.00 0.00 0.00 0 0.00 0.00 2539.00 3.79 12 0.92 211.58 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** PROFESSIONAL SERVICS TOTALS 0.00 0.00 0 0.00 4562.20 6.80 43 3.30 P R O F E S S I O N A L S E R V I C S --------------------------------------- 68761 PUNCTAL CLOSURE 225.00 0.00 0.00 0 0.00 0.00 100.00 0.15 1 0.08 100.00 92002 INTERMEDIATE OPHTHALMIC-N 70.00 0.00 0.00 0 0.00 0.00 630.00 0.94 9 0.69 70.00 92004 COMPREHENSIVE OPHTHALMIC 70.00 350.00 25.55 5 16.67 70.00 26760.00 39.90 382 29.32 70.05 92012 INTERMEDIATE OPHTHALMIC-E 70.00 0.00 0.00 0 0.00 0.00 420.00 0.63 6 0.46 70.00 92014 COMPREHENSIVE OPTHALMIC-E 70.00 700.00 51.09 10 33.33 70.00 11200.00 16.70 160 12.28 70.00 92081 VISUAL FIELD LIMITED 65.00 0.00 0.00 0 0.00 0.00 65.00 0.10 1 0.08 65.00 99201 OFFICE VISIT - NEW 35.00 0.00 0.00 0 0.00 0.00 95.00 0.14 2 0.15 47.50 99203 OFFICE VISIT 95.00 0.00 0.00 0 0.00 0.00 445.00 0.66 7 0.54 63.57 99204 OFFICE VISIT NEW 70.00 0.00 0.00 0 0.00 0.00 460.00 0.69 7 0.54 65.71 EY001 US HEALTHCARE EE GLASSES 59.00 0.00 0.00 0 0.00 0.00 70.00 0.10 1 0.08 70.00 --------- ------ ----- ------ ------- --------- ------ ----- ------ ------- **** PROFESSIONAL SERVICS TOTALS 1050.00 76.64 15 50.00 40245.00 60.01 576 44.21 ========= ====== ===== ====== ========= ====== ===== ====== **** CHARGE TOTALS **** 1370.00 100.00 30 100.00 67060.15 100.00 1303 100.00 DATE : 07/18/2003 Sample Practice PAGE : 0 CLINIC PRODUCTIVITY ANALYSIS REPORT ALL OFFICES ALL DOCTORS ==================================================================================================================================== CPT CPT CPT CURRENT % OF # OF % OF AVERAGE YTD % OF # OF % OF YTD CODE DESCRIPTION FEE TOTAL TOTAL TRANS TRANS FEE TOTAL TOTAL TRANS TRANS AVG FEE ===================================================================================================================================== ----PAYMENTS---- ---ADJUSTMENTS-- -----CHARGES---- NUMBER AMOUNT NUMBER AMOUNT NUMBER AMOUNT **** CURRENT MONTH TOTALS **** 91 -3,044.14 131 -1,398.61 30 1,370.00 **** YEAR TO DATE TOTALS **** 1,296 -40,531.05 2,500 -17,966.43 1,303 67,060.15