All American Home Health, Inc. Page: 1 Patients to be Billed Details Report For: All Payers From 12/13/98 to 04/04/99 Today`s date: 04/01/1999 Billing Service Billing Billing Patient Discip. Date Units Rate Extended --------------------------- ------- -------- -------- -------- ---------- ***********************Blue Cross of California ************************ Jackson, Michael PT 04/03/99 2.00 $ 130.00 $ 260.00 Jackson, Michael PT 04/07/99 2.00 $ 130.00 $ 260.00 ----------------------------------------------------------------------------- Smith, John OT 04/01/99 2.50 $ 125.00 $ 312.50 Smith, John OT 04/01/99 2.50 $ 125.00 $ 312.50 Total Units= 5.00 Charges=$ 625.00 ----------------------------------------------------------------------------- Blue Cross of California Total Units= 9.00 Charges=$ 1,145.00 ***************************************************************************** Grand Total Units= 9.00 Charges=$ 1,145.00