Patient Name /
Patient ID
Apt. ID Apt. Date /
Apt. Time
Department /
Doctor
Patient Billing
Code
Payment Type
Luis Hall
PID 681845
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
GEN Insurance Company Contract Social Security Self Pay Validate
Clui Reed
PID 921733
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
- Insurance Company Contract Social Security Self Pay Validate
Antonio Brluit
PID 432970
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
STFRL Insurance Company Contract Social Security Self Pay Validate
Amanda Wrilui
PID 893534
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
GEN Insurance Company Contract Social Security Self Pay Validate
Tanya Stewart
PID 261837
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
STF Insurance Company Contract Social Security Self Pay Validate
Patient Name /
Patient ID
Apt. ID Apt. Date /
Apt. Time
Department /
Doctor
Patient Billing
Code
Payment Type
Luis Hall
PID 681845
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
GEN Insurance Company Contract Social Security Self Pay Edit
Clui Reed
PID 921733
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
- Insurance Company Contract Social Security Self Pay Edit
Antonio Brluit
PID 432970
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
STFRL Insurance Company Contract Social Security Self Pay Edit
Amanda Wrilui
PID 893534
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
GEN Insurance Company Contract Social Security Self Pay Edit
Tanya Stewart
PID 261837
123456 25-03-2019
16:45
Surgery
Dr. Sateesh Talpade
STF Insurance Company Contract Social Security Self Pay Edit
; ;