info

Created By/On: Devel# 11/26/2015 | 5:23:47 AM

Maintained By/On: Jayden Smith 02/12/2018 | 5:06:479 AM

  • Name: Maria Rodriguez
  • DOB: 10/07/1976
  • Patient Type: Compliance Packaging , Care Facility Patient

A/R

Last Statement Balance .00
Current Balance .00
30 + Day Balance .00
60 + Day Balance .00
90 + Day Balance .00
120 + Day Balance .00
Finance Charge .00
Current Daily Balance 5.00
Head of Household Mr. Jessica, Wilson
Status
Acct No 88729
Credit Limit
A/R Groups
Auto Charge Rx
Current Transaction Detail
Date
Date
Patient
Patient
Type
Type
Description
Description
Subtotal
Subtotal
Tax
Tax
Total
Total
04/17/2018 Maria Rodriguez Prescription #51235833-000-04/17/2018 - D 1000 Capsule 1000 UNIT 5.00 .00 $5.00