Utilities

Patient

Prescriber

Drug

info

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

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

Accounts Receivable - Account Audit

Patient Info

A/R Account #

Name

Begin Date

End Date

A/R Account Audit Report
Patient
Account #:

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Date of Birth

Enter last name, first name

MRN

Phone

Address

City

State

ZIP

Name Name	Date of Birth Date of Birth	Address Address	City City	State State	ZIP ZIP	Phone Phone	CF CF	Status Status
Annie Wiedman	10/07/1978	88 Center Rd	Bedford	OH	44146	715-361-4850		Active
Maria Rodriguez	12/03/1976	2349 Spinnaker Lane	Joliet	LA	60432	724-376-4350		Active
Scott Adams	08/19/1979	1919 County Line Road	Tampa	FL	33634	727-729-9038		Active
Smith James	04/11/1978	1566 Elm Drive	Cambridge	NY	12816	532-247-7219		Active
Teresa Andresen	11/28/1987	1227 Perine Street	Alexandria	VA	22304	703-823-4297		Active