📄 Extracted Text (76 words)
SINGLE PATIENT LEDGER
Thomas J. Magnani, D.D.S.
Date: 04/18/2019 Page: 1
Patient Name: Chart Number.
9 East 71st Street
New York, NY 10021 Billing Type: 1
DATE TEETH DESCRIPTION PATIENT CHARGE PAYMENT BALANCE
02/18/2019 Patient Balance Forward 0.00 0.00
02/19/2019 Prophylaxis-adult 180.00 180.00
02/19/2019 Periodic oral evaluation 40.00 220.00
02/21/2019 Whitening Gel 22% 65.00 285.00
02/21/2019 3 Amalgam-2 surf. 450.00 735.00
02/21/2019 4 Resin composite-1s, posterior 425.00 1160.00
TOTAL PATIENT BALANCE AS OF 0411812019: 1160.00
EFTA00316502
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EFTA00316502
Dataset
DataSet-9
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document
Pages
1
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