📄 Extracted Text (244 words)
MAY-12-2011 09:50A FROM:CR THOMAS MAGNANI TO:16467067223 P.1/2
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HISTORICAL STATEMENT
11/22/2010 to 4/30/2011
Thom Magnanl D.D.S. Telephone:
Alvin son D.D.S.
New 10019
Mr. Jet stein Date Account
301 East th Street 5/12/2011
Apt 10p
New YOr NY 10065
Date Charges Credits Balance
Balan 0.00
11/22/2010 175.00 175.00
11/22/2010 325.00 500.00
11/22/2010 375.00 875.00
12/1312010 275.00 1,150.00
12/1312010 275.00 1,425.00
12/14/2010 50.00 1,475.00
12/14/2010 160.00 1,635.00
12/17/2010 1,425.00 210.00
12/20/2010 1,850.00 2,060.00
1/7/2011; 2,300.00 4,360.00
1/7/2011 2,300.00 6,660.00
1/14/2011 0.00 6,660.00
1/21/2011 1,850.00 4,810 00
1/25/2011 1,850.00 6,660.00
2/10/2011 25.00 6,685.00
3/2/2011. 375.00 7,060.00
4/21/2011 925.00 7,985.00
4/21/2011 925.00 8,910.00
4/21/201 j 1,900.00 10,810.00
Page 1 Continued
C 90 Days 120+ Days
ones D.D.S. New York NY 10019
EFTA00597014
MAY-12-2011 09:51A FROM:OR THOMAS HAGMANI TO:16467067223 P.2'2
I I
HISTORICAL STATEMENT
11/22/2010 to 4/30/2011
i mom Magnanl D.D Telephone:
Alvin son D.D.S.
NY 10019
Mr. Jeff stein Date Account
301 E7 th Street 5/1212011
Apt 10
New Y4 NY noes
Date ', [Pr lent DecrIptIon l i Charges Credits Balance
4/21/2011 1,900.00 12,710.00
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Page 2 1 1 I Account Total 12,710.00
1 Patient Charges 15,986.00
Patient Payments 3,275.00-
S Patient Credits 0.00
Patient Debits 0.00
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Cutrent i. 30 Days so Days 90 Days 120+ Days
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Thomas( 41 nani D.D.S. Grayeon D.D S. Now York NY 10019
EFTA00597015
ℹ️ Document Details
SHA-256
a1965720cd3151e30fb6d2c39e49a528554aac784bd18bf07a6d8efef33066f6
Bates Number
EFTA00597014
Dataset
DataSet-9
Document Type
document
Pages
2
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