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INV-202606-001104

Nell Whitfield

Issued 15 Jun 2026, due 15 Jul 2026

Part paidPatient record
Charges
Charges on invoice INV-202606-001104
ChargeQtyUnitDiscountTaxTotal
New patient consultationConsultation · Consultation1$120.00——$120.00
Ward bed, per dayRoom · Ward A, bed A13$120.00——$360.00
Subtotal
$480.00
Total
$480.00
Paid
-$100.00
Balance due
$380.00
Payments and refunds

Bank transfer payment

TRF 88120

21 Jun 2026, 15:43 · Remy Castellanos

$100.00
Insurance
Cedar MutualRejected

CDM-9902-1140 · claim CLM-87411

Claimed $384.00 · approved $0.00

Inpatient stay not covered under this policy.

Submitted 17 Jun 2026, 15:43 · decided 23 Jun 2026, 15:43

Notes

Patient asked to pay the balance in instalments.