Fair Haven community health center, Diabetes Prevention Program OGTT Billing Spreadsheet Sample Batch # insulin# 6 6 2 3 Date 10 / 10 / 14. Last Name First Name Doe Doek Jane John Ins InsBill Visit Coupon $145.00 $20.00 InsPay $0.00 $68.
Fair Haven community health center, Diabetes Prevention Program OGTT Billing Spreadsheet Sample Batch # insulin# 6 6 2 3 Date 10 / 10 / 14. Last Name First Name Doe Doek Jane John Ins InsBill Visit Coupon $145.00 $20.00 InsPay $0.00 $68.
Fair Haven community health center, Diabetes Prevention Program OGTT Billing Spreadsheet Sample Batch # insulin# 6 6 2 3 Date 10 / 10 / 14. Last Name First Name Doe Doek Jane John Ins InsBill Visit Coupon $145.00 $20.00 InsPay $0.00 $68.
Fair Haven Community Health Center, Diabetes Prevention Program Updated 29Nov10
OGTT Billing Spreadsheet Sample
Batch # Insulin# Date DPP # Chart Last Name First Name Ins InsBill Visit Coupon InsPay Age PCP Sex Race Ethnicity 6 2 10/10/14 5 445-78-01 Doe Jane None $0.00 $145.00 $0.00 40 Dr. Clark F Hispanic Guatemalan 6 3 10/10/14 6 523-99-04 Doek John AnthemBC $130.00 $20.00 $68.91 33 Mary Faste M Hispanic Mexican