FM:Ability_Statements

AmountDue1_1	AmountPaid1_1	CPTCharges1_1	CPTCode1_1	CPTDescription1_1	Date 1(1)	Number	PatientAddressLine1
0	71	71	99213	Return Visit	04/28/1998	679	PO BOX 22
121.63	10	131.63	99203	Office Visit	03/03/2000	764	168 BRIAR BRAE RD
216.85	28.96	245.81	99243	Office Consult	01/29/2002	823	23 BAYWATER DR
0	67	67	99202	Office Visit	02/16/1994	1071	83 SAINT GEORGE AVE
0	88	88	99203	Office Visit	02/17/1994	1091	18 CONNECTICUT AVE
0	67	67	99202	Office Visit	03/17/1994	1265	8 OAKSHADE AVE
0	109	109	17200	ED&C-skin tags	03/17/1994	1268	297 SYLVAN KNOLL RD
0	99	99	17000	Destruction, skin	03/25/1994	1311	14 FOX HILL LN
37	30	67	17100	Destruction, skin	03/31/1994	1357	2475 SUMMER ST APT 1A
0	76	76	10060	I & D Cyst	04/04/1994	1377	107 OLD CHURCH LN
0	58	58			04/04/1994	1380	15 MILES RD
45.72	50	95.72	99212	Return Visit	04/06/1994	1411	34 HEATHER DR
0	35	35	99211		04/13/1994	1467	126 CENTER ST
-55.14	97.32	42.18	17000	Destruction, skin	04/18/1994	1496	PO BOX 186
0	67	67	17100	Destruction, skin	05/12/1994	1698	24 WEED AVE
0	50	50	99212	Return Visit	05/31/1994	1817	511 SHIPPAN AVE APT 5J
0	67	67	17100	Destruction, skin	06/02/1994	1851	31 OUTLOOK DR
-46	113	67	17100	Destruction, skin	06/02/1994	1852	31 OUTLOOK DR
0	67	67	99202	Office Visit	06/09/1994	1884	551 Post Rd
0	67	67	99202	Office Visit	06/10/1994	1890	PO BOX 4235
-90.23	132.41	42.18	17000	Destruction, skin	06/23/1994	2018	16 DOVERTON DR
-11.53	50.87	39.34	17100	Destruction, skin	06/25/1994	24981	25 3RD ST APT 307
0	67	67	17100	Destruction, skin	07/15/1994	2157	192 WEED ST
10.53	31.65	42.18	17000	Destruction, skin	07/18/1994	21183	1500 HUDSON ST APT 11M
-27.54	69.72	42.18	17000	Destruction, skin	07/25/1994	2231	13 BROOKSIDE DR
17.6	70.4	88	99203	Office Visit	07/28/1994	2266	53 PROSPECT ST APT 111
0	79	79	11900	1-7 Injections	07/30/1994	2277	60 SEASIDE AVE # 3
0	67	67	99202	Office Visit	08/04/1994	2312	3 OAKWOOD AVE APT B5
0	67	67	99202	Office Visit	08/10/1994	2326	185 OLD COACH LN
0	67	67	11901	8 or more	08/24/1994	2408	189 BERRIAN RD
0	67	67	99202	Office Visit	08/31/1994	2482	2 GIDEON LN
0	167	167	99214	Return Visit	09/02/1994	2497	90 FLORAL ST
8.44	33.74	42.18	17000	Destruction, skin	09/02/1994	26502	43 SOUND BEACH AVE
-26.45	68.63	42.18	17000	Destruction, skin	09/09/1994	2540	12 SEVEN OAKS LN
0	67	67	17100	Destruction, skin	09/10/1994	2550	60 RAYMOND ST
108.65	34.59	143.24	17280	Mlg Dest <.6 cm	02/27/1995	3387	166 RIDGE ACRES RD
-37	111	74	17000	Destruction, skin	09/21/1994	2613	PO BOX 102
-76	159	83	11100	BIOPSY	03/14/1994	1249	13 ORCHARD HILL RD
64.17	4.82	68.99	99203	Office Visit	05/12/1995	3743	521 SHIPPAN AVE APT 402
-102	169	67	17100	Destruction, skin	08/23/1995	4246	91 Turn Of River Road
-220.02	372.5	152.48	99203	Office Visit	02/24/2006	394	11 Saxton Court
145.12		145.12	99203	Office Visit	04/19/2004	458	65 SALEM STRAITS
0	67	67	17100	Destruction, skin	06/19/1995	743	28 Miller Road
0	74	74	17000	Destruction, skin	02/05/1994	766	982 HOPE ST APT 3A
1.95	202.37	204.32	17281	Mlg Dest .6-1 cm	06/06/1994	1865	444 BEDFORD ST APT 2B
0	19.5	19.5	99213	Return Visit	07/06/1994	2095	12 HILLSIDE PL
0	67	67	17100	Destruction, skin	03/09/1994	1229	111 TOWNE ST APT 119
0	58	58	99213	Return Visit	05/13/1994	17002	96 Lewelyn Rd
12.74	50.94	63.68	99203	Office Visit	12/14/1994	3036	124 GOODWIVES RIVER RD
46.09	184.37	230.46	11603	Mlg Exc 2-3 cm	07/13/1995	1249	16 BERMUDA RD

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