Patient confirmed Payments
    text
    Claim Details
    Claim Number     File No.     Claim Status     Accident Date  
    First Name(s)     Surname  
    ID Number     Employer  
    Invoices
    Invoice No Invoice Date Item Sub Total VAT Total Amount Allowed Discount Fee Amount Received PracticeInvoiceID PaymentID ModifiedDate
      Total Received
    Payment Details
    Bank reference Date Received Received (Excl) Received (Incl) Discount Write Off Comment