Case Number: 99TR00717
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Name: MEDICINE, WENDY JO (S)
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HORSE MOUSE 18 + 45 = 63
| Receipt Number | Receipt Date | Payor Name | Description | Total Amount |
|---|---|---|---|---|
| 98838 | 01/08/2001 | MEDICINE, WENDY JO (S) | FINE AMOUNT | 63.00 |
| 98840 | 01/08/2001 | MEDICINE, WENDY JO (S) | DRIVER'S LICENSE | 50.00 |
| 98842 | 01/08/2001 | MEDICINE, WENDY JO (S) | FAX FEE | 2.00 |
| Receipt Number | Transaction Date | Description | Amount Due | Amount Received |
|---|---|---|---|---|
| 98838 | 01/08/2001 | PAYOR-> MEDICINE, WE | 63.00 | 63.00 |
| 98839 | 01/08/2001 | D L REINSTATEMENT | 50.00 | 0.00 |
| 98840 | 01/08/2001 | PAYOR-> MEDICINE, WE | 0.00 | 50.00 |
| 98841 | 01/08/2001 | FAX REIMBURSEMENT | 2.00 | 0.00 |
| 98842 | 01/08/2001 | PAYOR-> MEDICINE, WE | 0.00 | 2.00 |