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Date of visit
Total [Payments]: 7,700
3169 Date of visit06/08/2025 C/C & Rx plans Treatments37-Do with equia Forte filling Prescription Payment1,200.00 Balance Follow up date Lab
3155 Date of visit30/07/2025 C/C & Rx plans Treatments36 class 2 composite filling Prescription Payment1,300.00 Balance Follow up date Lab
3144 Date of visit24/07/2025 C/C & Rx plans Treatments16 , 46-MO Class 2 composite filling Prescription Payment2,600.00 Balance Follow up date Lab
3086 Date of visit07/07/2025 C/C & Rx plans Treatments25-MO class 2 composite filling Prescription Payment1,300.00 Balance Follow up date Lab
3085 Date of visit02/07/2025 C/C & Rx plans Treatments47- direct pulp capping with theracal equia forte MOD Class 2 filling Prescription Payment1,300.00 Balance Follow up date Lab
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      Import log entries for this record.

      CSV file must be formatted with comma as separator, double quote as enclosure, and UTF-8 encoded. Entries with an id that matches an existing entry will overwrite that entry. Entries with no id or with an id that does not match an existing entry will be added as a new entry.

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