| Date | Amount | Method | Reference | Memo | |
|---|---|---|---|---|---|
| 08/11/2026 | $234.80 | Credit Card | - | Balance payment | |
| 07/23/2026 | $30.00 | Credit Card | - | Copay | |
| 07/10/2026 | $20.00 | Credit Card | - | Copay | |
| 07/01/2026 | $50.00 | Credit Card | - | Copay |
| Date | Description | Payer | Charges | Payments | Clinic Adj | Insurance Adj | Write-off | Balance | |
|---|---|---|---|---|---|---|---|---|---|
| Encounter #104182 Partial Payment | |||||||||
| 2026-08-11 |
Patient payment - Credit Card
MANUAL
Balance payment
|
Patient | - | $58.20 | - | - | - | $0.00 | |
| 2026-07-23 | Patient copay - Credit CardCOPAY | Patient | - | $30.00 | - | - | - | $58.20 | |
| 2026-07-23 | Northwind Health payment MANUAL | Northwind Health | - | $76.80 | - | - | - | $88.20 | |
| 2026-07-23 | Northwind Health payment MANUAL | Northwind Health | - | $32.00 | - | - | - | $165.00 | |
| 2026-07-23 | Northwind Health payment MANUAL | Northwind Health | - | $48.00 | - | - | - | $197.00 | |
| 2026-07-23 | 97124 - Massage Therapy | - | $120.00 | - | - | - | - | $245.00 | |
| 2026-07-23 | 98940 - CMT 1-2 regions | - | $50.00 | - | - | - | - | $125.00 | |
| 2026-07-23 | 99213 - Est patient E/M | - | $75.00 | - | - | - | - | $75.00 | |
| Encounter #103828 Partial Payment | |||||||||
| 2026-08-11 |
Patient payment - Credit Card
MANUAL
Balance payment
|
Patient | - | $139.60 | - | - | - | $0.00 | |
| 2026-07-10 | Patient copay - Credit CardCOPAY | Patient | - | $20.00 | - | - | - | $139.60 | |
| 2026-07-10 | Northwind Health payment MANUAL | Northwind Health | - | $51.60 | - | - | - | $159.60 | |
| 2026-07-10 | Northwind Health payment MANUAL | Northwind Health | - | $25.80 | - | - | - | $211.20 | |
| 2026-07-10 | Northwind Health payment MANUAL | Northwind Health | - | $43.00 | - | - | - | $237.00 | |
| 2026-07-10 | 97124 - Massage Therapy | - | $120.00 | - | - | - | - | $280.00 | |
| 2026-07-10 | 98941 - CMT 3-4 regions | - | $60.00 | - | - | - | - | $160.00 | |
| 2026-07-10 | 99214 - Office Visit, Established - Detailed | - | $100.00 | - | - | - | - | $100.00 | |
| Encounter #103575 Partial Payment | |||||||||
| 2026-08-11 |
Patient payment - Credit Card
MANUAL
Balance payment
|
Patient | - | $37.00 | - | - | - | $0.00 | |
| 2026-07-01 | Patient copay - Credit CardCOPAY | Patient | - | $50.00 | - | - | - | $37.00 | |
| 2026-07-01 | Northwind Health payment MANUAL | Northwind Health | - | $8.00 | - | - | - | $87.00 | |
| 2026-07-01 | Northwind Health payment MANUAL | Northwind Health | - | $20.00 | - | - | - | $95.00 | |
| 2026-07-01 | Northwind Health payment MANUAL | Northwind Health | - | $30.00 | - | - | - | $115.00 | |
| 2026-07-01 | 97014 - Electrical stim unattend | - | $20.00 | - | - | - | - | $145.00 | |
| 2026-07-01 | 98940 - CMT 1-2 regions | - | $50.00 | - | - | - | - | $125.00 | |
| 2026-07-01 | 99213 - Est patient E/M | - | $75.00 | - | - | - | - | $75.00 | |
| Encounter #100044 Paid | |||||||||
| 2026-06-03 |
Northwind Health adjustment ERA
insurance payment
|
Northwind Health | - | - | - | $9.18 | - | $0.00 | |
| 2026-06-03 |
Northwind Health adjustment ERA
insurance payment
|
Northwind Health | - | - | - | $10.25 | - | $9.18 | |
| 2026-06-03 |
Northwind Health payment ERA
Check #CHK985596 | Deposit 2026-06-21
|
Northwind Health | - | $30.82 | - | - | - | $19.43 | |
| 2026-06-03 |
Northwind Health payment ERA
Check #CHK985596 | Deposit 2026-06-21
|
Northwind Health | - | $44.75 | - | - | - | $50.25 | |
| 2026-06-03 | 97110 - Therapeutic exercise | - | $40.00 | - | - | - | - | $95.00 | |
| 2026-06-03 | 98941 - CMT 3-4 regions | - | $55.00 | - | - | - | - | $55.00 | |
| TOTALS | $765.00 | $510.77 | $0.00 | $19.43 | $0.00 | $234.80 | |||
billing + ar_activity + ar_session