Specialist Orthodontist
50 Hutt Street
PROVIDER:
Con Laparidis - 0624662L
12B Wattle Terrace
PLYMPTON PARK SA 5038
Statement Date: 02/05/2023
Amount Due: 39.00
| Account Balance | Due This Month | Over 30 Days | Over 60 Days | Over 90 Days |
|---|---|---|---|---|
| 6,539.00 | 39.00 | 0.00 | 0.00 | 0.00 |
Account Activity Since Last Statement
| Date | Patient | Description | Amount | Doctor |
|---|---|---|---|---|
| 01/02/2023 | Kole | Complete course of orthodontic treatment Item 881 - Contract | 8,250.00 | Con Laparidis |
| 01/02/2023 | Kole | Complete course of orthodontic treatment Item 881 - Initial Fee (Contract) | 1,000.00 | Con Laparidis |
| 01/02/2023 | Kole | Cash : deposit (mum) | -500.00 | Con Laparidis |
| 01/02/2023 | Kole | Cash : deposit (dad) | -500.00 | Con Laparidis |
| 01/02/2023 | Kole | Study Models (Scanned) x 2 Item 071 x 2 | 95.00 | Con Laparidis |
| 01/02/2023 | Kole | Photographic Records - Intraoral Item 072 | 25.00 | Con Laparidis |
| 01/02/2023 | Kole | Photographic Records - Extraoral Item 073 | 25.00 | Con Laparidis |
| 23/02/2023 | Kole | Credit Card : | -125.00 | Con Laparidis |
| 01/03/2023 | Kole | Complete course of orthodontic treatment Item 881 - Contract Charge | 250.00 | Con Laparidis |
| 15/03/2023 | Kole | Cash : (Dad) | -250.00 | Con Laparidis |
| 01/04/2023 | Kole | Complete course of orthodontic treatment Item 881 - Contract Charge | 250.00 | Con Laparidis |
| 14/04/2023 | Kole | Credit Card : Item 881 (phone payment - Mum) | -125.00 | Con Laparidis |
| 01/05/2023 | Kole | Complete course of orthodontic treatment Item 881 - Contract Charge | 250.00 | Con Laparidis |
| 02/05/2023 | Kole | Cash : (Dad) | -500.00 | Con Laparidis |
12B Wattle Terrace
PLYMPTON PARK SA 5038
| Patient | Number | Amount Due |
|---|---|---|
| Kole | 184314 | 39.00 |
Statement Date: 02/05/2023
Amount Paid:
Internet Payment: BSB:085458 A/C:829638989
