360 Clinic | Admin Panel

Standing Order

Action	DOS	Appointment ID	Patient	Confirmation No	Visit Type	Email	Phone Number	Gender	Race	Street	Unit	City	State	Zip	Insurance Provider	Insurance Member ID	Insurance Group Number	Relationship to this insured	Identification Number	Identification Type	Social Security Number	Location Name	Date	Time	Kit Number	Update By
Action	DOS	Appointment ID	Patient	Confirmation No	Visit Type	Email	Phone Number	Gender	Race	Street	Unit	City	State	Zip	Insurance Provider	Insurance Member ID	Insurance Group Number	Relationship to this insured	Identification Number	Identification Type	Social Security Number	Location Name	Date	Time	Kit Number	Update By
Reply Move to Review	11-13-2021	FSS-APT00080333	PTID-1-3 Ravi Agrawal 11/29/1982	92D3546	New Patient	[email protected]	9443595860	Male	Asian	104 Rye Grass	03	Irvine	California	92618	00003	00001133	W0123546	Self	12315646	Driver License	333366544	Location 01	11-13-2021	09:00 AM - 10:00 AM	FSS-APT00080333	Ravi

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Appt Date	DOS	Check In Status	Soap Status	Result Status	Follow up Status	Billing Status
Appt Date	DOS	Check In Status	Soap Status	Result Status	Follow up Status	Billing Status
10/22/2020	10/23/2020	Signed Off	Physical Exam	Waiting Notification	Follow Up Needed	Ready to Bill
10/22/2020	10/23/2020	Signed Off	Physical Exam	Waiting Notification	Follow Up Needed	Ready to Bill

Appointment Date	DOS	Collection Date	Payment Type	Amount
Appointment Date	DOS	Collection Date	Payment Type	Amount
Appointment Date	DOS	Collection Date	Payment Type	Amount

PTID	First Name	Last Name	DOB	Phone	Street	City	State	Zip
PTID-1-1	Shakir	Ansari	10/10/1990	9173595860	Street	City	State	Zip

PTID	First Name	Last Name	DOB	Phone	Street	City	State	Zip
PTID	First Name	Last Name	DOB	phone	street	City	State	Zip
PTID-1-1	First Name	Last Name	DOB	Phone	Street	City	State	Zip
PTID-1-2	First Name	Last Name	DOB	Phone	Street	City	State	Zip

PTID	First Name	Last Name	DOB	Phone	Street	City	State	Zip
PTID	First Name	Last Name	DOB	phone	street	City	State	Zip
PTID-1-1	First Name	Last Name	DOB	Phone	Street	City	State	Zip
PTID-1-2	First Name	Last Name	DOB	Phone	Street	City	State	Zip