Imaging Center - New York

Patient Accounts

Report Date 4/18/2024

Statement Procedure Insurance Patient Account Past
Account Statement Date Age Amount Payment Responsibility Due
5102 12/29/2023 101 3045 2545 $ 500.00 TRUE
5103 1/10/2024 89 1404 964 $ 440.00 FALSE
5104 1/21/2024 78 2850 2350 $ 500.00 FALSE
5105 2/12/2024 56 1904 1700 $ 204.00 FALSE
5106 2/22/2024 46 4005 3850 $ 155.00 FALSE
5107 3/14/2024 25 3784 3084 $ 700.00 FALSE
5108 4/5/2024 3 2115 2115 $ - FALSE

Total # of Accounts 7
Average Procedure $ 2,729.57
Amount
Patient Responsibility $ 2,499.00

Ishmam Yunus