Carrot scenario details

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Invoice for treatment of clients from Banana and Chocolate claim scenarios

Patient 1
Patient:                                                         Barry Banana
DOB:                                                             (03/06/1950)

Claim:                                                           QQ00018
Accident Date:                                            20/11/2017

Invoice Line Details
Service Code:                                              GP1 (Or whichever code your provider type uses)
Contract ID:                                                 80 (or whichever contract ID your provider type uses)
Service Date:                                               Today's date
Billing Method:                                           Units
Units Claimed:                                            2
Invoice Amount:                                        63.06
Invoice Comment:                                     Test invoice for Carrot scenario - Client 1
Purchase Order number:                         1234567

Patient 2
Patient:                                                       Chip Chocolate
DOB:                                                           (01/01/1985)

Claim:                                                          ZA00504
Accident Date:                                           30/09/2017

Invoice Line Details
Service Code:                                            GP1 (Or whichever code your provider type uses)
Contract ID:                                               80 (or whichever contract ID your provider type uses)
Service Date:                                             Today's date
Billing Method:                                         Units
Units Claimed:                                          1
Invoice Amount:                                       31.53 (or the amount for the service you have chosen)
Invoice Comment:                                   Test invoice for Carrot scenario - Client 2
Purchase Order number:                       0000111

Provider:                                                   Your Test Provider ID/Profile
Vendor:                                                     Your Test Vendor ID/Profile
Declaration Date:                                    Today's date