Quarterly Supplemental Invoice

This is a "Quarterly Supplemental Invoice" created for a newly-enrolled member and is based on "effective" date.
invoice 7 page 001
1  -  Statement number ending in "QS" indicates this is a "Quarterly Supplemental Invoice"
2  -  This is the newly enrolled member.
3  -  This is the total amount due for this newly enrolled listed member "John Smith".