| Date and Time Added | Date Completed | Elapsed | Payer | Patient First | Patient Last | Agency | Login |
|---|---|---|---|---|---|---|---|
| #dateTimeFormat(Record_Creation_Date,"mm/dd/yy HH:nn")# | #dateFormat(F176,"mm/dd/yyyy")# | #diffdays# |
#Pay_Name# | #Pt_Last# | #Pt_First# | #Agency_Name# | #Agency_Login# |