A prescription management system is used by an orthodontic or dental lab and a plurality of prescribing users who send prescriptions for customized orthodontic or dental appliances to the lab. The prescriptions are stored in a database selectively accessible by the lab and plurality of prescribing users. A digital workspace is provided in the system in which the lab or prescribing users may create designs for the customized appliances. The designs of the appliances are stored in the database. A tracking record of fabrication of the appliances is stored in the database. A plurality of billings are simultaneously generated in response to the submissions and storage of the prescriptions, the designs of the customized appliances and the fabrication of the designed customized appliances.