EFTA00313691.pdf

DataSet-9 1 page 58 words document

👁 1 💬 0

📄 Extracted Text (58 words)

VISIT SUMMARY

              Life Steps Ob/Gyn Healthcare For Women.                                 Date
              LLP                                                                  May 23, 2017

                                                                Account ID:
                                                                Chart ID:

                                                                Coverage       Insurance   Policy ID

  lagnosis:

                                                 SERVICES
Date Claim-Line Provider             Units Mod    Description         Charges Payments       Adjusts Balance
5/23/17                                                                305.00                          305.00

5/23/17                                                                    35.00                        35.00

5/23/17                                                                    40.00                        40.00

5/23/17                                                                    25.00                        25.00

523/17                                                                     30.00                        30.00

5/23/17                                                                    25.00                        25.00

923/17                                                                     25.00                       25.00

923/17                                                                     20.00                       20.00

                                                                                             EFTA00313691

ℹ️ Document Details

SHA-256

151ccd510cbb438c143fa2e79416c67aa2746963506b41e7a7097fa34a9152c2

Bates Number

EFTA00313691

Dataset

DataSet-9

Document Type

document

Pages

1

Comments 0

Loading comments…