EFTA00313698.pdf
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📄 Extracted Text (65 words)
VISIT SUMMARY
Life Steps OblGyn Healthcare For Women. Date
LLP May 23, 2017
Account ID:
Chart ID:
Coverage Insurance Policy ID
agnosis:
SERVICES
Date Claim-lineProvider Units Mod Description Charges Payments Adjusts Balance
5/23/17 1 305.00 305.00
5/23/17 I 35.00 35.00
923/17 1 40.00 40.00
5/23/17 I 25.00 25.00
523/17 i 30.00 30.00
923/17 I 25.00 25.00
5123/17 I 25.00 25.00
5/23/17 1 20.00 20.00
EFTA00313698
ℹ️ Document Details
SHA-256
1ddda3ff461b5d9ac65ce117eea136f2c40ad3594945b3692e5355c920906d40
Bates Number
EFTA00313698
Dataset
DataSet-9
Type
document
Pages
1
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