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efta-efta00313691DOJ Data Set 9Other

VISIT SUMMARY

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Unknown
Source
DOJ Data Set 9
Reference
efta-efta00313691
Pages
1
Persons
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Text extracted via OCR from the original document. May contain errors from the scanning process.
VISIT SUMMARY lagnosis: Life Steps Ob/Gyn Healthcare For Women. LLP Date May 23, 2017 Account ID: Chart ID: Coverage Insurance Policy ID 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

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