Case File
efta-efta00313699DOJ Data Set 9OtherVISIT SUMMARY
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00313699
Pages
1
Persons
0
Integrity
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VISIT SUMMARY
Life Steps OblGyn Healthcare For Women.
LLP
Date
May 23, 2017
Account ID
Chan ID:
Coverage
Insurance Policy ID
SERVICES
Date Claim-Line Provider
X Ref CPT
Units Mod
Description
Charges
Adjusts Balance
Patient Balance :
505.00
RECEIPT
Thank You I
U.
NEXT VISIT
on
Time
Duration
Pro.**
Location
EFTA00313699
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