Transaction Detail
| Charge ID | Date of Service | CPT Code | Charges | Balance | Paid By Insurance | Allowed | Adjustment | Transfer | Transfer to Payer | Adjustment Qualifier | Adjustment Code | Billing Provider | Transaction Code |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1985745457 | 07/01/2019 | 97140 | $0.01 | $12.99 |
|
|
|
$0.00 |
|
|
|
Dan Brown
|
|
| 1985745457 | 07/01/2019 | 97140 | $1500.00 | $200.00 |
|
|
|
$0.00 |
|
|
|
James Miller
|
|
| Total | $1500.01 | $212.99 | $0.00 | $0.00 | $0.00 |