Billing Version 0.0089897

Patient Billing History

11/11/2018   11:22:10 AM
Claim
Date
Location
Provider
Insurance Name
Payer Group
Format
Run
Number
Charges
Ins Pay
Pat Pay
Ins Adj
Pat Adj
Balance
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
09/12/2014 Century City Office Stephen Paulseth Aetna CLEARING HOUSE CAPARIO ELECTRONIC 5010 1556412 $55.00 $0.00 $0.00 $0.00 $0.00 $0.00
Total $330.00 $0.00 $0.00 $0.00 $0.00 $0.00