Billing Version 0.0089897

Claim Indicator

CAPARIO

Charges

Charge ID Date of Service CPT Code Charge Amount Balance Last Billed Claim # Action Late Reason Condition Code Note Rebill
1985745457 07/01/2019 97001 $122.00 $122.00
1985745457 07/01/2019 97140 $20.00 $20.00
Total $142.00 $142.00