Transaction Detail
Charge ID | Date of Service | CPT Code | Units | Charges | Balance | Paid By Insurance | Allowed | Payment | Adjustment | Transfer | Transfer to Payer | Adjustment Qualifier | Adjustment Code | Transaction Code |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1985745457 | 07/01/2019 | 97140 | 1 | $0.01 | $12.99 |
|
|
|
|
$0.00 |
|
|
|
|
1985745457 | 07/01/2019 | 97140 | 1 | $1500.00 | $200.00 |
|
|
|
|
$0.00 |
|
|
|
|
Total | $1500.01 | $212.99 | $0.00 | $0.00 | $0.00 | $0.00 |