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Patient
DOS—
•
DOB05/28/1963
•
ProviderDr. Chen • NPI 1234567890
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Age
NaN days
Follow-Up
Not set
Touched
999 days ago
Checked
today

Summary

PAID

Fully paid. This claim to Unknown has been resolved with no outstanding balance. Total paid: $0.00.

Insurance & Patient Summary

Charged$0.00
Balance$0.00
Payer
Eligibility
Charged
Paid
Owed
Actions
Primary
Unknown
Not checked
—
$0.00
$0.00
Patient
—
—
—
$0.00
Total
$0.00
$0.00
$0.00

Claim Timeline

1 events
Show
Type
—
SubmissionInitial Submission
Details

ToPrimary

Patient Claim and Financial History

1 claims
Billed
$0.00
Collected
$0.00
Balance
$0.00
DateDetailsDXChargesPaidAdjIns BalPt Bal
—
CurrentPending
—
$0.00
$0.00
$0.00
$0.00
$0.00
DOSDetailsDXChargesPaidAdjIns BalPt Bal

Documents & Evidence

5
Submissions
EOBs
ERAs

No ERAs received

Other
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