Documents containing: 06/08/15
Found 9 document(s) with this date
EFTA00311404.pdf
...COUNT
ACTIVITY
Page I of I
06/08/15
Date
Patient
Dr
Claim
Wi...
EFTA00311404.pdf
...ount
Patient Responsibility
06/08/15
01
Limited Oral Evaluation ...
EFTA00311404.pdf
...l Evaluation
175.00
175.00
06/08/15
01
Panoramic Film
175.00
...
EFTA00311404.pdf
...noramic Film
175.00
175.00
06/08/15
01
I
Surgical Removal Comp...
EFTA00311404.pdf
...ony w Compli
700.00
700.00
06/08/15
01
16 Surgical Removal Comp...
EFTA00311404.pdf
...ony w Compli
700.00
700.00
06/08/15
01
32 Surgical Removal Comp...
EFTA00311404.pdf
...ony w Compli
700.00
700.00
06/08/15
lit
GENERAL. ANESTHESIA, 1S...
EFTA00311404.pdf
..., 1ST 30 MIN
575.00
575.00
06/08/15
0I
GENERAL ANESTHESIA. ADDL...
EFTA00311404.pdf
... ADDL 15 MIN
175.00
175.00
06/08/15
01
GENERAL ANESTHESIA. ADDL...