Acme Inc
CBW SMOKE TEST* - IDN - Grp 3
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$733.00
Sue Park

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Recent transaction

$1000.00

Date: 03/13/2023

Account balance

$7,100.00

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122333

Patient: Doe, John

DOB: 10/10/1960

Service Date: 02/14/2023

SSN: ***-**-9999

Responsible: WORK COMP 1ST...

Provider: ALFREDO, DAVID

Location: DOCTOR’S OFFICE

Status

Due now

Original Balance

$757.00

Balance

$757.00

Partner PayOnline | athenahealth@2023 WC Holding LLC.