Summary Table

Categories Total Count
PII 0
URL 0
DNS 0
EKL 0
IP 0
PORT 0
VsID 0
CF 0
AI 0
VPD 0
PL 0
Other 0

File Content

{beginDateOfService: "01/08/18"
charge: "59.46"
dateOfService: "01/08/18" // extra
dxDtPointers: "1, 2, 3, 4" // extra
endDateOfService: ""
facilityTax: ""
lineNumber: "2"
listOfDrugLines: []
listOfEquipment: null // extra
listOfProviderInfo: []
listOfTeeth: null // extra
modifiers: ""
ndcCode: "XX" // extra
operatorPhysicianName: null
operatorPhysicianNpi: null
pos: null // extra
primaryOhiServiceLineAdjustments: [] // extra
primaryPayerPaidAmount: "99.00" // extra
procedureCode: "97802"
quantity: "1"
quantityOrType: "1 UN" // extra
revCode: "0942"
salesTax: "" // extra
secondaryOhiServiceLineAdjustments: null // extra
secondaryPayerPaidAmount: "" // extra
serviceLineLevelAmbulanceInfo: null // extra
serviceLineLevelAmbulanceInfoShouldRender: false // extra
serviceTax: ""
type: "UN"
}