Select Payer |
|
Eval Cost |
|
Visit Costs |
|
Total # Visits |
# |
Total Charge for All Visits |
|
Co-pay/Visit
|
$%
|
Total Patient Co-pay |
|
Balance Remaining After Co-Pay |
|
Deductible Remaining |
$ |
Patient Deductible Responsibility |
|
Patient Net Cost for Services |
$ |
Net Cost per Visit |
$ |
|
Reimbursement rates are variable and dictated by your insurer's benefit plan.->
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