| Code | Service Name | Receipt # | Bill # | Price | Quantity | Disc. % | Disc. Amount | Tax | Payable | Approved Fee | Patient Share | Insurance Share | Coverage | Service Status | Supervising Provider | Rendering Provider | Actions |
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| Code | Service Name | Receipt # | Bill # | Price | Quantity | Disc. % | Disc. Amount | Tax | Paid | Approved Fee | Patient Share | Insurance Share | Coverage | Refund | Service Status | Supervising Provider | Rendering Provider | Actions |
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