Claim total
$1,258.88
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1971-11-03
- Stop
- 1971-11-03
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Criselda Bartell
- Payer
- payer No insurance
Record id
0054427e-44d7-94b2-2792-fffe4baf4c68