Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1991-02-21
- Stop
- 1991-02-21
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
007bcc47-8ca5-7eab-01e9-eff0f6c87f87