Claim total
$855.58
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-04-13
- Stop
- 2000-04-13
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Julene Lemke
- Payer
- payer No insurance
Record id
007bcc47-8ca5-7eab-9ea9-361157acad25