Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-01-22
- Stop
- 2003-01-22
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Remona Sanford
- Payer
- payer No insurance
Record id
0190d3b1-c50c-bf7b-6b81-ca8e7e73024f