Claim total
$505.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1933-06-26
- Stop
- 1933-06-26
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Tanna Macejkovic
- Payer
- payer No insurance
Record id
01a64b50-bd68-5ef7-6c42-4aac8a77503b