Claim total
$4,784.59
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-03-29
- Stop
- 2012-03-29
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer No insurance
Record id
01e64c71-bb1e-2212-aea1-d608d521e9f9