Claim total
$229.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-01-10
- Stop
- 2024-01-10
The parties
- Patient
- patient Johnathon Enrique Herzog
- Provider
- provider Amparo Pouros
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer No insurance
Record id
01f4bd01-9c32-7236-598e-67d88cf2e7b2