Claim total
$1,599.73
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-12-28
- Stop
- 2018-12-28
The parties
- Patient
- patient Nikole Ronald Crona
- Provider
- provider In Reichert
- Payer
- payer No insurance
Record id
0205d624-3e5e-6b66-ccbd-f837d0379621