Claim total
$837.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-07-05
- Stop
- 2017-07-05
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Ruben Farrell
Record id
0291d14d-46f7-a76b-9af3-f6b19291f3ce