Claim total
$830.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-04-16
- Stop
- 2003-04-16
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Sherwood Nicolas
- Payer
- payer No insurance
Record id
0291d14d-46f7-a76b-d982-eed832bf6d53