Claim total
$830.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-30
- Stop
- 2021-09-30
The parties
- Patient
- patient Britany Kerrie West
- Provider
- provider Simon Tremblay
- Payer
- payer No insurance
Record id
02a95708-afbd-de6b-0b0b-4ffdfde20369