Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-09-25
- Stop
- 2008-09-25
The parties
- Provider
- provider Ursula Nolan
- Payer
- payer No insurance
Record id
0366d403-b006-0b76-df07-d810de5c2a33