Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-08
- Stop
- 2014-02-08
The parties
- Patient
- patient Berry Aaron Deckow
- Provider
- provider Simon Tremblay
- Payer
- payer No insurance
Record id
03959b6c-660d-eecd-94f7-1a370b86d7fc