Claim total
$1,527.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-07-04
- Stop
- 2001-07-04
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Ursula Nolan
- Payer
- payer No insurance
Record id
03d7ab8f-b989-4d49-edb4-ca48bde02a02