Claim total
$1,189.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-06-10
- Stop
- 2001-06-11
The parties
- Patient
- patient Mike Brendon Hackett
- Provider
- provider Elbert Schaefer
- Payer
- payer No insurance
Record id
048bde62-95d9-bb18-3a86-bed6c956faac