Claim total
$1,147.63
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-19
- Stop
- 2017-03-19
The parties
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
05f1dbc7-3ebc-37ee-361c-12b0f5b3c2b8