Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-03-16
- Stop
- 2014-03-16
The parties
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
05f1dbc7-3ebc-37ee-6dea-8fd89c883a11