Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-04-05
- Stop
- 2026-04-05
The parties
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
05f1dbc7-3ebc-37ee-901b-3ada01d3c6b3