Claim total
$631.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-05-04
- Stop
- 2001-05-04
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Kim Lind
Record id
062f00f9-5db0-55c4-7f67-6f706cbce5d5