Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1972-04-14
- Stop
- 1972-04-14
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Ramiro Boehm
Record id
062f00f9-5db0-55c4-daa4-c9379190174d