Claim total
$758.25
base $93.83 · payer covered $758.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-04-11
- Stop
- 1997-04-11
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Kelvin Reichel
Record id
062f00f9-5db0-55c4-fb73-b0c26f15ae9d