Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1976-01-04
- Stop
- 1976-01-04
The parties
- Patient
- patient Lorenzo Alberto Upton
- Provider
- provider Shenna Metz
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer No insurance
Record id
0c0591a9-0f49-c13a-959a-06c23f7deeb2