Claim total
$921.31
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2005-12-14
- Stop
- 2005-12-14
The parties
- Patient
- patient Connie Abraham O'Hara
- Provider
- provider Rodrick Willms
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer No insurance
Record id
103e76c4-4cb3-237c-f908-b4c2bad03f06