Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1980-08-02
- Stop
- 1980-08-02
The parties
- Patient
- patient Stewart Dean Pouros
- Provider
- provider Eva Weissnat
- Payer
- payer No insurance
Record id
1135afcc-5534-4bcf-9c43-ed85b5682070