Claim total
$1,213.45
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-08-05
- Stop
- 2008-08-05
The parties
- Patient
- patient Gordon Hoyt Mraz
- Provider
- provider Kermit Emard
Record id
1bfe9dff-1e82-5076-a92c-75d25b0f714b