Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-11-22
- Stop
- 2004-11-22
The parties
- Patient
- patient Tony Evan Lind
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer No insurance
Record id
1ccbdc6a-138a-c811-1c74-0657b78c62a2