Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-08-11
- Stop
- 1980-08-11
The parties
- Patient
- patient Brooks Beer
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
1ebdf982-da2d-7123-92fa-83e7063b56c0