Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-11-06
- Stop
- 2020-11-06
The parties
- Patient
- patient Madelaine Leon Ankunding
- Provider
- provider Camille Gusikowski
Record id
1f96ac60-34fa-15d6-6cb4-cb5cb551cad2