Claim total
$989.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1970-02-01
- Stop
- 1970-02-01
The parties
- Patient
- patient Johnie Otis Swaniawski
- Provider
- provider Hazel Effertz
Record id
20266be5-d73a-d9b0-2705-143f93f466e6