Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-11-25
- Stop
- 1983-11-25
The parties
- Patient
- patient Corrina Joyce Shanahan
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
21b692df-92b8-fcf1-b05e-72206c451561