Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-12-25
- Stop
- 1975-12-25
The parties
- Patient
- patient Lon Jenkins
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
21be898a-3bf9-dfe6-23bd-81a90511e448