Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-12-09
- Stop
- 2019-12-09
The parties
- Patient
- patient Ty Cameron Koelpin
- Provider
- provider Brandi Kessler
Record id
23667586-d67c-33d2-910c-eeeed010084a