Claim total
$1,534.32
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1971-01-14
- Stop
- 1971-01-14
The parties
- Patient
- patient Dannie Timmy Koepp
- Provider
- provider Kelvin Reichel
- Payer
- payer No insurance
Record id
25f2b1e8-809d-dfd9-e34e-f623f7794136