Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-08-25
- Stop
- 2003-08-25
The parties
- Patient
- patient Timoteo Cristian Barreto
- Provider
- provider Clair White
- Care site
- care site DUE NORTH WELLNESS CENTER PLLC
- Payer
- payer No insurance
Record id
26456d5f-6355-f346-f9de-561610c295cf