Claim total
$1,722.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-03-24
- Stop
- 2003-03-24
The parties
- Patient
- patient Stormy Sarah Labadie
- Provider
- provider Tanna Macejkovic
- Payer
- payer No insurance
Record id
264e53b0-38e2-c118-9263-5ecddea6e6f8