Claim total
$1,290.96
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-08-15
- Stop
- 2007-08-15
The parties
- Patient
- patient Yong Zulauf
- Provider
- provider Kenneth Mayert
- Payer
- payer No insurance
Record id
27181dd6-98fe-9cef-2420-5549eb13aff3