Claim total
$636.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1940-10-18
- Stop
- 1940-10-18
The parties
- Patient
- patient Geoffrey Kilback
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
27d28cce-29f9-127f-f52a-ff82dadd49b0