Claim total
$1,722.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-01-19
- Stop
- 2003-01-19
The parties
- Patient
- patient Claud Roland Kutch
- Provider
- provider Oliva Greenfelder
- Care site
- care site WELLNESS WAY BLOOMINGTON LLC
- Payer
- payer No insurance
Record id
2807bb3b-10eb-cf70-3164-c9b02a212f59