Claim total
$789.62
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1968-08-22
- Stop
- 1968-08-22
The parties
- Patient
- patient Princess Felisha Kub
- Provider
- provider Rodrick Moen
- Payer
- payer No insurance
Record id
2918896c-6cc7-6a93-38de-486e5f54e1d2