Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-04-22
- Stop
- 1973-04-22
The parties
- Patient
- patient Samuel Tomi Luettgen
- Provider
- provider Tyson Kautzer
- Care site
- care site THE FAMILY PARTNERSHIP
Record id
2c68c985-bcbe-7914-2c1b-673dce87cfd2