Claim total
$644.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1941-06-15
- Stop
- 1941-06-15
The parties
- Patient
- patient Samuel Tomi Luettgen
- Provider
- provider Mike Monahan
- Care site
- care site THE FAMILY PARTNERSHIP
Record id
2c68c985-bcbe-7914-ae79-0f45b8193cb4