Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1950-11-14
- Stop
- 1950-11-14
The parties
- Patient
- patient Roy Billie Ankunding
- Provider
- provider Dan Leuschke
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer No insurance
Record id
2cc69e6e-eaec-c9c0-8039-89f59abac84f