Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-09-27
- Stop
- 1991-09-27
The parties
- Patient
- patient Alphonse Ricky Bernhard
- Provider
- provider Rosio Gleason
- Payer
- payer No insurance
Record id
2e3c3108-70f2-7f33-41a8-2b53a62f033f