Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-10-27
- Stop
- 2001-10-27
The parties
- Patient
- patient Sammie Tristan Metz
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
32e78bc3-8506-a26a-f3b5-02ed6e1a2f38