Claim total
$1,177.77
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-10-22
- Stop
- 1983-10-22
The parties
- Provider
- provider Trent Kozey
- Payer
- payer No insurance
Record id
3337be33-817c-c066-1421-74e40e7dacca