Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-11-22
- Stop
- 1997-11-22
The parties
- Patient
- patient Kazuko Tamie Tillman
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
3487d097-833b-5fcf-5ff9-4bf215752749