Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-10-26
- Stop
- 1996-10-26
The parties
- Patient
- patient Luigi Jakubowski
- Provider
- provider Robbi Stark
Record id
34909a24-77ed-f1db-0255-bc8ec4e63556