Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-10-03
- Stop
- 1989-10-03
The parties
- Patient
- patient Sarah Rosalinda Price
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
38553ed2-1e87-6b5c-993a-90a1164e148e