Claim total
$1,494.91
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-03-20
- Stop
- 2000-03-20
The parties
- Patient
- patient Shannon Dietrich
- Provider
- provider Ramiro Boehm
- Payer
- payer No insurance
Record id
38564dd1-5505-1cf8-c16b-079b60e9d64a