Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-03-12
- Stop
- 2000-03-12
The parties
- Patient
- patient Shiloh Barbra Aufderhar
- Provider
- provider Jan Nicolas
- Payer
- payer No insurance
Record id
390fed25-ddad-3781-3442-5115e2be561d