Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-12-22
- Stop
- 1967-12-22
The parties
- Patient
- patient Orval Lesley Hilll
- Provider
- provider Kermit Emard
- Payer
- payer No insurance
Record id
398caf93-d142-e99a-9ac0-4a5ee53b6e0f