Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-04-23
- Stop
- 1992-04-24
The parties
- Patient
- patient Emery Herbert Steuber
- Provider
- provider Kathern Krajcik
- Care site
- care site FAMILY LINK SOCIAL SERVICES
- Payer
- payer No insurance
Record id
003012ce-f819-e17b-d998-1dc4049328c5