Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-07-28
- Stop
- 2009-07-28
The parties
- Patient
- patient Harlan Luigi Bosco
- Provider
- provider In Reichert
- Payer
- payer No insurance
Record id
00d351d5-8ef1-f44d-e71c-1f857a8f142e