Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-01-09
- Stop
- 1978-01-09
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Sherly Hodkiewicz
- Payer
- payer No insurance
Record id
01a64b50-bd68-5ef7-7e48-e76e97a8e2f8