Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1966-11-07
- Stop
- 1966-11-07
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Tanna Macejkovic
- Payer
- payer No insurance
Record id
01a64b50-bd68-5ef7-e817-e0c8d3d08c2f