Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2013-01-28
- Stop
- 2013-01-28
The parties
- Patient
- patient Otha Jewel Ankunding
- Provider
- provider Miles Kuphal
- Care site
- care site WELLNESS CENTERS, PLLC
Record id
01bd7d75-9405-280a-8865-dd3f4a175e15