Claim total
$1,318.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-12-22
- Stop
- 2017-12-22
The parties
- Patient
- patient Nikole Ronald Crona
- Provider
- provider In Reichert
- Payer
- payer No insurance
Record id
0205d624-3e5e-6b66-1284-a74af26327ce