Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-11-08
- Stop
- 1994-11-08
The parties
- Patient
- patient Korey Lester Williamson
- Provider
- provider Brenda Moore
- Payer
- payer No insurance
Record id
02695016-2813-6239-a0ed-29d6578463b8