Claim total
$1,205.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-06-29
- Stop
- 2016-06-29
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Fatimah Schumm
Record id
0291d14d-46f7-a76b-24f3-ab5ffd19ce10