Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1971-04-14
- Stop
- 1971-04-14
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Fatimah Schumm
- Payer
- payer No insurance
Record id
0291d14d-46f7-a76b-328a-05b640ea516c