Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-09-12
- Stop
- 1988-09-13
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Shani Carroll
- Payer
- payer No insurance
Record id
02ec371b-21cc-5c35-3628-c3d2fb266ad7