Claim total
$1,391.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-08-16
- Stop
- 2001-08-16
The parties
- Provider
- provider Elbert Schaefer
- Payer
- payer No insurance
Record id
0366d403-b006-0b76-dfe5-b150976b0261