Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-10-10
- Stop
- 1992-10-10
The parties
- Patient
- patient Berry Aaron Deckow
- Provider
- provider Simon Tremblay
- Payer
- payer No insurance
Record id
03959b6c-660d-eecd-479d-7d02c9f6e82b