Claim total
$1,170.89
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1953-06-03
- Stop
- 1953-06-03
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Wesley Nader
- Payer
- payer No insurance
Record id
03d8f92f-53db-d7af-a944-2f82acf19a38