Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-06-28
- Stop
- 1985-06-28
The parties
- Patient
- patient Josh Monahan
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
03f57d95-a536-8def-7c40-982f35943971