Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-11-25
- Stop
- 1988-11-25
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Simon Tremblay
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-0118-820f09cd2a7a