Claim total
$976.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-09-26
- Stop
- 2014-09-26
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Lowell Blick
- Payer
- payer No insurance
Record id
04384da7-7311-e99a-62c6-f94087446c99