Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-12-26
- Stop
- 2000-12-26
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Douglas Will
- Payer
- payer No insurance
Record id
047ee4ec-c50b-b504-9b79-7534d5aa7ad7