Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1977-07-17
- Stop
- 1977-07-17
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Shani Carroll
- Payer
- payer No insurance
Record id
048ae427-86b6-6ce9-e56e-e7f5064090c2