Claim total
$986.90
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-06-07
- Stop
- 1998-06-08
The parties
- Patient
- patient Mike Brendon Hackett
- Provider
- provider Ursula Nolan
- Payer
- payer No insurance
Record id
048bde62-95d9-bb18-88d6-c47800d96ac2