Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1960-08-13
- Stop
- 1960-08-13
The parties
- Patient
- patient Jani Yolando Nitzsche
- Provider
- provider Vanda Lebsack
- Care site
- care site MORNINGSIDE FAMILY PHYSICIANS
- Payer
- payer No insurance
Record id
04f07ca4-67b1-b65a-e786-d29955a7ff5a