Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1962-09-06
- Stop
- 1962-09-06
The parties
- Patient
- patient Mireya Bode
- Provider
- provider Douglas Will
- Payer
- payer No insurance
Record id
04f53306-ad14-544b-fe91-d432469e7b7a