Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-03-07
- Stop
- 2010-03-07
The parties
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
05f1dbc7-3ebc-37ee-12ae-331b993b8f5e