Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2009-03-01
- Stop
- 2009-03-01
The parties
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
05f1dbc7-3ebc-37ee-bb0e-c798a226f297