Claim total
$838.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-07-03
- Stop
- 2025-07-03
The parties
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
06014704-4726-adb5-3b36-93dafab15dd5