Claim total
$894.25
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-03-31
- Stop
- 1995-03-31
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Andria Spinka
Record id
062f00f9-5db0-55c4-5d13-c14c874978cb