Claim total
$758.25
base $93.83 · payer covered $758.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-04-17
- Stop
- 1998-04-17
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Andria Spinka
Record id
062f00f9-5db0-55c4-7a75-615da9f68b03