Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-04-24
- Stop
- 1981-04-24
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Andria Spinka
Record id
062f00f9-5db0-55c4-f2e3-1ffff9d77e4a