Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-01-03
- Stop
- 2002-01-03
The parties
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer No insurance
Record id
06444eb9-3bbb-5546-7abe-92a7046429a8