Claim total
$1,616.91
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-02-15
- Stop
- 1998-02-15
The parties
- Provider
- provider Tangela Koelpin
- Payer
- payer No insurance
Record id
0743cfb3-f6a5-0a94-b0aa-45e39c0d12c4