Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1960-02-18
- Stop
- 1960-02-18
The parties
- Patient
- patient Luis Block
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
081ceedd-df07-7c20-2b3a-b7f9360d889d