Claim total
$1,602.75
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-11-24
- Stop
- 1996-11-24
The parties
- Patient
- patient Jonell Mirella Kerluke
- Provider
- provider Concepcion Reichert
- Care site
- care site DAKOTA CHILD AND FAMILY CLINIC
- Payer
- payer No insurance
Record id
084f0d96-54a9-8cd2-aeb1-494f02d181f6