Claim total
$1,185.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-01-20
- Stop
- 1994-01-20
The parties
- Patient
- patient Harland Schroeder
- Provider
- provider Magen Mertz
- Payer
- payer No insurance
Record id
0b4e32a4-f92e-1b22-1d84-c5f38da245a1