Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-06-21
- Stop
- 2001-06-21
The parties
- Patient
- patient Sang Raymundo Wolff
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
0c6ad717-8d19-38b7-30d0-9b7eee3b0098