Claim total
$911.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-14
- Stop
- 2018-01-14
The parties
- Patient
- patient Zella Astrid Lehner
- Provider
- provider Long Konopelski
- Care site
- care site SAMA HEALTH CARE
Record id
105f6429-e0e9-3b7c-4793-84396ea5e7dd