Claim total
$1,143.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-13
- Stop
- 2018-03-13
The parties
- Patient
- patient Ivory White
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
1229d65c-3256-9004-3888-71080e822664