Claim total
$1,046.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-03-19
- Stop
- 2019-03-19
The parties
- Patient
- patient Ivory White
- Provider
- provider Abram Ullrich
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
Record id
1229d65c-3256-9004-f0bc-ac2e7468d9e2