Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-02-17
- Stop
- 1984-02-17
The parties
- Patient
- patient Harold Grant
- Provider
- provider Kelvin Reichel
- Payer
- payer No insurance
Record id
14e15864-fa5b-18f5-9cc0-8c937df64224