Claim total
$6,629.02
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-10-29
- Stop
- 1993-10-29
The parties
- Provider
- provider Dustin Ernser
- Care site
- care site WSCHS, INC - AGAPE CLINIC
- Payer
- payer No insurance
Record id
14e6967f-4e43-8710-38a0-3335388356cb