Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-06-12
- Stop
- 1994-06-12
The parties
- Patient
- patient Zita Sharita Baumbach
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
15e93d16-025d-6783-713a-f73b008c9042