Claim total
$1,595.44
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-01-28
- Stop
- 1984-01-28
The parties
- Patient
- patient Dane Randolph Lynch
- Provider
- provider Rodrick Moen
- Payer
- payer No insurance
Record id
1632b7b9-383c-c840-354f-009ec38a49af