Claim total
$1,527.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-04-14
- Stop
- 1967-04-14
The parties
- Patient
- patient Daniel Carlos Acosta
- Provider
- provider Ramiro Boehm
- Payer
- payer No insurance
Record id
1bc96a10-ad49-d71d-7eae-4d44f0f73fe9