Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1952-10-19
- Stop
- 1952-10-19
The parties
- Patient
- patient Elvin Benny Christiansen
- Provider
- provider Ursula Nolan
- Payer
- payer No insurance
Record id
1cc1c88b-99ff-9af7-e526-37ff5a7b250e