Claim total
$844.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-09-12
- Stop
- 1985-09-12
The parties
- Provider
- provider Trent Kozey
- Payer
- payer No insurance
Record id
1f156774-6ac9-1ef9-ea8c-557b85c6a7a2