Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1958-09-19
- Stop
- 1958-09-19
The parties
- Patient
- patient Francine Ziemann
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
1f94a255-3b6e-f1dc-6d2a-386e7d8f3ae4