General examination of patient

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patient Madelaine Leon Ankunding
General examination of patient

Claim total

$1,110.97

base $93.83 · payer covered $0.00

The visit

Class: Wellness
Code: 162673000
Reason: —
Start: 2022-11-18
Stop: 2022-11-18

The parties

Patient: patient Madelaine Leon Ankunding
Provider: provider China Kshlerin
Care site: care site NEW BEGINNINGS EMOTIONAL WELLNESS & HOLISTIC THERAPIES
Payer: payer Blue Cross Blue Shield

Record id 1f96ac60-34fa-15d6-9017-b7a5d740325c