Claim total
$910.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1982-06-15
- Stop
- 1982-06-15
The parties
- Patient
- patient Tereasa Quigley
- Provider
- provider Jayme Rempel
- Care site
- care site LIFE LINE COMMUNITY HEALTHCARE
- Payer
- payer No insurance
Record id
1fa9953f-bec7-471e-da65-38ffc76255a8