Claim total
$1,060.44
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-01-29
- Stop
- 1983-01-29
The parties
- Patient
- patient Milissa Tien Smitham
- Provider
- provider Davis Steuber
- Care site
- care site MECCA MEDICAL CENTER, LLC
- Payer
- payer No insurance
Record id
20b28cd3-f10e-9c06-fed7-d4198e6772c4