Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-12-10
- Stop
- 1989-12-10
The parties
- Patient
- patient Kassie Freeda Mann
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer No insurance
Record id
20e03f0e-0182-78e0-c734-28e6f70be176