Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-08-20
- Stop
- 1988-08-20
The parties
- Patient
- patient Winford Hector Johnston
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
20f1c08f-f88f-5656-18d8-b568d2c44794