Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-03-19
- Stop
- 1987-03-19
The parties
- Patient
- patient Shon Treutel
- Provider
- provider Dan Leuschke
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer No insurance
Record id
22038bd6-13c2-0b0a-6f30-cf324f25b4ea