Claim total
$1,115.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-11-16
- Stop
- 2003-11-16
The parties
- Patient
- patient Ulysses Rick Kihn
- Provider
- provider Criselda Bartell
- Payer
- payer No insurance
Record id
22b90427-9632-4f64-8baa-3fc6a4a0a8c9