Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1974-07-01
- Stop
- 1974-07-01
The parties
- Patient
- patient Raymundo Bradley Monahan
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer No insurance
Record id
2387da0b-9a14-9a7e-107e-54e2e254a4d5