Claim total
$1,106.25
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1968-04-08
- Stop
- 1968-04-08
The parties
- Patient
- patient Erwin Eli Hackett
- Provider
- provider Dan Leuschke
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer No insurance
Record id
24f27ab5-b47f-0e8d-5325-764ded5ca96a