Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1959-05-18
- Stop
- 1959-05-18
The parties
- Patient
- patient Max Don Farrell
- Provider
- provider Ramiro Boehm
- Payer
- payer No insurance
Record id
255c6642-35d4-c675-c588-8f2bad06fc21