Claim total
$1,438.32
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-11-18
- Stop
- 1989-11-18
The parties
- Patient
- patient Rudy Fausto Prohaska
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
25c375cb-0200-f47a-8c7c-5727e0b3e08e