Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-07-12
- Stop
- 1988-07-12
The parties
- Patient
- patient Felton Zachary Hyatt
- Provider
- provider Florentino Boehm
- Payer
- payer No insurance
Record id
26abe078-4f7c-6455-6a86-16498df33f00