Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-10-19
- Stop
- 1999-10-19
The parties
- Patient
- patient Walton Klocko
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer No insurance
Record id
26c20147-5b5e-d87e-d3db-22933a621f35