Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1972-01-10
- Stop
- 1972-01-10
The parties
- Patient
- patient Glennis Juliana Borer
- Provider
- provider Jared Berge
- Payer
- payer No insurance
Record id
2886847e-da4b-74ed-67ec-58ab7975536b