Claim total
$1,787.44
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-07-20
- Stop
- 2001-07-20
The parties
- Patient
- patient Sheldon Milan Koch
- Provider
- provider Randee Sawayn
- Payer
- payer No insurance
Record id
28fc4489-6f3e-4157-bcda-3b2c0907e883