Claim total
$700.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1940-10-24
- Stop
- 1940-10-24
The parties
- Patient
- patient Princess Felisha Kub
- Provider
- provider Rodrick Moen
- Payer
- payer No insurance
Record id
2918896c-6cc7-6a93-357a-2aa332e3fea8