Claim total
$849.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-07-01
- Stop
- 2011-07-01
The parties
- Patient
- patient Gus Krajcik
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer No insurance
Record id
295755aa-ec3c-f3a6-addb-21d8fb438756