Claim total
$1,114.45
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-04-22
- Stop
- 1979-04-22
The parties
- Patient
- patient Pete Roberto Streich
- Provider
- provider Janice Huel
- Payer
- payer No insurance
Record id
29a638b7-ee8f-0f2e-7800-8a5625da1f17