Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-01-12
- Stop
- 1999-01-12
The parties
- Patient
- patient Norris Rigoberto Walker
- Provider
- provider Seymour Pacocha
- Payer
- payer No insurance
Record id
2b6e6bde-a769-b695-2651-aa207517e78b