Claim total
$631.25
base $93.39 · payer covered $0.00
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2003-01-26
- Stop
- 2003-01-26
The parties
- Patient
- patient Hubert Carey Donnelly
- Provider
- provider Hazel Effertz
- Payer
- payer No insurance
Record id
2d78cd30-6b9a-db6f-8ec1-9a2d3c233e7f