Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1968-07-04
- Stop
- 1968-07-04
The parties
- Patient
- patient Norris Jimmy Kuhn
- Provider
- provider Wes Jast
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
2d90965f-f4f7-8f82-237b-b3615409a840