Claim total
$899.40
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-11-19
- Stop
- 1984-11-19
The parties
- Patient
- patient Maybelle Pansy Buckridge
- Provider
- provider Remona Sanford
- Payer
- payer No insurance
Record id
2db4e680-0037-4778-4663-6726caa4e846