Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-09-19
- Stop
- 1975-09-19
The parties
- Patient
- patient Maryjo Amal Goldner
- Provider
- provider Mike Monahan
- Care site
- care site THE FAMILY PARTNERSHIP
- Payer
- payer No insurance
Record id
2ed77eab-3571-a72d-ec07-a491af387d02