Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-08-16
- Stop
- 2024-08-16
The parties
- Patient
- patient Shanda Miyoko Cassin
- Provider
- provider Randee Sawayn
- Payer
- payer No insurance
Record id
2fe31e20-d066-3ec8-1f42-5d4f31467580