Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-07-05
- Stop
- 1984-07-05
The parties
- Patient
- patient Nevada Wonda Konopelski
- Provider
- provider Julene Lemke
- Payer
- payer No insurance
Record id
31d69929-3dc2-161a-24ee-6ca30ffbedea