Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-01-21
- Stop
- 1985-01-21
The parties
- Patient
- patient Antonio Olen Stroman
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer No insurance
Record id
3268cb3d-1913-f6e6-f352-3fb5e4ef9d9d