Claim total
$505.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1989-06-05
- Stop
- 1989-06-05
The parties
- Patient
- patient Matilde Olene Harvey
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
33a98c52-0030-f7ee-8673-147058960da0