Claim total
$908.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-01-02
- Stop
- 1993-01-03
The parties
- Patient
- patient Roselee Katharina Brown
- Provider
- provider Adelia Dickens
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer No insurance
Record id
355d5f82-4db9-11d6-64fe-f78783891958