Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1965-12-17
- Stop
- 1965-12-17
The parties
- Patient
- patient Quentin Ian Zieme
- Provider
- provider Remona Sanford
- Payer
- payer No insurance
Record id
38dff7ea-54a1-0c08-d1ed-91743a6c61eb