Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1958-09-26
- Stop
- 1958-09-26
The parties
- Patient
- patient Clora Kerluke
- Provider
- provider Andria Spinka
- Payer
- payer No insurance
Record id
3977a6f4-7643-18f4-dd42-3b72a18e56a9