Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1961-02-24
- Stop
- 1961-02-24
The parties
- Patient
- patient Orval Lesley Hilll
- Provider
- provider Kermit Emard
- Payer
- payer No insurance
Record id
398caf93-d142-e99a-a03c-dce2f33cf573