Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-08-18
- Stop
- 1995-08-18
The parties
- Patient
- patient Rufus Milford Koelpin
- Provider
- provider Julene Lemke
- Payer
- payer No insurance
Record id
3a95383e-dcb8-456a-e307-379c9cc429d3