Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-04-09
- Stop
- 1980-04-09
The parties
- Patient
- patient Christel Torp
- Provider
- provider Guillermo Granado
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-cac7-0e9d2a80dfad