Claim total
$5,919.15
base $93.83 · payer covered $5,919.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-06-18
- Stop
- 2026-06-18
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Ronnie Gleason
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-eb74-38f83ebb2716