Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-09-02
- Stop
- 2023-09-02
The parties
- Patient
- patient Barry Adam Heller
- Provider
- provider Trisha Gleason
- Payer
- payer Dual Eligible
Record id
02680c28-26cc-4bca-0427-71ced80fac1d