Claim total
$830.97
base $93.83 · payer covered $830.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-27
- Stop
- 2021-10-27
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-7c8d-1edd91df0d7f