Claim total
$1,043.93
base $93.83 · payer covered $655.10
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-12-27
- Stop
- 2007-12-27
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
056f2732-3438-a432-d6fa-6deeaf89dfcc