Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-04-18
- Stop
- 1975-04-18
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Rosio Gleason
Record id
062f00f9-5db0-55c4-1893-875611a0a8bd