Claim total
$2,623.46
base $155.66 · payer covered $168.47
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2003-07-16
- Stop
- 2003-07-16
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Criselda Bartell
Record id
062f00f9-5db0-55c4-555b-c403e4fcace5