Claim total
$775.00
base $93.83 · payer covered $740.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-12-08
- Stop
- 2001-12-08
The parties
- Patient
- patient Ellis Gary Cronin
- Provider
- provider Kim Lind
- Payer
- payer Dual Eligible
Record id
0c89b8f2-1b95-b082-1a45-a4a48aee08ea