Claim total
$1,615.51
base $93.83 · payer covered $1,515.51
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-11-04
- Stop
- 2012-11-04
The parties
- Patient
- patient Miguel Esteban Adame
- Provider
- provider Ronnie Gleason
- Payer
- payer Medicaid
Record id
12b23762-7134-891c-4cb8-77368a8f16f5