Claim total
$840.41
base $93.83 · payer covered $690.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-02-10
- Stop
- 2005-02-10
The parties
- Patient
- patient Erick Herzog
- Provider
- provider Rosio Gleason
- Payer
- payer Medicaid
Record id
19941adf-c334-2ea0-6b1d-f72a01605f2c