Claim total
$843.43
base $93.83 · payer covered $808.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-10-28
- Stop
- 1987-10-28
The parties
- Patient
- patient Eloy Mosciski
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
22bf68a7-fc86-adb6-0603-92ec64e5b824