Claim total
$229.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1979-11-20
- Stop
- 1979-11-20
The parties
- Patient
- patient Corey Sherwood Larkin
- Provider
- provider Guillermo Granado
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
- Payer
- payer No insurance
Record id
23c57423-286f-e157-8db5-8cdb48835e90