Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-11-22
- Stop
- 2002-11-22
The parties
- Patient
- patient Mauro Isaias Braun
- Provider
- provider Rosio Gleason
Record id
2d68ad16-268a-478c-50ec-8ab93a524cd9