Claim total
$978.26
base $155.66 · payer covered $684.78
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2022-10-14
- Stop
- 2022-10-14
The parties
- Patient
- patient Edythe Nga Pacocha
- Provider
- provider Pasquale Grimes
Record id
00cb11fd-f3f7-0950-abf5-7204adab31fd