Claim total
$1,042.52
base $93.83 · payer covered $729.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-15
- Stop
- 2017-03-15
The parties
- Patient
- patient Christel Torp
- Provider
- provider Guillermo Granado
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-175c-fd67d6643988