Claim total
$901.56
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-26
- Stop
- 2014-02-26
The parties
- Patient
- patient Christel Torp
- Provider
- provider Guillermo Granado
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
Record id
00edd987-99b7-13d9-72ab-53adec4f2cd5