Claim total
$1,054.75
base $93.83 · payer covered $1,054.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-27
- Stop
- 2017-03-27
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-ec31-00d1a395b80a