Claim total
$979.43
base $93.83 · payer covered $829.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-10-25
- Stop
- 1984-10-25
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Ronnie Gleason
- Payer
- payer Medicaid
Record id
01e64c71-bb1e-2212-6346-edcbcfb82ec3