Claim total
$5,874.54
base $93.83 · payer covered $5,874.54
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-05-03
- Stop
- 2018-05-03
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Ronnie Gleason
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-d72b-407323f233b5