Claim total
$1,514.27
base $93.83 · payer covered $1,211.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-10-09
- Stop
- 2008-10-09
The parties
- Patient
- patient Simon Frederic Gulgowski
- Provider
- provider Ursula Nolan
- Payer
- payer Medicare
Record id
034c4f48-8c73-4f35-9f7b-e04c697f5f78