Claim total
$1,018.96
base $93.83 · payer covered $1,018.96
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-01-09
- Stop
- 2021-01-09
The parties
- Provider
- provider Rosio Gleason
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-cbd5-b8c6e1b3c7b8