Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-03-26
- Stop
- 2005-03-26
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Simon Tremblay
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-f055-b93fbd3863f9