Claim total
$767.69
base $93.83 · payer covered $427.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-01-25
- Stop
- 1996-01-25
The parties
- Patient
- patient Mireya Bode
- Provider
- provider Ronnie Gleason
- Payer
- payer Medicare
Record id
04f53306-ad14-544b-4f72-61e605711f04