Claim total
$847.72
base $93.83 · payer covered $491.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-10-19
- Stop
- 1995-10-19
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
056f2732-3438-a432-3fe1-b752d866c49d