Claim total
$917.37
base $93.83 · payer covered $562.54
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-03-28
- Stop
- 2024-03-28
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
056f2732-3438-a432-93c6-75e21fa61123