Claim total
$711.72
base $93.83 · payer covered $569.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-03-11
- Stop
- 2021-03-11
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
056f2732-3438-a432-b114-edbfc7d6474f