Claim total
$2,623.46
base $155.66 · payer covered $577.04
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 2004-06-10
- Stop
- 2004-06-10
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Rosio Gleason
Record id
062f00f9-5db0-55c4-05df-f32ac6570330