Claim total
$2,623.46
base $155.66 · payer covered $2,623.46
The visit
- Class
- Ambulatory
- Code
- 36228007
- Reason
- —
- Start
- 1997-11-04
- Stop
- 1997-11-04
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Rosio Gleason
Record id
062f00f9-5db0-55c4-5590-b8388d88f665