Claim total
$631.69
base $93.83 · payer covered $442.19
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-04-28
- Stop
- 2000-04-28
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Rosio Gleason
Record id
062f00f9-5db0-55c4-7c7f-256fa3ac77af