Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-05-16
- Stop
- 2003-05-16
The parties
- Patient
- patient Fermin Legros
- Provider
- provider Rosio Gleason
Record id
062f00f9-5db0-55c4-f6a4-fe42791cdb5b