Claim total
$1,069.32
base $93.83 · payer covered $1,034.32
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1963-05-25
- Stop
- 1963-05-25
The parties
- Patient
- patient Francisco Barton Beahan
- Provider
- provider Rosio Gleason
- Payer
- payer Dual Eligible
Record id
11955095-c3cb-a03d-9a25-aa240631ddf6