Claim total
$780.15
base $93.83 · payer covered $437.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-11-21
- Stop
- 1990-11-21
The parties
- Patient
- patient Josh Shane Leannon
- Provider
- provider Rosio Gleason
- Payer
- payer Medicare
Record id
1476d15d-eaee-a45a-97dd-8cc3fbabef48