Claim total
$1,321.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-11-22
- Stop
- 2011-11-22
The parties
- Patient
- patient Corey Sherwood Larkin
- Provider
- provider Guillermo Granado
- Care site
- care site DAKOTA MEDICAL CLINIC, PA
- Payer
- payer Anthem
Record id
23c57423-286f-e157-0c60-89b36734b931