Claim total
$1,288.80
base $93.83 · payer covered $847.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-01-11
- Stop
- 2004-01-11
The parties
- Patient
- patient Alden Raul Grady
- Provider
- provider Rosio Gleason
- Payer
- payer Medicare
Record id
242df0d7-e6c5-1c3a-3577-3ec8ea977361