Claim total
$780.15
base $93.83 · payer covered $630.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1970-05-13
- Stop
- 1970-05-13
The parties
- Patient
- patient Arnold Guillermo Parker
- Provider
- provider Trisha Gleason
- Payer
- payer Medicaid
Record id
27f92d06-19f5-0088-1550-7b5b499b55a7