Claim total
$1,047.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-06-15
- Stop
- 2011-06-15
The parties
- Patient
- patient Yolanda Luisa Carrion
- Provider
- provider Ronnie Gleason
- Payer
- payer Humana
Record id
28158b6b-6270-9db1-12ed-f0f44931d686