Claim total
$1,666.03
base $93.83 · payer covered $1,631.03
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-04-03
- Stop
- 1995-04-04
The parties
- Patient
- patient Ashley Ira Turner
- Provider
- provider Simon Tremblay
- Payer
- payer Dual Eligible
Record id
326482dc-ce5c-abc8-a0a5-e9c39ecf332d