Claim total
$1,115.45
base $93.83 · payer covered $1,015.45
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-28
- Stop
- 2024-01-28
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Remona Sanford
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-0619-c58b44dbcf12