Claim total
$985.80
base $93.83 · payer covered $885.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-01-15
- Stop
- 2012-01-15
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Magen Mertz
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-f3ec-fead017a4f56