Claim total
$1,334.87
base $93.83 · payer covered $1,234.87
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-08-08
- Stop
- 2012-08-08
The parties
- Patient
- patient Wyatt Lewis McGlynn
- Provider
- provider Randee Sawayn
- Payer
- payer Medicaid
Record id
0123b099-d1de-2c0a-c9df-ea10908ff23f