Claim total
$6,189.21
base $93.83 · payer covered $6,189.21
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-06-12
- Stop
- 2025-06-12
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-9f08-2d1878e9aa8d