Claim total
$939.32
base $93.83 · payer covered $789.32
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1934-04-14
- Stop
- 1934-04-14
The parties
- Patient
- patient Harland Carmine Herzog
- Provider
- provider Douglas Will
- Payer
- payer Medicaid
Record id
0302711f-bc3a-898e-f063-c7c52b600c84