Claim total
$1,112.36
base $93.83 · payer covered $962.36
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-05-24
- Stop
- 1995-05-24
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Janice Huel
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-0e98-6141679eaaf3