Claim total
$220.39
base $93.83 · payer covered $220.39
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-13
- Stop
- 2024-11-13
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Rosio Gleason
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-9433-c7ef760b0ead