Claim total
$775.00
base $93.83 · payer covered $625.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-09-07
- Stop
- 2005-09-08
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-1db9-73eb1085013a