Claim total
$1,176.60
base $93.83 · payer covered $1,076.60
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-08
- Stop
- 2017-04-08
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-e41b-265bc3afc35d