Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-11-20
- Stop
- 2018-11-20
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Dorotha Walker
- Care site
- care site PARKWAY FAMILY PHYSICIANS
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-07df-4cbebc8b61de