Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-14
- Stop
- 2017-11-14
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Ricky Wolff
- Care site
- care site PARKWAY FAMILY PHYSICIANS
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-3493-37de6a71f7d2