Claim total
$936.09
base $93.83 · payer covered $836.09
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-09-28
- Stop
- 2017-09-28
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-69a7-19c2aa29e578