Claim total
$775.00
base $93.83 · payer covered $775.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-10
- Stop
- 2019-10-10
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-a72b-c3b62ac791ee