Claim total
$1,186.78
base $93.83 · payer covered $1,036.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-11-12
- Stop
- 1996-11-12
The parties
- Provider
- provider Jerold Bednar
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Medicaid
Record id
0d356957-437c-c593-0a4b-3d11a4d11a45