Claim total
$892.63
base $93.83 · payer covered $892.63
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-02-04
- Stop
- 2025-02-04
The parties
- Patient
- patient Elton Pierre Cummerata
- Provider
- provider Janice Huel
- Payer
- payer Medicaid
Record id
10e19c97-2fb2-0e88-6784-cdbcd9e194bf