Claim total
$979.43
base $93.83 · payer covered $829.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-07-04
- Stop
- 1991-07-04
The parties
- Patient
- patient Karl Ashley DuBuque
- Provider
- provider Julene Lemke
- Payer
- payer Medicaid
Record id
137de79d-0db3-0ab0-a384-69a3c4f57404