Claim total
$1,248.36
base $93.83 · payer covered $1,098.36
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-03-25
- Stop
- 2002-03-25
The parties
- Patient
- patient Darren Elvin Graham
- Provider
- provider Lizeth Schiller
- Payer
- payer Medicaid
Record id
14d46125-afcf-62e9-a762-b4eec279b8f8