Claim total
$1,238.92
base $93.83 · payer covered $1,238.92
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-05-02
- Stop
- 2016-05-02
The parties
- Patient
- patient Darin Seymour Bartell
- Provider
- provider Fatimah Schumm
- Payer
- payer Medicaid
Record id
19a58afe-af3e-3190-2fc6-bf3b498ab301