Claim total
$894.25
base $93.83 · payer covered $794.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-01-13
- Stop
- 2007-01-13
The parties
- Patient
- patient Lacy Schumm
- Provider
- provider Kim Lind
- Payer
- payer Medicaid
Record id
1b98fd26-00a1-c39a-a7a7-14d0587986bb