Claim total
$1,610.06
base $93.83 · payer covered $1,460.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-04-13
- Stop
- 1991-04-13
The parties
- Patient
- patient Jere Neal Berge
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
1d7259f1-41e7-40b7-1e7a-eaf07944071b