Claim total
$1,503.32
base $93.83 · payer covered $1,353.32
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-06-17
- Stop
- 2004-06-17
The parties
- Patient
- patient Coleen Hester Boyle
- Provider
- provider Evelyn Lind
- Payer
- payer Medicaid
Record id
1fee85c9-7061-f223-a79a-0a23a4e46aaa