Claim total
$979.43
base $93.83 · payer covered $829.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-10-17
- Stop
- 1988-10-17
The parties
- Patient
- patient Olin Stefan Von
- Provider
- provider Criselda Bartell
- Payer
- payer Medicaid
Record id
20a1fdbb-e395-532e-c505-ca99e9bdf4c4