Claim total
$979.43
base $93.83 · payer covered $879.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-04-18
- Stop
- 2012-04-18
The parties
- Patient
- patient Bell Casper
- Provider
- provider Nenita Glover
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Medicaid
Record id
2363ad65-7b0d-dffb-4bfe-4167a24feb06