Claim total
$976.41
base $93.83 · payer covered $826.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-07-11
- Stop
- 2002-07-11
The parties
- Patient
- patient Sade Kassie Aufderhar
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
24f4a8d9-e64c-e3ef-dba2-9744f7981af9