Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1947-08-04
- Stop
- 1947-08-04
The parties
- Patient
- patient Guillermo Neil Dickinson
- Provider
- provider Lovie Turcotte
- Payer
- payer Medicaid
Record id
293f5dd0-3f7a-994e-5eaf-3df96c38df08