Claim total
$780.15
base $93.83 · payer covered $780.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-05-09
- Stop
- 2021-05-09
The parties
- Patient
- patient Hans Austin Skiles
- Provider
- provider Randee Sawayn
- Payer
- payer Medicaid
Record id
2a801a9c-9341-ed04-7933-b6f359f2288f