Claim total
$780.15
base $93.83 · payer covered $680.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-07-17
- Stop
- 2011-07-17
The parties
- Patient
- patient Jules Homer Corkery
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
2b38c847-07f0-3b1a-4ada-a0783026a115