Claim total
$1,247.09
base $93.83 · payer covered $1,097.09
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-03-25
- Stop
- 1981-03-25
The parties
- Patient
- patient Wesley Aron Barton
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2eb86dfb-4252-0570-0240-5710cd9c82b7