Claim total
$780.15
base $93.83 · payer covered $780.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-10-02
- Stop
- 2013-10-02
The parties
- Patient
- patient Bobby Bret Stoltenberg
- Provider
- provider Derick Feil
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Medicaid
Record id
2f08bddf-ff57-70bd-a812-1c7741341e1e