Claim total
$836.12
base $93.83 · payer covered $686.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-10-28
- Stop
- 1979-10-28
The parties
- Patient
- patient Angila Delfina Friesen
- Provider
- provider Jesse Turner
- Payer
- payer Medicaid
Record id
2fb62ca5-b037-fe29-ac72-7f589bd51083