Claim total
$775.00
base $93.83 · payer covered $675.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-01-25
- Stop
- 2010-01-25
The parties
- Patient
- patient Olympia Heathcote
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicaid
Record id
3577a267-6e0f-9250-3225-cf75c0a0943c