Claim total
$1,318.06
base $93.83 · payer covered $1,318.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-18
- Stop
- 2014-02-18
The parties
- Provider
- provider Janice Huel
- Payer
- payer Medicaid
Record id
35db3789-0c9b-f3d8-3451-4fae5f6517fe