Claim total
$707.43
base $93.83 · payer covered $557.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1940-03-02
- Stop
- 1940-03-02
The parties
- Patient
- patient Ethan Cary Abernathy
- Provider
- provider Shaunda Ledner
- Payer
- payer Medicaid
Record id
36047b27-9044-b82c-f6ea-1e71be9a3d1e