Claim total
$775.00
base $93.83 · payer covered $711.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1956-01-12
- Stop
- 1956-01-12
The parties
- Patient
- patient Morris Hartmann
- Provider
- provider Lovie Turcotte
- Payer
- payer Medicaid
Record id
36a22334-42e4-d3c9-6e07-b8cc71b4ca01