Claim total
$894.25
base $93.83 · payer covered $844.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-05-29
- Stop
- 1980-05-29
The parties
- Patient
- patient Morris Hartmann
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
36a22334-42e4-d3c9-9b0b-04208f09d30a