Claim total
$899.40
base $93.83 · payer covered $749.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1953-01-08
- Stop
- 1953-01-08
The parties
- Patient
- patient Morris Hartmann
- Provider
- provider Hazel Effertz
- Payer
- payer Medicaid
Record id
36a22334-42e4-d3c9-d6e5-0d15fa0610f2