Claim total
$1,049.08
base $93.83 · payer covered $1,049.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-09-03
- Stop
- 2018-09-03
The parties
- Patient
- patient Vonda Tamra Ziemann
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
37344a78-3652-b029-b7b8-98d3e4b8f9ba