Claim total
$1,251.71
base $93.83 · payer covered $1,251.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-11-26
- Stop
- 2020-11-26
The parties
- Patient
- patient Paris Trey Walter
- Provider
- provider Ursula Nolan
- Payer
- payer Dual Eligible
Record id
37673647-f996-00e9-de48-fad0c29f3fee