Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-06-10
- Stop
- 1996-06-10
The parties
- Patient
- patient Adam Jones
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicaid
Record id
00229130-e769-8779-2bd0-9215bebdf5e3