Claim total
$911.00
base $93.83 · payer covered $911.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-21
- Stop
- 2018-01-21
The parties
- Patient
- patient Adrian Grady O'Keefe
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
00a9bdc8-6b4d-5df7-501a-9e73360ef2c1