Claim total
$1,046.06
base $93.83 · payer covered $946.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-29
- Stop
- 2024-04-30
The parties
- Patient
- patient Elliott Crooks
- Provider
- provider Remona Sanford
- Payer
- payer Medicaid
Record id
016f6acf-14e3-04d0-18f7-9fbe61ad1d5c