Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-04-26
- Stop
- 2021-04-27
The parties
- Patient
- patient Elliott Crooks
- Provider
- provider Remona Sanford
- Payer
- payer Medicaid
Record id
016f6acf-14e3-04d0-3437-3569feb595ea