Claim total
$1,112.41
base $93.83 · payer covered $1,012.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-04-20
- Stop
- 2015-04-21
The parties
- Patient
- patient Elliott Crooks
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
016f6acf-14e3-04d0-4438-939a7986f9fb