Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-10-29
- Stop
- 1987-10-29
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Medicaid
Record id
01e64c71-bb1e-2212-109f-d302620f90ad