Claim total
$11,801.65
base $93.83 · payer covered $11,801.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-05-09
- Stop
- 2019-05-09
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-1ca4-8da9cfa206e3