Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-10-16
- Stop
- 1980-10-16
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Medicaid
Record id
01e64c71-bb1e-2212-4352-c3e5bbc5267e