Claim total
$10,129.44
base $93.83 · payer covered $10,129.44
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-06-06
- Stop
- 2024-06-06
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Dual Eligible
Record id
01e64c71-bb1e-2212-e271-dc150c62795b