Claim total
$4,534.40
base $93.83 · payer covered $4,434.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-09-11
- Stop
- 2008-09-11
The parties
- Patient
- patient Laveta Russel
- Provider
- provider Douglas Will
- Payer
- payer Medicaid
Record id
01e64c71-bb1e-2212-ff94-63e8df9a7e69