Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-06-04
- Stop
- 1997-06-04
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Kim Lind
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-8201-8122d0ce8751