Claim total
$1,397.10
base $93.83 · payer covered $1,397.10
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-02-14
- Stop
- 2025-02-14
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider Jesse Turner
- Payer
- payer Dual Eligible
Record id
035310e6-92e0-05c1-391b-6125240bd228