Claim total
$1,052.43
base $93.83 · payer covered $952.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-01-11
- Stop
- 2019-01-11
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider Jesse Turner
- Payer
- payer Medicaid
Record id
035310e6-92e0-05c1-b309-ef96aed57160