Claim total
$700.12
base $93.83 · payer covered $650.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-07-29
- Stop
- 1998-07-30
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-582b-2c0f4c0f7c7f