Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-08-09
- Stop
- 2000-08-10
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-acf2-2c32b5e62e40