Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-06-06
- Stop
- 1984-06-07
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-c87b-49180d591e0d