Claim total
$894.25
base $93.83 · payer covered $894.25
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-11-28
- Stop
- 2018-11-29
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-f066-2aa90457c60b