Claim total
$837.34
base $93.83 · payer covered $837.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-07
- Stop
- 2017-04-07
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
0400ef40-232f-be7a-04fd-480fda97531f