Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-04-05
- Stop
- 2014-04-05
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Lowell Blick
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-4a3a-6791209b5141