Claim total
$1,142.46
base $93.83 · payer covered $1,042.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-02-07
- Stop
- 2026-02-07
The parties
- Patient
- patient Bernard Gleichner
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
04317637-3b9f-f5e4-ae6f-c85df6ae2e57