Claim total
$972.12
base $93.83 · payer covered $822.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-08-30
- Stop
- 2001-08-30
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-b9ca-0cf404c06cfa