Claim total
$906.71
base $93.83 · payer covered $806.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-03-30
- Stop
- 2007-03-30
The parties
- Patient
- patient Fermin Jamison Rolfson
- Provider
- provider Jesse Turner
- Payer
- payer Medicaid
Record id
07833d62-1d3a-a411-7e96-7799eed139da