Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1954-09-16
- Stop
- 1954-09-16
The parties
- Patient
- patient Roderick Carter
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
08fee322-deac-8f86-f5ec-98a73fb2cc7f