Claim total
$846.78
base $93.83 · payer covered $677.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-08-30
- Stop
- 2019-08-30
The parties
- Patient
- patient Mignon Janay Johnson
- Provider
- provider Elijah Beahan
- Care site
- care site DAKOTA CHILD AND FAMILY CLINIC
- Payer
- payer Medicare
Record id
0a37331a-7bd1-f3a9-f56b-de2d19db9c26