Claim total
$1,115.75
base $93.83 · payer covered $1,045.98
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-10-19
- Stop
- 2023-10-19
The parties
- Patient
- patient Sherlyn Clarice Schuppe
- Provider
- provider Rosio Gleason
- Payer
- payer Medicaid
Record id
0b40911b-036e-86a4-563c-881bb65fe12f