Claim total
$843.43
base $93.83 · payer covered $743.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-05-02
- Stop
- 2023-05-02
The parties
- Patient
- patient Dirk Donny Grimes
- Provider
- provider Kenny Walker
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Medicaid
Record id
0bb69e69-fdc7-4885-ed18-b81626e718e9