Claim total
$780.15
base $93.83 · payer covered $780.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-09-02
- Stop
- 2018-09-02
The parties
- Patient
- patient Kittie Olevia Walter
- Provider
- provider Lowell Blick
- Payer
- payer Medicaid
Record id
178c01a3-2a21-ca97-6e57-8ed62868f6f5