Claim total
$843.43
base $93.83 · payer covered $743.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-05-02
- Stop
- 2013-05-02
The parties
- Patient
- patient Tamara Tawny Stroman
- Provider
- provider Douglas Will
- Payer
- payer Medicaid
Record id
1b14600d-3645-9b36-7489-6082ee5803d5