Claim total
$838.28
base $93.83 · payer covered $688.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-10-30
- Stop
- 2000-10-30
The parties
- Patient
- patient Olin Stefan Von
- Provider
- provider Janice Huel
- Payer
- payer Medicaid
Record id
20a1fdbb-e395-532e-5d34-2862912f6617