Claim total
$780.15
base $93.83 · payer covered $730.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-02-21
- Stop
- 1985-02-21
The parties
- Patient
- patient Delbert Steuber
- Provider
- provider Eva Weissnat
- Payer
- payer Medicaid
Record id
23b57b91-5135-9e20-7525-03eecd0dfad1