Claim total
$1,342.04
base $93.83 · payer covered $1,192.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-01-20
- Stop
- 1983-01-20
The parties
- Patient
- patient Bob Sergio O'Hara
- Provider
- provider Kim Lind
- Payer
- payer Medicaid
Record id
261c034c-cc44-5f0f-6a08-f304804e6cb1