Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1980-05-15
- Stop
- 1980-05-15
The parties
- Provider
- provider Phylis Lind
- Payer
- payer Medicaid
Record id
2b999228-9ebb-3076-3c10-124ff1a2dcd5