Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-05-01
- Stop
- 2024-05-01
The parties
- Patient
- patient Lanelle Valrie Barton
- Provider
- provider Abram Ullrich
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicaid
Record id
2d0d3531-8acb-0cb2-5958-14bc1b8acccc