Claim total
$1,151.46
base $93.83 · payer covered $1,051.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-07-10
- Stop
- 2011-07-11
The parties
- Patient
- patient Demarcus Vance Kuhlman
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
314e740b-6595-c290-8db8-7f8497c8963f