Claim total
$830.97
base $93.83 · payer covered $680.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1965-07-11
- Stop
- 1965-07-11
The parties
- Patient
- patient Whitney Gonzalo Spinka
- Provider
- provider Criselda Bartell
- Payer
- payer Medicaid
Record id
3993c7c5-7c54-f876-df07-667cd4a1dca2