Claim total
$767.69
base $93.83 · payer covered $617.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-04-10
- Stop
- 1985-04-10
The parties
- Patient
- patient Grady Wayne Sauer
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
39d4f819-e788-754b-0894-fb619726c061