Claim total
$836.12
base $93.83 · payer covered $736.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-10-30
- Stop
- 2025-10-30
The parties
- Patient
- patient Tamra Darlena Feeney
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
39f891f2-42e3-2507-5b54-bb329da3644a