Claim total
$704.41
base $93.83 · payer covered $704.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-09-18
- Stop
- 2020-09-18
The parties
- Patient
- patient Colby Wunsch
- Provider
- provider Trent Kozey
- Payer
- payer Dual Eligible
Record id
02d10ce5-acf0-36ed-f80f-419dacd5876d