Claim total
$704.41
base $93.83 · payer covered $563.52
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-11-28
- Stop
- 2019-11-28
The parties
- Provider
- provider Rodrick Moen
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-3a11-d411e7c340a1