Claim total
$973.34
base $93.83 · payer covered $973.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-02-01
- Stop
- 2025-02-01
The parties
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-1815-0dde0870d2ff