Claim total
$830.97
base $93.83 · payer covered $830.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-11-11
- Stop
- 2015-11-12
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-2022-0be10f9bab8e