Claim total
$1,243.42
base $93.83 · payer covered $1,243.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-22
- Stop
- 2017-11-23
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-308a-28bce3319b93