Claim total
$830.97
base $93.83 · payer covered $730.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-09-30
- Stop
- 2009-10-01
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-d52f-ba4e7d62d55a