Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-06-19
- Stop
- 1991-06-20
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-e28b-8210b2d2dacb