Claim total
$821.53
base $93.83 · payer covered $821.53
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-03
- Stop
- 2024-01-04
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Dual Eligible
Record id
03ef4f74-940b-d219-f0c4-4a805f202b4a