Claim total
$6,110.12
base $93.83 · payer covered $4,888.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-08-17
- Stop
- 2012-08-17
The parties
- Patient
- patient Akilah Ebert
- Provider
- provider Rodrick Moen
- Payer
- payer Medicare
Record id
1ef9913f-d7aa-d611-4188-4b2077683dae