Claim total
$704.41
base $93.83 · payer covered $554.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-10-22
- Stop
- 1986-10-22
The parties
- Patient
- patient Eloy Mosciski
- Provider
- provider Andria Spinka
- Payer
- payer Medicaid
Record id
22bf68a7-fc86-adb6-38c0-da44f6837c5c