Claim total
$1,384.64
base $93.83 · payer covered $924.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-06-10
- Stop
- 2009-06-10
The parties
- Patient
- patient Jordan Darrel Hodkiewicz
- Provider
- provider Rodrick Moen
- Payer
- payer Medicare
Record id
26a1fd64-1e1f-4fc3-cb25-e1a047a2e74b