Claim total
$906.71
base $93.83 · payer covered $756.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-03-02
- Stop
- 1987-03-02
The parties
- Patient
- patient Olympia Heathcote
- Provider
- provider Rodrick Moen
- Payer
- payer Medicaid
Record id
3577a267-6e0f-9250-c67c-947bf2ad6842