Claim total
$838.28
base $93.83 · payer covered $838.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-10-08
- Stop
- 2023-10-08
The parties
- Patient
- patient Manuel Dusty Mitchell
- Provider
- provider Rodrick Moen
- Payer
- payer Dual Eligible
Record id
391ddd05-98fd-5656-36f5-920fcea7a0a0