Claim total
$1,369.42
base $93.83 · payer covered $1,369.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-03-30
- Stop
- 2020-03-30
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Andria Spinka
- Payer
- payer Dual Eligible
Record id
015dd051-d88b-0f3d-4142-bc933653b575