Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-15
- Stop
- 2023-04-15
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Rodrick Moen
- Payer
- payer Aetna
Record id
01ce818c-8f9f-924a-7faa-2921e1ebce36