Claim total
$946.64
base $93.83 · payer covered $911.64
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1971-08-29
- Stop
- 1971-08-29
The parties
- Provider
- provider Randee Sawayn
- Payer
- payer Dual Eligible
Record id
02b0534d-1cdc-7379-f0b3-0b056254d28b