Claim total
$1,463.73
base $93.83 · payer covered $1,463.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-12-17
- Stop
- 2016-12-17
The parties
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-7e86-3d6373b9cd56