Claim total
$1,233.50
base $93.83 · payer covered $801.95
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-16
- Stop
- 2019-10-16
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Ursula Nolan
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-b7af-3d0568f4e3f3