Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-09-01
- Stop
- 2004-09-02
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider George Rowe
- Payer
- payer Medicaid
Record id
03ef4f74-940b-d219-3181-8cb02c97315d