Claim total
$694.97
base $93.83 · payer covered $694.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-12-15
- Stop
- 2021-12-16
The parties
- Patient
- patient Bess Mindy Boyer
- Provider
- provider Kenneth Mayert
- Payer
- payer Dual Eligible
Record id
03ef4f74-940b-d219-6636-053f1c46ce61