Claim total
$1,660.88
base $93.83 · payer covered $1,660.88
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-10-24
- Stop
- 2022-10-24
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Trent Kozey
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-02bd-6a0893ed53cf