Claim total
$711.72
base $93.83 · payer covered $711.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-18
- Stop
- 2021-10-18
The parties
- Patient
- patient Adrian Isaiah Durgan
- Provider
- provider Randee Sawayn
- Payer
- payer Dual Eligible
Record id
046903bc-0773-63cf-2c73-c5fc19928075