Claim total
$982.78
base $93.83 · payer covered $982.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-03-10
- Stop
- 2021-03-11
The parties
- Patient
- patient Rodolfo Cesar Cartwright
- Provider
- provider Rodrick Moen
- Payer
- payer Dual Eligible
Record id
1c95d9b2-6189-e9d5-1354-79383ad764d8