Claim total
$1,527.01
base $93.83 · payer covered $1,527.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-10-04
- Stop
- 2008-10-04
The parties
- Patient
- patient Brian Feeney
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
1de4e9b8-22a7-be84-622b-e8cd06f50e3d