Claim total
$13,765.97
base $93.83 · payer covered $13,730.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-06-09
- Stop
- 2000-06-09
The parties
- Patient
- patient Akilah Ebert
- Provider
- provider Rodrick Moen
- Payer
- payer Dual Eligible
Record id
1ef9913f-d7aa-d611-5c8c-8c009d9386c4