Claim total
$1,758.66
base $93.83 · payer covered $1,758.66
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-11
- Stop
- 2024-04-11
The parties
- Patient
- patient Marya Laronda Hand
- Provider
- provider Rodrick Moen
- Payer
- payer Medicaid
Record id
23751e2f-eb63-35d9-6dcb-88bbdbcf18b7