Claim total
$1,450.87
base $93.83 · payer covered $975.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-08-09
- Stop
- 2025-08-09
The parties
- Patient
- patient Tatiana Mozella Doyle
- Provider
- provider Olin Mosciski
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
24379d93-202b-0dcf-088b-7dcfd524e4e3