Claim total
$5,600.84
base $93.83 · payer covered $5,600.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-12-31
- Stop
- 2024-12-31
The parties
- Patient
- patient Cecil Smith
- Provider
- provider Andria Spinka
- Payer
- payer Dual Eligible
Record id
29d86494-f39d-b250-be82-a0b66215c147