Claim total
$1,005.70
base $93.83 · payer covered $905.70
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-06-25
- Stop
- 2019-06-25
The parties
- Patient
- patient Philip Allan Watsica
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
2dcab3fc-d581-a646-2944-9854f3000c76