Claim total
$15,063.27
base $93.83 · payer covered $12,050.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-27
- Stop
- 2017-11-27
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Mose Nicolas
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-cb9a-b8f8ee893023