Claim total
$774.06
base $93.83 · payer covered $619.24
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-06-09
- Stop
- 2004-06-09
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Andria Spinka
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-3931-eec503caa0b9