Claim total
$1,150.19
base $93.39 · payer covered $920.14
The visit
- Class
- Outpatient
- Code
- 185349003
- Reason
- —
- Start
- 2003-07-30
- Stop
- 2003-07-30
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-f037-a195ab010ee9