Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-01
- Stop
- 2017-11-01
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-3990-05819355fd29