Claim total
$1,565.49
base $93.83 · payer covered $1,565.49
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-12-11
- Stop
- 2024-12-11
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-5f7f-ac6144e7cdfb