Claim total
$980.65
base $93.83 · payer covered $980.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-12-06
- Stop
- 2023-12-06
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-9c58-4806c7ae1949