Claim total
$711.72
base $93.83 · payer covered $569.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-01-26
- Stop
- 1981-01-26
The parties
- Patient
- patient Gale Stokes
- Provider
- provider Sherly Hodkiewicz
- Payer
- payer Medicare
Record id
01a64b50-bd68-5ef7-3958-6568983f759f