Claim total
$1,178.99
base $93.83 · payer covered $831.50
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-18
- Stop
- 2019-10-18
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-a91b-a1c4c8cc1c0d