Claim total
$2,101.49
base $93.83 · payer covered $1,494.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-09-02
- Stop
- 2011-09-02
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-b3ab-ac06c57d0cad