Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-09-04
- Stop
- 2024-09-04
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Ruben Farrell
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-9305-7e2913f05c0b