Claim total
$987.02
base $93.83 · payer covered $789.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-09-14
- Stop
- 2015-09-14
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Shani Carroll
- Payer
- payer Medicare
Record id
02ec371b-21cc-5c35-a293-6539b889ce8b