Claim total
$2,288.86
base $93.83 · payer covered $2,288.86
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-11-19
- Stop
- 2025-11-19
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-c417-f3827165fcc8