Claim total
$957.55
base $93.83 · payer covered $957.55
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-10-21
- Stop
- 2020-10-21
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-d540-1d6f935c7177