Claim total
$1,183.37
base $93.83 · payer covered $1,183.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-10
- Stop
- 2018-10-10
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Kelvin Reichel
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-f8dc-068ad05551cb