Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-20
- Stop
- 2018-01-20
The parties
- Patient
- patient Harry Will Streich
- Provider
- provider Magen Mertz
- Payer
- payer Medicaid
Record id
0399299d-024a-c139-571e-5877cabd6b37