Claim total
$1,095.27
base $93.83 · payer covered $1,095.27
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-02-07
- Stop
- 2026-02-07
The parties
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicaid
Record id
03d1ce86-efe3-018d-85b6-0f76f7e5b6a3