Claim total
$837.34
base $93.83 · payer covered $837.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-05-19
- Stop
- 2023-05-19
The parties
- Patient
- patient Efren Wilderman
- Provider
- provider Julene Lemke
- Payer
- payer Dual Eligible
Record id
0400ef40-232f-be7a-203f-bea1949d21cb