Claim total
$911.00
base $93.83 · payer covered $728.79
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-02-11
- Stop
- 2016-02-11
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider Magen Mertz
- Payer
- payer Medicare
Record id
056f2732-3438-a432-09d2-4c18228eccc2