Claim total
$1,042.99
base $93.83 · payer covered $834.38
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-07-03
- Stop
- 2011-07-03
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider In Reichert
- Payer
- payer Medicare
Record id
058279b6-7701-4823-3aee-d18b38a2d928