Claim total
$1,115.71
base $93.83 · payer covered $842.33
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-09-09
- Stop
- 2014-09-09
The parties
- Patient
- patient Mickey Adalberto Yost
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicare
Record id
0644c3ae-21ed-d13a-4391-ba062c4d093a