Claim total
$1,110.46
base $93.83 · payer covered $1,110.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-10-17
- Stop
- 2020-10-17
The parties
- Patient
- patient Edison Sterling Batz
- Provider
- provider Florentino Boehm
- Payer
- payer Dual Eligible
Record id
08777515-d11a-6c50-66a4-e91eb9c8461f