Claim total
$780.15
base $93.83 · payer covered $630.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-06-19
- Stop
- 1967-06-19
The parties
- Patient
- patient Len Wilbert Windler
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicaid
Record id
161124e8-a4e5-2a23-3311-605c89490de5