Claim total
$775.00
base $93.83 · payer covered $467.03
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-02-12
- Stop
- 2008-02-12
The parties
- Patient
- patient Jamal Barry Funk
- Provider
- provider Criselda Bartell
- Payer
- payer Medicare
Record id
19b3aec3-eaf6-e809-6dc0-f078d057e568