Claim total
$979.43
base $93.83 · payer covered $944.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-05-09
- Stop
- 2001-05-09
The parties
- Patient
- patient Joe Abe Koch
- Provider
- provider Magen Mertz
- Payer
- payer Dual Eligible
Record id
20ddca7d-6cee-85eb-bb52-718999cad010