Claim total
$830.97
base $93.83 · payer covered $664.76
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-03-14
- Stop
- 2011-03-14
The parties
- Patient
- patient Ines Shiloh Jacobi
- Provider
- provider Derick Feil
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Medicare
Record id
25075e04-8a2f-41db-f270-c4f8d8390cf9