Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-09-14
- Stop
- 1999-09-14
The parties
- Patient
- patient Adrian Micha Kerluke
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
2b9ed8b6-8e66-2dd9-d1bd-0755db11f144