Claim total
$1,186.30
base $93.83 · payer covered $949.03
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-10
- Stop
- 2024-04-10
The parties
- Patient
- patient Carl Brooke Dietrich
- Provider
- provider Shani Carroll
- Payer
- payer Medicare
Record id
2ce0ad34-3115-7435-2a2e-404351e4d459