Claim total
$782.31
base $93.83 · payer covered $625.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-03-02
- Stop
- 2019-03-02
The parties
- Patient
- patient Luigi Jakubowski
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Medicare
Record id
34909a24-77ed-f1db-ef93-0ac6ed1ae8ca