Claim total
$1,054.87
base $93.83 · payer covered $954.87
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-04-05
- Stop
- 2022-04-05
The parties
- Patient
- patient Sandee Carma Bayer
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
36c2ae21-205d-6aeb-7a4d-b3b5813700fe