Claim total
$12,552.56
base $93.83 · payer covered $10,042.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-11-16
- Stop
- 2015-11-16
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Aaron Champlin
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-a8c5-b3974dfa36a7