Claim total
$6,939.19
base $93.83 · payer covered $5,551.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-12-26
- Stop
- 2022-12-26
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Dominick West
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-b8e6-5cd68bb129a0