Claim total
$9,162.33
base $93.83 · payer covered $7,329.85
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-12-03
- Stop
- 2018-12-03
The parties
- Patient
- patient Maria Dibbert
- Provider
- provider Dominick West
- Payer
- payer Medicare
Record id
000287f5-a0d8-f77b-e8ff-7531b205d1c5