Claim total
$694.97
base $93.83 · payer covered $555.96
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-03-03
- Stop
- 1993-03-03
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-0e3d-89291b371e7a