Claim total
$1,780.13
base $93.83 · payer covered $1,424.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-05-14
- Stop
- 2003-05-14
The parties
- Patient
- patient Donny Wilfred Ruecker
- Provider
- provider Criselda Bartell
- Payer
- payer Medicare
Record id
0054427e-44d7-94b2-36b0-ab10f3736380