Claim total
$1,047.00
base $93.83 · payer covered $1,047.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-10-26
- Stop
- 2016-10-26
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-cf6e-02feef7409d3