Claim total
$906.71
base $93.83 · payer covered $756.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-12-01
- Stop
- 1999-12-01
The parties
- Patient
- patient Joe Maximo Kozey
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0135e6bd-cd4d-6318-f416-aa7fff7ef265