Claim total
$1,391.95
base $93.83 · payer covered $927.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-09-30
- Stop
- 2016-09-30
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-1816-ce72c9bd41e1