Claim total
$1,274.67
base $93.83 · payer covered $833.33
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-10-23
- Stop
- 2020-10-23
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Ramiro Boehm
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-2e4a-97cfdb90a29b