Claim total
$1,114.43
base $93.83 · payer covered $891.54
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-29
- Stop
- 2021-10-29
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Janice Huel
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-3dca-fad956f1f88b