Claim total
$1,123.02
base $93.83 · payer covered $712.01
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-12
- Stop
- 2018-10-12
The parties
- Patient
- patient Rosario Jim Braun
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicare
Record id
023d14fa-8b29-07fb-44e0-e95d74c76e98