Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-10-30
- Stop
- 2017-10-30
The parties
- Patient
- patient Latrisha Simonne Kuhlman
- Provider
- provider Lowell Blick
- Payer
- payer Medicare
Record id
0277738c-b3e3-4ada-aa69-baca575d1d0c