General examination of patient

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patient Brandee Margaretta Marvin
General examination of patient

Claim total

$641.13

base $93.83 · payer covered $512.90

The visit

Class: Wellness
Code: 162673000
Reason: —
Start: 2016-09-18
Stop: 2016-09-18

The parties

Patient: patient Brandee Margaretta Marvin
Provider: provider Trent Kozey
Care site: care site CENTRAL INTERNAL MEDICINE ASSOCIATES PA
Payer: payer Medicare

Record id 02b0534d-1cdc-7379-071a-7c795ae947e1