Claim total
$1,464.67
base $93.83 · payer covered $1,171.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-09-25
- Stop
- 2017-09-25
The parties
- Patient
- patient Garland Thiel
- Provider
- provider Shani Carroll
- Payer
- payer Medicare
Record id
02ec371b-21cc-5c35-d053-fd9a9e631fd5