Claim total
$704.41
base $93.83 · payer covered $554.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-05-17
- Stop
- 1989-05-17
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Kelvin Reichel
- Payer
- payer Medicaid
Record id
0324eea5-bb16-c29a-50df-db191b691a35