Claim total
$1,609.61
base $93.83 · payer covered $1,609.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-11-08
- Stop
- 2023-11-08
The parties
- Patient
- patient Gene Erin Wehner
- Provider
- provider Hazel Effertz
- Payer
- payer Dual Eligible
Record id
0324eea5-bb16-c29a-b2e0-b27e9392a9c4