Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-10-13
- Stop
- 1989-10-13
The parties
- Patient
- patient Abe Adolph Berge
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
035310e6-92e0-05c1-020c-a0d6dfd30394