Claim total
$93.83
base $93.83 · payer covered $75.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-16
- Stop
- 2017-11-16
The parties
- Provider
- provider Tangela Koelpin
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-1891-8f4f26681fd0