Claim total
$3,979.26
base $93.83 · payer covered $3,183.39
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-19
- Stop
- 2018-10-19
The parties
- Patient
- patient Loma Tawanna Ferry
- Provider
- provider Julene Lemke
- Payer
- payer Medicare
Record id
04384da7-7311-e99a-0001-789f3d66920b