Claim total
$639.00
base $93.83 · payer covered $511.19
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-02-16
- Stop
- 2017-02-16
The parties
- Patient
- patient Joan Donnie Quitzon
- Provider
- provider David Klein
- Payer
- payer Medicare
Record id
056f2732-3438-a432-675c-d2518a8160c8