Claim total
$1,169.55
base $93.83 · payer covered $935.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-06-21
- Stop
- 2009-06-21
The parties
- Patient
- patient Lesia Catalina Ledner
- Provider
- provider In Reichert
- Payer
- payer Medicare
Record id
058279b6-7701-4823-f379-01f4267a211a